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Form CPF M 102 -0: Campaign Finance Report <br />Municipal Form <br />once or campaign and Political Finance <br />Ceotwnwedl6 , <br />a m.bwatu <br />City or.Town of i /6'`�1� <br />Please print or type all information, except signatures. <br />Fill in dates: Month Day Year Month Day Year <br />Reporting Period Beginning / 01 B Ending t 2 31 '90 / j <br />Type of Report: (Check One) <br />8th day preceding 8th day preceding election 30th day following election 20th day of January <br />preliminary/primary (Town or Special) (Year -E R eport)' <br />Pursuant to M.G.L., Chapter 55: <br />1. I certify that I am a candidate for or hold Municipal Office, <br />2. I certify that 1 have not received any contributions, made any expenditures, or incurred any obligations during this <br />reporting period, and do not have a campaign fund in existence. <br />3. I certify that I do not have a political committee. <br />DATE <br />1. SIGNATURE <br />Signed under the penalties of perjury <br />II. RESIDENTIAL ADDRESS <br />(Street and Number) <br />III. OFFICE SOUGHT <br />F <br />C i <br />11 /97 <br />M <br />