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Form CPF M22: REPORT OF BALLOT QUESTION EXPENDITURES <br />BY CORPORATION, ORGANIZATION OR INDIVIDUAL <br />MUNICIPAL FORM <br />Commonwealth Office of Campaign and Political Finance <br />of Massachusetts <br />File with: Local Election Official Filing Date: ❑ 8"' day preceding election <br />Ef' 30 day after election <br />1:1 January 201h <br />Please print or type, except signatures. <br />1. Name of Corporation/Organization ' 4 <br />or Individual: <br />2. Address: - 2 -A -foq s -- a <br />J <br />3. Reporting Period: to . 2- <br />Month Day Year Month Day Year <br />4. The expenditures below were made to (check one) support / oppose <br />question number t relating to ce- 1)v \) a, 40 f <br />(if applicable) (Describe question briefly) " J <br />submitted to the voters in on <br />(Name of City/Town) lection Date) <br />5. Expenditure(s) (attach additional pages if necessary): <br />Date Paid <br />To Whom Paid <br />Address <br />Purpose <br />Amount or <br />Value* <br />l'l� /Z <br />Iv � T� � <br />C e <br />5oue (vV <br />Uq <br />Total expenditures on this report <br />Total expenditures previously reported <br />Total expenditures to date <br />*In-kind contributions should be included here. <br />OVER <br />