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Form CPF M 102: Campaign Finance Report <br />Municipal Form <br />Omce of Campaign and Political Finance <br />1M.a.ria.da - ; t o <br />File with: L' w <br />City or Town Clerk or Election Commission <br />Please print or type all information, except signatures. <br />Fill in dates: Marsh Due Yew mmth oea Year <br />Reporting Period Beginnin —n 2 01 Z Ending LEA I;z 7 20-1 � <br />Type of report: (Check one) <br />08th day preceding preliminary 108th day preceding election 030 day after election Oyear -end report Odissolution <br />Full Name of Candidate (if applicable) <br />Office Sought and District <br />f' L Y C r, , F,016-V V) 1 1 <br />�J Residential Address <br />X /!Ga 'f '; j V /' /. <br />Tel. No. (optional) <br />G /�:� 5i4 e- <br />Committee Name <br />Name of Committee Treasurer <br />Committee Mailing Address <br />zX_'y - 9Y <br />Tel. No. (optional) <br />SUMMARY BALANCE INFORMATION: <br />Line 1: Ending balance from previous report $ <br />Line 2: Total receipts this period (page 2 line 11) $_ ;'` %'G' <br />Line 3 : Subtotal (line 1 plus line 2) <br />Line 4: Total expenditures this period (page 3 line 14) <br />Line 5: Ending balance (line 3 minus line 4) <br />$ W1 <br />$ vq <br />$ - <br />---------------------------------- <br />Line 6: Total in -kind contributions this period (page 4) $ <br />Line 7: Total (all) outstanding liabilities (page 4) $ - <br />Line 8: Name of bank(s) used Iva Ive - c /T,s ly e ) /, /- <br />Affidavit of Committee Treasurer. <br />I eatify that I have examined this report including attached schedules and it ice, to the beat of my knowledge and belief, a true and complete statement of all campaign <br />finance activity, including all contributions, loans, receipts, expenditures, disbunemrnb, irAdnd contributions and liabilities for this reporting period and represents the <br />campaign finance activity of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L.. c. 55. <br />'-Y /°) /1 /—) Signed under the penalties of perjury: <br />// FOR CANDIDATE FILINGS ONLY (CANDIDATE MUST SIGN BELOW) <br />Affidavit of Candidate: (cheek 1 box only) <br />0 Candidate with CoouniNee and no activity independent of the committee <br />I certify that I have examined this report including attached schedules and it is, to the best of my knowledge and belief a true and complete statement of all campaign <br />finance activity, of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L a 33. I have not received any <br />contributions, incurred any liabilities nor nude any expenditures on my behalf during this reporting period. <br />0 Candidate without Committee OR Candidate with Independent activity filing separate report <br />I certify that I have examined this report including attached schedules and it is, to the best of my knowledge and belie!; a true and complete statement of all campaign <br />finance activity, including contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the <br />campaign finance activity of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L a SS. <br />