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Form CPF M 102 -0: Campaign Finance Report <br />Municipal Form . <br />omee orcampaign and Political Finance <br />Commonwealth '..... <br />orManac6mtttt <br />t-7 T7 <br />City or Town of <br />Candidate 1 2C' i k -�� �� �.4y�� Office <br />Please print or type all information, except signatures. <br />Fill in dates: Month Day Year Month Day Year <br />Reporting Period Beginning Ending _ ? G n <br />Type of Report: (Check One) <br />8th day preceding °d 8th day preceding election 30th day following election 20th day of January <br />preliminary/primary (Town or Special) (Year - End Report)' <br />Pursuant to M.G.L., Chapter SS: <br />1. 1 certify that 1 am a candidate for or hold Municipal Office, <br />2. I certify that I 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. 1 certify that I do not have a political committee. <br />CJ <br />