HomeMy WebLinkAbout2012-12-31-McKenna-OCPFForm CPF M 102: Campaign Finance Report
Municipal Forma
l ug Office of Campaign and Political Fin C 691AA0q, .19 :•
Commonwealth
of Massachusetts �
File with: � (( lt � Ti4� 00 8 r�lection C mmission
I Fill in Reporting Period dates: Beginning Date: January 1, 2012 Ending ate: December 1, 012
of Report: (Check one)
❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election X❑ year -end report ❑ dissolution
Dawn McKenna
Candidate Full Name (if applicable)
1 9 Hancock Street, Lexington, MA 02420
Residential Address
Committee to Elect Dawn McKenna
Committee Name
16 Franklin Road, Lexington, MA 02420
Committee Mailing Address
SUMMARY BALANCE INFORMATION:
Line 1: Ending Balance from previous report -3o 3
�c o
Line 2: Total receipts this period (page 3, line 11) 0 .0
Line 3: Subtotal (line 1 plus line 2) $, ® Y. 3
Line 4: Total expenditures this period (page 5, line 14) ®. Dd
Line 5: Ending Balance (line 3 minus line 4) � ®s 3 a
Line 6: Total in -kind contributions this period (page 6) ®, a
Line 7: Total (all) outstanding liabilities (page 7) !3 , U
Line 8: Name of bank(s) used: Cambridge Savings Bank
Affidavit of Committee Treasurer:
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 finance
activity, including all contributions, loans, receipts, expenditures, disbursements, in -kind contributions and liabilities for this reporting period and represents the 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.
Signed under the penalties of perjury: (Treasurer's signature) Date: 1 1 ^_ 1
Affidavit of Candidate: (check 1 box only)
ndidate with Committee and no activity independent of the committee
B�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 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. I have not received any contributions,
incurred any liabilities nor made any expenditures on my behalf during this reporting period.
Candidate without Committee OR Candidate with independent activity filing separate report
❑ 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
finance activity, including contributions, loans, receipts, expenditures, disbursements, in -kind contributions and liabilities for this reporting period and represents the
campaign finance activity of all persops,ac ing under the autho or behalf of this committee in accordance with the requirements of M.G.L. 0 55.
.,
Date: D
Signed under the penalties of perjury: (Candidate's signature)
SCHEDULE C: "IN -KIND" CONTRIBUTIONS
Please itemize contributors who have made in -kind contributions of more than'$50. In -kind contributions $50 and under may be
addPA tnaP.thP1r frnm the rnmmittem.'c rermrds and inclnded in line 16.
Date
Received
From Whom Received*
Residential Address
Description of
Contribution
Value
I J
f
Enter on page 1, line 6
Din 15: I n -kind over $50
Line 16: In -kind $50 and under
Line 17: Total In -kind
Line 18: OUTSTANDING LIABILITIES (ALL)
• if an in -kind contribution is received from a person who contributes more than $50 in a calendar year, you must report the name
and address of the contributor, in addition, if the contribution is $200 or more, you must also report the contributor's occupation and
employer,
SCHEDULED: LIABILITIES
M.G.,L. c, 55 requires committees to report ALL liabilities which have been reported previously and are still outstanding, as well as
those liabilities incurred during this reporting period
Date
Incurred
To Whom Due
Address
Purpose
Amount
Enter on page 1, line 7
Line 18: OUTSTANDING LIABILITIES (ALL)
This page may be copied if additional pages are required to report all activity. Please include your committee name and a page
number on each page. ` te a printed on recycled paper page 4