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Form CPF M 102-0: Campaign Finance Report
Municipal Form
bmee of Cempatge awl Political Finance
City or Town of;
Candidate L., bor0.h r p writ Office Mtoaera4
Please print or type all information, except signatures.
Fill in dates: Mon Dar
Reporting Period Beginning ' pw/t
Year Month Day Year
A D /o/ Ending Pp C,. 3 / 2 015/
Typo of Report: (Check Ono)
0 8th day preceding ❑ 8th day preceding election ❑ 30th day following election
preliminary /primary (Town or Special)
5 20th day of January
(Year -End Report)'
Pursuant to M.G,L., Chapter 55:
I. I certify that I am a candidate for or hold Municipal Office.
2. I certify that t have not received any contributions, made any expenditures, or incurred any obligations during this
reporting period, and do not have a campaign fund In existence.
3, I certify that 1 do not have a political committee,
DATE
I. SIGNATURE
Signed under the penalties of perjury
11. RESIDENTIAL ADDRESS
(Street and Number)
IA. OFFICE SOUGHT
/ /A(%s
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"97 /Pob,k o.t Roo
m,de Tor
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. 11/97
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