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Form CPF M 102-0: Campaign Finance Report
Municipal Form
One otCampaign and Political Finance
City or Town of:
L.? X(LLShLI
Candidate L -80 NC ceeil office /4US(*j'Wk J
Please print or type all information, except signatures.
Fill in dates: Month Day Year Month Day Year , .
Reporting Period Beginning I 1 G ( Sr Ending a/ 1.3 .2-0l45
Type of Report: (Check One)
kr 8th day preceding 0 8th day preceding election ❑ 30th day following election 0 20th day of January
preliminary/primary (Town or Special)
(Year -End Report)
Pursuant to M.G,L., Chapter 55:
I. I certify that 1 am a candidate for or hold Municipal Office.
2, 1 certify that 1 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
NATURE
Signed under e penalties f�erjury
11. RESIDENTIAL ADDRESS
(Street and Number)
III. OFFICE SOUGHT
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