HomeMy WebLinkAbout2021-09-27-Freeman-OCPF Form CPF M101: STATEMENT OF ORGANIZATION
C'ANDIDATE'S COMMITTEE
MUNICIPAL. FORME ` V
Conunonwealth Office of Campaign and Political Finance
of Massachusetts 2921 '' 27 P11 4: 02
File with: City/Town Cleric or Election Commission
NOTICE IS HEREBY GIVEN in accordance with the provisions of General Laws,Chapter 55,as gatation of a
candidate's committee as follows:
CANDEDATE: FutIName: Larry Freeman
Residential Address: 218 Lowell St
City I State 1 Zip: Lexington MA 02420
E-Mail Address: Freeman4Lexington@gmail.com Phone#: 404 783-7563
Party Affiliation: (If applicable)
OFFICE SOUGHT/PURPOSE:
Title: Member- School Committee
District: LEXINGTON
COMMITTEE: Name of Committee: Committee to Elect Larry Freeman
(The name of the committee must include the candidate's last name)
Corntaittee Mailing Address: 8 Hancock Ave
City/State/Zip: Lexington MA 02420 Phone#: 781-223-4417
OFFICERS:
Chair: Matthew Cohen Treasurer*: Margaret Counts-Klebe
Residential Address: 23 Tower Road Residential Address: 8 Hancock Ave
City/state/Zip: Lexington MA 02421 City/state/Zip: Lexington MA 02420
Phone#: 781-640-8362 Phone#: 781-223-4417 Email: margck@yahoo.com
"A public cm to ce mpy not serve as treasurer of an lLohticA committee Lsee reverse).
Other Officertritle: Other Officer/Title:
Residential Address: Residential Address:
City I State I Zip: 78 City/State/Zip:
Phone#: Phone#:
(Complete and attach a Form CPF MA 101,if necessary,with other officers and(mance committee,if any.)
I hereby consent to the filing of this committee. I understand that a candidate shall not give consent to the organization of more than one committee on his/her
behalf. I am aware that candidates are required to keep detailed accounts and records of all campaign Finance activity for a period of six years from the date of
the relevant election.
SIGNED CINDER THE PENALTIES OF PERJURY:
Date: C_
Candidate' sig ature
I hereby accept the office of Treasurer of the above-named co mmi ee.I affirm that I am not a public employee as defined by M.G.L.c.55,s. 13.I understand
that: 1)I am subject to certain duties and liabilities under M.G.L.c.55, including the timely filing of campaign finance reports and keeping detailed accounts
and records of all campaign finance activity for a period of six years from the date of the relevant election;2)if atter my acceptance of this office I become an
appointed public employee,I must resign this position and notify OCPF of my resignation;and 3)a candidate may not serve as treasurer of the political
committee organized on his/her behalf. �r
SIGNED UNDER THE PENALTIES OF PERJURY:
Date:
Treasurer's signature '
I hereby accept the office of Chairman of the above-named committee.
SIGNED UNDER THE PENALTIES OF PERJURY: P�
Chair's sN re Date: