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Home My WebLink About2016-04-01-Jay-OCPFCommonwealth of Massachusetts Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance File with: City or Town Clerk or Election Commission Fill in Reporting Period dates: Beginning Date: Feb 13, 2016 ti Ending Date: Mar 21, 2016 Type of Report: (Check one) ❑ 8th day preceding preliminary ❑ 8th day preceding election p 30 day after election ❑ year -end report ❑ dissolution Eileen Jay Candidate Full Name (if applicable) School Committee Board Member Office Sought and District 191 Waltham St., Lexington, MA 02421 Telephone Number (optional): Residential Address Eileen Jay for School Committee Campaign Committee Name Becky Barrentine Name of Committee Treasurer 100 Bedford St., Lexington, MA 02420 Committee Mailing Address Telephone Number (optional): SUMMARY BALANCE INFORMATION: Line 1: Ending Balance from previous report Line 2: Total receipts this period (page 3, line 11) Line 3: Subtotal (line 1 plus line 2) Line 4: Total expenditures this period (page 5, line 14) Line 5: Ending Balance (line 3 minus line 4) 5,235 Line 6: Total in -kind contributions this period (page 6) Line 7: Total (all) outstanding liabilities (page 7) Line 8: Name of bank(s) used: 2,945 8,180 6,784 1,396 0 0 Citizens 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: -�-C-51 — � (Treasurer's signature) Date: aice FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate: (check 1 box only) Candidate with Committee and no activity independent of the committee 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.O.L. c.55. I have not received any contributions, incurred any liabilities nor made any expenditures on any 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 hue 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 persons acting under the . m ty ' r , , -half of this committee in accordance with the requirements of M.G.L. c. 55. Signed under the penalties of perjury: (Candidate's signature) Date: SCHEDULE A: RECEIPTS M.G.L. c. 55 requires that the name and residential address be reported, in alphabetical order; for all receipts over $50 in a calendar year. Committees must keep detailed accounts and records of all receipts, but need only itemize those receipts over $50. In addition, the occupation and employer must be reported for all persons who contribute $200 or more in a calendar year. (A "Schedule A: Receipts" attachment is available to complete, print and attach to this report, if additional pages are required to report all receipts. Please include your committee name and a page number on each page.) Date Received Name and Residential Address (alphabetical listing required) Amount Occupation & Employer (for contributions of $200 or more) Mar 17, 2016 Dailey, William and Maryelene 114 Marrett Road 02421 100 Retired Feb 16, 2016 Masson, Colin 12 Hayes Ave 02420 2,000 Retired Feb 16, 2016 Masson, Leslie 12 Hayes Ave 02420 2,000 Retired Feb 16, 2016 Sakhuja, Ravi 50 Turning Mill Rd 02420 500 Retired Feb 18, 2016 Wang, Hua 55 Merlam St 02420 100 Line 9: Total Receipts over $50 (or listed above) 2,700 Line 10: Total Receipts $50 and under* (not listed above) 245 Line 11: TOTAL RECEIPTS IN THE PERIOD 2,945 F Enter on page 1, line 2 * If you have itemized receipts of $50 and under, include them in line 9. Line 10 should include only those receipts not itemized above. Page 2 SCHEDULE A: RECEIPTS (continued) Date Received Name and Residential Address (alphabetical listing required) Amount Occupation & Employer (for contributions of $200 or more) F Enter on page 1, line 2 Line 9: Total Receipts over $50 (or listed above) Line 10: Total Receipts $50 and trader* (not listed above) Line 11: TOTAL RECEIPTS IN THE PERIOD * If you have itemized receipts of $50 and under, include them in line 9. Line 10 should include only those receipts not itemized above. Page 3 SCHEDULE B: EXPENDITURES M.G.L. c. 55 requires committees to list, in alphabetical order, all expenditures over $50 in a reporting period. Committees must keep detailed accounts and records of all expenditures, but need only itemize those over $50. Expenditures $50 and under may be added together from committee records, and reported on line 13. (A "Schedule B. Expenditures" attachment is available to complete, print and attach to this report, if additional pages are required to report all expenditures. Please include your committee name and a page number on each page.) Date Paid To Whom Paid (alphabetical listing) Address Purpose of Expenditure Amount Mar 20, 2016 Colonial Times POB 473 Lex 02420 Ad 900 Mar 20, 2016 lay, Elleen 191 Waltham St 02421 Paper, copying & mailing - $73 Networking event - $50 173 Feb 22, 2016 Lexington Graphics 76 Bedford St 02420 Town mailing 4,890 various Paypal online transaction fees 61 Mar 9, 2016 Rowley, Elise 90 North Street 02420 Paper, copying & mailing - $225 Campaign reception food - $311 536 Mar 7, 2016 Wang, Hua 55 Meriam St 02420 Food 91 Mar 9, 2016 Yuan, Ruixi 663 Lowell St Unit 42 02420 lawn sign wires 133 Enter on page 1, line 4 -> Line 12: Total Expenditures over $50 (or listed above) 6,784 Line 13: Total Expenditures $50 and under* (not listed above) 0 Line 14: TOTAL EXPENDITURES IN THE PERIOD 6,784 * If you have itemized expenditures of $50 and under, include them in line 12. Line 13 should include only those expenditures not itemized above. Page 4 SCHEDULE B: EXPENDITURES (continued) Date Pahl To Whom Paid (alphabetical listing) Address Purpose of Expenditure Amount r Enter on page 1, line 4 -> Line 12: Expenditures over $50 (or listed above) Line 13: Expenditures $50 and under* (not listed above) Line 14: TOTAL EXPENDITURES IN THE PERIOD * If you have itemized expenditures of $50 and under, include them in line 12. Line 13 should include only those expenditures not itemized above. Page 5 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 added together from the committee's records and included in line 16 on page 1. Date Received From Whom Received* Residential Address Description of Contribution Value Enter on page 1, line 6 -, Line 15: In -Kind Contributions over $50 (or listed above) Line 16: In -Kind Contributions $50 & under (not listed above) Line 17: TOTAL IN -KIND CONTRIBUTIONS • 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. Page 6 SCHEDULE D: 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: TOTAL OUTSTANDING LIABILITIES (ALL) Page 7