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of Massachusetts
Form CPF M 102 -0: Campaign Finance Report
Municipal Form
Office of Campaign and Political Finance
City or Town of: Lexington
Please print or type all information, except signatures.
Reporting Period: Beginning: 01/01/2016
(MM/DD/YYYY)
Ending: 12/31/2016
(MM/DD/YYYY)
Type of Report: (Check One)
D 8th day preceding preliminary/primary ❑ 8th day preceding election ❑ 30th day following election (town or special)
20th day of January (Year -End report)
Pursuant to M.G.L. Chapter 55:
1. I certify that I am a candidate for or currently hold Municipal Office.
2. I certify that I have not received any contributions, made any expenditures, or incurred any obligations
3. I certify that I do not have a political committee.
during this reporting period, and do not have a campaign fund in existence.
DATE
PRINT NAME
SIGNATURE
Signed under the penalties of perjury
RESIDENTIAL ADDRESS
(Street and Number)
OFFICE SOUGHT
01/04/2017
Charles Hornig
75 Reed Street
Planning Board