HomeMy WebLinkAbout2016-12-31-Colburn-OCPFCommonwealth
of Massachusetts
Form CPF M 102: Campaign Finance Report
Municipal Form
Office of Campaign and Political Finance
I,
Fill in Reporting Period dates:
Beginning Date:
(Nov 30, 2016
File with: City or Town Clerk or Election Commission
Ending Date:
Jan 20, 2017
Type of Repoli: (Check one)
0 8th day preceding preliminary ❑ 8th day preceding election (] 30 day after election D year -end report D dissolution
KATHRYN R. COLBURN
Candidate Full Name (if applicable)
SCHOOL COMMITTEE
Office Sought and District
49 Forest Street, Lexington, MA 02421
Residential Address
Telephone Number (optional): I (617)
872 -9428
!SCHOOL COMMITTEE
Committee Name
(CERISE JALELIAN
Name of Committee Treasurer
7 Lois Lane, Lexington, MA 02420
Committee Mailing Address
Telephone Number (optional):
(617) 733 -6278
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)
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:
Affidavit of Committee 'I reasuren
0
7,418
7,418
0
7,418
199.8
0
BROOKLINE BANK
I certify that 1 have examined this report including atta hed 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, pendimres, disbursemers in -kind contributions and liabilities for this reporting period and represents the campaign
finance activity of all persons acting under the a ority or on behalf of this! =tee in accordance with the • quirements of M.G.L. c. 55.
Signed under the penalties of perjury:
FOR CANDJDATE FILINGS ONLY: Affidavit of
(Treasurer's signature) Date:
ndidale• (check 1 box only)
Jan 19, 2017
Candidate with Committee and no activity Independent o- he . nrmittee
1 certify that 1 have examined this report including attached schc ules and it is, to the best of my knowledgc 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.G.L. c. 55. I have not received any contributions,
incurred any liabilities nor made any expenditures on my behalf during this reporting period.
Candidate without Committee 4R Candidate with independent activity filing separate report
❑ I cenify that 1 have examined this report including attached schedules and it is, to the best of my knowledge and belief, a toe 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 yodei the authority or 0 behalf of this committee in accordance with the requirements of M.G.L. c 55.
i
Signed under the penalties of perjury: a ' — (Candidate's signature) Date:
Jan 19, 2017
SCHEDULE A: RECEIPTS
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 nuts( be reported for all persons who contribute S200 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 pa¢e.)
Date Received
Name and Residential Address
(alphabetical listing required)
Amount
Occupation & Employer
(for contributions of $200 or more)
PLEASE REFER TO ATTACHED REPORT.
r
-`
Line 9: Total Receipts over $50 (or listed above)
Line 10: Total Receipts $50 and under* (not listed above)
F Enter on page 1, lint 2
Line 11: TOTAL RECEIPTS IN THE PERIOD
7,418
* 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
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SCHEDULE A: RECEIPTS (continued)
Date Received
Name and Residential Address
(alphabetical listing required)
Amount
Occupation & Employer
(for contributions of $200 or more)
r—
Line 9: Total Receipts over $50 (or listed above)
F Enter on page 1, line 2
Line 10: Total Receipts $50 and under* (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
A1.G.L. c. 55 requires committees to list, in alphabetical order, all expenditures over $50 in a repelling 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,
, ronn 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
NONE AS OF 1.19.17,
0
Enter on page 1, line 4 -r
Line 12: Total Expenditures over $50 (or listed above)
Line 13: Total Expenditures $50 and under* (not listed above)
Line 14: TOTAL EXPENDITURES IN THE PERIOD
o
* 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 Paid
To Whom Paid
(alphabetical listing)
Address
Enter on page 1, line 4 —>
* if you have itemized expenditures of $50 and unde
above.
Purpose of Expenditure
Amount
Page 5
Line 12: Expenditures over $50 (or listed above)
Line 13: Expenditures $50 and under* (not listed above)
Line 14: TOTAL EXPENDITURES IN THE PERIOD
o
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
1.19.17
PK SHIU
19 Grant Place, Lexington, MA
website and domain names
199.8
(�J
Enter on page I, line 6 •
Line 15: In -Kind Contributions over $50 (or listed above)
199.8
Line 16: In -Kind Contributions $50 & under (not listed above)
Line 17: TOTAL IN -KIND CONTRIBUTIONS
199.8
* If an in -kind contribution is received from a person w to 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
NONE AS OF 1.19.17.
cam-
f-
(^J
Enter on page 1, line 7 -->
Line 18: TOTAL OUTSTANDING LIABILITIES (ALL)
0
Page 7