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HomeMy WebLinkAbout2016-12-31-Crocker-OCPF1 Commonwealth of Massachusetts Form CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance (Fill in Reporting Period dates: Beginning Date: 111/16/16 File with: City or Town Clerk or Election Commission Ending Date: 112/31/16 Type of Report: (Check one) ® 8th day preceding preliminary © 8th day preceding election ©30 day after election 17udith A Crocker Candidate Full Name (if applicable) 'School Committee Office Sought and District 15 Currier Court, Lexington, MA 02420 Telephone Number (optional): Residential Address year -end report ® dissolution [Judy Crocker for School Committee 1 Committee Name 'Mary McDonald Name of Conunittee Treasurer 15 Nickerson Rd, Lexington, MA 02421 r° : Committee Mailing Adding? Telephone Number (optional): 1 r '— I 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 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 c mittee in accordance with the requirements of M.G.L. c. 55. Signed under the penalties of perjury: GrGrl (Treasurer's signature) Date: 0.00 705,00 7 DS, 00 0i0�+ 4-7 PS, D0 III.00 (r SO DO [FD Bank FOR CANDIDATE FILINGS ONLY: Affidav t of Candidate: (check t 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.G.L. e. 55. I have not received any contributions, incurred any liabilities nor made any expenditures on my behalf during this reporting period. Candidate without Committee OE, 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 true 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 authority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. .144,4 M- N o0/16 112/31/16 Signed under the penalties of perjury: (Candidate's signature) Date: 112/31/16 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) 12/11/16 Susan Conway & Clifton Jay 29 Woodland Rd Lexington, MA 02420 $200 President HealthNEf Systems Consulting Inc. $205 Retired Clinical Laboratory Scientist 11/16/16 Judith A Crocker 5 Currier Court Lexington, Ma 02420 $250 Business owner Ariex Oil Corp. 12/20/16 Kathy and Jack Maloney 589 Bedford St PO Box 515 '.j C i L'\ Line 9: Total Rece pts over $50 (or listed above) Line 10: Total Receipts $50 and under* (not listed above) $655.00 F Enter on page 1, line 2 $50 Line 11: TOTAL RECEIPTS P4 THE PERIOD $705 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 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 repm•t 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 h ' \LJ Enter on page 1, line 4 -> 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 So * 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 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 11/24/16 Elaine Ashton 32 Cliffe Ave Lexington, MA 02420 Premium upgrade of WordPress.com webslte $63.12 k Ji 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) $63.12 $47.88 Line 17: TOTAL IN-KIND CONTRIBUTIONS $111.00 * 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 MG.L. a 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 12/5/16 CTM Publishing PO Box 473 Lexington, MA 02420 1/4 page ad $325 $325 12/31/16 CTM Publishing PO Box 473 Lexington, MA 02420 1/4 page ad r j ITl -I C. - ct --a Enter on page 1, line 7 - Line 18: TOTAL OUTSTANDING LIABILITIES (ALL) $650.00 Page 7