HomeMy WebLinkAbout2016-12-31-Steigerwald-OCPFCommonwealth
of Massachusetts
Form CPF M 102: Campaign Finance Report
Municipal Form
Office of Campaign and Political Finance
Fill in Reporting Period dates:
File with: City or Town Clerk or Election Commission
Type of Report: (Check one)
❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election ear -end report ❑ dissolution
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Candidate Full Name (if applicable)
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Office Sought and District
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Telephone Number (optional):
Residential Address
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Committee Name
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Name of Committee Treasurer
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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)
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:
0
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:
(Treasurer's signature)
Date:
FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate: (check I box only)
((; andidate with Committee and no activity independent of the committee
Nfi certify that 1 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. 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 OR Candidate with independent activity tiling separate report
1 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 ulwer 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:
(Candidate's signature) Date: