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HomeMy WebLinkAbout2017-12-31-Crocker-Dissolution-C�N Form CPF M 102: Campaign Finance Report NJ Municipal Form Office of Campaign and Political Finance Commonwealth of Massachusetts Pile with: City or Town Clerk or Election Commission Fill in Reporting Period dates: Beginning Date: 1 ) G Ending Date: ) 1 G / $ Type of Report: (Check one) EJ 8th day preceding preliminary 0 8th day preceding election © 30 day after election year-end report QX dissolution ith A Crocker Candidate Pull Name (if applicable) School Committee Office Sought and District 5 Currier Court, Lexington, MA 02420 Residential Address udy Crocker for School Committee Committee Name Mary McDonald Nance of Conunittee Treasurer 5 Nickerson Rd, Lexington, MA 02421 Committee Mailing Address -' Telephone Number (optional): - _ -� -- am 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) �_.-..... _ 0.00 0.00 0.00 0.00 Line 6: Total in-kind contributions this period (page 6) 1 0.001 Line 7: Total (all) outstanding liabilities (page 7) 0.00 Line 8: Name of bank(s) used: Fsank certify that I have examined this report including attached schedules and it is, to the best of my knowledge mid belief, a true and complete statement of all campaign finance etivity, including all contributions, loans, receipts, expenditures, disbursements, in-kind contributions mrd liabilities for this reporting period and represents the campaign inance activity of all persons acting under the authority or on behalf of this romtnittepin aecordafn�}' with he requirements of M.G.L. n 55. signed under the penalties of perjury: it ! signature) Date: g p p I ry: 1-' / ("freaswers si alure TOR 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 die best of my knowledge and belief, a true and complete statement of all campaign fuiance activity, of all persons acting ander 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 my expenditures on my behalf during this reporting period. Candidate without Committee OR Candidate with independent activity filing separate report X7 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, disbumoments, in-kind contributions and liabilities for this reporting period and represents fire 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, under the penalties of perjury: signature) Date: 1 ) ) G ) 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 Hurst keep detailed accounts and records ofall 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) - L IF Line 9: Total Receipts over $50 (or listed above) o.00 F Enter on page 1, line 2 Line 10: Total Receipts $50 and under* (not listed above) o.00 Line 11: TOTAL RECEIPTS IN THE PERIOD o.00 * 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 reportingperiod. Committees must keep detailed accounts and records ofall 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) I - -- - - - --- 71 F--1 Address , 7 Purpose of Expenditure F— Amount 7 F 7F M I 7= F I s Enter on page 1, line 4 Line 12: Total Expenditures over $50 (or listed above) o.00 Line 13: Total Expenditures $50 and under* (not listed above) o.00 Line 14: TOTAL EXPENDITURES IN THE PERIOD 0.00 * 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 __1 F I F F711 F Enter on page 1, line 6 � Line 15: In -Kind Contributions over $50 (or listed above) o.00 Line 16: In -Kind Contributions $50 & under (not listed above) o.00 Line 17: TOTAL IN -HIND CONTRIBUTIONS o.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 SCHEDULED: LIABILITIES M.G.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 Page 7