HomeMy WebLinkAbout2017-12-31-Pato-OCPFLDForm CPF M 102: Campaign Finance Report
Municipal Form � r 1 -g r It {Z� 54_
Office orcampadgn and Political n 1swe I-"
Pile with:
City or Town Clerk or Election Commfafm
Please print or type all information, except signatures.
Fin r agPeU °I�ecemberons 31 2Tle17
ReporingpertadHeginning_J"�I11ary 1 2017 Ending
Type of report: (Check one)
08th day preceding preliminary 08th day preceding election 030 day after election ®year-end report ❑dissolution
Joe Pato
Full Name of Candidate (If applicable)
Selectman
Office Sought and District
900 Mass. Ave., Lexington, MA 02420
Residential Address
TOL No. (optional)
Committee to Elect Joe Pato Selectman
Committee Name
Kerry Brandin
Name of Committee Treasurer
16 Franklin Rd, Lexington, MA 02420
Committee Mailing Address
Tel. No. (optional)
SUMMARY BALANCE INFORMATION:
Line 1: Ending balance from previous report
$ 209.17
Line 2: Total receipts this period (page 2, line )1)
$ 0.00
Line 3: Subtotal eine t plus line 2)
$ 209.17
Line 4: Total expenditures this period (page 3, line Its)
$ 9.17
Line 5: Ending balance (tine 3 minus line a)
$ 200.00
-------------------- --------------
Line 6: Total in-kind contributions this period (page a)
$ 0.00
Line 7: Total (all) outstanding liabilities (page a)
$ 14 as
Line 8: Name of bank(s) used Cambridge Savings Bank
Amdavit of ConaltinTreaaurarr
I certify dw I have exa shad ads report including enadted sch dules and it 4 to the bed of my knowledge and belief, a true and eo rPic4 rlatemmt of all ampeign
Cowles activity, including all conuibutlom, loam, rw6p4, expe"num, diaburvacuu, btddnd contributions and liabilities for this reporting period and repro enp dw
eampsign then O, usivity of all perms acing under the authority son behalf of rids owunium In soconimoo with the requiranents ofM.O.L, o. $5.
LAS signed wader the Penalties of per)uryr
.--i
1/212018
FOR CANDWATE FILINGS ONLY: (CANDIDATE MUST SIGN BELOW)
Affidavit orCandlda4s (cltttk l box osdy)
❑ Candldaa with Committee amt no*cavity hwepadent ofdte eommmaa
I oenify dot I lave oundeed this report including alladW seladuta and it it, to the bat of my knowledge aid belie& a toe and complete statement Oren cufiWp
finuaa activity, of all persons acing under do Authaniry or on behalf of gds oomadees in accordance with the roquiranems of M.O.I. c. 55. 1 have not received any
contributions, incurred any liabilities nor mado my *VmaWm on my behalf during this roportingpodad.
❑ Cmndldatewithout Commllke OR Csndidx4 with dndependenl "Oly nllns separate report
1 certify that I have examined this report Including atacdad tdadules and 4 4 In da beet of my knowledge and beII4 awe and complete eatmant of All ampsign
finance activity, alluding cadributione. tam, mceip4 experdlnw, didasmang irokind eordributi" and liabilities for this reposing period and represents the
cmnpaignfuanc*xxxlyylwty of,#x-•.�-R�.-,�,�—� aping under the sudarity oro bduVof this cormnince in accordance with aw requirements ofM.QL. e. 35.
L�/I ,t '\- t glguedunderMeperWaesofper)ury;
SCHEDULE A: RECEIPTS 1
ALG.L, a SS requires that the name and residential address be reported, in alphabetical order,-AAr61r etpt¢
oppr $So, in a calendar year. Committees must keep detailed accounts and records of all receipts, but need onW
iien7ize those receipts over $50. In addtNon, the occupation and employer crust be repC6 did for' 411 periosts who
enutribute $200 or more in a calendar year.
'ilds page may be copied if additional pages are required to report all receipts. Please include your committee name and a page
nW nbcr on each page
Date
Iteceived
Name and Residential Address
(alphabetical listing required)
Amount
Occupation & Employer
(for contributions of $200 or more)
Line 9: Total receipts in excess of $50 (or listed above)
o0
00
Enter on page 1, line 2
Lina 10: Total receipts $50 and under' (not listed above)
00
00
r a t t: TOTAL RECEIPTS IN THE PER IOA
00
0o
ece
e If you have itemized receipts of $50 and under include them in line 9. Line t0 should include only tPage 2 ipts not itemized
above.
SCHEDULE B: EXPENDITURES
M.G,L. c. 55 requires committees to list, in alphabetical order, all expenditures qtef SSO. iu repprtrgtiod
Committees must keep detailed accounts and records of all expenditures, but nedt Wj, itemize those over $50.
IJrpenditures $50 and under may be added together, from committee records, and repgrted on line 13.
This page may be copied if additional pages are required to report all expenditures. Please include yoiirreotdmitlee name and a page
Date Paid
To Whom Paid
(alphabetical listing)
Address
Purpose of Expenditure
Amount
9/14/2015
John Krawczk
78 Outlook Drive
Lexington, MA 02421
.com Domain renewal
$9.
7
Enter on nage 1, line 4
Line 12: Expenditures over $50
00
00
Line 13: Expenditures $50 and under*
$917
Line MTOTAL EXPENDITURES
$9-17
*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 3
SCHEDULE C: "IN-KIND" CONTRIBUTIONS N _j
Please itemize contributors who have made in-kind contributions of more than'. $50, In-kind coptlud ns M andpal.rnbe
added together from the committee's records and included in line 16,
Date
Received
From Whom Received*
Residential Address
Descriotign of , -
Contfibntiou,
Value
9/14/2017
John Krawczk
723 Outlook Drive .
Lexington, MA 02421
.com Domain renewal
$14.99
Enter on page I, line 6
Line 15: In-kind over $50
Line 16: In-kind $50 and under
Line 17; Total In-kind
o.o°
• 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.
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
9/14/2017
John Krawczk
723 Outlook Drive .
Lexington, MA 02421
.com Domain renewal
$14.99
Enter on page 1, line 7
Line 18; OUTSTANDING LIABILITIES (ALL)
$14.99
This page may be copied if additional pages are required to report all activity. Please include your committee name and a page
number on each page. :i prhted on recycled neper Page 4