HomeMy WebLinkAbout2017-12-31-Barry-OCPfForm CPF M 102: Campaign Finance Report
Municipal Form
uV Offcti of gampaign and Political Finance
Commonwealth t(I10 1 ' 1 ::'t �."' 1 . a
of MaccarhucPttc fi tt. ,++(,
Type of Report: (Check one)
❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election year-end report ❑ dissolution
Suzie Barry
Candidate Full Name (i r applicable)
Selectman
Office Sought and District
159 Burlington St, Lexington, MA 02420
Residential Address
Telephone Number (optional) (781) 862-5853
Line 1: Ending Balance from previous report
Line 2: Total receipts this period (page 3, line 11)
Line 3: Subtotal (line I plus line 2)
lCommittee to Elect Suzie Barry
Committee Name
Kim Coburn
Name of Committee Treasurer
66 Liberty Ave, Lexington MA 02420
Committee Mailing Address
'telephone Number (optional). 1 (781) 863-6285
INFORMATION:
Line 4: Total expenditures this period (page 5, line 14)
Line 5: Ending Balance (line 3 minus line 4)
707.07
"I
707.07707. 7
_I
707.07
Line 6: Total in-kind contributions this period (page 6)
Line 7: Total (all) outstanding liabilities (page 7) 0
Line 8: Name of bank(s) used: TD Bank
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 ofall 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 author ty or on half of II is coi 5nni ice in accordance with the requirements of M.G.L. c. 55.
Signed under the penalties of perjury: L(IYIQ"— (Treasurers signature) Date: /
FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate (chect, I box only)
Candidate will, Committee and no activity independent of tine 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. 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 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 tun a authority or on he a f ofdnis co
Ti cc in accordance with the requirements of M.G.L. c. 55.
Signed under the penalties of perjury: (Candidate's signature) Date: j
File with:
City or Tovm Clerk or Election Commission
Fill in Reporting Period dates:
Begi bai8:'
oanuary 1, 2017
Ending Date:
December 31, 2017
Type of Report: (Check one)
❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after election year-end report ❑ dissolution
Suzie Barry
Candidate Full Name (i r applicable)
Selectman
Office Sought and District
159 Burlington St, Lexington, MA 02420
Residential Address
Telephone Number (optional) (781) 862-5853
Line 1: Ending Balance from previous report
Line 2: Total receipts this period (page 3, line 11)
Line 3: Subtotal (line I plus line 2)
lCommittee to Elect Suzie Barry
Committee Name
Kim Coburn
Name of Committee Treasurer
66 Liberty Ave, Lexington MA 02420
Committee Mailing Address
'telephone Number (optional). 1 (781) 863-6285
INFORMATION:
Line 4: Total expenditures this period (page 5, line 14)
Line 5: Ending Balance (line 3 minus line 4)
707.07
"I
707.07707. 7
_I
707.07
Line 6: Total in-kind contributions this period (page 6)
Line 7: Total (all) outstanding liabilities (page 7) 0
Line 8: Name of bank(s) used: TD Bank
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 ofall 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 author ty or on half of II is coi 5nni ice in accordance with the requirements of M.G.L. c. 55.
Signed under the penalties of perjury: L(IYIQ"— (Treasurers signature) Date: /
FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate (chect, I box only)
Candidate will, Committee and no activity independent of tine 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. 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 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 tun a authority or on he a f ofdnis co
Ti cc in accordance with the requirements of M.G.L. c. 55.
Signed under the penalties of perjury: (Candidate's signature) Date: j
SCHEDULE A: RECEIPTS (continued)
Date Received
Name and Residential Address
(alphabetical listing required)
Amount
Occupation & Employer
(for contributions of $200 or more)
F-1
---
=-F
F
I
-
I
F
7-1
Line 9: Total Receipts over $50 (or listed above)
F Enter on page t, line 2
Line 10: Total Receipts $50 and under* (not listed above)
Line 11: TOTAL RECEIPTS IN THE PERIOD
701
* 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 (continued)
Date Paid
F-
To Whom Paid
(alphabetical listing)
F-771
Address
F- I
Purpose of Expenditure
7E-1.
Amount
F
I
F
-1
Line 12: Expenditures over $50 (or listed above)
Line 13: Expenditures $50 and under* (not listed above)
Line 14: TOTAL EXPENDITURES IN THE PERIOD
Enter on page 1, line 4
* 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 5
SCHEDULED: LIABILITIES
M.G.L. c. 55 requires committees to reportALL liabilities which have been reported previously and are still outstanding, as well
as those liabilities incurred dewing this reporting period.
Page 7