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Form C PF M 10 ® Campaign ]Finance Report
a - 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: 03/23/2019 Ending Date: Dec 31, 2019
Type of Report: (Check one)
❑ 8th day preceding preliminary ❑ 8th day preceding election ❑ 30 day after electionX❑ year-end report ❑ dissolution
Eileen]ay Eileen Jay for School Committee
Candidate Full Name(ifapplicable) Committee Name
School Committee Becky Barrerltine
Office Sought and District Name of Comm ittee Treasurer
191 Waltham St., Lexington, MA 02421 100 Bedford St., Lexington, MA 02420
Residential Address Committee Mailing Address
Telephone Number(optional): Telephone Number(optional);
SUMMARY BALANCE INFORMATION:
Liti►e I: lading.Balance from previous report
Line 2: Total receipts this period(page 3, line 1 1)
Line 3: Subtotal (line I plus line 2) r _
i t'o
Line 4: Total expenditures this period(page 5, line 14)
Line 5: Ending Balance(line 3 minus line 4) Cie 1,17
Line 6: Total in-kind contributions this period (page 6) >' t
Line 7: Total (all)outstanding liabilities(page 7)
Line S: Name of bank(s)used: Citizens Bank, Paypal
Affidavit of Committee"treasurer:
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 oral]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 underthe i or on behalf of this committee in accordance with the requirements of M.G.L.c.55.
Signed under the penalties of per jury: _- (Treasurer's signature) Date: / f
FOR CANDIDATE FILINGS ONLY: Affidavit of Candidnte:(check I box only)
Candidate with Committee and no activity independent of the committee
I certify that I have examined lhis report including attached schedules and it is,to the best of my knowledge and belief,a true and complete statement oral]campaign finance
activity,of all persons acting under[lie 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 beha€f during this reporting period.
Candidate without Committee Olt Candidate svith independent activity riling 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 ofall 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 aut ori 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: i