HomeMy WebLinkAbout2021-01-04-Thompson-OCPF CPF ID#:
(For Ogee Use Only)
Form CPF 101: STATEMENT OF ORGANIZATION
CANDIDA'TE'S COMMITT'EE
Commonwealth f F, a c, Office of Campaign and Political Finance
of Massachusetts
I ile with: Director (617)979-8300 I(800)462-OCPF
Office of Campaign and Political Finance ocPf@cpf.slatc.ma•us
One Ashburton Place,Room 911,;BostM/102108 www.mass,govlocpf
NOTICE IS HEREBY GIVEN in accordance with the provisions of General Laws,Chapter 55,as amended,of the organization of a
candidate's committee as follows:
CAr DEDATE: T+irstName: Melanie Middle Initial: Last Name:Thompson
Residential Address: 360 Lowell St
City/State/.Zip: Lexington MA 02420
Email Address: melaniethompson2020@gmail.com
Party Affiliation:(if applicable) Phone M 7818627073
OFFICE SOUGHT/PURPOSE:
Title: Member- Planning Board
District:
COMMITTEE: Name of Committee: Committee to Elect Melanie Thompson
(The name of the connnittee must include the candidate's last name)
Committee Mailing Address: 8 Hancock Avenue
City I State I Zip: Lexington MA 02420 Phone 0: 7812234417
OFFICERS:
Chair: Larry Freeman Treasurer": Margaret Counts-Klebe
Residential Address: 218 Lowell St Residential Address: 8 Hancock Ave
City I State/Zip: Lexington MA 02420 City/State!Zip: Lexington MA 02420
Email: ldfree@yahoo.com Email: margck@yahoo.com
Phone H: 4047837563 Phone#: 7812234417
"A public employee may not serve as treasurer of any political committee(see reverse),
I hereby consent to the filing of this committee. I understand that a candidate shall not give consent to the organization of more than one committee on his/her
behalf. I am aware that candidates are required to keep detailed accounts and records of all campaign finance activity for a period of six years from the date of
the relevant election.
SIGNED UNDER THE PENALTIES OF PERJURY: Date; (12,1D
........ Candidate's signature
I hereby accept the office of Treasurcr of the above-named committee.I affirm that I am not a public employee as defined by M.G.L.c.55,s. 13,I understand
that: 1)1 am subject to certain duties and liabilities under M.G.L.c.55,including the timely filing of campaign finance reports and keeping detailed accounts
and records of all campaign finance activity for a period of six years from the date of the relevant election;2)if after my acceptance of this office I become an
appointed public employee,I must resign this position and notify OCPF of my resignation;and 3)a candidate may not serve as treasurer of the political
committee organized on his/her behalf.
SIGNED UNDER THE PENALTIES OF PERJURY: Date:
Treasurer s;signature
I hereby accept the office of Chair of the above-nam7;5z�
SIGNED UNDER THE PENALTIES OF PERJUR `
l C�
Date_
hair's sign