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HomeMy WebLinkAbout2021-01-07-Hai-OCPF `®r : Campaign ce Report Municipal Or Office of Campaign and Political Finance Commonwealth of Massachusetts File with'. Citv or•fonvn Clcrk or Election Commission Fill in Reporting Period dates: Beginning Date: 01/01/2020 Ending Date: 12/31/2020 Type of Report: (Check one) © Sth day preceding preliminary 8th day preceding election 30 day after electiot3 ® year-end report dissolution Til! I. Hai Jill lJai for Lexington Candidate Full Name(if applicable) Committee Name Select Board Jodi R. Galin Office Sought and District Name of Committee Treasurer 6 Highland Avenue, Lexington, MA 02421 5 Raymond Street, Lexington, MA 02421 Residential Address Committee Mailing Address Telephone Nu.mber(optional): (781) 862-3766 Telephone Number(optional): (7 81) 910-4681 SUMMARY BALANCE INFORMATION: Line 1: Ending Balance from previous Deport 760.51 Line 2: Total receipts this period(page 3, line 1 1) 0 Line 3: Subtotal (line 1 plus line 2) 760 5 Line 4: Total expenditures this period(page 5, line 14) 9A9.76 Line 5: Ending Balance(life 3 minus line 4) � 660 72 Line 6: Total in-kind contributions this period (page 6) 0 cs�t Linc 7: Total (all)outstanding liabilities(page 7) 0 Line 8: Name of bank(s)used: citizens Bank 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 of all campaign finance activity,including all contributions,loans,receipts,expenditures,disbursements,io-kind contributions and liabilities for this reporting period and represents the campaign finance activity of all persons acting under the authority or n eh of nis coomittee in accordance with the requirements of M.G.L.c.55. Signed under the penalties of perjruy: (Treasurer's signature) Date: kv FOR 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 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. 1 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 [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,loa ,receipts,expenditures,disbursements,in-kind contributions and liabilities for this reporting period and represents the campaign finance activity of al I persons a i under the auth on behalf of this committee in accordantce with the requirements of A I.Ci.L.c.55. Signed ruder the.penalties of perjury: (Candidate's signature) Date: C7I b�f SC +DULE A: RECEIPTS M.G.L. c. 55 requires drat the name arid r-esidenticrl{addr'ess he reported, in alphabetical order;for all receipts overS50 in a calendar year, Committees must keep detailed accounts and records of all receipts, but need only itenri�e those receipts over S50. In addition, the occupation crud employer nnrst be reported for•all persons who contribute$200 or more in a calendar year. (A"Seliedule 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 cumber on each page.) Name and Residential Address Occupation & Employer Date Received (alphabetical listing required) Amount (for contributions of$200 or more) Line 9: Total Receipts over$50(or listed above) Lille 10: Total Receipts $50 and under* (not listed above) Line II. TOTAL RECEIPTS IN THE PERIOD 0 � Enter on page 1,line 2 if you have itemized receipts of$50 and udder,include them in line 9. Lice 10 should include only those receipts not itemized above. Page 2 i' SCHEDULE A: RECEIP'T'S (Contended) Name and Residential Address Occupation &Employer }late Received (alphabetical listing required) Amount (for contributions of$200 or more) 7 Line 9: Total Receipts over$50(01•listed above) Line 10: Total Receipts $50 and under* (not listed above) Line II: TOTAL RECEIPTS IN THE PERIOD Enteron page ],lime 2 If you leave itemized receipts of$50 and under,include them in line 9. bine 10 should include only those receipts not itemized above. Page 3 SCHEDULE R: EXPENDITURES MG.L. c. 55 requires commitlees to list, in alphabelical order•, all expenditures over$50 in a reportingperiod. Committees mast keep detailed accowds and records of all expenditures, but need only iternize those over$50. Eal)enditrrres$50 and raider may be added together, from committee records, and reported on line 13. (A"Schedule P,: Expenditures" attachment is available to complete,print and attach to this report,if additional pages are requited to report all expenditures. Please include your committee name and a page number on each page.) To Whom Paid Date Paid (alphabetical listing) Address Purpose of Expenditure Amount 78 Outlook Drive Reimburse For I©NOS by 1&1 11/20/2020 Krawczyk,John Lexington, MA 022421 Internet hosting website 99.79 invoice #202030481231 Line 12. Total Expenditures over$50(or listed above) 99.79 Line 13. Total Expenditures$50 and under* (slot listed above) F�- Enter on page I, tine 4 Dine 14: TOTAL EXPENDITURES IN THE PERIOD F��99.79 1f you have itemized expenditures of$50 and under, include them in line 12. Line 13 should include only[Bose expenditures not itemized above. Page 4 SCHEDULE I3: EXPENDITURES (continued) To Whom Paid Date Paid (alphabetical listing) Address Purpose of Expenditure Amount ---------------------------- n: Line 12: Expenditures over$50 (or listed above) Line 13:Expenditures $50 and under* (not listed above) Enter on page 1,line 4 Line 14: TOTAL EXPENDITURES fN THE PERIOD if you have itemized expenditu3•es of$50 and under,include them in line 12. Line 13 should include only those expenditures not itemized above. Page 5 SCHEDULE C: 9 IN- ND" CONT UTIONS ['lease 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 r Line 15:In-Kind Contributions over$50(or listed above) F7 Line 16: In-Kind Contributions$50&under(not listed above) Enter on page 1,line 6 Line 17: T®TAI.IN-KIND CONTRIBUTIONS T 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: LIABYLITIE, S M.G.L. c. 55 requires committees to report ALL liahilities i-Mich 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 Enter on page 1,fide 7 Line 1.8: TOTAL OUTSTANDING LIABILITIES(ALL) o Page 7