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Form CPF M 102: Campaign Finance Report
Commonwealth Municipal Form
of Massachusetts
Office of Campaign and Political Finance
File with:
City or Town Clerk or Election Commission
$0.00
Reporting Period - Beginning: 1/1/2011 Ending: 2/11/2011
Type of report: Pre - election
Michelle Ciccolo Committee to Elect Michelle Ciccolo
Full Name of Candidate Committee Name
Pl Board /Lexington Margaret Counts -Klebe
Office Sought/ District Name of Committee Treasurer
50 Shade Street 94 Winter Street
Lexington, MA 02421 Lexington, MA 02420
Residential Address Committee Address
SUMMARY BALANCE INFORMATION
Ending Balance from previous report:
Total receipts this period:
Subtotal:
Total expenditures this period:
Ending Balance:
Total inkind contributions this period:
Total outstanding liabilities:
Name of bank(s) used: TD Bank
2/15/2011
$5,631.33
$5,631.33
$1,813.48
$3,817.85
$21*. 55
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Affidavit of Committee Treasurer:o �-
I certify that I have examined this report, including attached schedules and it is, to the best knoo led nd
belief, a true and complete statement of all campaign finance activity including all contributio ,'`]0arf reqqa4,p ts,
expenditures, disbursements, inkind contributions and liabilities for this reporting period and represent's the- e°ampaign
finance activity of all persons acting under the authority or on behalf of this committee in accordance b th the
requirements of M.G.L. c. 55.
Signed under the penalties of perjury:
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s signature (in ink)
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Date
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, and 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 geport.
I certify that I have examined this report and 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, inkind contributions and liabilities for this reporting period and represents the 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. >
Signed under the penalties of perjury:
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M.G.L. c. 55 requires that the name and residential address be reported, in alphabetical order, for all receipts
over $50 in a calendar year. Committees must keep detailed accounts and records of all receipts, but need only
itemize those receipts over $50. In addition, the occupation and employer must be reported for all persons
who contribute $200 or more in a calendar year.
Date Name and Residential Address
1/29/2011 Barons, Mark
4 Bowser Road
Lexington, MA 02420
Amount Occupation and Employer
$300.00 Real Estate Developer
Self
1/20/2011 Blier, Vicki
41 Shade Street
Lexington, MA 02421
1/22/2011 Blier, Vicki
41 Shade Street
Lexington, MA 02421
2/11/2011 Borghesani, Elizabeth
24 Hastings Rd
Lexington, MA 02421
1/31/2011 Burbidge, Robert
108 Wood Street
Lexington, MA 02421
1/26/2011 Ciccolo (Loan), Michelle
50 Shade Street
Lexington, MA 02421
1/25/2011 Ciccolo, Grace
11 Bennington Road
Lexington, MA 02421
1/25/2011 Ciccolo, Raymond
11 Bennington Road
Lexington, MA 02421
1/20/2011 Cohen, Robert
10 Grassland St
Lexington, MA 02421
1/25/2011 Counter Klebe, M'VWfff19tjjX.jj
94 Winter StreetX �} ' m0i
Lexington1 02420
$100.00 Designer
Self
$1.00 Designer
Self
$100.00
$200.00
$1,000.00
$500.00
$500.00
$100.00
$100.00
Business Owner
Genesis Consolidated S
Homemaker
Self
President, Village Aut
Self
Community Volunteer
Self
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Date Name and Residential Address
2/9/2011 Dailey, William J.
1 Bushnell Drive
Lexington, MA 02421
2/7/2011 Eagle, Dave
138 Grove St
Lexington, MA 02420
2/7/2011 Grossier, Lilah
1010 Waltham St #219
Lexington, MA 02421
2/9/2011 Krawczyk, John
78 Outlook Drive
Lexington, MA 02421
2/9/2011 Leader, Judith C.
17 Fairfield Dr
Lexington, MA 02420
2/7/2011 Maloney, John
289 Bedford St
Lexington, MA 02420
2/7/2011 McSweeney, Leo
435 Lincoln St
Lexington, MA 02421
2/8/2011 Murnaghan, George
70 Spring St
Lexington, MA 02421
2/2/2011 Olsen, Kathleen
462 Marrett Road
Lexington, MA 02421
2/7/2011 Ouellette, Margaret
23 Tucker Ave
Lexington, MA 02421
2/3/2011 Parker, Glenn
186 Spring St
Lexington, MA 02421
V W H
2/7/2011 Provost, Cynthia A �q to N h io,
229 Worthen Rd E 00 . 01 WV L � ��� j(a�
Lexington, MA 02421
13
Amount Occupation and Employer
$100.00
$150.00
$75.00
$100.00
$200.00 Homemaker
Self
$100.00
$100.00 Paint Contractor
McSweeney Painting Co.
$100.00
$75.00
$75.00
$500.00 Retired
Retired
$100.00
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Date Name and Residential Address
2/7/2011 Wilson, Donald
36 Fern St
Lexington, MA 02421
Total Itemized Receipts
Total Unitemized Receipts
Total Receipts
Amount Occupation and Employer
$100.00
$4,676.00
$955.33
$5,631.33
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Schedule B: Expenditures
M.G.L. c. 55 requires committees to list, in alphabetical order, all expenditures over $50 in a reporting period.
Committees must keep detailed accounts and records of all expenditures, but need only itemize those over $50.
Expenditures over $50 and under may be added together from committee records, and reported on line 13.
Date Name and Address
1/30/2011 Connolly Printing
178 Gill Street
Woburn, MA 01801
Amount Purpose
$496.98 Lawn Signs
2/2/2011 Lexington Graphics
76 Bedford St
Lexington, MA 02420
1/25/2011 Lexington Graphics
76 Bedford St
Lexington, MA 02420
1/28/2011 Lexington Graphics
76 Bedford St
Lexington, MA 02420
Total Itemized Expenditures
Total Unitemized Expenditures
Total Expenditures
$625.29 Printing For Mailing
#1
$150.00 Deposit For Mailing #1
$500.00 Postage For Mailing 41
$1,772.27
$41.21
$1,813.48
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Schedule C: "Inkind" Contributions
Please itemize contributors who have made inkind contributions of more than $50. In -kind contributions $50 and
under may be added together, from the committees records, and included in line 16. An exception to this is that
all contributions (under or over $50) given by persons who have contributed more than $50 in the calendar year
must be itemized. Please report the names and addresses of contributors. Also give the occupation and employer
of any contributor who has given an aggregate amount of $200 or more in the calendar year.
Date Name and Residential Address
1/19/2011 Jackson, Philip
50 Shade St
Lexington, MA 02420
Value Description
Occupation /Employer
$95.60 Website Hosting
Marketing
The Village Auto Group
1/12/2011 Jackson, Philip
50 Shade St
Lexington, MA 02420
Total Itemized Inkind Contributions
Total Unitemized Inkind Contributions
Total Inkind Contributions
$114.95 Domain Name
Registration
Marketing
The Village Auto Group
$210.55
$0.00
$210.55
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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 the liabilities incurred during this reporting period.
Date To Whom Due
1/26/2011 Ciccolo (Loan), Michelle
50 Shade Street
Lexington, MA 02421
Amount Purpose
$1,000.00 Loan from candidate
Total Outstanding Liabilities
$1,000.00
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