HomeMy WebLinkAbout2012-02-17-McCabe-OCPFForm CPF M 102: Campaign Finance Report
Municipal Form
Omce of Campaign and Political Finance
1M.a.ria.da - ; t o
File with: L' w
City or Town Clerk or Election Commission
Please print or type all information, except signatures.
Fill in dates: Marsh Due Yew mmth oea Year
Reporting Period Beginnin —n 2 01 Z Ending LEA I;z 7 20-1 �
Type of report: (Check one)
08th day preceding preliminary 108th day preceding election 030 day after election Oyear -end report Odissolution
Full Name of Candidate (if applicable)
Office Sought and District
f' L Y C r, , F,016-V V) 1 1
�J Residential Address
X /!Ga 'f '; j V /' /.
Tel. No. (optional)
G /�:� 5i4 e-
Committee Name
Name of Committee Treasurer
Committee Mailing Address
zX_'y - 9Y
Tel. No. (optional)
SUMMARY BALANCE INFORMATION:
Line 1: Ending balance from previous report $
Line 2: Total receipts this period (page 2 line 11) $_ ;'` %'G'
Line 3 : Subtotal (line 1 plus line 2)
Line 4: Total expenditures this period (page 3 line 14)
Line 5: Ending balance (line 3 minus line 4)
$ W1
$ vq
$ -
----------------------------------
Line 6: Total in -kind contributions this period (page 4) $
Line 7: Total (all) outstanding liabilities (page 4) $ -
Line 8: Name of bank(s) used Iva Ive - c /T,s ly e ) /, /-
Affidavit of Committee Treasurer.
I eatify that I have examined this report including attached schedules and it ice, to the beat of my knowledge and belief, a true and complete statement of all campaign
finance activity, including all contributions, loans, receipts, expenditures, disbunemrnb, irAdnd 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.
'-Y /°) /1 /—) Signed under the penalties of perjury:
// FOR CANDIDATE FILINGS ONLY (CANDIDATE MUST SIGN BELOW)
Affidavit of Candidate: (cheek 1 box only)
0 Candidate with CoouniNee 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 a 33. I have not received any
contributions, incurred any liabilities nor nude any expenditures on my behalf during this reporting period.
0 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 belie!; 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 under the authority or on behalf of this committee in accordance with the requirements of M.G.L a SS.
SCHEDULE A: RECEIPTS
kf,G.L. c. 55 requires that the name and residential address be reported, in alphabetical order, for all receipts
otter $50.in a calendar year. Committees must keep detailed accounts and records of all receipts, but need only
ihttnize those receipts over $30 In a"Uun, the occupation and employer must be reported for all persoirs who
4(yaribute $200 or more in a calendar year.
19iis page may be copied if additional pages are required to report all receipts. Please include your committee name and a page
..h—r nn each nave.
fills'.— - -
Date
lieeeived
- k --
Name and Residential Address
(alphabetical listing required)
Amount
Occupation & Employer
(for contributions of $200 or more)
6
�q
Line 9: Total receipts in excess of $50 (or listed above)
410
Y
7 Enter on page 1, line 2
,. 1n ..6....td — 1 - A. — 1 - thncn rptrpintc not itemb
Line 10: Total receipts $50 and under* (not listed above)
Z
Line 11: TOTAL RECEIPTS IN THE PERIOD
.— e_ .:__
n T :
* If you have itemized receipts or jw and under inccuue mun1 111 11116 7. Llln, 1V
above. Page 2
ed
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 $50 and under may be added together, from committee records, and reported on line 13.
This page may be copied if additional pages are required to report all expenditures. Please include your committee name and a page
number on each page.
Date Paid
To Whom Paid
(alphabetical listing)
Address
Purpose of Expenditure
'Amount
, 1 9/V,4
11 tzr
' M
/qc
Enter on page 1, line 4
Line 12: Expenditures over $50
j 0
Line 13: Expenditures $50 and under*
f
11,17,
Line MTOTAL EXPENDITURES
ct
*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 3
SCHEDULE C: "IN- KIND" CONTRIBUTIONS
Please itemize contributors who have made in -kind contributions of more thar�$50. In -kind contributions $50 and under may be
added together from the committee's records and included in line 16.
Date
Received
From Whom Received*
Residential Address
Description of
Contribution
Value
Enter on page 1, line 6
Line 15: In -kind over $50
Line 16: In -kind $50 and under
Line 17: Total In -kind
1 Line 18: OUTSTANDING LIABILITIES (ALL)
* 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.
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
those liabilities incurred during this reporting period.
Date
Incurred
To Whom Due
Address
Purpose
Amount
Enter on page 1, line 7
1 Line 18: OUTSTANDING LIABILITIES (ALL)
This page may be copied if additional pages are required to report all activity. Please include your committee name and a page
number on each page ` printed an recycled paper Page 4