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Miller BruceForm CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance Commonwealth 0 File with: City or Town Clerk or Election Commission Fill in Reporting Period dates: Beginning Date: lFebruary 27, 2012 Ending Date: March 30, 2012 Type of Report: (Check one) n c 8th day preceding preliminary X 8th day preceding election 30 day after election yeaa4endHort dissolution Bruce D. Miller Candidate Full Name (if applicable) Selectman, Nantucket Office Sought and District 142 Nonantum Avenue, Nantucket, MA 02544 Residential Address Telephone Number (optional): Committee to Elect Bruce Miller M Commltt e Nam M Penelope Dey Name ofCommitteelLwsure;::7 n Cn 17 Warren Street, Nantucket, 02&¢ Committee iling Address Telephone Number (optional): 1 (508) 228 -9074 SUMMARY BALANCE INFORMATION: Line 1: Ending Balance from previous report Line 2: Total receipts this period (page 3, line 11) Line 3: Subtotal (line 1 plus line 2) Line 4: Total expenditures this period (page 5, line 14) Line 5: Ending Balance (line 3 minus line 4) vl 12,730.99 12,730.99 9,384.72 3,346.27 Line 6: Total in -kind contributions this period (page 6) 0l Line 7: Total (all) outstanding liabilities (page 7) 0 Line 8: Name of bank(s) used: cape Cod 5 Affidavit of Committee Treasurer: 1 certify that I have examined this report including attached schedules and it is, to the best ofmy knowledge and belief, a true and complete statement ofall 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 under the ayt rity or on behalf ofthis mittee in accordance with the requirements of M.G.L. c. 55. Signed under the penalties ofperjury: (Treasurer's signature) Date: March 30, 2012 FOR CANDIDATE FILINGS ONLY. Affidavit of andidate: (che k ox only) Candidate with Committee and no activity independent ofthe committee 1 certify that 1 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 financeXactivity, of all persons acting under the authority or on behalf ofthis 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 E] 1 certify that 1 have examined this report including attached schedules and it is, to the best of my knowledge and belief, a true and complete statement ofall campaignfinanceactivity, including contributions, loans, receipts, expenditures, disbursements, in -kind contributions and liabilities for this reporting period and represents the campaign finance activity ofall persons acting he authori oron behalfofthis committee in accordance with the requirements of M.G.L. c. 55. Signed under the penalties of perjury: .^ (Candidate's signature) Date: March 30, 2012 WIW W ' W W '. W W::. W W IW.. W I(` W'. W W W W W N N N', tJ N N NINIW NIN'' iIV N 0)( n N) N W 0)' N N N. N W N N N N OD OD 0) ( Na INN Nj0 cn v',. l\ 7 01'', IO) I N v IIWI W., N1IV , OWN N_, vl, c" V 0) 0) v, W. N1V a)' W - 3 R3 v W V' Q1 w N) K) N N, N N'. N IIN N NIN N NIN N N. N INI N N' N NIiN N N N; N NNIN NIN N N N NIN N N,, N N. 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O 0 0 0 ( O O O O O O O ( O p O O O ( O O'' O' O OO OO O O O O O O O ( O ' 0. 010 O; O O O. 00 OO O O fJC-Avt, 5-gzz- AT-,ro SCHEDULE A: RECEIPTS *"`0--'k b kW9r=:,— — Z 04: 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 ofall receipts, but need only itemize those receipts over $50. In addition, the occupation andemployer must be reportedfor all persons who contribute $200 or more in a calendaryear. A "Schedule 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 number on each page.) Date Received Name and Residential Address alphabetical listing required) Amount Occupation & Employer for contributions of $200 or more) Line 9: Total Receipts over $50 (or listed above) 11,423 F Enter on page 1, line 2 Line 10: Total Receipts $50 and under* (not listed above) 1,307.99 Line 11: TOTAL RECEIPTS IN THE PERIOD 12,730.99 If you have itemized receipts of $50 and under, include them in line 9. Line 10 should include only those receipts not itemized above. Page 2 SCHEDULE A: RECEIPTS (continued) Date Received Name and Residential Address alphabetical listing required) Amount Occupation & Employer for contributions of $200 or more) Line 9: Total Receipts over $50 (or listed above) Enter on page 1, line 2 Line 10: Total Receipts $50 and under* (not listed above) Line 11: TOTAL RECEIPTS IN THE PERIOD Ifyou have itemized receipts of $50 and under, include them in line 9. Line 10 should include only those receipts not itemized above. Page 3 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 ofall expenditures, but need only itemise those over $50. Expenditures $50 and under may be added together, from committee records, and reported on line 13. A "Schedule B: Expenditures" attachment is available to complete, print and attach to this report, if additional pages are required 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 Mar 1, 2012 Cape Cod 5 Zero Main Street, Nantucket Office Expense 13.11 Mar 29, 2012 Flowers on Chestnut 4 Chestnut Street, Nantucket Fundraising 118.25 Feb 28, 2012 Barbara Gookin P.O. Box 492, Nantucket Graphic Design 850 Mar 12, 2012 Barbara Gookin P.O. Box 492, Nantucket Graphic Design 825 Feb 28, 2012 Inquirer & Mirror 1 Milestone Road, Nantucket Advertising 2,000 Mar 30, 2012 Inquirer & Mirror 1 Milestone Road, Nantucket Advertising 547.9 Mar 16, 2012 Miacomet Golf Club Miacomet Road, Nantucket Fundraising 1,928.45 Mar 29, 2012 Bruce Miller 42 Nonantum Avenue, Nantucket Printing Reimbursement 2,487.94 Mar 29, 2012 Bruce Miller 42 Nonantum Avenue, Nantucket Repay Loan 500 Feb 27, 2012 Nantucket Office Products 96 Pleasant Street, Nantucket Office Supplies 38.25 March 9, 2012 Nantucket Office Products 96 Pleasant Street, Nantucket Office Supplies 11.69 Mar 22, 2012 Nantucket Office Products 96 Pleasant Street, Nantucket Office Supplies 19.12 Line 12: Total Expenditures over $50 (or listed above) 9,339.72 Line 13: Total Expenditures $50 and under* (not listed above) 745]_ Enter on page], line 4 -4 Line 14: TOTAL EXPENDITURES IN THE PERIOD 9,384.72 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 4 SCHEDULE B: EXPENDITURES (continued) Date Paid Feb 27, 2012 To Whom Paid alphabetical listing) USPS Address Federal Street, Nantucket Purpose of Expenditure Postage Amount 45 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 IN THE PERIOD Ifyou have itemized expenditures of $50 and under, include them in line 12. Line 13 should include only those expenditures not itemized above. Page 5 SCHEDULE C: "IN- KIND" CONTRIBUTIONS Please 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 Enter on page 1, line 6 Line 15: In -Kind Contributions over $50 (or listed above) Line 16: In -Kind Contributions $50 & under (not listed above) Line 17: TOTAL IN -KIND CONTRIBUTIONS 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 ofthe contributor; in addition, ifthe contribution is $200 or more, you must also report the contributor's occupation and employer. Page 6 SCHEDULED: LIABILITIES MG. L. c. SS 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 -+ Line 18: TOTAL OUTSTANDING LIABILITIES (ALL) o Page 7