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HomeMy WebLinkAbout2017 8th day preceding Form CPF M 102: Campaign Finance Report Municipal Form d Office of Campaign and Political Finance Commonwealth of Massachusetts File with: City or Town Clerk or Election Commission Fill in Reporting Period dates: Beginning Date: Mar 10, 2017 Ending Date: 4/3/2017 Type of Report: (Check one) ❑ 8th day preceding preliminary © 8th day preceding election ❑ 30 day after election ❑ year-end report [ldissolu4oz. Oq v �Z Kristina Jelleme Committee to Elect Kristina Jelleme . Z Candidate Full Name(if applicable) Committee Name tt �G Land Bank Commission, Nantucket Penny Dey Office Sought and District Name of Committee Treasurer 9 Kelley Road, Nantucket, MA 02554 17 Warren Street, Nantucket, MA 02554 i Residential Address Committee Mailing Address E-mail: kjelleme @gmail.com E-mail: penny @nantucketrealestate.com Phone#(optional): Phone#(optional): SUMMARY BALANCE INFORMATION: Line 1: Ending Balance from previous report 0 Line 2: Total receipts this period(page 3, line 11) 2,600 Line 3: Subtotal (line 1 plus line 2) 2,600 Line 4: Total expenditures this period(page 5, line 14) 2,013.63 Line 5: Ending Balance(line 3 minus line 4) 586.37 Line 6: Total in-kind contributions this period(page 6) 0 Line 7: Total (all)outstanding liabilities(page 7) 0 Line 8: Name of bank(s)used:(Cape Cod Five Affidavit of Committee Treasurer: 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,including all contributions,loans,receipts,ex nditures,disbursements,in-kind contributions and liabilities for this reporting period and represents the campaign finance activity of all persons acting under the auth ty r on behalf of this commi in accordance with the requirements of M.G.L.c.55. Date: April 3, 2017 Signed under the penalties of perjury: (Treasurer's signature) FOR CANDIDATE FILINGS ONLY: ffidavit of Candida e:(check 1 box o 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. 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 report 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 1-1 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.c.55. Date: Signed under the penalties of perjury: (Candidate's signature) SCHEDULE A: RECEIPTS MG.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. (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.) Name and Residential Address Occupation & Employer Date Received (alphabetical listing required) Amount (for contributions of S200 or more) Michael Beamish Mar 27, 2017 30 Sherburne Commons 500 Painter/Self Employed Nantucket, MA 02554 Paul Bennett Mar 27, 2017 4 Gardner Road 100 Nantucket, MA 02554 Penelope Dey Mar 10, 2027 17 Warren Street 250 Real Estate/Self Employed Nantucket, MA 02554 Kristine Jelleme Mar 13, 2017 9 Kelley Road 300 Office/Toscana Corporation Nantucket, MA 02554 Howard M. Jelleme Mar 18, 2017 12 Nobska Way 300 Retired Nantucket, MA 02554 Carl Jelleme March 27, 2017 19 Arrowhead Drive 100 Nantucket, MA 02554 Pamela Jelleme Mar 31, 2017 21A Evergreen Way 250 Retired Nantucket, MA 02554 Paddy Nicholls Mar 21, 2017 21A Evergreen Way 100 Nantucket, MA 02554 Scott O'Connor Mar 24, 2017 6A Arrowhead Drive 500 General Contractor/OCB, LLC Nantucket, MA 02554 James Patterson Mar 13, 2017 61 Meadowview Drive 100 Nantucket, MA 02554 George Stolgitis March 21, 2017 303 Barker Street 100 Three Rivers, MA 01080 Line 9: Total Receipts over$50(or listed above) 2,600 Line 10: Total Receipts$50 and under* (not listed above) 0 Line 11: TOTAL RECEIPTS IN THE PERIOD 2,600 E- Enter on page 1, line 2 * 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) Name and Residential Address Occupation & Employer Date Received (alphabetical listing required) Amount (for contributions of S200 or more) Line 9: Total Receipts over$50 (or listed above) Line 10: Total Receipts $50 and under* (not listed above) Line 11: TOTAL RECEIPTS IN THE PERIOD <— Enter on page 1,line 2 * 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 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 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. (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 28, 2017 1st Ad Specialties 321 Pearl Street Yard Signs 678.27 Fitchburg, MA 01420 Mar 13, 2017 Inquirer&Mirror P.O. Box 1198 Print Advertising 445.12 Nantucket, MA 02554 March 27, 2017 Inquirer&Mirror P.O. Box 1198 Print Advertising 445.12 Nantucket, MA 02554 March 31, 2017 Inquirer&Mirror P.O. Box 1198 Print Advertising 445.12 Nantucket, MA 02554 Line 12: Total Expenditures over$50 (or listed above) 2,013.63 Line 13: Total Expenditures $50 and under* (not listed above) Enter on page 1,line 4 - Line 14: TOTAL EXPENDITURES IN THE PERIOD 2,013.63 * 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) To Whom Paid Date Paid (alphabetical listing) Address Purpose of Expenditure Amount 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 * 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 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 Line 15: In-Kind Contributions over$50 (or listed above) Line 16: In-Kind Contributions$50 & under(not listed above) Enter on page 1, line 6 - 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 of the contributor; in addition,if the contribution is$200 or more,you must also report the contributor's occupation and employ er. Page 6 • 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 - Line 18: TOTAL OUTSTANDING LIABILITIES(ALL) Page 7 Form CPF M101: STATEMENT OF ORGANIZATION ,� , CANDIDATE'S COMMITTEE j MUNICIPAL FORM Commonwealth Office of Campaign and Political Finance of Massachusetts • . File with: City/Town Clerk or Election Commission C 7 NOTICE IS HEREBY GIVEN in accordance with the provisions of General Laws,Chapter 55,as amended,of the organigion of candidate's committee as follows: G CANDIDATE: Full Name: . Oa-- e41 e.,-- ° Residential Address: Q ` l e(,c' . cc'- City/State/Zip: ICJ��-�" k/� k4- .r�, E-Mail Address: ,{c t c i l ,yy-. r Ley-y-1 Phone#: A' •�• /Lo� Party Affiliation: v (If applicable) OFFICE SOUGHT/PURPOSE: Title: N yin K t- land s ev r cL &Ai e vy m is V'` District: N Q, ✓� Y��� COMMITTEE: Name of Committee: Cilrr\v • -ems Z/1 e Cwt �/1 ' �1 S 1 �1 �l1 (The name of the committee must include the candidate's last name) Committee Mailing Address: g ed1/4._ City/State/Zip: J a n-t-Kuy)( s Phone#: cbt'- . t WS OFFICERS: Chairman: 64,3- yQ,c �„��� � Treasurer*: ri n n DpM Residential Address: �L j p w Residential Address: )— (� �L—r L 1 ' eQ4-- City/State/Zip: \U`!1 tt; C ICe, I-- Al n- 3 City/State/Zip: s)! .{'l - r/o.�i► 1AL U;l Phone#: Se-5613,0,1?. 0�I 0 Phone U•ob14 P)5)-1 Email:pen Al"(le etflan l-:�,,b�re•CN SA public employee may not serve as treasurer of any litical committee(see reverse). Other Officer/Title: Other Officer/Title: Residential Address: Residential Address: City/State/Zip: City/State/Zip: Phone#: Phone#: (Complete and attach a Form CPF M A 101,if necessary,with other officers and finance committee,if any.) 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: 4 �� �� ,.jig / 1���`ar Date: idate's signature 1 hereby accept the office of Treasurer 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)I am subject to certain duties and liabilities under M.G.L.c.55, including the timely filing of campaign fmance 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 OC of my resignation;and 3)a candidate may not serve as treasurer of the political committee organized on his/her behalf. A j/SIGNED UNDER THE PENALTIES OF PERJURY: Date: 3 // 11- Treasu is ature I I hereby accept the office of Chairman of the above-named commi ee. SIGNED UNDER THE PENALTIES OF PERJURY: ,, I Ch':'rman's signature Date: 9 '