HomeMy WebLinkAboutKristina JellemeForm CPF M 102: Campaign Finance Report
Municipal Form
Office of Campaign and Political Finance
Commonwealth
or massacnuseus
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 preliminaryX❑ 8th day preceding election ❑ 30 day after election ❑ year-end report [�6dissol4c2
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Kristina Jelleme
Candidate Full Name (if applicable)
Land Bank Commission, Nantucket
Office Sought and District
9 Kelley Road, Nantucket, MA 02554
Residential Address
E-mail: kjelleme@gmail.com
Phone # (optional):
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Committee to Elect Kristina Jelleme �p 7
Committee Name
Penny Dey r
Name of Committee Treasurer 3
17 Warren Street, Nantucket, MA 02554
i
Committee Mailing Address
E-mail: penny@nantucketrealestate.com r
Phone # (optional):
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 ditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign
finance activity of all persons acting under the authcty r on behalf of this committy in accordance with the requirements of M.G.L. c. 55.
13 2017
Signed under the penalties of perjury:
of Candidate: (check 1 box
(Treasurer's signature)
Date. Apri ,
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 9B 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
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)
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 ditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign
finance activity of all persons acting under the authcty r on behalf of this committy in accordance with the requirements of M.G.L. c. 55.
13 2017
Signed under the penalties of perjury:
of Candidate: (check 1 box
(Treasurer's signature)
Date. Apri ,
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 9B 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
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
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.
(A "Schedule A: Receipts" attachment is available to complete, print and attach to this report, if additional pages are required to
re -n- all rPeeintc Please include vour committee name and a page number on each page.)
* 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
Name and Residential Address
Occupation & Employer
Date Received
(alphabetical listing required)
Amount
(for contributions of S200 or more)
Mar 27, 2017
Michael Beamish
30 Sherburne Commons
500
Painter/Self Employed
Nantucket, MA 02554
100
Mar 27, 2017
Paul Bennett
4 Gardner Road
Nantucket, MA 02554
Mar 10, 2027
Penelope Dey
17 Warren Street
250
Real Estate/Self Employed
Nantucket, MA 02554
Mar 13, 2017
Kristine Jelleme
9 Kelley Road
300
Office/Toscana Corporation
Nantucket, MA 02554
300
Retired
Mar 18, 2017
Howard M. Jelleme
12 Nobska Way
Nantucket, MA 02554
March 27, 2017
Carl Jelleme
19 Arrowhead Drive
100
Nantucket, MA 02554
Mar 31, 2017
Pamela Jelleme
21A Evergreen Way
]250
Retired
Nantucket, MA 02554
Mar 21, 2017
Paddy Nicholls
21A Evergreen Way
100
Nantucket, MA 02554
Mar 24, 2017
Scott O'Connor
6A Arrowhead Drive
500
General Contractor/OCB, LLC
Nantucket, MA 02554
100
Mar 13, 2017
James Patterson
61 Meadowview Drive
Nantucket, MA 02554
March 21, 2017
George Stolgitis
303 Barker Street
100
Three Rivers, MA 01080
Line 9: Total Receipts
over $50 (or listed above)
2,600
F- Enteron page 1, line 2
Line 10: Total Receipts
$50 and under* (not listed above)
o
Line 11: TOTAL
RECEIPTS IN THE PERIOD
2,600
* 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) 7
-
10: Total Receipts $50 and under* (not listed above)
Line
<-- Enter on page 1, line 2
Line 11: TOTAL RECEIPTS IN THE PERIOD
* 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.G. 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 Box 1198
Nantucket, MA 02554 Print Advertising 445.12
Nan
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 1 s snouia mciuue only UIVu IU UAPcAl L --
above. Page 4