HomeMy WebLinkAbout2018-Jan - April Committee to Elect Linda Williams1 Form CPF M 102: Campaign Finance Report
Municipal Form N A N r i t C <<
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2016 APR L Pt! 3, 33
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File with:
City or Town Clerk or Election Commission Please print or type all information, except signatures.
Fill in dates: to f Date p Year n bate Yry
Reporting Period Beginning IL/. C) 1 1 � /� Ending ��CCCC��
Type of report: (Check one)
❑ 8th day preceding preliminary 08th day preceding election 030 day after election ❑year-end report ❑dissolution
Full Name of Candidate (if applicable)
1 Office Sought and District `
6.
Residential Address
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Tel. No. (optional)
Comme�Name
Name of Committee ireasurer
Committee Mailing Address
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SUMMARY BALANCE INFORMATION:
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$ -779z
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$ 5 2-, I 1
Tel. No. (optional)
Line 1: Ending balance from previous report
Line 2: Total receipts this period (page 2, line 11)
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)
Line 6: Total in-kind contributions this period (page 4) $ c1.�
Line 7: Total (all) outstanding liabilities (page 4) $
Line 8: Name of bank(s) used
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, expenditures, disbursements, in-kind contributions and liabilities for this reporting period
and represents-thm campaign finange tivity of all persons acting under the authority or on behalf of this committee in accordance with the requirements of
M.G.L. c. 5�. Si ned under the penalties of perjury:
Treasurer's signs ure (in ink) ate
FOR CANDIDATE FILINGS ONLY: (CANDIDATE MUST SIGN BELOW)
Affidavit of Candidate: (check I box only)
❑ Candidate with Committee and no activity independent of the committee
I certify that I have examined this report including attached schedules and itis, 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.
D 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 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. Signed under the penalties of perjury:
Candidate signature (in ink) Date
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.
This page may be copied 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)
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Line 9: Total receipts in excess of $50 (or listed above)
570
Enter on page 1, line 2
Line 10: Totalllreceipts $50 and under* (not listed above)
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 2
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
C",
l
Enter on page 1, line 4
Line 12: Expenditures over $50
Line 13: Expenditures $50 and under*
Line 14: TOTAL EXPENDITURES
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*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 than $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
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.
SCHEDULED: 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: 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. Page 4