HomeMy WebLinkAbout2018 8th day preceeding110
Form CPF M 102: Campaign Finance Report
Municipal Form
Office of campaign and Political Finance a
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File with:
City or Town Clerk or Election Commission t
PIease print or type all information, except signatures.
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Fill in dates: Nonni Date Year Month Date vets'j rnrF"`
Reporting Period Beginning 0 1 f l) DO1 Ir Ending 0 L-1 U. c y i G
CAP
T pe of report: (Check one)
8th day preceding preliminary 08th day preceding election 03 day after election year-end report Odissolution
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Full Name of Candidate (if applicable)
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Office Sought and District
Residential Address
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Tel. No. (optional)
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Committee Name
Name of Committee Treasurer
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Committee Mailing Address
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Tel. No. (optional)
SUMMARY BALANCE INFORMATION:
Line 1: Ending balance from previous report $ ( tp`-, aq
Line 2: Total receipts this period (page 2, line 11) $
fl,
Line 3: Subtotal (line I plus line 2) $ '410
Line 4: Total expenditures this period (page 3, line 14) $ a E +'Kl . a I
Line 5: Ending balance (line 3 minus line 4) $ 11 a3[ f oy
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 C ta; g
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, awe 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 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:
Treasu s signature (in ink) Date
FOR CANDIDATE FILINGS ONLY: (CANDIDATE MUST SIGN BELOR)
Affidavit of Candidate: (check 1 box only)
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 ofall campaign
finance activity, ofall 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 Ming 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 represerrta the
campaign fi ce 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) bate
SCHEDULE A: RECEIPTS
M.G.L. c. SS 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
itemise those receipts over $50. In addition, the occupation and employer must be reported for all persons who
cor-tribute $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 naee.
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 $50 (or listed above) 3$ Cn
Enter on page 1, line 2
Line 10: Total receipts $50 and under' (not listed above)
Line 11: TOTAL RECEIPTS IN THE PERIOD ddb
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 ofall 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
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Enter on page 1, line 4
Line 12: Expenditures over $50
Line 13: Expenditures $50 and under*
Line 14: TOTAL EXPENDITURES a, -4,Ffl 1
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.
SCHEDULE D: LIABILITIES
M.G.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: 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