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HomeMy WebLinkAbout2018-30 days afterForm CPF M 102: Campaign Finance Report Municipal Form Office of Campaign and Political Finance Commonwealth of Massachusetts File with: Ciri or Town Clerk or Electioi Fill in Reporting Period dates: Beginning Date: © L4 — (73 — Ending Date: b-S Type of Report: (Check one) G 8th day preceding preliminary 8th day preceding election IW 30 day after election year-end report [ issolw6n2 1 WAA)n L 411 Ids -fig Candidate Full Name (i applicable) Ze5SC nm cum 1 00- v, -VL Office Sought and District V pgzC L -a. yq, aResidential Alidress ,,--- E-mail: VQ-WYi f"c -l n"t-P"Y` `'{'• CYYYI Phone # (optional): LGO ` f6(L-, Ll 3 L4 e. ta4.I T Committee Name Name of Committee Treasurer tJ J Ll r1(lna Ince".& Cy, K)&v'T1'LC i Ft Pt YA Committee Mailing Address E-mail: (''LX , tis Phone # (optional): - '- L41 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) Line 6: Total in-kind contributions this period (page 6) F 77 Line 7: Total (all) outstanding liabilities (page 7) Line 8: Name ofbank(s) used: I 06,1 C,Qeu 5F 11" ffidavit of Committee Treasurer: 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 tivity, including all contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign nance 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. under the penalties of perjury: Affidavit of Candidate: (check 1 box only) signature) Date: ';_ I _- I ( V C idate with Committee and no activity independent of the committee 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, of all persons acting under the authority or on behalf of this 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 QIj Candidate with independent activity filing separate report I 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 of all campaign finance activity, including contribution s, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign finance activity of all p ons ding er the authority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. Date: r Signed under the penalties ofperjury: (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 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) Enter on page 1, line 2 Line 10: Total Receipts $50 and under* (not listed above)] ° U Line 11: TOTAL RECEIPTS IN THE PERIOD a 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 It: 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 i_ i 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. 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.) Date Paid To Whom Paid alphabetical listing) Address Purpose of Expenditure Amount Line 12: Total Expenditures over $50 (or listed above) Line 13: Total Expenditures $50 and under* (not listed above) Line 14: TOTAL EXPENDITURES IN THE PERIODEnteronpage1, line 4 -> 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 To Whom 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) Line 14: TOTAL EXPENDITURES IN THE PERIODEnteronpage1, line 4 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 I, line 6 -1 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 employer. Page 6 SCHEDULED: 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 Enteron page 1, line 7 Line 18: TOTAL OUTSTANDING LIABILITIES (ALL) Page 7