HomeMy WebLinkAbout8th Day Preceding Form CPF M 102: Campaign Finance lOport
1 4 r' Municipal Form "� i C L E i
•. : { Office of Campaign and Political Finance2021 JUG _$ AM 9
Commonwealth
of Massachusetts File with: City or Town Clerk or Election Commission
Fill in Reporting Period dates: Beginning Date: )7/S/2„074 Ending Date: tD /1/ 20"
Type of Report: (Check one)
❑ 8th day preceding preliminary [7k8th day preceding election ❑ 30 day after election ❑ year-end report ❑ dissolution
'I w'v ?As' aF-40,4 Committee NameV/'► • E
Candidate Full Name(if applicable)
` i �'v It(.— •b.f7en, Name of Committee Treasurer
Office Sought and District N .� i�,1-ea-
8�,2, - Committee Mailing Address
If � ia
Residential Address
E-mail: k J�w j44yt ej yy � �k ' r �IVt. E-mail:
Phone#(optional):+ 5'0 '"i• 3 -- Ili Phone#(optional):
SUMMARY BALANCE INFORMATION:
Line 1: Ending Balance from previous report I 4
Line 2: Total receipts this period(page 3,line 11) I 0
Line 3: Subtotal(line 1 plus line 2) I 0 1
Line 4: Total expenditures this period(page 5, line 14) I J,•-C. i q•
Line 5: Ending Balance(line 3 minus line 4) I 0 I
Line 6: Total in-kind contributions this period(page 6) I 0
Line 7: Total(all)outstanding liabilities (page 7) I 0
f Ct> c fhN.r
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 compl andmrepresentsfallcampaign
mpaia n finance
activity,including all contributions,loans,receipts expenditures,disbursements,in-kind contributions and liabilities for this reporting period7.1-72.4,finance activity of all persons acting under the a 'ty or on behalf of this committee in accordance with the requirements of M.G.L.c.55• Date: �I L�Signed under the penalties of perjury: (Treasurer's signature) i
FOR CANDIDATE FILINGS ONLY. Affidavit of Candidate:(eh 1 box only)
didate with Committee
Eletcst
certify that 1 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 that are not otherwise disclosed in this report.
Candidate without Committee
ri 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 lithority or o 'behalf of this candidate in accordance with the requirements of M.G.L.c.55. •
r j
Date:i 6! ( 2--I
J (Candidate's signature) f !
Signed under the penalties of perjury: W i
SCHEDULE A: RECEIPTS (continued)
Name and Residential Address Occupation & Employer
Date Received (alphabetical listing required) Amount (for contributions of$200 or more)
-
•
I1
Line 9: Total Receipts over$50 (or listed above) I
Line 10: Total Receipts$50 and under* (not listed above) f I
Line 11: TOTAL RECEIPTS IN THE PERIOD
0
J 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
5 L / °
'14 Low‘god, oh 43445 ts • Snff u
5 /70 lri tki 4 M,; ! ar a sir ,t rtic `,�-S3i,
i Nt�it 4f S►' y Cfrm.PAi c�/ t'1t p,
5/13/104 i
I
Line 12:Total Expenditures over$50(or listed above) I cc I 1.'lS
Line 13:Total Expenditures$50 and under*(not listed above) I I
Enter on page 1,line 4
--, Line 14:TOTAL EXPENDITURES IN THE PERIOD 15 J I 1 -
*if you have itemized expenditures of$50 and under,include them in line 12. Line 13 should include only those expenditures not itemi7ed 4
above. Page