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CPF ID W: <br />Ube (COMMOnbuealtb of Aa!"arbU9Vt19E0(Fo office U. Only) <br />ELECTED CITY, WARD AND TOWN POLITICAL COMMITIVR&NUIS <br />RU PING, r)ass. <br />NAME OF CITYgOWN: ,CC,4 .1A4— WARD (if applicable): <br />PARTY: 72�- P6le"Cli-� DATE OF REPORT: <br />INDICATE THE PURPOSE OF THIS REPORT BY CHECKING THE APPROPRIATE BOX BELOW: <br />.,M STATEMENT OF ORGANIZATION ❑ CHANGE OF OFFICER(S) ❑ MEMBERSHIP UPDATE <br />1. Office of Campaign and Political Finance <br />2. Secretary ofthe Commonwealth, William Francis Galvin <br />One Ashburton Place, Room 411 <br />Elections Division <br />Boston, MA 02108 <br />One Ashburton Piece, Room 1705 <br />(617) 979-8300 / (800) 462-OCPF (toll free in MA) <br />Boston, MA 02108 <br />ocpf@cpfsmte.ms.us / bttp://www.mm.gov/ocpf <br />(617) 727-2828 / (800) 462 -VOTE (toll free in MA) <br />C'bWShtelzip <br />elections@sec.state.ma.us / http://www.sec.sMw.ma.us/ale/cloidx.btm <br />3. State Party Committee Headquarters 4. City / Town Clerk or Election Commission <br />a list ofof(cers and members with the chat. cfthe city cammium ofthepolificel parry which rveprerents (Ch. 52, Sec 5). <br />I hereby submit this list of officers and members (including associate members) ofthe above-mentioned committee to the Secretary ofthe Commonwealth in <br />accordance with Ch. 52, Sec. 5 of the Massachusetts General Laws. <br />i,/ii r Date: <br />%cretary's signature <br />I hereby accept the office of Treasurer of this committee. 1 understand that I am subject to certain duties and liabilities under M.G.L. c. 55, including the <br />timely filing of campaign finance reports. turn also aware that an appointed public employee may not serve as treasurer of a political committee. his <br />acceptance is required m be filed with the Office of Campaign and Political Finance as provided in M.G.L. c. 55, s. 5. <br />f,��, & �k� Date: y -a -/z <br />Treasurees s� <br />LIST OTHER OFFICER'S NAMES, TITLES, RESIDENTIAL ADDRESSES AND ZIP CODES BELOW: <br />lal,v cDT 0'rec7t7CrtJ¢ VICE rHnle N4 &*C9e b6W RDI 2eAbJr* wv4 0160 <br />Elected Ward and Town Political Committee Report Page 1 <br />7F(- 7,0-0&,11 <br />r1+4/''1- WE[.✓� <br />GO /!/trNL3r✓y s7' <br />/wx-Di/v!>+7t2a <br />oiF,(p7 k>11.4p, ye1-1un,, ul <br />Name <br />! <br />Street Addreo <br />C'bWShtelzip <br />¢-Marl Telphone# <br />?2 Arae4e-444-Ae, <br />781-9yy-6002 <br />-i[Er.V Lfmwo <br />'N'D A7 oA44 <br />11&7 AhAterla7egAud. <br />Name <br />Street Addrerr <br />00151"'e/Zip <br />¢-Marl Telephone# <br />781-249- 3053 <br />fr,-Nr�AcWC <br />�kiN / N/bNG,4w <br />ev <br />O/6G bclta 77 <br />Name <br />Street AdAvar <br />Ctty/Smte25p <br />a -Mail Terephonep <br />I hereby submit this list of officers and members (including associate members) ofthe above-mentioned committee to the Secretary ofthe Commonwealth in <br />accordance with Ch. 52, Sec. 5 of the Massachusetts General Laws. <br />i,/ii r Date: <br />%cretary's signature <br />I hereby accept the office of Treasurer of this committee. 1 understand that I am subject to certain duties and liabilities under M.G.L. c. 55, including the <br />timely filing of campaign finance reports. turn also aware that an appointed public employee may not serve as treasurer of a political committee. his <br />acceptance is required m be filed with the Office of Campaign and Political Finance as provided in M.G.L. c. 55, s. 5. <br />f,��, & �k� Date: y -a -/z <br />Treasurees s� <br />LIST OTHER OFFICER'S NAMES, TITLES, RESIDENTIAL ADDRESSES AND ZIP CODES BELOW: <br />lal,v cDT 0'rec7t7CrtJ¢ VICE rHnle N4 &*C9e b6W RDI 2eAbJr* wv4 0160 <br />Elected Ward and Town Political Committee Report Page 1 <br />