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Form CPF M 101 BQ: STATEMENT OF ORGANIZATION <br /> BALLOT QUESTION COMMITTEE k i_i t I V E U <br /> ;rz <br /> MUNICIPAL FORM TOWN CLERK <br /> READING, ;MASS. <br /> Commonwealth of Office of Campaign and Political Finance <br /> Massachusetts 20';0 JUN i b PFile with:City or Town Clerk 3: O 0 <br /> or Election Commission <br /> Please print or type all information,except signatures <br /> NOTICE IS HEREBY GIVEN, in accordance with the provisions of M.G.L. Chapter 55, of the organization of <br /> a ballot question committee as follows: T,; <br /> 1. Name: • d e X41:_ 1.L� - C,(- - <br /> (See note 1) e Q M m rI L`Qe <br /> 2. Mailing Address: t aq P l i .11�f-S -t p PJ <br /> (� 111$ 11 ,4- CI57 <br /> 3. Purpose/Specific issues lc? oQOO,Q '0\12_ ivgc5) krof <br /> and interests (See note 2) 00 ` <br /> 4. Topic of question: OUJ(fI S hC)v Q_,pprol�7 u n P71`QQ 15 <br /> QJ2c.t.Ste/r- `v eCcep- *.LyocaAs1-04C- Question number,if applicable <br /> 5. Committee is formed to (check one): support / oppose the question. <br /> 6. Officers: Name Residential Address City/State/ZIP Tel.No. <br /> —727-3°C". <br /> Chairman: (`U? pleas 4&IJ-Sf 7.— (Zadtict 1467 LiP3y <br /> Treasurer: _ 17.4 Plea Set rty-Sf- z-- 14‘;,i 4-OL.�l 7 *7pl-y�3_ <br /> Other Officer: J 5e <br /> Attach additional page,if necessary,with other officers and finance committee,if any. <br /> The chairman and treasurer of a political committee should be aware that provisions of M.G.L.c.55 specify that each treasurer of a <br /> political committee shall keep and preserve detailed accounts,vouchers and receipts for a period of six years from the date of the <br /> relevant election. Chapter 55 also specifies that no expenditures shall be made for,or on behalf of,a political committee without the <br /> authorization of the chairman or treasurer,or their designated agents;and,that all the funds of a political committee shall be kept <br /> separate from any personal funds of any officers,members or associates of such committee. <br /> SIGNED UNDER THE PENALTIES OF PERJURY: <br /> I hereby accept the offic• e Cha'. .n o = ove-named committee:vinalfs <br /> l/ <br /> ✓! b �/� <br /> Cha'rman's signature Date <br /> I hereby accept the office of treasurer of the above-named committee. I understand that I am subject to certain duties and <br /> liabilities under M.G.L.c.55,including the timely filing of campaign finance reports. I am aware that an appointed public <br /> employee may not serve as tr asure • - •= of question committee. <br /> 6__/ ) <br /> Treasu is signatur— Date <br /> I <br />