HomeMy WebLinkAbout2015 Stempeck - 30 day � .
Form CPF M 102-0: Campaign Finance Report r�t C r I�f E D
, Municipal Form � O W N C L E R K
Otiice of Cam p ai�n and Politiul Finaoa !--:^`����' ��S�.
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Ciry or Town of: �����N�
Please print or type all informarion,except signatures.
Fill in dates: Month Day Year Month Day Year
Reporting Period Beginning � �� (5 Ending � �� � S
Type of Report: (Check One)
� 8th day preceding � 8th day preceding eleciion � 30th day foliowing election � 20th day of]anuary
preliminary/primary (Town or Special) (Yeaz-End Report)'
Pursuant to M.G.L.,Chapter 55:
1. I certify that I am a candidate for or hold Municipal Office.
2. I cortify that 1 have not received any contributions,made any expenditures,or incurred any obligations during this
reporting period,and do not have a campaign fund in existence.
3. 1 certify that I do not have a political committee.
DATE I. S1GNA RE II. RESIDENTIAL ADDRESS III. OFFICE SOUGHT
Si d nde e pe ties of perjury (Street and Number)
.
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