HomeMy WebLinkAbout2015 Collins - 30 day � .
Form CPF M 102-0: Campaign Financ��pldriftD
. _ Municipal Form � �WN ��MaSS.
OtTice of Csmpai�o and Politiul Finaoa _ r�.v�N�
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Please print or type all informarion,except signatures.
Fill in dates: Month Day Year Month Day Year
Reporting Period Beginning � �( �5 Ending �{ �� � C'
Type of Report: (Check One)
� 8th day preceding � 8th day preceding election � 30th day following election � 20th day of lanuary
preliminary/primary (Town or Special) (Year-End Report)"
Pursuant w M.G.L.,Chapter 55:
1. I certify that I am a candidate for or hold Municipal Office.
2. I certify that I 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. I certify that 1 do not have a political committee.
DATE 1. SIGNATURE II. RESIDENTIAL ADDRESS III. OFFICE SOUGHT
Signed under the penalties of perjury (Street and Number)
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