HomeMy WebLinkAbout2012-04-17 Statement of Organization - Democrat Town CommitteeNAME OF
CPF ID t!:
The Commonwealp of,Aawcbuoett0
. ELECTED CITY, WARD AND TOWN POLITICAL, COMMITTEE REPORT
WARD (if applicable):
PARTY: bC,1 J6/C ffAT DATE OF REPORT: r7/ 11- ;?a / ?--
INDICATE THE PURPOSE OF TIES REPORT BY CHECKING THE APPROPRIATE BOX BELOW:
Ig STATEMENT OF ORGANIZATION ❑ CHANGE OF OFFICERS) EIMEMBERSHIP UPDATE
sbout this report to thefour offices fisted below. File the original with she OJ%w of Campaign and Politica/Finance, anditle wr a olithis report with the
!her throe ti icea listed
1. Office of Campaign and Political Finance 2. Secretary ofthe Commomvealth, William Francis Galvin
One Ashburton Place, Room 411 Elmfi. Division
Boston, MA 02108 One Ashburton Place, Romn 1705
(617) 979-8300 / (800) 462-OCPF (toll free in MA) Boston, MA 02108
ocpf@cpf state.ma.us / http://www.mws.gov/ocpf (617) 727-2826 / (800) 462 -VOTE (toll free in MA)
electioas@seastate.ma.us / httpJ/www.=.Mw.m&us/elelelcidLhtr
3. State Party Committee Headquarters
City Ward Commluee secretarno meal abo,
Chairperson: '•/ 1 i'Vials
4. City/ Town Clerk or Election Commission
the chairman ofdh city mmmiaee.fthepoli#calparty which It rewerenu(CF. 52, Sec. 5).
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Nmx Street Adbess Ciry/StmelLip e -M.1 Telephwua
- 3178
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ecretary: A Bre �Cy�K�f�: aL'T
Nasse Strep Address Cdy/St wzP a -moll Tetq+ho s #
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Treasurer: fN7AL"e 5&4Z%0 t 2 544bY Fhf t. LW 0/867 761- 941V-44
Nome Street Addvas
Ctry/3mteZip
e -Mail Telephone #
hereby submit this list ofofficers and members (including associate members) ofthe above-mentioned commune W the Secretary ofthe Commonwealth in
,contacts with Ch. 52, Sm. 5 oftheMRsachosetts Geaeml Laws.
Data: - //-'7 2—
rt to o1E,e of Treasurer.fthis commi0ee. I understand that I. subject W certain duties and liabilities under M.G.L. c. 55, including the
.f campaign financereports. I sum also aware that an appointed public employce spay not serve as treasurer of a political committee. This
required to be filed with the Office of Campaign and Political Finance as provided in M.G.L. c. 55, s. 5.
Date:
LIST OTHER OFFICER'S NAMES, TITLES, RESIDENTIAL. ADDRESSES AND ZIP CODES BELOW:
Elected Ward and Town Political Committee Report Pelle 1
NAME OF CITY / TOWN / WARD: %I"p /40�G
PLEASE PRINT OR TYPE OTHER OFFICERS NAMES, TITLES, RESIDENTIAL. ADDRESSES AND ZIP CODES BELOW:
Vic G- cN.l i2
-ZONN 61AST t'7 L3 41/410.4, 57-
ASSOCIATE
r
ASSOCIATE MEMBERS:
lolW 9110 Elated Ward and Tow Poli6cel Covwittee Repan Paget