HomeMy WebLinkAbout2017 Calvo-Bacci - Statement of Organization � Form CPF M101: STATEMENT OF ORGANIZATION
CANDIDATE'S COMMITTEE ;:,�,- �;`� .K `��
MUNICIPAL FORM t������c���
co,,,�,on.�eai�n Office of Campaign and Political Finance
K SS.
of Massachusetts
Filc with: City/Town Clcrk or Election Commission � ,���
NOTICE IS HEREBY GIVEN in accordance with the provisions of General Laws,Chapter 55,as amended,of the organization of a
candidate's committee as follows:
CANDIDATE: Full Name: — �
Residential Address: �� � � I
City/State/Zip: � �-� I R�n�
E-Mail Address: (1(�(,l� I� C (� Phone#: 7 g I-��(.�-O�3��
Party Affiliation: � (If applicable)
OFFICE SOUGHT/PURPOSE:
Title: � 1
District: '
COMMITTEE: Namc of Committcc: ' � O'M � C � V ��0.�L�
(The name of the committee st include the candidate's last name)
Committee Mailing Address: �� ; � � ��
City/State/Zip: � �,� �}� � Phone#: ���_�Q'l—3.`'J 1 `�-/
-�-1-�1� "l-
OFFICERS:
Chairman: (� Treasurer*: �Qr � CL (
Residential Address: �� ��.� �- �� Residential Address: y� ���
City/State/Zip: ����1 �G � � City/State/Zip: �� �,�< � ����
Phone#: Phone#: �' ' Emai " ��� ��� �� • ���
-�,.�u�- ���� `i �a3�3
*A ublic em lo ee ma not serve as tre urer of an olitical committee see reverse.
Other Officer/Title: ��,/L1{J/� ���� Other Officer/Title: tv/��v� 1"Y C.1/L V
ResidentialAddress 5�q � �pv6l� 5'+ ResidentialAddress [s��/�Ul,(, ��/(,',�
Ciry/State/Zip: �..�G„d.�►�(� � rI�J� ('��-��L l Ciry/State/Zip: ��� �a (�� j�- � �
��«-r-F
Phone#: ��g'_�3�_ G S'a,a Phone#: ���'
(Complete and attach a Form CPF M A 101,if necessary,with other officers and finance committee,if any.)
I hereby consent to the filing of this committee. I understand that a candidate shall not give consent to the organization of more than one committee on his/her
behalf. I am aware that candidates are required to keep detailed accounts and records of all campaign finance activity for a period of six years from the ate of
the relevant election.
SIGNED UNDER THE PENALTIES OF PERJURY:
Date:� � � 1�
Candidate's signatu
I hereby accept the office of Treasurer of[he above-named committee.I affirm that I am not a public employee as defined by M.G.L.a 55,s. 13.I understand
that: 1)I am subject to certain duties and liabilities under M.G.L.c.55,including the timely filing of campaign finance reports and keeping detailed accounts
and records of all campaign finance activity for a period of six years from the date of the relevant election;2)if after my acceptance of this office I become an
appointed public employee,I must resign this position and notify OCPF of my resignation;and 3)a candidate may not serve as treasurer of the political
committee organized on his/her behalf. ,
SIGNED LJNDER THE PENALTIES OF PERJURY: /"' I �/����� Date: �-'(�"�'� �
( /!/`�L
Treasurer's signature
I hereby accept the office of Chairman of the above-named committee.
SIGNED UNDER THE PENALTIES OF PERJURY:
rman's signature Date: �'�,�� �