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� Form CPF M 102: Campaign Finance Report �
Municipal Form 1��;��� �: � --:-����.
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Office of Campaign and Political Finance i``�r'�"�`•' ` ``�S.
Commomcealth q ;r
of Massachusetts L�i� I,r�1 —� P 2' �� �
File with: Ci or Town Clerk or Election Commission
Fill in Reporting Period dates: Beginning Date: s/ia/zoi� Ending Date: 4/24/2017
Type of Report: (Check one)
❑ 8th day preceding preliminary ❑ 8th day preceding election ❑X 30 day after election ❑ year-end report ❑ dissolution
John Halsey Committee To Elect John Halsey
Candidate Full Name(ifapplicable) Committee Name
Board of Selectmen Brandon P. Chapman
Office Sought and District Name of Committee Treasurer
75 Beaver Road Reading, MA 01867 178 Lowell St Unit 1 Reading, MA 01867
Residential Address Committee Mailing Address
E-mail: E-mail:
Phone#(optional): Phone#(optional):
SUMMARY BALANCE INFORMATION:
Line 1: Ending Balance from previous report 806.91
Line 2: Total receipts this period(page 3, line 11) z,012.46
Line 3: Subtotal (line 1 plus line 2) �,8i9.3�
Line 4: Total expenditures this period(page 5, line 14) 2,412.28
Line 5: Ending Balance(line 3 minus line 4) 407.09
Line 6: Total in-kind contributions this period(page 6) o
Line 7: Tota] (all)outstanding liabilities(page 7) o
Line 8: Name of bank(s)used: Reading Co-Operative Bank
Affidavit of Committee Treasurer:
1 certify that I have examined this report including attached schedules and it is,to the best of my knowledge and belief,a true and complete statement of all campaign finance
activity,induding all contributions,loans,receipts,expenditures,disbursements,in-kind contributions and liabilities for this reporting period and represents the campaign
finance activity of all persons acting under the aut ty or on behalf of thi mittee in accordance with the requirements of M.G.L.a 55.
Signed under the penalties of perjury: ���ils�// �" " ��—t_ (Treasurer's signature) Date: 5/1/2017
FOR CANDIDATE FILINGS ONLY: Aftidavit of Candidate:(check 1 box only)
Candidate with Committee and no activity independent of the committee
I certify that I have examined this report including attached schedules and it is,to the best of my knowledge and belief,a true and complete statement of all campaign finance
0 activity,of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L.c.55. I have not received any contributions,
incurred any liabilities nor made any expenditures on my behalf during this reporting period.
Candidate without Committee OR Candidate with independent activity filing separate report
I certify that I have examined this report including attached schedules and it is,to the best of my knowledge and belief,a true and complete statement of all campaign
� finance activiry,including contributions,loans,receipts,expenditu es,disbursements,in-kind contributions and liabilities for this reporting period and represents the
campaign tinance activity of all pers s act� unde e author or on ehalf of this committee in accordance with the requirements of M.G.L.a 55.
Date: 5/1/2017
Signed under the penalties of perjury: (Candidate's signature)
�
SCHEDULE A: RECEIPTS
M.G.L. c. SS requires that the name and residential address be repor•ted, in alphabetical order,for all receipts over$SO in a calendar
year. Committees must keep detailed accounts and records of al!receipts, but need only itemize those receipts over$50. In addition, the
occupation and employer must be reported for all persons who contribute$200 or more in a calendar year.
(A"Schedule A:Receipts" attachment is available to complete,print and attach to this report,if additional pages are required to
report all receipts. Please include your committee name and a page number on each page.)
Name and Residential Address Occupation & Employer
Date Received (alphabetical listing required) Amount (for contributions of$200 or more)
Christopher Coleman
4/4/2017 53 Zachary Lane 250 Attorney/Coleman Law Office, PC
Reading, MA 01867
John Halsey
3/25/2017 75 Beaver Road 1,272.46 Candidate
Reading, MA 01867
Eugene 0'Leary
3/28/2017 22 Algonquin Ave 200 Optometrist/Reading Eye Asscoiates
Andover, MA 01810
Line 9: Total Receipts over$50(or listed above) 1,722.46
Line 10:Total Receipts$50 and under* (not listed above) 290
Line 11: TOTAL RECEIPTS IN THE PERIOD 2,012.46 � Enter on page 1,line 2
*If you have itemized receipts of$50 and under,include them in line 9. Line ]0 should include only those receipts not itemized above.
Page 2
. � SCHEDULE B: EXPENDITURES
MG.L. c. 55 requires committees to list, in alphabetical order, all expenditures over$50 in a reporting period. Committees must keep
detailed accounts and records of all expenditures, but need only itemize those over$50. Expenditures$50 and under may be added together,
from committee records, and reported on line 13.
(A"Schedule B: Expenditures" attachment is available to complete,print and attach to this report,if additional pages are required to
report all expenditures. Please include your committee name and a page number on each page.)
To Whom Paid
Date Paid (alphabetical listing) Address Purpose of Expenditure Amount
3/28/2017 Connolly Printing 17B Gill St post cards/postage 1,466.82
Woburn, MA 01801
4/12/2017 John Halsey 75 Beaver Road reimbursement 600
Reading, MA 01867
3/20/2017 Staples 34 Walkers Brook Drive print and copy services 272.46
Reading, MA 01867
Line 12: Total Expenditures over$50 (or listed above) z,339.28
Line 13: Total Expenditures $50 and under* (not listed above) 73
Enter on page 1,line 4 -� Line 14: TOTAL EXPENDITURES IN THE PERIOD 2,412.28
* If you have itemized expenditures of$50 and under,include them in line 12. Line 13 should include only those expenditures not itemized
above. Page 4