HomeMy WebLinkAbout2017 Snow Dockser - 30 Day �------�-�
� Form CPF M 102: Campaign Finance Report
`�� � Municipal Form
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�,r`t'���1,��, ►..�,�� Office of Camp$ign and Political Finance
Commonwealth
ofMassachusetts 9A'1 �.�;y —
�U � � ( P File with: Citv or Town Clerk or Electi n Commission
Fill in Reporting Period dates: Beginning Date: 3/18/2017 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
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C Candidate Full Name(if appli e) Committee Name
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Office Soua,ht and District Name of mittee Treasurer
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Residential Address Committee Mailing Address
E-mail: � � C� Ct �S��Y' � U t'v �:?�l� , 11['"� E-maiL ,t � 1)1CC�tiCl k C�h �/ �`�1r I �I�11 � � 'f�'�
Phone#(optional): �j ��( �,� ' �, Phone# o tional : � C �. �
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SUNiMARY BALANCE INFORMATION:
Line 1: Ending Balance from previous report � �.� S� � _��
Line 2: Total receipts this period(page 3, line 1 l) a �� L, �;
Line 3: Subtotal(line 1 plus line 2) �-Zy j _ j y
Line 4: Total expenditures this period(page 5, line 14) 1 (v 4 u° � ��
Line 5: Ending Balance(line 3 minus line 4) ,� �£� , �; �,.t
Line 6: Total in-kind contributions this period(page 6) �
Line 7: Total (all)outstanding liabilities (page 7)
Line 8: Name of bank(s) used: F:a��t�-[;n� t`c��� ���{-i rt +� ,l�l
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Affidavit of Committee Treasurer:
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 all contribu[ions,loans,receipu,expenditures,disbursements,in-kind contributions and liabilities for this reporting period and represents the campaign
finance activity of all persons acting under the authority or on behalf of this committee in accordance with the requuements of M.G.L.c.55.
Signed under the peaslties of perjury: � " ' i' � " L�! Gt�'t,. ' (Treasurer's signature) Date: <-f �,;�� a�{
FOR CANDIDATE FILINGS ONLY: Affidavit of Candidate:(check 1 box only)
Candidate with Committee and no activity iodependent 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
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 conuibutions;
incurred any liabilities nor made any expenditures on my behalf during this reporting period.
Candidate without Committee Q$Candidate wit6 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 belie�a true and comp]ete statement of all campaign
finance activity,including 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 authority or on behalf of this committee in accordance with the requiremenu of M.G.L.c.55.
Signed under the penalties of perjury: -���f3.�P'�'�s+. �C l�..f (Candidate's signature) Date: .S i �Ci
SCHEDULE A: RECEIPTS
�1�1.G.L. c. 55 reguires that the name and residential address be reported, in alphabetical order,for all receipts over$50 in a calendar
year. Committees must keep detailed accounts and records of all 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 alt 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 5200 or more)
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Line 9:Total Receipts over$50(or listed above) �2�;p,���j
Line 10:Total Receipts$50 and under* (not listed above) �� ?p . U U
Line 11: TOTAL RECEIPTS IN THE PERIOD `-+ ?U ��U � Enter on page 1,line 2
*lf you have itemized receipts of$50 and under,include them in line 9. Line 10 should include only those receipts not itemized above.
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SCHEDULE B: EXPENDITURES (continued)
To Whom Paid
Date Paid (alphabetical listing) Address Purpose of Expenditure Amount
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Line 12:Expenditures over$50(or listed above)
Line 13:Expenditures$50 and under* (not listed above)
Enter on page 1,line 4-> Line 14: TOTAL EXPENDITURES IN THE PERIOD
*If you have itemized expenditures of$50 and under,include them in line 12. Line 13 should include only those expenditures not itemized
above.
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