HomeMy WebLinkAbout2017 Snow Dockser - Year End � � Form CPF M 102: Cam , ai n Finance.Re .o�r . '
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- - Municip al Form :, !- ` �� ��� � ,, ,„„.
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' Office of Campaign and Political Finance
Commonwealth 1��� Jt�ty 2� f-1 q• �3 1
ofMassachusetts
File with: Ci or Towa Clerk or Elcction Commission
Fill in Reporting Period dates: Beginning Date: � o� 2��� Ending Date: �
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Type of Report: (Check one)
❑ 8th day preceding preliminary � gth day preceding elecdon � 30 day after election �year-end report ❑ dissolution
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Candidate Full Name(if applicablel � � Commiuee N.ame
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Resideneal Address
� Committee Mailing Address
E-mail: � � /, ���'.�`�.d'` � 1�Gfi�,'Q,l� y�'�i�`. . E_mail: Jl
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�Phone#(og6onal): "��b .._G��� 'r ��� Phone#f(opdonal): � .
SUMMARY BALANCE INFORMATION:
Line 1: Ending Balance from previous report � �-�� � �
Line 2: Total receipts this period(page 3,line 11) � v
Line 3: Subtotal(line 1 plus line 2) � :��--� � �
Line 4: Total expenditures this period(page S,line 14) ,��� �, ��y-� G���- : �� �
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Line 5: Ending Balance(line 3 minus line 4) �U y� �'� ��
I,ine 6: Total in-kind contributions this period(page.6) �
Line 7: Total(all)outstanding liabilities(page 7) . �
Line 8: Name of bank(s)used: • .�' .L� �' .��;. � VG�' -
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AfSdavit of Committee Treasarer. .
I certify that I have examined this report including attached schedules and�t is,to the best of my Imowledge aad belief,•a hue and complete statement of all campaign finance
activity,including all contributions,loans,mceipts,expenditures,disbursements,in-kind contrfbutions aad liabilities for this reporting period and represents the campaign
finance activity of all persons acting under�e authority or on behalf of ttris comm�ttee in accordancc with t}�e requirecnents of M.G.L.c.55.
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Signed nnder the penalties of perjary: � ' � '' —� . (Treasurer's signature) Date: �—,�,3 -���\,
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FOR CANDIDATE FII,INGS prTI,y; At�darit of Candidate:(check 16oa onty)
Candidate with Committee and no activity independent of the committee
� I certify that I have ezamined this report including aVached scheilules and it is,to tl�e best of my Imowledge and belief,a true and complete statement of all campaign finance
activity,of all pe�sons acting under the authority or on behalf of this cammittee in accordance wich the requiremenfs of M.G.L.a 55. I have not received any contributioas,
incurred any liabilities nor made any expenditures on my behalf during this reporting period
Candidate withont Committee OR Cstndidate with independent activity£iliag separat¢report
❑ I ceetify that I 6ave examined this report including attached schedules and it is,to the best of my lmowledge and belief,a true and complete statement of all campaign
finance activiry,including contn'bu6ons,loans,receipts,expenditures,disbu�ements,in-Idnd conhibutians and liabilities for this reporting period and repirscnts Ihc
campaign finaace activity ofall p o ons�acdng under t6e autharity or on behalf of this committee in accocdance with the requirements of M.G.L.c.55.
Signed nnder the penalties of perjury:i��� �j�j� ��� Date: /—��—��?��
. '� (Candidate's signature)
� SC�DULE A: RECEYPTS
Nl,G.L. c. SS requires that�he name and residential address be reported, in calphabetical order,for all receipts
��;i•r$S0.in a ccalendar year. Committees mrest keep detailed accounts cmd records af all receipts, but need only
�/���nJze those receipts vver�SD. In additiun, 1he uu.upuliv�t cand ernplvyer�nust be reported�r all persons wlro
����ril�'lbute$200 or more in a calendar year. .
��i►y page may be copied if additional pages are required to report all receipts. Please include your committee name and a page
ntu��bcr on each page.
pnte Narne and R�sidential Address Amount Occupation & Employer
ldcceived (alptaabetical listing required) (for contributions of$200 or mv�-e)
- Line 9: Total receipts in excess of$50{or listed above) p p
Line 10: Total receipts$50 and under' (not iisted above) v �
4ine 11: TOTAL RECEIPTS IN THE PERIOD U C� Enter on page 1, line 2
+� lf you have itemized receipts of S50 and under inciude them in Iine 9. Line 10 should include only thase receipts not itemized
���c. Page 2
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SCHEDiTLE Be EXPEIVDITUItES
M.G.L. c. SS require�committees to list, in alphabetical order, all expenrditures over�SO in a reportingperioc�
Comrnittees must keep detailed accounts and records of call expenditures, but need only itemaze those over$S0.
Fxpenditures$SO and under�rrary be added together,from committee records, and reported on line 13.
This page may be copied if additional pages are required io report all expenditures. Please include your wmmittee name and a page
number on each page.
Date Paid �'o Whoun Paid Address Purpose of Expenditure Amount
(aiphabetical listing)
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Line 12: Expenditures over$50 � � � `�
Line 13: Expenditures$50 and under*
Enter on page 1,line 4 � Line 14:TOTAL EXPENI}IT�JRES �'3 ( L.��
*If you have itemizetl expenditures of �50 and under, include them in line 12. Line 13 should include onty those expenditures not
itemized above. Page 3
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SCHEDULE C: "IN-I�TD" CONTRIBUTIUNS
Please itemize wntnbutors who have made in-kind contributions of more than�S50. In-kind contributions S50 and under may be
added together from the committee's reoords and included in line 16.
Date From Whom Received* Residential Address Description of Value
Received � Contribution
Line 15: In-ldnd over$50 Q
Line 16: In-kind $50 and under
Enter on page l,line 6 Line 17: Total In-kind
*If an in-kind contribution is recelved from a person who contributes more than�50 in a calendar year,you must report the namc
and address of the oontributor, in addition,if the contribution is�200 or more,you must also report the contnbutor's occupation and
employer.
SCHEDULE D: LIABILTTIES
M.G.L. c. SS requires committees to report ALL liabilities which have been reported previously and are stiil oulstanding, as well as
those liabilities rncrtrred during this reporting period.
Date To Whom Due Address Purpose � Amount
Incurred
Enter on page l,line 7 Line 18:OUTSTANDING LIABILITIES (ALL) v
This page may be copied if additional pages are required to report all activity. Please include your committee name and a page
number on each page. `�J p���,����r Page 4