HomeMy WebLinkAbout2019 Wise - Statement of Organization � Form CPF MI01: STATEMENT OF O ATION
CANDIDATE'SCOMMI '��VEa
MUNICIPALFOR E� N CLERK
�i�uc, MA, �
com��,.kaim Oflice of Campaign and Politi��FEB�e�
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Fi�ewi�A: CiN/IownClerkar£Iutio�Cummissio�
NOTICE[S H8R[3I3Y GNCN in acco�dancewi�h�he provisions of Genetai Laws,Chaplc�55,as emendeQ of�he organi�ation ofa
candidele's commi�lee as follows:
CANDIDATF.: F„nNy��: / f/U:v1YI S Fr7UKLi/v' Lti iS �
ae��a���oinaa���: / �'/ 50:, il't S?2Yg i
ctryis���iz�v� ��2�.9�p:riG— �"�lH L�l�{;��
�Maenaa�s: ;+H6M/iS. �� l,+.'iSE �• �M�?-IG� CU.^v! r�,o��n: (•l � �f�"i �C���Z�
Parly A�lia�iun: (Ifapplicablc)
OFFICE tiOUGHT/1'URPOSF.:
r,n�: �c K U c L C c ..,� .a � TT� �
o�s�d�:
CUMMITTF.F,: N�eotco�ln�: '� tfL �0;4� Iui D7� 5 � L�CYLi �G2'( �+.'i,$ �
(The eof�heuumminccmmllndudutheca�didum'slastwne)
co��u��m�aNg aaa�s: ��I lj::v�'1 S 1 t'�`z � I
�,ry�s�a�,��,� ,�ti:1� � Nb ,+�v� p/�'t � eno�.a� 6r'�-�'G% LS�S
oeeiceus:
cn.��.o: 112),.t� G�1;S `G �rre,eorer: � tiDi ';S
n�.�am���waa.ess�. j ( S�.J!}1 �;n z L.T ue5�amn�aaaress: j I j�,'.:� �Sj n r£ l
cyismaiz�ry �ff�Y�iNG— !�I Gl�� c�yis,ai��a� I �rT7; N �;- /Vl� C�l�� �
rn�ea�. ��} uG�� E�-�� eno�.a�.��16yL'C�IG�j cma�i�. �11 �ca��Mw '�� C' ��Yhi ��� e.
•A blic m I notu aztrresure0.rofan- liticalcommitta s
tahmOlTccrT�u: n/ I�11'L�L2 /,�`15.�i1.(fZ�— /u�tA•t}L cMaOtTmeNi'itle��..l�/� G'"C YiLH'i�'I' �y4.uf� avm
NvreidentialAdJnss- /� ' � Residw[ialAddrese � �
lY' I tRk.'iil.-P ' �-hLL mp"�L `� /lc:s //�v ��orFn
cryrsmreiz�n� � .' �N /� � (,�IJW � c�ryrsm�ain��. �74T0/�::� /�1A- ct �'6-'
N�o�ea� :�_ . Ny 552� �,o�a� � I ito °u2
(Compine a�d anach a Pwm CPF M A 101,if uoessapy wi�M1 oNm olTicen and financccomminve,Sany.)
I herebY����o�he fiivp otthis commincc. I wMrsrend�ha�a candidate shall no�Ave wnsem�o�he orgvueation oCmo�e Wan ove commincc on M1is/her
behalt: I am aware that cy�dida¢s arc rcquired�o keep de�eileA acvouna�nd rcwrJs uf all�ampaigv f ance ac�iviry for a period nf six ycan 6om�M1e de[e of
tAerelea�eeiteleetion.
SIGNEDUND�RffIEPENAl'CIESOFPF.RJURY: � � ��� �,� � �
Da�e: �n�zI I
Cand�ate'e si�eWre
I hereby acccpt ihc oflico of'I'reavurer of�he aMva-uemed wmvlinee.l affim�Nat I an mt e public cmploym as dcfincd by M.f,J,.c.S5,s. 13.1 undeoiand
thne p l e�n subject m crnaiv du�ics and GaMGtiec wder M.<;.I_c.55,inulvdiug the timely fling oCewipeien finenm repons and kecping deiailed nccuun�s
a�d records of ull cam0ui�f w umivity Lor u period of six years f om Ihu de�c of thc�cicvent dcc�imr.2)if eftn my acccp�cc uf�his ufficc I bcwme en
appointed public employee,[must cuign�his posifio�end notify OCPF oCmy rcsigoatirny v�d 3)a ca�didate may not serve as�rexcwer of the politicnl
�vnuniuee orgm�ivsA on his/her bshalf.
SIGNEDIINDGRTFILPGNAL77ESOF1'CRIURY: � �� I� � ( ti _� �/�/� Datc Z�'-I��`�
6�. v `
�� ���e�
IherebyaccopuheolSwoCChairtnenoftheebwe-uamedmm�ninec.l � �
SIGNEU UNDER Tli[P[NN TIGS OF PF,RJURY: � ��" � /
Chaimn�s�igvvure Date: j� �� � C i