HomeMy WebLinkAbout2013 Dubois - 8 Day �
� Form CPF M 102-0: Campaign Finance Report i��N CLERK
MunicipalForm Rc ;,p1NG. NASS.
OR<e af Gmqite�ed Poli�ic�l Fioanae
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aty o�Ta.m or: 2 �..c��
Pleaze print or type ali infortnation,ezcept signaNres.
Fillindams: Monih Day Year Month Da� Y��
Reporting Periad Beginning � / � 3 Ending 3
Type of Report: (Check One)
� 6th day preceding i"� &h day przceding eleaion � 30th day following election � 20th day of January
preliminary/primary (Town or Special) (Yeaz-End Report)�
Puauant to M.G.L.,Chapter 55:
1. I certify that I am a candidate for or hald Municipal Office.
2. 1<ertify that 1 have no[received any conhi6utions,made any ezpendimres,or incurted any obligations during this
reporting period,and do not have a campaign Cund in exiscence.
3. I certify Nat I do not have a political committee.
pp7'g I. SIGNATURE IL RESIDENTIAL ADDRESS III. OFFICE SOUGHT
Signedunderthepenal[iesofperjury (Stree[andNumber)
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