HomeMy WebLinkAbout2012 ONeill - 30 Day � Form CPF M 102: Campaign Finance Report
Municipal Form
Office of Campaign and Poli[iwl Finance
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Fill in Reporting Period dates: Beginning Date: d / 7 /a Ending Dare: 3 �G /a
Type of Report: (Check one)
❑ 8th day preceding preliminary � Bth day preceding election �30 day after election ❑ yeaz-end report � dissolu[ion
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CandidemFull Neme(ifapplioeble) CommittxNeme
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Offi«Sought end Oisvict Name ofComminee Trcaswcr
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Residential Addmss Comminee Mailing AGdress
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SUMMARY BALANCE INFORMATION:
Line 1: Ending Balance from previous report
Line 2: Total receipts Ihis period(page 3, line 11)
Line 3: Subtotal(line 1 plus line 2)
Line 4: Total expendiNres this period(page 5, line 14) '�/(p 3 —
Line 5: Ending Balance(line 3 minus line 4) — //o,�. —
Line 6: Total in-kind contributions this peciod(page�
Line 7: Total(all)outstanding liabilitiu(page 7)
Line 8: Name of bank(s)used:
nrt�mru orcummin.e'rnuu.e.:
1 certify Net I have examined this rtpon including anached uMdules aM it is,m[he bcs[of my knowlcdge and belief,a We and<omDkre neammt ofaV campai�financc
ectivity,incl Wing all contnbutio�,loens,rcceipts,expendiWres,disbursements,imkind wntributiorm end liabilities fm Nis reporting period end represents he wmpaigi
lwrte ectiviry ofeil persons acting wder the autMority or on bchelf of this comminee io accorAence wiN O�e requiremmts of M Gl.c.55.
Sigoeduoderthepm�l�iao(peryery: (Trcesurctssignatwe) Date: �
EOR CANDIDATE FILINC.S ONI.Y: ntrca..��o�c.oe�a.�e(<ne<��bo.o�iy�
Gedid�h with Commim<ooE na�c�ivity iedepeotlmt ofthe aomminee
� I ttrtiy thet 1 heve eraminea Nis repon including aneched uhedulu vM it is,m�he best ofmy knowledge end belief,e we a�M compleee s�ammmt ofall cempaign£nance
aztivfry,ofell persow actiog undee h�e auMoriry or on brhalf of Nis commivae in ecco�Emme wi[h Ne mquiameos oPM G L c.55. 1 M1ew not rcceived any conmbutfons,
mcwred eny liabilities nor made any cxpendimres on my belrelfduring J�is reporting period.
C�ntliAate withaot Commiuee9g GndiAote rvith indepeodent o<tivity Niog eep�nte repon
I ccrtify thet I heve examined Nis mport including anschcd schedules ena it is,ro lM1e best of my knawlNgc and belief,a vue and<omplcro stekmrnt of ell cvnpaign
f ceaaiviry,intludingm�mibutions,loens,rceeipts,expeMimres,disbwsemrnts,in-kindcontributionsendliabiliciesforthisreponingperiodandreprcsmtsNe
pvg�fina�ac[ivity of ell persons ac�ing wder lM1e auNority or on behelf oftAis comminee in acrorGentt with Ne requirements of M G L.c.55.
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Signetlontlerthepeo�lfieiofperjury: � wWt�- � /[,L/(�C-C. (Candidace'ssigneNre) D3I¢: `� 3 /a
� SCHEDULE B: EXPENDITURES (continued)
To Whom Paid
DahPaid (alphabeticallistinpJ Addrese PurposeoYEapenditure Amoant
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Line 12:ExpendiNres over$50(or listed ebove) $/(3,
Line 13: Expendihves$50 and under" (not lis[ed above) �
Enter an page I,line 4-� Line 14: TOTAL EXPENDITURES IN THE PERIOD ��/0 3,
"Ifyou have iremiied expenditures of$50 and undeq include them in line 12. Line 13 should include onty those expendimres mc itemiud
above.
Page 5
SCHEDULE A: RECEIPTS
MG L.a 55 reqdires that fhe name arcd residentia/address be repor[ed, in alpha6elica[order,for a!!receipfs over$50 in a calendar
yeac Committees must keep demiled accaunts and records afa!l receipts, bu(need arcly ilemize lhase receipts over$50. fn addi[iort, the
ocarprrtron and employer mvst be reporled jar all persons who contri6ute$200 or more in a ca/endar year.
(A"Schedule A:Receipts" attechment is available to complete,print and attach[o this report,if additional pages are required to
repoR all receipis. Please include yaur committee name and a page number on each page.)
Name and Resideotisl Address Occupatiao&Employer
Date Received (alphabeStal listing required) Amount (for contribuHons of$200 or mare)
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Line 9: Total Receip4 over$50(or listed above) �
Line 10:Total Receipts$50 and undec*(not lis[ed above) �
Line ll:TOTAL RECEIPTS IN THE PERIOD � �— Enrer on page I,line 2
•If you have itemized receipts of$50 and under,include them in line 9. Line 10 should incWde only those receipts wt itemiud above.
Page 2
� SCHEDULE A: RECEIPTS(continued)
Name sud Rwideotial Address Occupation& Emplayer
Date Received (alphabefital listing required) Amaunt (for con[ributioos of$200 or mare)
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Line 9:Total Receipts over$50(or listed above) �
Line 10:Total Receipd$50 and undec* (not listed above) �
Line 11:TOTAL RECEIPfS IN THE PERIOD � e- gnter on page 1,line 2
•Ifyou have itemized receipts of$50 and under,include them in line 9. Line 70 should indude only those receipts not iremized above.
Page 3
SCHEDULE B: EXPENDITURES
MQL. c. 55 requires commi(lees m list, in alphabetical arder, al!espenditvres over$50 in a reporling period. Committees must keep
delailed accounGs and recordr ofall espenditures, but need on(y itemize those over$50. Ezpendi(ures$50 and vnder may be added togefher,
from commi(tee recards, and reporfed on lirce/3.
(A"Schedule B:Eapenditures"attachment is availabk to compleh,prin[and atlach to this report,it additionnl pages are repuired la
report ell ezpenditures. Please include yaur committee name and e pege number on each page.)
To Wham Paid
Date Paid (alphabelical listiog) Address Purpose of Ezpenditure Amount
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Line 12: TotalBxpenditures ovec$50(oc listed above) �
Line 13:Total Expenditures$50 and under' (not listed above) �
Enter on page l,line 4-� Line 14: TOTAL EXPENDTTURES IN THE PERIOD �
"If you have itemized expenditures of$50 and undeq include�hem in line l2. Line 13 should include onty those expenditures mt iremized
above.
Page 4
� SCHEDULE C: "IN-KIND" CONTRIBUTIONS
Please i[emize contributors who have made in-kind contributions of more than$50. In-kind contributions$50 and under may be
added[ogeNer from the committee's rewrds and included in line 16 on page 1.
Date Received From Whom Received* Residential Address Description of Contribution Value
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� Line 15: In-Kind Contribu[ions over$50(oc listed above) �
Line 16: In-Kind Conhibutions$50&under(not listed above)�
Enter on page 1,line 6-� Line 17: TOTAL IN-KIND CONTRIBUTIONS �
•If an in-kind contribu�ion is received from a person who contributes more than$50 in a calendar year,you must report Ihe name and address
of the contriburor;in additioq if the contribution is$200 or more,you must also report Ne connibu[or s occupation and employer. page 6
, SCHEDULE D: LIABILITIES
MG.L. c.55 reguires committees to report ALL liabiJities which have 6een reparted previously and me sfill outslattding, as well
as those liabilities incuned during this reporting period.
Date Incurced To Whom Due Address Purpose Amaunt
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Enteron page 1,line 7-� Line 1S: TOTAL OUTSTANDING LIABILTTIES(ALL) �
Page 7