HomeMy WebLinkAbout2011 Gibbs - 8 Day ��p� iviumc�pxi� rurm �
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City or Town of:��
Pleaze print or type all information,except signatures.
Fill in da[es: Month Day Year Mon[h Da Year
Reparting Period Beginning Ending �l � ��
Ty e 0f Report: (Check One) .
��.Sth day preceding [h day preceding election � 301h day following election � 20th day of January
preliminary/primary (Town or$pecial) (Year-End Report)
Pursuant m M.G.L.,Chaprer 55:
1. I certify[ha[1 am a candidare for or hold Municipal Office.
2. 1 certify that I have no[received any contributions,made any expendimres,or inwrted any obligations during this
reporting period,and do mt have a campaign fund in existence.
3. I certify that I do not have a political committee.
DATE I. SIGNATURE ❑. RESIDENTIALADDRESS ❑1. OPFICESOUGHT
Sig d under t penalties f perjury (Stree[and Number)
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11/97
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