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� Form CPF M 102-0: Campaigo Binance Report � � �I�,
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Municipal Form M '.`��
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Please print or type alI infolmation,except signatures.
Fill in da[es: MonN Day Year MonN Day Year
Reporting Period Beginning H 2"7 2o I a Hnding 1 Z— 3� "�-4< <'
Type of Report: (Check One)
� Bth day preceding � 8�h day preceding eleaion � 30[h day following election � 20th day of January
preliminary/primary (Town or Special) (Year-Hnd Report)
Pursuant to M.G.L.,Chapter 55:
I. 1 cenify that 1 am a candidate for or hold Municipal O�ce.
2. I certify Ihat I have not received any connibutions,mede any expmdiNrts,or inwrred any obligations during this
reporting period,and do nol have a campaign fund in existence.
3. I certify that I do noi have a political committee.
DATE 1. SIGNATURE 71. RESIDENTIAL ADDRESS I11. OFFICE SOUGHT
Signed under�he penalties of perjury (Sneet and Number)
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