HomeMy WebLinkAbout2010 Webb - Year End �
� Form CPF M 102-0: Campaign Finance Repor4 i p�
Municipal Form
om�.oramP.iee..a roun�.i r�o.�a
`�w� 2@I JAN -5 A 10 01
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CityorTownof: Q �9���
Please print or type all infortnalion,except signaNres.
Fill in dat<s: Month Day Ywr Mon1h Day Year
Reponing Period Beginning �'/ Z 7 �oi o Ending � �1 ✓�/ ,� O/ c
TypeafReport: (CheckOne)
� eth day preceding � Sth day preceding dec[ion � 30N day fallowing election 20th day of January
preliminary/primary (Town or Special) (YearvEnd Report)
Pursuant to M.QL.,Chapter 55:
1. 1 cenify that 1 am a candidate for ar hold Municipal O�a.
2. I certify the[I have mt¢ceived any contributions,made any expendimres,or inwrted any obligations during this
reporting period,and do mt have a campaign fund in exisance.
3. I certify Na[I do not have a political cammittee.
DATE ` I. SIGNATURH IL RESIDENTIAL ADDRESS III. OFFICE SOUGHT
�' der the penalties af erju (Srteet and Number)
I ,t,GJ �t � Ca,V l � CG✓�[n� �
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� Form CPF M 102: Campaign F►nance Report
MunicipalForm� �,K
Omce of Campaign and Polit�cal F�aettce � � '���
Commonweann
�rMaz�=�n������ 2011 JR�! -5 A 10- 01
Filewi�k Ci oeToxmCle�korElu�ionCommission
FillinReportingPeriodda[es: BeginningDare: y� Zp�p EndingDate: \ j 31 10�0
Type of Report: (Check one)
❑ Sth day preceding preliminary � Sth dny preceding election � 30 day afler eleaion � year-end repon ❑ dissolutiun
CenJide�e Full Name(ifeppllaableJ Commlvee Nemc
VY`MV�
O%ia Sough�an�Diso-itt Name of Commil¢e Treasuru
L
Reaid¢ntisl Address Commlvee Meiiing Aaaress
TelepFoneNumber(opuonal)'. � TelephoneNumbcr(o0��onal)'.
SUMMARY BALANCE INFORMATION:
Line L Ending Balance from previous report +
Line 2: Total receipts this period(page 3,line I I)
Line 3: Subm[al Qine I plus line 2) � ��
Line 4: Totel expenditures this period(page 5, line 14)
Line 5: Ending Balance Qine 3 minus line 4)
i
Lioe 6: Total in-kind contribu[ions this period(page 6) Q
Line 7: Total(all)outstanding liabilities(page 7) ��
Line S: Name of bank(s) used: ��
nrrmmr orcommm��rre.:�.��:
I rertifl�ha�1 hare examine4lM1is report IncWamg a�isched schedules and il i;m Ne bes�of my knowledge am1 bellef,a We and wmple¢sulemen�ol ell campeign ilnance
enivin,incluaing all comributions.loans,receip�s,expenAiwrcs,Jisbursemenis,irvkina cumribW ions and Ilabilities for[bis reponing perioG anG represems�he aampeign
❑nance ac�iviry of ell pcaonz nc�ing un�er�M1e xutM1orlry or on hhnlf of Ihis coinmincc in eecoNnnu�.with�he aquiremena af M Gl.c.55.
Sign<tluntlar�M1<p<nalciesofpefjury: (TreasurcYssignalure) Ddl¢: �
FORCANDIDATEp1�,INGSONLY: rrcJ�.�rofCanaiaa�e(anecklno:omr)
onma.�ewimcomminr�,�a�o,arv;ry;naeoe�aemormecommume �
❑ 1 ttrtify lha�I have exemineA Uia rcpon incluJing eneche0 uM1eAules anA n Is,m Ihe bes�o(my knowledge anA belief,a We and compkle sla�emenl of all campaign finance
ac[inry.ofallpermnsee�ingunducM1eau@oriry nbeM1alfoC�FiSwmmitleelnacomGeneewllhtM1ercqmremen¢ofMGL.c55. IhnvenolreceivWenywnvibwions,
�nwrredonyliabiliciesno�medcenyexpe.ndilum on,mybeM1elf4nringt�isreponingpuloG.
GntliJa�e wilM1oul Commi��ee Qy CanJitlatt 'i�M1 intlepen0eni vclivilY����6 yepen�e r
IcenifytM1�eilM1aveexaminetltM1lsrcOonln� cFedschedulesendi�is,m�M1ebeslofe knowleGgeandbelief,utmeanCcompleas�acemen�ola�campaign
eactiviN,incWdingronvibwions. , ca,pl5,expendiWres,dlsbursemen in-k� omribmionsa�Mllabilitiesfor[hisreportingpenotlendreresemsFe
cempeignfinaneeactivlryofnllp¢rsons ctin5 enM1eamhoriryoronbe ello-Ni e mh�eelnecco�denceNitM1iAereqmmmemsofMGl. c.55
SignetluntlerlM1epenahiaufperjury: (Candida�e'ssignamre) Det¢:
SCHEDULE A: RECEIPTS
M QL. c. 55 reqvires that the name and residen(ia!address 6e reported, in a(phabelical order.for all recelpts aver�550 in a ca(enaar �
yem. Commi(rees musl keep delalled accoim(s and records ajol!receip(s. bu(need only ilemL-e Ihore recelp(e'o��er 550. In additioq (he
occupntlon and emp[oyer must be reported jor a!l persons ivho cantrlbure$200 ar more]n a calendar year_
(A "Schedule A: Receipts"at[achment is avnilable to comple�e�prin�and attaeh fo this report,if additional pages are required to
repon all receipts. Please include your comminee name and a pa�e number on each page.)
Name and Residential Address Occupation& Employer
Date Reeeived (alphabetical listing required) Amount (for con[ribufions of$200 or more)
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Line 9: Total Receipts over$50(or lis[ed above) �
Line 10:Total Receipts$50 and under' (not listed above) � .
Line I1:TOTAL RECEIPTS IN THE PERIOD � F Enrer on page 1,line 2
* If you have itemized receipis of S50 and undeq include them in line 9. Line 10 should include onty those receipts not ieemized a6ove.
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