HomeMy WebLinkAbout2010 Dubois - 30 Day SS_.\
� Form CPF M 102-0: Campaign Finance Report , ,`U
Municipal Form ? t + l '_�RK
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Please print or type all infortnation,except signaNres.
Fill in dams: Month Day Year Month Day Year
ReportingPeriodBeginning M0.r;',L. �p .�,61U Ending_J3��,�.,Q .�� �010
Type of Report (Check One)
� S�n oay preceding C Sth day preceding elecnon � 30th day following election � 20th day of lanuary
preliminary/primary (Town or Special) (YearEnd Repottj
Pursuant�o M.QL.,Chapter 55�.
I. I certify[hat I am a candidate for or hold Municipal Oflice.
2. I certify that I have not received any conhibutions,made any expendicures,or incurted any obligations during this
reporting period,and do not have a campaign fund in exisrence.
3. I cenify Ihat I do mc have a political<omminee.
DATH I. SIGNATURE ❑. RESIDENTIAL ADDftESS ❑I. OFFICE SOUGHT
Signed under ihe penalties of perjury (Sveet and Number)
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II/97
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