HomeMy WebLinkAbout2009 Dubois - Year End �
� Form CPF M 102: Campaign Fivance Report ��ECEIVED
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Typeof'sport: (Checkone)
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SUMMARY BALANCE INFORMATION:
Line 1: Ending balance from previous report $ ��
Line 2: Total receipts this period �ge z, i��e i D $ L�
Line 3: Subtotal piM � pius i�e z� $ �1
Line 4: Total expenditures this period �yage s, i�� �a� S G
Line 5: Eoding balance �tio�3 m�m�Ne a> S�
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Line 6: To[al in-kind con4ibutions this period �,ge a� S �.C�
Line 7: Total (all) outstanding liabilities �ge a> $ ,�,���
Line 8: Name of bank(s) used i1,� .N�,.Z—
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SCHEDULE A: RECEIP'CS ,
A.LG.L. �� 55 requi�es that fhe name and residen�ia!address 6e reporled, in alphabefica!order,for a!(receipts
�y��550.in a calendar year. Committees musl keep detailed accounts and records of a!1�eceipts, bv1 need only
��¢mlze lhose recelpts oves 530. In artrlrtioq rhr u�.��vµ.tiuii un�i emp/oycr must be repor(cd fw'all pereory who
c•nelrlbute 5200 or mare in a ca(endar year.
7'hls page may be wpied J additio�ul pagcs are required ro mpon all receip�s. Pleau include your committa name and a page
niii��y�r on cach Page.
pple Name and Residential Address Amoun[ Occupa[ion & Employer
Recei�ed (alphabetical lis[ing required) (for contri6utians of$200 or more)
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Line 9' Total receipts in excess of S50(or lis[ed above)
41ne 10� Total roceipts S50 and under• (not listcd above)
Line ��� TOTAL RECEIPTS IN THE PER[OD En[er on page 1, line 2
• �(you have itemiud rece�Ws of S50 and under include lhem in line 9. Line ]0 should incNde only thou receipB not itcmizW
��c Page 2
' SCHEDULEB: EXPENDITURES
M G.L. c. 55 requises committees to list, in alphabe�ica!order, alf espenditures over 350 in a reporfing pe�iod
Committees must keep de[arled accoun�s and records o,jal!expenditures, but need only ilemize those over SSO.
Fipenditures$SO and unde�may be added fogether,from committee records, and reporled on line 13.
1Ttis page may be copieA it additlo�al pages are requireA m repon all expen6nua. Pleau include your wmmince name and a page
number on each page.
Date Paid To Whom Paid Address Purpose of Expenditure Amount
(siphabeticai listing)
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Line 12: Expendi[ures over S50
Line 13: Exprnditures S50 and wder•
Enter on page 1,Iine 4 Line 14:TOTAL EXPENDITURES
"If you luvt ilcmizW acpenNtura oC S50 and under, include Ihem in line 12. Line 13 should include only ti�ou czpendiavcs nol
itemized above. Page 3
SCHEDULE C: "IN-KIND" CON1'RIBUTIONS
Please ilemiu conlnbumrs wtw fiave madc in-kind wnlributions of more lhan f50. Imkind comribulions S50 and und<r may be
added logc�hcr from Ihe tommina's rxords and included in line 16.
Date From Whom Received' Residen[ial Address Description of Value
Received Con[ribution
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Line 15: In-kind over$50
Line 16: In-kind S50 and under
Encer on page I,line b Line 17: Total In-kind
• If an in-kind conlriW�on is rxeived from a person who wnvibma morc Nan S50 in a calendar yrar,yau muR report Ne wme
a�M address of We convibutor, in addition, it 1M wntribuuon is 5200 or more,you muA also repon[he conlriWtofs occtipation and
employer.
SCHEDULE D: LIABII.ITIES
M.G.L. c 55 requires commitfees(o reporf ALL liabilifies which have 6een reparled prrviousfy and are s�il(ou(smnding, aa we(l as
thase liabilifies incuned during lhis repor(ing period.
Da[e To Whom Dut Addrcse Purpose Amount
Incurted
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Entcr on page 1, line 7 Line 18: OUTSTANDtNC LIABILITIES (ALL)
Titis page may bc copied d adNtional paga are rcquirW to repon all anivity. Pleau include ywr comrttina tamc anA a page
number on each pa6e. " p„q�an,ntt�p�, PegE 4 ,
54.\
� Form CPF M 102-0: Cam ai u Finance Re ort ���-CEIVEO
p g p Tr�WN CLERK
Municipal Form RE.ADING, MASS.
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"".'"•.."� 201U JAN 1 1 P �` �
cyo�row�or: 22 cEla _
Please prin[or type all information,except signaNres.
Fill in dates: Month Day Year MaNh Day Ycar
Reporting Period Beginning���?� �� Ending /� 3/ ��
Type of Report (Check One) �y,
� S�h day preceding � Sth day preceding election � 30th day following election 1�- 20th day of lanuary
preliminary�primary (Town or Speciap (Year-End Report)
Pursuam[o M.QL.,Chapmr 55�.
1. I certify tha[I am a candidam for or hold Municipal Office.
2. 1 certify that I have mt received any wnnibutions,made any ezpendiwres,or incurted any obiigations during this
reporting period,and do no[have a campaign fund in exis¢nce.
3. I cercify that I do mt have a political committee.
DATE 1. SIGNATURE II. RESIDENTIAL ADDRESS III. OFFICE SOUGHT
Signed under�he penalties of perjury (Shee[and Number)
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