HomeMy WebLinkAbout2019 Berman - Year End � Form CPF M 102: Campaign Finance Report
- ' Municipal Form
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Fill in Reporting Period dates: segiming Dace: Z� Zp�9 Ending Date: �a 3/ �/y
Type of Report (Check oue)
❑ Bth day preceding preliminary ❑ Sth day preceding election ❑ 30 day alier election � year-end report � dissolution
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I Residen1lial Address —� iling Addrtss
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SUMMARY BALANCE INFORMATION:
Line 1: Ending Balance from previous report } p� , �f
Line 2: Yo[al receipts this period(pagc 3,line 11)
Line 3: Subtotal(line 1 plue line 2) �.
Line 4: Total expendiNres this peciod(page S,line 14) 'L�-p d
Line 5: Ending Balance(line 3 minus line 4) 3
Line 6: 'Cotal imkind contributions this pertod(page 6)
Line 7: Todl(all)outsTanding liabilitiea(page 7)
Line 8: Name of bank(s)used:
Affia,Nt orcomminee rreourer:
I cenify tha�1 have exemived this rcport iuclodivg eneched schcdules end it is,m Ne bcst otmy Imowledge md belief,a we aod compine summmc of ell cempeigv&vance
ec�ivity,includivg ell conlnbulio�s,loans,receipts,expevEicures,disbmsemmtv,irvkinA cono-ibutions avd liabilines Por�his reporling pcnod end represm�e Ihe campai�
finenw ectiviry af ell persans acti�g wda Ne eutharity ar on behelf ofvyy camminee in eccardenw with thc requiremrnts ofM G L.c.55.
SignetlunderthepeoalHeeo(perjury: ,���-C (r.easurer'ssfqnamre) Date:�
� �I IN : AfliaM�of Cantlltl�lr.(aheak 1 Eox only)
C didate wilh CommiHee
cenify that I have ex ined Nis repon wcludwg anached mhedules aod it u,�o We best ofmy knowledge and belieL a W<and compleh ste�emrnt of eil cempv�Enance
ecrivity,otall persons eeling under�he auNonty or o�beAallot�Aix comminee in acwrdance wi�A ehe reyoiremrn6 of MAL.a 55. I have no�received evy cono-ibutions,
mewrcd any liabili[ics vor mede a�y expendimres on my behelf dwing Nis rcporting penod thet are mt otherwise disclosed in this rcpon.
Cavdidste wiPoou�Commin¢e
I emify tM1et I heve exemived Ws repon i�cloding etmched schedules and it is,w�he bes�ofmy knowledge and belief,a true and complem s*ecemrnt of all campeign
� finance saiviry,ivcluding cono-ibmiovs,loevs,rccci0�.cxpc�di�wes,disbwscments,inkind conMbmiays a�d iiebilifies far ttis reparti�g pcnad md repmsenu�he
campei�finance azfivity of ell persons a [i�g under Ne amhonty or o�behalf of�his candidate in accordance wi�h We requirements of M.G L.c 55� �� �� � r�
SI ued under ihe Itin o( Candide4's si ryrp D3tC: � �\\\ (N
B Pm� perjury: ( B^e ) '+Y
SCHEDULE A: RECEIPTS .
M.G.L. c. 55 reguires thatlhe name and residenlia(address be reported, in a(phabetical order,for a[1 receipts over$50 in a calendar
year. Cammittees mus(keep defailrAaccounts attd records ofa(1 receipfs, buf need only itemize fhose rueipts over$50. In addifian, the
occupabon and emp[ayer must be reportedfor al!persans who conMbute ffi00 or more in a calendar year. '
(A"Schedule A:Receipts"attachmenl is available ta complete,pdnt and attach to this reporq if additlonal pages are required to
report ell receipte. Please iuclude your commiMee name and a page number on each page.)
Name and ResidenHal Address Occupatioo&Employer
Date Received (alphabetical lisling required) Amount (for contributlons af$200 or more)
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Line 9: Total Receipte over$50(oc lieted above) �
Line 10:Total Receipts$50 and under* (not listed above)
Line ll: TOTAL RECEIPTS IN THE PERIOD F Enter ov page 1,Iine 2
•If you have itemized receip[s of$50 and undeq incWde[hem in line 9. Line 10 should include only fhose receipts not itemized above.
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� SCHEDULE A: RECE[PTS(continued)
Name and ResidenNal Address Occupation&Employer
Date Received (alpM1abetical liating required) Amount (for contributlons of$200 or more)
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Liue 9: Total Receipts ovec$50(oc liated above) �
Line 10: Total Receipts$50 and undec* (not listed above) �
Line 11:TOTAL RECEIPTS IN THE PERIOD � F Enter on page I,line 2
"If you have icemized receipts of S50 and under,include fiem in line 9. Line ]0 shoWd include only those receipts not itemized above.
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SCHEDULE B: EXPENDITURES
MGl.c.55 requiru commiJ/ees to lisf, in a7phabefim/order, a/I upendttures aver$SO in a reporHng peHad Committees mus(keep
detailed accaunts and records of a/l expendiMres,but need only itemize fhase over$50. Ezpenditures$50 and under may be added together,
from commiftee rerords,and reported on(ine 13. �
(A"SchedWe B:Expenditures" attachment is available ta complete,print and attach to this reparq if additioual pages are required ta
report a0 e:penAltures. Please include your committee name and a page number on each page.)
To Whom Paid
Date Paid (alphabeticallisHng) Address Purpose of Expenditure Amoun[
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Line 12: Total Erzpendinvea over$50(or listed above) �
Line 13: Total Bxpenditures$50 and under' (not listed above) �
Enter on page I,line 4 -� Line 14: TOTAL EXPENDITURES IN THE PERIOD �
•If you heve itemized expe�dinvee of$50 avd�vdeg include them iu live 12. Line 13 ehould include only lhose expendimrea mt i[emized
above.
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. SCHEDULE B: EXPENDITURES(wnUnued)
To Whom Paid
�, Date Paid (alphabetical lisdng) Address Purpose of Expenditure Amount
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Line 12:ExpendiNrea over$50(oc listed above) �
Line 13: Expendilures$50 and undeP (not listed above) �
Enter on page l,line 4—> Line 14: TOTAL EXPENDITORES IN THE PERIOD �
*If you have itemized expenditures of 550 and wder,include them in line 12. Line 13 should include only those expenditures not itemized
above.
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SCHEDULE C: "IN-KIND" CONTRIBUTIONS
Please itemize contributors who have made in-kind wntributions of more than$50. In-kind contlibutions$50 and under may be
added together from the committee's rewrds and included in line 16 on page 1. �
Da[e Received From Whoro Received' ResidenBal Address DescripHon of Contributlon Value
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Line 15: ImKind Contributions over$50(or]isted above) �
Line 16: In-Kind Contributions$50&under(not listed above)�
Enter on page I,line 6-� Line 17:TOTAL IN-KIND CONTRIBOTIONS �
" If an io-kind contribution is received 6om a person who con[ributes more�han$50 in a calendar year,you must report Ihe name and address
of the conhibumr;in additioq if the contribution is 5200 or more,you must also repotl[he con[ribumr's occupatioo and employer. page 6
SCHEDULE D: LIABILITIES
MG.L. a 55 requires committees to repartALL liabilities which have been reported previously and are stil/outstanding, as we/7
es those ltobiliHes incumed during this reportdng penod.
Date locurred To Whom Due Address Purpose Amount
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Enteron page 1,line 7-� Line 18:TOTAL OUTSTANDING LIABILITIES(ALL) �
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