HomeMy WebLinkAbout2021 Friedmann - Dissolution Form CPF M 102: Campaign Finance Report
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jp�/dP,! CLERK
i a, Otfice of Campaign and Polilical Finance
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ofMaveachiisetls r � FEg I6 AM �' 2� Filewitk. Ci or?ownClerkoeLlectionCommission
Fill in Repoding Pe�iod dates: Beginning Date: � / �O� / Ending Date: oZ�/� �4��
Type of Report: (Check one)
❑ 8th day preceding preliminary ❑ g�h day preceding election ❑ 30 day after eleclion ❑ year-end report dissolution
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CandidalcPollNam (�fapplmable) G/ CommilteeName
S/ect �D�tY..n-� �P2d'n yi �a . �/�� �.f�iea� 0`�CJ// _
Otfice SougM1t and D sVict Name ofCommittce Tmasurer
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//�� RuidenVd AAAress Committee Me�ling Address
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SUMMARY BALANCE INFORMATION:
Line 1: Ending Balance from previous report
Line 2: Tofal receip[s this period(page 3, line I 1)
Line 3: Subtotal(line l plus line 2)
Line 4: ToffiI expendi[ures this period(page 5, line 14)
Line 5: Ending Balance(line 3 minas line 4)
Line 6: Total in-kind contributions this period(page 6)
Line 7: Total(all)outstanding liabilities(page 7)
Line 8: Name of bank(s)used: PR-2�f -d ��/✓ ,8��
AR�arvit of Comminre Trcneurtr:
1 eMify�M1at I have e�mined Nis report including anacM1ed sche4ules and il is,lo Ne bes�of my knowledge and belicf,e Vue ana wmplele s�etement of all campaign Flnance
eccivity,including all conttibu�io�,loens,receip¢,ex0endiNres,disbmuments,in-kind conUibutions and liebilities for this reporting periad and represrnts(Ae cempeign
Hnanco aativfry of all persorts aMiog undu Ne au�horiry or/o[o�b�ahe��fof�his oommftlee in acco�dence with N,e a/quire+nwta of M.G L_a SA — ,S�B�
Signed unAer IM1e pmaltia of perju
. e�'[L�m� ����/4•`^(9teavurcissignmua) Da[e: yJ
F'OR CANDIDATE FILINGS ONIY: Arcdavi[of ConOiOet�:(�heck 1 box only)
Gnditlah with Cammiltee
I arlify Riat I have examined�his repotl including aneched schedules end i�is,to Ne best of my knowledge enJ bclief,a wc ana compleh ststement af all campaign Mance
� araiviq�,of all persons azting under Ne auUority or on behalfof @is committee in acrordance wiN[he requirement�ofM.G L.c.55. I have mt received any contributions,
iceurted eny liabili[ies�ror medc eny expendiwres on my beM1all'dming�Ais reporting period�hv are mt o�M1erwrse disclosed in Nis rcport.
Gnditl��e wi[hout Canmittee
1 certify Net 1 have enemincd this report including attachea schedules and it is,m Ne best of my knowledge and belief,a we and complek stetemmt of all cempaign
� finena anivity,incWding wnUibu�ions,loans,reaipts,expendiwms,disbursementc,imkinJ mmributions end liabilities for Nis reporting period and re0mxntt Ihe
campaign Flnance eclivity of all O�sons accing uvder Ne auNority or un behalf of Ihis candidam in accordence wiN Ne requirements of M G L.a 55.
Da[e:
9igneC unda the pendfin of peryury: (Candid&e's sigiffiury
SCHEDULE A: RECEIPTS
MG.L, a 55 regvires(hat Jhe name and residerc(ial address be repar(ed, in a(phabetico(order,jor ol!receipts over$50 in n ca/endor
yeac Commi[tees must keep detailed accounts and records ojol[reeeip(s, bu!need om7y itemize those recerpfs over$50. /n additiom the
ocapo(ion and employer mus!be reporled for ol!persons who contribufe$200 or more in a calendar year
(A "Schedule A:Receipts"atlachment is available[o complele,print and attach b[his report,if additional pages are required to ,
report all receip[s. Please include your committee name and a page number on each page.)
Name aod Residential Address Occupation & Employer
Date Received (alphabetical listing required) Amount
� �for contributions of$200 or more)
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Line 9: Total Receipts over$50(or listed above) �
Line 10: Total Receipts$50 and under*(no[listed above)
Liue 1L• TOTAL RECEIPTS IN THE PERIOD f
Enter on page 1, line 2
' Ifyou have i[emized receipts of$50 and undeq include them in line 9. L ne 10 should include only those rereipts not i[emized above.
Page 2
SCHEDULE A: RECEIPTS(continued) �
• Name and Resideutial Address Occupation&Employer
'Date Received (alphabetical listing required) Amoun[ (for contributions of$200 or more)
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Line 9: Tofal Receip[s over$50(or listed above) �
Line 10:Total Receip[s$50 artd under• (not listed above) �
Lioe 11: TOTAL RECEIPTS IN THE PERIOD f Enter on page I,line 2
* If you have itemiud receipts of$50 and undeq include them in line 9. Line 10 should include only those receipts not itemized above.
Page 3
SCHEDULE B: EXPENDITURES
M.G.L. a 55 requires wmmiftees(o list, in olphobe(icp(order, oll expenditures over$50 in a reporting period Committees must keep
de(ai(¢d accoun(s and records of4l1 ecpenditwes, but need orcly iremize lhose over$50. Expendilures$50 ond under may 6e added mgefher,
jrom rommittee records, ond reported on line 13.
(A "Schedule B: Expenditures"attachment is availeble to complete,print and attach to this report,ifadditional pages are required to
report all expenditures. Please include your commitfee name and a page number on each page.)
To Whom Paid
DatePaid (alphabeticallisting) Address
� PO�seofExpeoditure Amouot
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Line 12: Total Expenditures over$50(or listed above) �
Line 13:Total 8xpendi[ures$50 and under*(no[lis[ed above) �
Enter on page I,line 4-> Line 14: TOTAL EXPENDIT[7RES IN THE PERIOD
* Ifyou have itemized expendi[ures of$50 and undeG inNude them in line 12. Line 13 should include only those expenditures no[itemized
above.
Page 4
SCHEDULE B: EXPENDITURES(continued)
• To Whom Paid
'Date Paid (alphabefical listing) Address Purpose of Expenditure Amount
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Line 12: Expenditures over$50(or lis[ed above) �
Line 13: ExpendiNres$50 and under* (no[lis[ed above) �
Enter on page l,line 4-� Line 14: TOTAL EXPENDITURES IN THE PERIOD
* Ifyou have itemized expenditures o($50 and under,include lhem in line 12. Line 13 should include only[hose expendiNres not i[emized
above.
Page 5
SCHEDULE C: "IN-KIND" CONTRIBUTIONS
Please i[emize conhibu[ors who have made in-kind con[ributions of more[han $50. In-kind contributions$50 and under inay be
added together from [he committee's records and included in line 16 on page l. •
Date Received From Whom Received* Residential Address Description of Cootribution Value
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Line I5: In-Kind Contributions over$50(or lis[ed above) �
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Line 16: In-Kind Contributions$50&under(mt listed above)
Enter on page I,line 6+ Line 17: TOTAL IN-KIND CONTRIBUTIONS
' If an in-kind contribution is received from a person who contribu[es more[han$50 in a calendar year,you mus[report the name d address
of the wn[ributor, in addi[ioq if[he contribution is$200 or more,you must also report[he wntribu[ots occupation and employer.
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SCHEDULE D: LIABILITIES
MG.L. c. 55 reguires commitlees!o repar(ALL liabili[ies which hwe been reported previously and are sliAoutstandittg as well
as�}�ose°liabi[ities incurred during[his reporting period.
Date Incurred To Whom Due Address Purpose Amouot
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Enter on page l,line 7-� Line 18:TOTAL OUTSTANDING LL4BILITIES(ALL)
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