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Home My WebLink About2021 Stempeck - 30 Day � Form CPF M 102: Campaign Finapce Re�oJ� , Municipal Form � p OfficeofCampaiguandPotiticalFinapon ,_ �/ ;� I� 31 com caiir ofMa�e.mchuse��s Filevnl}e Ci ovTownClerkorLlecu'onCommission Fill in Reporting Period da[es: Beginning Date: 03/20/2021 Ending Date: 04/26/2021 � Type of Report: (Check one) � 8th day preceding preliminary ❑ g�h day preceding election �X 30 day after election ❑ year-end report ❑ dissolution ON� J72 Y+YO G�� . Candide�eFuI1N epfappl ble) CommnteeName �N�LI� �vm•s� � ss�v�-� eR ORce Sou�l aM Distr�et Neme of Comminee Treesurer / l S A�� a (� Reaidcntial Addmss Commina Meiling Addass G-mail'. G�' J7�G��I� L-/m'� E-mnil�. Phone X(o0�one1J- Phonc q(opuonalJ SUMMARY BALANCE INFORMATION: Line 1: Ending Balance from previous report Line 2: Total receip[s this period(page 3, line 1 I) Line 3: Subtotal(line I plus line 2) Line 4: Total expendimres this peciod(page 5,line 14) Line 5: Ending Balance(line 3 minus line 4) Line 6: Total in-kind contributions[his period(page 6) Line 7: Total (all)outs[anding liabilities(page 7) Line S: Name of bank(s)used: A(Rdvvit of Commillee T[nsurer: Ieertil'ythtlh . minrAtM1s pn�ncludingaveohedsehedule d�t�. t theb i f k teA6 dbeff t d plmsutemem fell peignlinence acivity � I d� g II t b ( � I ec 'pts expendlu�es,disb t � k J t b C ' dl� tiIC - t th�� p n gp 'adandrap t�ih empa�gn [nence azti�ry of nll persons ac�ng u Acr lhe omM1ority ov on behell ot tF�s com nitcc i unrdence w tM1 tM1e requ re na of M C L. .05- Signed untler�he penahies af perjury: ('IMes�rerssignaWre) Date: FOR('ANDIDATE FILINGS ONLY: nmay.�t otond�eete:(�ne�k�bo:onlyi Gntlidate with Comminee md no activity intlepmJem o(t�e eomminee � i cenlfy tM1at I heve ueminW this reqnn indudln68neched scM1edules and It is,m the besi o(my knuwledge end belie[e Imeand eomplete s�etementolell campei6n finance mpviry,of all persons eetmg wdcr�M1e au[horiq ar on beFalt of thls commucee m ucmrdunec with tFe mqm�emcnls of M G.I-.c 55. I have mt rweivcd any comnbutions, mcuned em Ilabililies nov made eny expenAimres on my bcFalf dwing�his rcpotling Ocriod. Gndtl � t� t(. t� 2RC Jd � IM1 J 1 1 'ry(I R � � P � peign Icefly�htlh ' d0i p �� Id� gtl" d hdl � m�M1 betf k idg 461 f [uewdeonpleicsutemrntofallcam �linenceacl' ity includ�ngeontibufons I ns reccp x0 �dmms d. mi k A Rb t ' dl' bft m�chisrepoNnyperodnnArcpasen�s�he wmpaignGnenceac�iviryol'allpersonsacGn6underheauio Ifofth�sc iuccinaccordarnewlhthemqu'remenuofMGL.e.». Date: �i� ?.O�I Signed unJer�he penetlies u(perjory: (Cendidate's signaNrel SCHEDULE A: RECEIPTS MGJ_a 55 reguires lhat the nome and residen(ia]qddress be r'epor(ed, in alphabelicaf or'der,jor a][i�eceip[s over$50 irs a cq(endar year Commitlees musl kee�defailed acroim[s and recovds n,jo(l recefp(s. bul need onlv i[emire[hose rerefp[s over$50_ [n addilian. (he occupntion qnd emploper mtm'(he repnr(ed jor q]!persuns who coniribale$200 ar more in a co(endar year. (A "Schedule A: Rereipts" a[tachment is available m complete,print and at[ach to[his report,if additional pnges are required to report all receipte. Please ineluUe your rommittee oame and a pege oumber on each page.) Name and Residential Address Occupa[ion& Employer Date Received (alphabetical listiog required) Amoun[ (for con[ributions of$200 or more) � � � � � � � � �� Line 9: Toql Receip[s over$50(or lis[ed above) � Line 10: To[el Receipts$50 and under* (mt listed ebove) � Liue 11: TOTAL RECEIPTS IN THF, PERIOD F Ente�on pege I, line 2 'If you have itemized receipts of$50 and under, include them in lice 9. Line 10 should include only those receipts not i�emized above. Page 2 SCHEDULE A: RECEIPTS (coutinoed) Name and Residential Address Occupa[ion & Employer Date Received (alphabetical lis[iug required) Amouu[ (for mn[ributioos of$200 or more) � � � � � � � � � � � � � � � � � � � � , � � � � � � Line 9: Total Receipts over$50(or listed above) � Line 10:Total Receip[s$50 and under* (not lis[ed above) � Line 11: TOTAL RECEIPTS IN THE PERIOD F Enter on page I,line 2 ' Ifyou have itemized receipts of$50 and undeq include them in line 9. Line 10 should include only those receipts not i�emized above. Page 3 SCHEDULE B: EXPENDITURES diG.L. c SS reguires cammi(fees to lisl, in alphqbeliml order, u(7 expenditures over$50 in q repmting period Committees must keep de(qiled qreounts and records ojal]expenditures, hM need on[y i(emise(hose over$50_ Fxpendinnes$50 and under may be added mge(her, from eommi!(ee rerords. qnd r'epor'(ed on line /J. (A 'Schedule B:Expeoditures"attachmeot is available m complete,print and a[tach to[his report,iCadditional pages are required to report all expendi[ures. Please include your committee name anJ a page number on each pageJ To Whom Paid Da[ePaid (alphabeNcallisfin� Address PurposeofExpendihre Amount � � � � � _ _ � � � � � � � � � � � � � � � � � � � Line 12: Totel 8xpenditures over$50(or IisteA ebove) � Line 13:To[al F,xpendiNces$50 and under'" (not lisled above) � F.nter on page I,line 4� Line 14: TOTAL EXPENDITURES IN THE PERIOD * If you have itemized expenditures oC$50 and undeq i�ciode them in line 12. Line 13 shoold include oNy those expendimres not i emized abme. Page 4 SCHEDULE B: EXPENDITURES(wntiuucd) To Whom Paid Da[e Paid (alphabe[ical lis[ing) Address Purpose of Expenditure Amouut � � � � � � � � � � � � � � � � � � � � � � � � � � Line 12: Expenditures over$50(oc listed above) � Line 13: Expendimres$50 and under' (not listed above) � Enrec on page I,line 4+ Line 14: TOTAL EXPENDITURES IN THE PERIOD *Ifyou have icemized expenditures of$50 and undeq include them in line 12. Line 13 should include onty those expendimres not i mized above. Page 5 SCHEDULE C: "IN-KIND" CONTRIBUTIONS Please itemize contribu[ors who have made in-kind contributions of more then $50. In-kind wntributions$50 and under may be addeA[ogether&om [he committee's records and included in line 16 on page I. Date Received From Whom Received* Residential Address Description ofContribution Value � � � � � � � � � � � � � � � � � � � � � � � � Line 15: In-Kind Contributions ovec$50(or lis[ed above) � Line 16: In-Kind Contributions$50&under(not IisteA above)� Emer on page I,line 6-� Line 17: TOTAL 1N-KIND CONTRIBUTIONS • If an in-kind contribution is received from a person who connibures more�han$50 in a calendar yeaq you must report ihe name a d address of�he contribulor; in addi[ioq if[he m�tribu[ion is$200 0�more,you musl also report[he conhibutor's occupa�ion and employe�. Page 6 SCHEDULE D: LIABILITIES M.G.L. c. 55 reguires rommiltees to reporiALL lia6ililies which have been reported previously attd are sti[7 outstanding, as rve[1 as those fiabilities incurred during this reporting period. Date Incurred To Whom Due Address Purpose Amount � � � � � � � � � � � � � � � � � � � � � � � � � � � � Enter on page I, line 7 -� Line 18: TOTAL OUTSTANDING LIABILITIES(ALL) Page 7