HomeMy WebLinkAbout2021 Stempeck - Year End � � Form CPF M 102: Campaign Finan��f;e�pq�� E R K
Municipal Form ��� �°��+ �> "AA.
Office of C.ampaign and Polifical Financc
2u�2 J�SH —3 aH 10� 59
��m�n�,�„����n
„rmaan�n�.�u.
ra�«�n � cu on'o.��ciod:o.n«r��c �
Fillin Reporting Period datCs: Beginning Date: 04/2]/2021 Ending Dace: iz/3i/zozi
Type of Rcport: (Check one)
� Sih day preceding prelimi�ary ❑ 8th day precoding elec[ion ❑ 30 day afte�clmtion ❑�( year-end ceport ❑ dissolution
.1rJ NN �7E�'YiYIfC�
Candi�am Pull Namc(i appllcuble) Commiucc Namc
QM L f� C��ifl� an�
om«so��ani,�a o�n��oi rv��n�oreom�n�u��rre���.e�
/�S� �v,�Lan /��/�D
—� s��m<�,uai ndd.�� co�nme�«me�r�s naa.�.�
i�:�n�a�. �lollN . S72✓I10��° 9/YJ/J��, tar� c-",^��:
rno��a(orro�oU. rno��w mpdo�aq�.
SUMMARY BALANCE INFORMATION:
Line l: F.nding Balance kom previous report � 2 2 �, y d
Line 2: Total receipts this period (page 3. line i I)
Lioe 3: Subrotal Qine 1 plus line 2) — ZZ,'� , �(�
Line 4: Tolal expcnditures this period (page 5, linc 14)
Liue 5: G'nding t3alance Qine 3 �ninus Iinc 4) ^ 2 Z, � , ��
Line 6: Total in-kind contribu[ions this period(page 6)
Lfne 7: "foial(all) outstanding liabilities(page7) �
Line 8: Name of bank(s) used:
nrrud.�i orcomm�a::i�n,:�.:.:
I¢nily ihai I heve creinined�M1is apon including a��ached s'Fedules unJ ii is,m iM1c Msi ofm}knmNcdgc and Fdle(a�me and mmplele sWte�nenl olall cmnryaign�inance
azxiviip,indudingull mnvibwions,louns,rtecipa,cxprndilums,disM1urvenania,in-kind ronm�ulions and liabililics lor Ihis repotling pcnod nnd repasenb ihe cempaign
fnianccattiviryolallperomnciingunderiM1euwM1orityoon�eM1Slfotthismmmiuccinv�mNenu.wiih�Fercyui menuofMGJ..eS3.
6igneaunaeriM1ene^��tlesofperJan: f�«osumr'ssi5�o�ure) Date:
FORCANDIDATEFILINGSONLi': nffd..i��fCa�dlanie�cM1eaklbowonty)
c��e�ai<w�m eomm�v.:.�a na ac�i.iry�indepenJmt of�be commitma
� IwntiM1 �ll � .� iW�M1saPotl�sldg i"M14: F � 1 dl� � �hbc� f 'l idb � dbll � t A Plt�siu�c itll 0 liu
ace� � iullpi.nonsvctn�ii4cr�licawhiprunb�M1ulfofiM1�. nl¢cn wdaum�ihihioy � amso�ML1. S . IM1vr.noi �v.denymnmbCi
mcurred anv Ilnbiliiles nnr madv uny c�pcn�mucs on my bchulf dunnp iM1iy rro���ng prnod.
CandidnlawilM1nulCommiitnORCvntlitlat<xitM1inJep mnnirip'flingttpxra4rtport
�q'Iecny �htlh � .- d�A�.- pi� Id' 'u I -M1 I dt�:.i �F b t f :k 9d6 ` dAfL� � ea�dconpleLLzlvre 1 f�ll - p��gn
�%lnon i �ry � I 4' g � �A i - I ae pi p i t r d�burs crt A d i b t dl� bltcsfa �M1 pori igperotl i4rcprescnsMc
aampagn�nmc�ecib�trolellpersoisac�b@undui �ewM1 �p� r nbch � f�hsii lLLi � iw d' '�F�Mereq � ��o1MCLe55.
s�•�.a��a.�m. ie�.ar �c��a�eni�ss� ei�,�� oare: ( 2 -26 ' ZuZ/
�, pena perjurp L��
� SCHEDULE A: RECEIPTS � '
AL GJ. c. �5 reqnires(ha(!he name pnd resldenGal addr es 5e repn led, in ulphabe(��ul order',for q(l receip(a'orer'350 in a a�dendar'
year. C nmrriineev aras!keep demileAacmunis nnd r'erords �falf recel�ro, bul need onh'ilemee those recc�p[s oi•er 5�0. In oddi(ion, the
accnpation pnd emplocer nmst be repnrlcd,fr�r all pn'snn.v vhn oontrib�ile 5100 or more in a cnlendm penr'.
(A"Schedule A: Receipts" at[achment is availablc to comple[e,print and attach to�his reporl,iCaJditional pages nre required to
repor[all receipts. Plexse include your eommit[ee name and a page number on rach page.)
Name and Residential Address Oreupa[ion& Employer
Uate Received (alphabe�ical listing reqoired) Amouol (Por eontributioos of$200 or more)
� �
� �
� � �
� _--" �
� � �
� �
� �
� �
� � �
� � �
� �
� �
Line 9: Total Receipts ovcr$50(o� lisied above)
Line 10: 'Potai Receipts$50 and under* (no� lisled above)
Line Il: TOTAL RECEIPTS IN THF. PF.RIOD <— F,nceron page I,line 2
* Ifyou have i�emized reecipts of$50 and undec include�hem in line 9. I.ine 10 should include only those�eceip[s mt itemized above.
Page 2
SCHF.DULE A: RECEIPTS(confinued)
Name and Residen[ial Address Occupation & Empluyer
Date Received (alphabe[ical lis[ing rcquired) Amoun[ (for coolributions of5200 or morc)
� �
� �
� �
� �
� � �
� �
� � �
� � �
� �
� � �
� �
� �
� �
Line 9: 'lotal ftcceipts ovcr$50(or lisred above) �
Linc 10: Total Rcccipts$50 and undcr* (not listed above) �
Line 11: TOTAL RECEIPTS IN THE PERIOD F Fnter on page I,line 2
* Ifyou have itemized receipis of$50 and undcq include them in line 9. Line 10 should i�cludc only ihose receipts not itemized abovc.
Page}
SCHEDULE B: EXPENDITURES '
hf G_L c J)reyair'es cammi([ees(n l(sl. ur nlpdabe(icnl oider. ad espendlhves over S�0 in n rzpw�ting per'iod Commilleee mus[keep
delnlled acroainis and records ujall expendilures, bu!need unh�ilemive[ho.se nver'550_ FxpendJures 5.i0 and under nraN be added tugelher,
jrom mrmuillee records, anrl reporled on line !3.
(A "Schedule B: Ezpenditures"aftachment is available to complete,print nnd atlach�o fhis report,if addi[ional pages are requireA�o
reportallexpendiWres. Pleaseincludeyourcommitteenameandapagenumberunenchpage.)
To Whom Paid
Uate Paid (alphabetical listing) Address Purpose of Expendi[ure Amuun[
� �
� �
� �
� — —__ �
� �
� �
� �
� �
� �
� �
� �
� �
I.inc 12: Total 8xpendilures over$50(or listed above)
I,ine 13: Totel Expenditures $50 and under* (not listed abovc)
Emer on pa�c I, line 3—� Line 14: '1'O'PAL F.XNF.NDITURF.S IN THE PERIOD
* Ifyo�have iremized espendilures o($50 and onder,include�hem in line 13_ I.ine I}should include only[hose expe�diwres no�i�emized
abme.
ra��a
SCHEDULE B: EXPENDITURES(continued)
To Whom Paid
Date Paid (alphabe[ical lis[ing) Address Nurpose of Expendi[are Amoun[
� �
� �
� �
� �
� . �
� �
� �
� �
� �
� �
� �
� �
� �
Line 12: Cxpenditures ovcr$50(or IistcA abovc) �
Line 13: 6spenditures$50 and under' (not lis[ed above) �
Cntcr on pege I,line A -� Linc 14: TOTAL EXPENDITURES IN THE PERIOD
` If you have iremized cspcndi�ures o($50 and under, include[hem in line 12. Linc I3 should includc only[hose expendimres no itemized
above.
Yage 5
SCHEDULE C: "IN-KIND" CONTRIBUTIONS �
Plcasc ilemize contriburors who have madc in-kind conlributions of more than$J0. In-kind contributions$50 and under may bc
added rogcthcr from the committee's records and indudcd in line 16 on page I.
Uate Rueived From Whom Rceeived* Residential Address Descrip[ion of Contribution Value
� �
� �
� �
� �
� �
� �
� �
� �
� �
� �
� �
� �
Line I5: In-Kind Contributions over$50(or listed above)
I.ine 16: In-Kind Comributions$50 & undcr(not lis(cd abovc)
Fnceron page I,Iine 6-� Line 17: TOTAL IN-KIND CONTRIBUTIONS
* If en in-kind conl[ibulion is received ftom a person who w�h'ibWes more[han$50 in a calendar yeflr,you mus'[report�he name end address
of the contribu[or;in addition,ifthe contribWion is$200 0�morc,you must elso repon the comribumr's occupetion end employcr. ppge b
SCHEDULE D: LIABILITIES
M.G.L. c. JJ reyuires rommitfeee'(o r'epor'i ALL lia6ililies�rhir/�hu��e heen repnr/ed pre��iouslV and qre.s[ill oufstanding, as �nell
as(hose lia6ili/ies incu»�ed d¢�ring Jtis reporling pn�iod
Da[e Incurred To Whom Due Address Parpose Amount
� �
� �
� �
� �
� �
� �
� �
� �
� �
� �
� �
� �
� � Ii
� �
F.nteron page I, line 7 � Line 18: TOTAL OUTSTANDING LIABILITIES(ALL)
Page 7