HomeMy WebLinkAbout2024 DuBois - Statement of No Activity � ceF in a:
(For ORre U e Only�
Form CPF D]04:
� � � Statement of Candidate
� }�(ot�iaing or Expending Campaign Funds
commo�H���im _ � .,._. .. ,
ornnassa�n��us �� Office of CamoaiEn and Political Finance
Filex�irA: Dimcror (619)9]9A300/(R00)i62-0CPF
OtHw of Cempaign and Political Pioe�mc ocOK��^ase_gov
Onc Ashburton Plaa,Aoom 411.Bosmn.NA 0210A hnp�.//www.ocpCus
CHECK ONE: �f do mt heve e political committee. OR � I have organizeA a poli�ical commiuee on my behalC.
Candidate's Name: l/��1'� l� 4/ (/' �� 1 S
OffiwSoughUllistricC �—�b(`a�� ����Pp
RcsidcntialAddross � 1`�l,`�a� '�O° �'^ �h`"�
City i Statc/Zip: � �O-�� . �,ll �����
E-MailAddtess: ��C�� ''e- �g°1'� �������� �honeNumber: �
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I hereby certify that I have not opened a wmpaign bank account for campaign funds because I do not inlend to accept
wmribulions,make expendimres, including expenditueav oCmy own CunJs, or incur liabilities for any campaigmrelated
pucpose. I submi[[he following es my campaign report for ull bank ceporting periods in this electio¢cycle as pmvided for in
Chapter 55 oCihe Massachusetts General Laws:
1. Ending balance from previous report ZF,RO
2. Total receipts for reporting period ZERO
3. Subtotal ZlAO
4. Total Expendi[ures for reporting perioJ ZF,RO
, 5. Hnding balancc ZERO
If, aftcr filine Ihis sla[emen[, I decide to raise or cxpend Cunds for a campaign-rclalcd purpose, I will immedia[ely
designate a deposi[ory bank, open an account al lhe dcsignatcd bank,and complctc and filc an Appointmenl oC Deposi[ory Bank
(D103)Fonn.
Until such notice is on file with lhe Diroctor, I certify that the above Zero roport will be in effect for each reporting period
required by Chapter 55 of the Massachuse[[s General Laws.
SIGNED UNDER TIIE PENALTIES OF PERJURY:
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Candidale's signawre Da[a � �� ��-Z
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