Municipal Form. , 37.g,., e, e30day after. election Lyearend report. Committee Name Name of Committee. r h, MZt LL33 y. committeeinaccordance

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1 . Form CPF M 102 Campaign Finance Report r,4 y Commonwealth of Maaaachuu q Municipal Form.Office of Campaign and Political Finance File with City or Town Clerk or Election Commission Please print or type all information, except signatures Fill in dates Reporting Period Month Date Year lvhwr 7 a2t a 1 i....., j.r Month Date year Ending t re. a.,..., v Type of report Check one 8th day preceding preliminary 8th day preceding election, 37.g,., e, e30day after,r u., J Tlr 4itl Full Name of Candidate if applicable Office Sought and District tjr7r vy, y t,i.vrlj ti4 Miydvl Address J Residefntial w7ocig Tel. No. optional election Lyearend report dissolution Committee Name Name of Committee C u,,n1 fctt Treasurer Mvc 7L,. r r. qtr r h, MZt LL33 y ICommittee Mailing Address7 l V S Cay Tel. No. optional SUMMARY BALANCE INFORMATION Line1 Ending balance from previous report Line 2Total receipts this period page2, line 11IUt tj Line 3 Subtotal line 1 plus line2,. F.,r, Line 4Tota1 expenditures this period page 3, line 14 a Line 5 Ending balance tine3minus line S, Line6Totalin kind contributions this.e period page4 Line 7Total all outstanding liabilities page ad,line8 Name of bank s used 13,h. n,.,.,,,, Affidavit of Committee Treasurer T certify that T have examined this report including attached schedules and itis, tothe bestofmy knowledge and all contributions, loans, belief,atrue and complete statement receipts, expenditures, disbursements, in kind ofall campaign finance contributions and liabilities for activity, including this reporting period and under the authority represents the or campaign finance activity of all behalf of persons acting on this committee in accordance with therequirements of M.G.L. c. 55. Signedunderthe penalties of perjury Treasurer signature in ink.date FOR CANDIDATE FILINGS ONLY CANDIDATE MUST SIGN BELOW,A,f1iditof Candidate check 1 box only I SYCandidate with Committee and noactivity independent of the committee I certify thati have the best of my knowledge examined this report including attached schedules and belief,atrue and complete statement of all campaign finance this committeein accordance activity,of all persons withthe requirementsof acting under M.G.L. c. the authority 55.Ihave not received any contributions, incurred any liabilitiesnor made any expenditures on mybehalf during this reporting period. Candidate without Committee OR Candidate with independent activity filing separate report I certify thatihave examined this report including anditis, to or on behalf of ofmy knowledge and belief,a andit is,to the best true receipts, and complete statement of expenditures, disbursements,inkind all campaign finance activity, including contributions and liabilities forthis reporting period and contributions, loans, or on behalf represents the campaign finance activity of this of all persons acting committeeinaccordance underthe authority with the of requirements attached schedules Signed under the penalties M.G.L. c. 55.

2 erom SCHEDULE A RECEIPTS M, G.L, c. SS requires that the name and residential addressbe reported,in alphabetical order,for all receipts over SO in a calendar year. Committees must keep detailed accounts and recordsofall receipts, but need only itemize those receipts over S0. In addition, the occupation and employer must be reported forall persons who contribute 200or morein a calendar year. This page may be copied if additional pages are requiredto report all receipts. Please include your committee name and a page number on each page. Date Received o Ip Name and Residential Address alphabetical listing required U w 1 itt..t.a. 3 LlrfF c.g o2 S Amount ri Occupation Employer,for contributionsof 200 or I Line 9 Total receipts inexcess of 50 or listed c Line 10 Total receipts 50 and under not listed above 1 above Line 11TOTAL RECEIPTS IN THE PERIOD t, CEnter on page 1, line 2 If you have itemized receipts of50 and under include them in line 9. Line 10should include only those receipts notitemized above.

3 , SCHEDULE B EXPEI TDITURES M.G.L. c. 55 requires committees tolist, in alphabetical order,all expenditures over SO inareporting period. and records of Committeesmust keep detailed all expenditures, but need only itemize accounts those over S0. Expenditures 50 and under maybe added together, from committee records, and reported on line 13. This page may be copied if additional pagesare required to report al expenditures. Please include your committee name and a page number on each page. Date Paid To Whom a 1a lv., 1 v t, Paid alphabetical listing Address Purpose 1. srcu r.t1r a Tz 4ii rpk Uc7Qa,. r rt.z. rv,i h cs of trrr4 actl yh sr W,irti, min v.zys1 ua r l. k.a. re itp lil r c,s.z M,7t v Expenditure Amount la y m p3y vi,.t, L rt,.r Av t vrg o Ib a Si 1r vv1 J r Tt vn yo s u s P c. 8,7, v w iy v. oe. re, ur,,.pct,,y,l3 v Line 12 Expenditures over 50 Line 13 Expenditures50 and under Enter on page 1,line 4 Fri Line 14 TOTAL EXPENDITURES,,P 11 yuu nave itemized expenditures of50 and under, include

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5 mohw SCHEDULE C KIND CONTRIBUTIONS Please itemize contributors who have madein kind contributions of more than 50.In together from the kind contributions 50 committee srecords and under and may be added included in line 16. Date From Whom Received Residential Address Received Description of Contribution Value Enter on page 1, line 6 Line 15 In kind over50 Line 16 In kind50 and under Line 17 TotalIn kind y If anin kind contribution is received from a person who contributes more than 50 in a calendar year, you must report the name and address of the contributor in addition, if the contribution is 200 or more, you must also report the contributor s occupation and employer. SCHEDULE D LIABILITIES M.G.L, c. SS requires committeesto report ALL liabilities whichhave been reported previously andare still outstanding, as well as those liabilities incurred during thisreporting period. DateI To Purpose Due Incurred Address Amount Enter on page 1, line 7 Line 18 OUTSTANDING LIABILITIESALL. This page may be copiedif additional pages are requiredto report all activity, Please include your committee nameanda page numberon each page. Page 4