Form CPF M 102: Campaign Finance ReportMunicipal For{i..:'i1 :l: ..1n, :, r ii si.

OfficeofCampaign and Politicalfihdncd : I i rJ' i "''

Commonlvealthof Massachusetts

4Candidate Full Name (if applicable)

a,t t .{'Le}*a-n - ArlaOffice Sought and District

-t1 fhpbl-a- tF.Residentral Address

Telephone Number (optionaJ)

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CTE ,ftt*-r. (dvr.t-<Committee Name

Name of Committee Treasurer

Committee Mail ing Address

Telephone Number (optional)

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ype of Report: (Check one)

I Sttr Oay preceding preliminary [ Stn Aay preceding election f 30 day after election fiear-end report f] dissolution

SUMMARY BALANCE INFORMATION:

Line l: Ending Balance from previous report

Line 2: Total receipts this period (page 3. line 11)

Line 3: Subtotal (line I plus line 2)

Line 4: Total expenditures this period (page 5, line 14)

Line 5: Ending Balance (line 3 minus line 4)

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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: 44 r

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Affi davit of Committee'Ireasurer:I certily that I have examined thrs report including attached scheduies and it is, to the best of nry knowJedge and beliel, a true and complete statement ofall campargn linance

finance activily ofali persons acting under the authonty or on behalfofthis committee rn accordance with the requirements olM G.L, c 55

under the penalties of periury; (Treasurer's signature)

: Affidavit ofCandidate: (check I box only)

Candidate with Committee and no activity independent of the committee

incurred any liabilrtres nor made an1, expenditures on my behalfduring this reporting period.

e without Committee OR Candidate with independent activity filing separate reportcertily that I have examined this report includtng atlached schedules and it is. to the best of my knowledge and belief, a true and complete statement ofall calnpatgn

campaign finance actrvity of all persons acting under/he authority or orr behalf of thrs corrmittee in accordance w:th the requirements of M.G L. c 55

Fill in Reporting Period dates: Beginning Date: t3 3 I

Ir ISigned under the penalties of perjury: (Candrdate's signature) Date

Date PaidTo Whom Paid

(alphabetical listin g) Address Purpose of Expenditure Amount

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Enter on page l, line 4 -+

Line 12: Total Expenditures over $50 (or listed above)

Line l3: Total Expenditures $50 and under* (not listed above)

Line l4: TOTAL EXPENDITURES IN THE PERIOD

SCHEDULE B: EXPENDITURESM.G.L. c. 55 requires committees to list, in alphabetical order, all expenditures over $50 in a reporting period. Commitlees must keep

detailed accounts and records of all expenditures, but need only itemi:e lhose over $50. Expenditures $50 and under may be added logether,

from committee records, and reporled on line I 3,

(A "Schedule B: Expenditures' attachment is available to complete, print and attach to this report, if additional pages are required toreport all expenditures. Please include your committee name and a page number on each page,)

*lfyouhaveitemizedexpendituresof$50andunder,includetheminlinel2. Linel3shouldincludeonlythoseexpendituresnotitemizedabove. page 4