Form CPF M 102: Campaign Fina

Municipal Form
Office of Campaign and Political Finance
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Commonwealth
Or Massachusetts
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File with: Ci or Town Clerk or Election Commission
IFill in Reporting Period dates; Beginning Date:
1-1-11
Ending Date:
iro -21- i 1
fType of Report: (Check one)
j 0 8th day preceding preliminary (;@ 8th day preceding election 0 30 day after election 0 year-end report 0 dissolution
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MJChcte L t<. Bard s!e c1
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Candidate Full Name (if applicable) Committee me
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Name of Treasurer Office Sought and District
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Residential Address Committee Mailing Address
lTelephone Number (optio,.l): I
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- /28 (o --I L[3L
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Telephone Number (optional): j
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SUMMARY BALANCE INFORMATION:
Line 1: Ending Balance from previous report
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c')._ / .;1/. 3 CJ
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Line2: Total receipts this period (page 3, line 11)
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c).5'5'J3,<N
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Line3: Subtotal (line 1 plus line 2)
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.9-7(oC/S-,38
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Line 4: Total expenditures this period (page 5, line 14)
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.9,(,:, 9 20' 5 (.)
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Line 5: Ending Balance (line 3 minus line 4)
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I 7tf, 'Z8
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Line 6: Total in-kind contributions this period (page 6)
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(o Lj :J
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Line 7: Total (all) outstanding liabilities {page 7)
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137&798
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Line 8: Name ofbank(s) used: I P/ cr. nee..
Saoinc'.s a;!L I
Affidavit of Committee Treasurer:
I certify that I have examined this report including attached schedules and it is, to the besfof my knowledge and belief, a true and complete statement of all campaign finance
activity, including all oontributions, loans, receipts, expenditures, in-kind contributions and liabilities for !his reporting period and repre..ents the campaign
activity of aU persons acting under the tjj. with the requirements c. 55.. . . -
Signedunderthepenaltle.sofperjury: . :67 0 . ,(.f.f'7.i \C.li:J\ (Treasllrel'sS!gnature) Date.,// /- J(
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FOR CANDID Jil?ILINGS ONLY: Affidavit of Candidate: {check 1 box on(y)
Candidate with Committee and no activity independent of the committee
,
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0 I that I have this report inclu?llg attached schedu_les and is, the best of my.knowledge. and belief: a true and of all campaign
actiVIty, of all persons actmg under the authonty or on behalf of this committee tn accordance WJth the requtrements ofMG.L. c. 5:l. I have notrece1ved a:ny contnOunons,
incurred ally liabilities nor made any expenditures on my behalf during this reporting period.
Candidate without CommitteeQR andidate with Independent activity filing separate report
0 I certifY that I have examined this rep rt schedules and it is, to best of my knowledge and belief, a true and complete statement of all campaign
fmanco activity, including contributi s, loans, r 'p :':;, in-kind liabilities for this reporting period and represents the
campaignfinanceactivityofallpecs s 'fling de alfof s:vtteein
Signedunderthepenaltlesoiperjury: V i_\
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0. andidare'ssignature) Date: I// -f-!l
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SCHEDULE A: RECEIPTS
M G.L. c. 55 requires that the name and residential address be reported, in alphabetical order, for all receipts over $50 in a calendar
1
year: Committees must keep detailed accounts and records of all receipts, but need only itemize those receipts over $50. In addition, the
occupation and employer must be reportedfor all persons who contribute $200 or more in a calendar year.
(A "Schedule A: Receipts" attachment is available to complete, print and attach to this report, if additional pages are required to
report all receipts. Please include your committee name and a page number on each page.)
Name and Residential Address Occupation & Employer
Date Received (alphabetical listing required) Amount (for contributions of .$200 or more)
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Line 9: Total Receipts over $50 (or listed above)
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I Line l 0: Total Receipts $50 and under* (not listed above)
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Line 11: TOTAL RECEIPTS IN THE PERIOD
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If- Enter on page 1, line 2
If you have t!emtzed recetpts of$50 and under, mclude them m \me 9. Lme 10 should mclude only those recetpts not ttemtzed above,
Page 2
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/ Date Received
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SCHEDULE A: RECEIPTS (continued)
Name and Residential Address
. (alphabetical listing required)
f'i\-c.en A. l::xznGr 1
2 iO k-i nnE:bYOL'i::-RcL
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2--1 T(.:t.n::z. U rxJ e.
F\o , IYl et
Amount
100.00
11-.
I Licb.OO II
10000 I
20000 .
200('l0 1
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iDO. DC::>
' Occupation & Employer
(for contributions of $200 or more)
Re..+irecl
I< t:A-i ,-e c\
12.e:h r-eel
Pf-tsi6_uyr
w\ nn, ;, c:J G(}r i .\-c;-s.
-tContrud fYisr.
\t;<;,oo Be.hQvion:d HeMh
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Line 9: Total Receipts over $50 (or listed above)
Line !0: Total Receipts $50 aod under* (not listed above)
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., I Enter on page 1, line 2




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7
h:=!Jould mclude only those recetpts not tlemtzed above,
Line 11: TOTAL RECEIPTS IN THE PERIOD
Page3
SCHEDULE A: RECEIPTS (continued)
I Date Received
ll '/-')1- I/
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il;f-10-1!
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1 '/ ;'2 t-f-11
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Name and Residential Address
. (alphabetical listing required)
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Line 9: Total Receipts over $50 (or listed above)
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I Line 10: Total Receipts $50 a.n.d under* (not listed above)
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Line 11: TOTAL RECEIPTS IN THE PERIOD
Amount
iDD-00
dJ5-Dc)
.t;o oo
\ '7':>-,o() I
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1 () 0' ['T()
!&o o-o
50.()()
D'()
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Occupation & Employer
(for contributions of $200 or more)
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t I Enter on page 1, line 2

mclude only those rece1pts not 1tem1Zed ahove.
Page 'i
SCHEDULE A: RECEIPTS (continued)
Date Received
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Name and Residential Address
. (alphabetical listing required)
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[3(}6 i JnanqareJ f!;dCffe_
Po Jx;x_ Y r ; s ~
Leeds. II? f)
r:v(.:.nc../ s m 12 iclt:LLR_
17tu Calle-r s,y.
F I() (C('/) (_,{ /}1 A
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1 Line 9: Total Receipts over $50 (or listed above)
Line I 0: Total Receipts $50 and under* (not li_sted above)
:Line 11: TOTAL RECEIPTS IN THE PERIOD
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Amount
IOODD
,;) "'J'O , (rQ
510 (J{)
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Occupation & Employer
(for contributions of $200 or more)
\/ice_ Ple<;lcien f-
[(),,J,1117S Wrikrs.
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Enter on page 1
1
line 2
*If you have Itemized receipts of$50 and under, mclude them in line 9. Line 10 should mclude only those recetpts not itemized above,
Page 5'
SCHEDULE A: RECEIPTS (continued)
Date Received
I g J1-lt
I cy 30 -It
; '-1-UJ/
7-31-//
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'Z -1'7-1/
f,-2'-/-11
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Name and Residential Address
. (alphabetical listing required) Amount
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Flor.entc . t'tJrr
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/Line 9: Total Receipts over$50 (or listed above)
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Line 10: Total Receipts $50 and uoder (not above)
Line 11: TOTAL RECEIPTS IN THE PERIOD
Occupation & Employer
(for contributions of $200 or more)
LOAAJ5 H q. I
'
Enter onpage 1, line 2
*If you have Itemized receipts of$50 and under, mclude them m hne 9. Lme 10 should mclude only those receipts not Ilenuzed above.
Page G
SCHEDULE B: EXPENDITURES
M G.L. c. 55 requires committees to list, in alphabetical order, all expenditures over $50 in a reporting period Committees must keep
detailed accounts and records of all expenditures, but need only itemize those over $50. Expenditures $50 and under may be added together,
from committee records, and reported on line 13.
(A
11
Schedule B: Expenditures
11
attachment is available to complete, print and attach to this report, if additional pages are required to
report aU expenditures Please include your committee name and a page number on each page)
I
To Whom Paid
Date Paid (alphabetical listing) Address Purpose of Expenditure Amount
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Line 12: Total Expenditures over $50 (or listed above)

Line 13: Total Expenditures $50 and under* (not listed above)
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Enter on page 1, line 4 -> Line 14: TOTAL EXPENDITURES IN THE PERIOD
I I
.
If you have Itemized expenditures of$50 and under, mclude them m lme 12. Lme !3 should mclude only those expenditures not ,temJzed
above.
SCHEDli'LEB: EXPENDITURES (continued)
To Whom Paid
Date Paid (alphabetical listing) Address Purpose of Expenditure Amount
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Line 12: Expenditures over $50 (or listed above)
Line 13: Expenditures $50 and under* (not listed above)
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Enter on page I, line 4 -> Line 14: TOTAL EXPENDITURES IN THE PERIOD
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*
..
l> you have 1tem1zed expenditures of $50 and under, mclude them m lme 12. Lme 13 should mclude only those expenditures nOl1tem1zed
above.
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Page 8
SCHEDULE B: EXPENDlTURES (continued)
To Whom Paid
Date Paid (alphabetical listing)
3 -Jfvlf jse...+-h -.P(/a
5
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Purpose of Expenditure
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Line 12: Expenditures over $50 (or listed above)
Line 13: Expenditmes $50 and under* (not listed above)
Enter on page 1, line 4 _, Line 14: TOTAL EXPENDITURES IN THE PERIOD
Amount
II SIJJ.OOI
I I 2,() &3 '
ll c9'
2
-
31
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11 J37.'76-l
:1.00 00
ILJ
ILJ
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ILJ
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* If you have Itemized expenditures of $50 and under, mclude them m !me 12. Lme 13 should mclude only those expenditures not Iterni7.ed
above.
SCHEDULE C: "IN-KIND" CONTRIBUTIONS
Please itemize contributors who have made in-kind contributions of more than $50. In-kind contributions $50 and nnder may be
added together from the committee's records and included in "line 16 on page I.
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I
! Date Received From Whom Received* Residential Address Description of Contribution Value
~ ~ ~ r
J,. -10--J/
_..0/ a-1:; L
1
ti.pt' 1/?c
/37 /-Jigh Si-.
Florence, n11+
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Line 15: In-Kind Contributions over $50 (or listed above)
Line 16: In-Kind Contributions $50 & under (not listed above) l 'j't) :;). b(v I
Enter on .page 1, line 6-> Line 17: TOTAL IN-KIND CONTRIBUTIONS
I & '/;2.ti?vl
~
* I.t. an m-kmd contnbut10n 1s receiVed from a person who contributes more than $50 tn a calendar year, you must report the name aqd address
of the contributor; in addition, if the contribution is $200 or more, you must also report the contributor's occupation and employer.
Page 10
SCHEDULED: LIABILITIES
M G.L. c. 55 requires committees to report ALL liabilities which have been reported previously and are still outstanding, as well
as those liabilities incurred during this reporting period. /
Date Incurred To Whom Due Address Pjirpose
Amount
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Enter on page 1
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Line 18: TOTAL OUTSTANDING LIABILITIES (ALL)
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Page I