Form CPF M 102: Campaign Finance Report Municipal Form RECEJVEO·CITY CLERK

omce or campaign and Political Finance CITY OF PITTSFIELD. MA Commonwealth of Massachusetts

Fill in Reporting Period dates: Beginning Date:

2019 JAN f 8 AH If: 01 File with: Ci or Town Clerk or Election Conuuission

Ending Date: ~I

Type of Report: (Check one)

D 8th day preceding preliminary 0 8th day preceding election 0 30 day after election IE( year-end report 0 dissolution

K~V/h :John hfo~cuuJ /

e:t_:j Candidate Full Name (if applicable) Covnc}/or- W«Pd Ol /{_ev/11. /41ora.~tJ,' Ca~~n CoJUJHiffee

Committee Name

$ LJSt£11 s a_~t_ TlJ I; n Office Sought and District

llJ Sav+lt C artJ 1/1\ a. 1/ve, ,f/+l-5..-t::/e/J1ftJI! Residential Address 1

Name of Committee Treasurer

/q S, Da_~~f:tJ.a.. Ave,~ fltrfs .. ·£./ei~ N/1 Committee Mai ing Address

E-mail: /5lrl0f'a.~/ (D. cf+~ o£1-lH_s-r=..'e/cl, llf'~ Phone# (optional): {Lf../.3) lj_ q Cf- t) L 0 cg

E-mail: kfr?D~ct.Jtd(' & c_i-1--j ~~;();tf:s:'CJ-e_{t:l_ (1~ (f.( 2 r Phone#(optional):_(3_ IJ.?r- tJLa S?

SUMMARY BALANCE INFORMATION:

Line 1: Ending Balance from previous report ~~~, I Line 2: Total receipts this period (page 3, line 11) ol Line 3: Subtotal (line 1 plus line 2) b ?t!ill Line 4: Total expenditures this period (page 5, line 14) ol Line 5: Ending Balance (line 3 minus line 4) b?,~ll Line 6: Total in-kind contributions this period (page 6) ol Line 7: Total (all) outstanding liabilities (page 7) q o 21 a;2l Line 8: Name ofbank(s) used: I 8erk.sJt,',.. e Sa 11-K I

Affidavit of Committee Treasurer: I certify that I have examined this report including attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all campaign finance activity, including all contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign finance activity of all persons acting under the aut rity or on behal of is com · · cordance with the requirements ofM.G.L. c. 55. I ;· Signed under the penalties of perjury: (Treasurer's signature) Date: I r I 7 ,I 9' FOR CANDIDATE FILINGS ONLY: Affidavit of candidate: {check t box only)

Candidate with Committee and no activity independent of the committee I:E( I certify that I have examined this report including attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all campaign finance

activity, of all persons acting under the authority or on behalf of this committee in accordance with the requirements of M.G.L. c. 55. I have not received any contributions, incurred any liabilities nor made any expenditures on my behalf during this reporting period.

Candidate without Committee .QR Candidate with independent activity filing separate report 0 I certify that I have examined this report including attached schedules and it is, to the best of my knowledge and belief, a true and complete statement of all campaign

finance activity, including contributions, loans, receipts, expenditures, disbursements, in-kind contributions and liabilities for this reporting period and represents the campaign finance activity of all persons acting und the authority or on ehalf of this committee in accordance with the requirements ofM.G.L. c. 55.

· . . Date: t/;t;/Jy Signed under the penalties of perjury: .....::#s,.,===="'-7!~:___e:;t?:-~~===::z::~:!._-----

SCHEDULE A: RECEIPTS MG.L. c. 55 requires that the name and residential address be reported, in alphabetical order,for all receipts over $50 in a calendar

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 reported for 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)

I IDI I Dl I Dl I Dl I D I D I D II D II D II Dl II Dl II IDI

Line 9: Total Receipts over $50 (or listed above) I I Line 10: Total Receipts $50 and under* (not listed above) I l Line 11: TOTAL RECEIPTS IN THE PERIOD I 0 I~ Enter on page 1, line 2 *If you have ttemtzed recetpts of$50 and under, mclude them in line 9. Line 10 should include only those receipts not itemized above.

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I I I I I I I I I

I I I

SCHEDULE A: RECEIPTS (continued) . Name and Residential Address Occupation & Employer

Date Received (alphabetical listing required) Amount (for contributions of $200 or more)

I IDI I IDI I IDI I IDI I D I

I I D I I II D I I II D I I II D I I II D I I II D I I II IDI I I II IDI I Line 9: Total Receipts over $50 (or listed above) I I Line 10: Total Receipts $50 and under* (not listed above) I I Line 11: TOTAL RECEIPTS IN THE PERIOD I ol ~ Enter on page 1, line 2 *If you have itemized receipts of$50 and under, include them in lme 9. Line 10 should include only those receipts not Itemized above.

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

To Whom Paid Date Paid (alphabetical listing) Address Purpose of Expenditure Amount

D I II ID D I II ID D I II ID D I I ID D I I ID Dl I I I ID Dl I I ID Dl I I ID Dl I I ID Dl I II ID Dl I II ID Dl I II ID

Line 12: Total Expenditures over $50 (or listed above) I c I Line 13: Total Expenditures $50 and under* (not listed above) I I

Enter on page 1 , line 4 ~ Line 14: TOTAL EXPENDITURES IN THE PERIOD I o! * . . lfyou have Itemized expenditures of$50 and under, mclude them mIme 12. Lme 13 should mclude only those expenditures not Itemized above. Page4

SCHEDULE B: EXPENDITURES (continued)

To Whom Paid Date Paid (alphabetical listing) Address Purpose of Expenditure Amount

Dl I II D Dl I II D D I I II D Dl I I D Dl I I ID Dl I I ID Dl I I ID Dl I II ID Dl I II ID Dl I II ID Dl II II ID Dl II II ID Dl II II ID

Line 12: Expenditures over $50 (or listed above) I I Line 13: Expenditures $50 and under* (not listed above) I I

Enter on page 1, line 4 -+ Line 14: TOTAL EXPENDITURES IN THE PERIOD I ol * Ifyou have Itemized expenditures of$50 and under, mclude them in hne 12. Line 13 should include only those expenditures not itemized above.

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SCHEDULE C: "IN-KIND" CONTRIBUTIONS

Please itemize contributors who have made in-kind contributions of more than $50. In-kind contributions $50 and under may be added together from the committee's records and included in line 6 on page 1.

Date Received From Whom Received* Residential Address Description of Contribution Value

Dl I II ID Dl I I ID Dl I I ID Dl I I ID Dl I I ID D I I ID D I II ID D I II ID D I II ID D I II ID Dl I II ID Dl I II ID

Line 15: In-Kind Contributions over $50 (or listed above) I I Line 16: In-Kind Contributions $50 & under (not listed above) I I

Enter on page 1, line 6 -+ Line 17: TOTAL IN-KIND CONTRIBUTIONS I ol * If an m-kmd contnbut10n IS received from a person who contnbutes more than $50 m 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.

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SCHEDULED: l.IABILITIES "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 Purpose

01 0[ II IC I II : ~ I[ IC 0[ I I I' I 01 II 1~1 01 II I[

Amount

11 j I J

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l i l j

II ! I I L

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ID Enter on page l, line 7 ~ Line 18: TOTAL OUTSTAJ.~DING LIABILITIES (ALL) ~ tfO '/:·El~

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