Form CPF M101 BQ: STATEMENT OF ORGANIZATION
BALLOT QUESTION COMMITTEE
MUNICIPAL FORM
Office of Campaign and Political Finance
le with:

City / Town Clerk or Election Commission

IOTICE IS HEREBY

GIVEN

question
in accordance with the provisions of General Laws, Chapter 55, of the organization of a ballot

committee as follows:

Name (See note |):

Nicotine Free Generation

Committee mailing address:

PQ Box 192

City/State/Zip:

MA

Relchertawn

01007

Phone #:

E-mail Address: KenElstein@gmail.com

Purpose
/ specific issues | Nicotine Free Generation
and interests (See note

2):

Topic of question &

Town Meeting Article 19

question no.. if known:

This committee is formed to (check one):

support

or

[_] oppose _ the question.

OFFICERS:

Chairman:

Kenneth Elstein

Treasurer*:

Kenneth Elstein

Residential Address:

76 North St

Residential Address:

76 North St

City/State/Zip:

Belchertown

City/State/Zip:

Belchertown

01007

E-mail: KenElstein@gmail.com

Phone #:

Phone #:

MA_

* public employee may not serve as treasurer of any political committee (see reverse).

Other Officer/Title:

Other Officer/Title:

Residential Address:

Residential Address:

City / State / Zip:

City / State / Zip:

| Phone #

Phone #:

(Complete and attach a Form CPF M A 101, if necessary, with other officers and finance committee, if any.)

specify that each treasurer of a political
The chairman and treasurer of a political committee should be aware that provisions of M.G.L. c. 55

years from the date of the relevant election.
committee shall keep and preserve detailed accounts. vouchers and receipts for a period of six
without the authorization of the
committee
political
a
of,
behalf
on
or
for.
made
Chapter 55 also specifies that no expenditures shall be
separate from any personal funds of
kept
be
shall
committee
political
a
of
funds
all
that
and.
agents:
designated
their
or
chairman or treasurer.
any officers, members or associates of such committee.

[hereby accept the office of Chairman of the above-named committee.
f

SIGNED UNDER THE PENALTIES OF PERJURY

rete 2h g Luh

Date: 05/21/2025

Chairman's signature
as defined by M.G.L. c. 55, s. 13. L understand
Lhereby accept the office of Treasurer of the above-named committee. | affirm that | am not a public employee
including the timely filing of campaign finance reports and keeping detailed accounts
that: 1) Iam subject to certain duties and liabilities under M.G.L.

and records of all campaign finance activity for a period of six

years from the date of the relevant election; and 2) if after my acceptance of this office |

become an appointed public employee. | must resign this position and notify OCPF of my resignation.
o
SIGNED UNDER THE PENALTIES OF PERJURY:

tices
Treasurer's signature

sf

:

Date: 05/21/2025