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<br />~yJ <br />~~ <br /> <br />CAMPAIGN FINANCIAL REPORT CERTIFICATION OF FILING <br /> <br />Each county, municipal or school district candidate or treasurer of a committee formed <br />to promote or defeat a ballot question shall certify to the filing officer that all reports <br />required by Minnesota Statutes 211A.02 have been submitted to the filing officer or that <br />the candidate or committee has not received contributions or made disbursements <br />exceeding $750 in the calendar year. The certification shall be submitted to the filing <br />officer no later than seven days after the general or special election. (Minnesota Statutes <br />211A.05, subdivision 1) <br /> <br />Name of candidate or committee <br /> <br />-"'l)/{ i/ i 'cl A , /L/(J t^ V' q LA t/ i/J <br />(J <br />(l ;' l V do {; }1 (!.,' / <br />I <br /> <br />Office sought by candidate <br />(if applicable) <br /> <br />or <br /> <br />Identification of ballot question <br />(if applicable) <br /> <br />Check appropriate box below: <br /> <br />I do swear (or affirm) that all campaign financial reports <br />required by Minnesota Statutes 211A.02 have been submitted <br />to the filing officer. <br /> <br />~" I <br />I "'''X'I <br />I / I <br />/ <br /> <br />I do swear (or affirm) that campaign contributions or <br />disbursements did not exceed $750 in the calendar year. <br /> <br />ILU~I <br /> <br />(Signature of candidate or comm <br /> <br /> <br />///50}15 <br />(Dati) / <br /> <br />08890846 <br />