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<br /># <br /> <br />CITY OF ROSEVILLE <br />CAMPAIGN CONTRIBUTION REPORT <br /> <br />A candidate for office must file with the City Clerk. <br /> <br />Within the previous year no individual, committee or organization has made <br />one or more contributions that in the aggregate are greater than $50; or <br /> <br />~ithin the previous year the following individual(s), committee(s) or <br />organization(s) has (have) made one or more contributions that in the aggregate is <br />(are) greater than $50. <br /> <br /> <br />{(j a <br />100 <br /> <br />d <br /> <br /> <br />.D <br /> <br />Employer or occupation <br />if self em 10 ed <br />~ ~r , r2.€b <br /> <br />~;, OM'C- ~ <br /> <br />.J2eT/~ <br /> <br />Date of Amount Name of individual, Address <br />contribution committee or or anization <br /> <br />(Use additional sheets, if needed.) <br /> <br />Name of Candidate 10 YY) k (} U G-kf <br />Name of Person filing report ~L SAt'Jd.2 <br />Address of Person filing report L...-(.", / '- A L 0 I j1/ <.:C <br />R 0 Se--J ~.vh Yh -IV} <br /> <br />~d\~ <br /> <br />'Sr, y) <br /><(sf (7 <br /> <br />Signature <br />Period of time covered by this report: From jO!-v4 <br /> <br />to <br /> <br />J~o <br /> <br />All information in this report is public information. <br /> <br />(Over) <br />