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<br />. <br /> <br />. <br /> <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 />;>< Within 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 />Date of Amount Name of individual, Address <br />contribution committee or or anization <br />a..\A.,~t:le6 \ \ \.bU <br /> S <br />y ~ 1.. 'f-1) S- ~o <br />\'"100- <br /> <br />Employer or occupation <br />if self em 10 ed <br /> <br /> <br />Sc.Jt <br /> <br />R~cJ <br /> <br />C(M.- 'cJe.. <br /> <br />(Use additional sheets, if needed.) <br /> <br />Name of Candidate qrcJt., P ~ <br />Name of Person filing report t~41~ i ~ ! '"\I\.I~ <br />Address of Person filing report -z,-R. \::: Gl~ t ~ ~ tc-J <br /> <br />~q~~~DI~ <br /> <br /> <br />Period oftime covered by this report: From \/\/l.-Co~ to 1 - I - 2A'P~ <br /> <br />Signature <br /> <br />All information in this report is public information. <br /> <br />(Over) <br />