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<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 /> <br />Employer or occupation <br />if self em 10 ed <br /> <br /> <br />(Use additional sheets, if needed.) <br /> <br />Name ofCandidat~ -r; M W\.l/ -p~ + <br />Name of Person filmg report ,..-1" r rl F(PA' -e- r <br />Address of Person filing report ~ /5 M ,. II wooci. A v-e <br />"Bs.eIJ" II e I M..N S ~ II'? <br /> <br />Signature ~ ~'/". '~ <br /> <br />Period of time covered by this report: From } 0 ( ) ( to 1/" g 10 5, <br /> <br />All information in this report is public information. <br /> <br />(Over) <br />