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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 />Y.... 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 /> <br />Employer or occupation <br />if self em 10 ed <br /> <br />~ <br /> <br /> <br /> <br />(Use additional sheets, if needed.) <br /> <br />Name of Candidat~ TG. YY\ r'Y\ \.f PIA ~ 1-. , <br />Name of Person filIng report < Jpy ri Fret e r <br />Address of Person filing report 6' 15 M: it woo& ;qyp. <br />kbvv,' 11.0 1 fVlrJ ss J (3 <br /> <br />Signature ~~~. ~ <br /> <br />Period of time covered by t~port: From q 1#161 to q /8/1J 5' . <br /> <br />All information in this report is public information. <br /> <br />(Over) <br />