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<br />~; e.). ~~r (cf) <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 /> <br />Date of Amount <br />contribution <br /> <br />Address <br /> <br />Employer or occupation <br />if self em 10 ed <br /> <br />/.. U.//1I/V... ~~.z;~ <br />~'/c/.?/~.7 ~./1A <br /> <br /> <br />Signature /"_<e..d~~ <br /> <br /> <br />Period of time covere~~-this re~;t: From ' ",,<10 ~)~~- <br /> <br /> <br />All information in this report is public information. <br /> <br />(Over) <br />