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<br />NOU-09-2006 12:59 <br /> <br />LRW OFFICE <br /> <br />612 337 5151 <br /> <br />P.02 <br /> <br />CAMPAIGN FINANCIAL REPORT CERTIFICA nON OF FILING <br /> <br />Each county, municipal or school district candidate or treasurer of a committee formed to promote or <br />defeat a ballot question shall certii)' to the filing officer that an reports reC1uired by Minnesota Statutes <br />211A.02 have been submitted to the filing officer or that the candidate or committee has not received <br />contributions or made disbursements exceeding $750 in the calendar year. The certification shall be <br />submitted to the filing officer not later than seven days after the general or special election. (Minnesota <br />Statutes 211A.05, subdivision 1) <br /> <br />Office sought by candidate <br />(if applicable) <br /> <br />.ftw, J -:IJ\ I al'\ ! lid I wd~ u) -Iw- f\.. 'j <br />:Ihl ((Y'\ <br />Rt!)~t:..v~ lle.. m~ <br /> <br />Name of candidate or committee <br /> <br />or <br /> <br />Identification of ballot question <br /> <br />...' '. " <br /> <br />Check the appropriate box below: <br /> <br />I' ~ .' . . I" . <br /> <br />JZI <br />D <br /> <br />I do swear (or affirm) that aU 'campaign financial rep~rts ~ciuired, bY,', ' " <br />Minnesota Statutes 211A.02 h~ve b~en sybmitted to th~.filing offi,cer. :',' <br /> <br />I do swear (or affirm) that campaign contributions or disbursements did not <br />exceed $750 in the calendar year. <br /> <br />~ " ~': <br /> <br />. Q ~Pli?. . .... <br /> <br />(Signature of candidate or committee treasurer) <br /> <br />NdV,:, '1.,)- ~O(J '" <br />(Date) <br /> <br />" ' .' <br /> <br />TOTRL P.02 <br />