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<br />DEC. 8. 2006 . 1: 17PM <br /> <br />NO. 3496 P. 2 <br /> <br />CIlY 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; o! <br /> <br />X 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 $50. <br /> <br />Date of <br />contribution <br /> <br />Amount Name ofindividual, <br />committee or or anization <br /> <br />Address <br /> <br />Employer or occupation <br />if self 1 d <br /> <br />~ <br /> <br /> <br />11 ~ 5" 11,.... SP <br />e>{.iI'/J.e. 55113 <br />17 mt~ t)a.~$ u.. <br />osa....."e 6'5IJ~ <br />~,OD FtI,'r"V)'t.uI ~ <br />ev,'II.e. 6'5/13 <br /> <br /> <br />(Use additional sheets, if needed.) <br /> <br />Name of Candidate l( a r'"H\ '5 f!. n fA. f{!c. y- <br />Name of Person filing report _rlJ VTn 5 c: hA.. f-f<:: v- <br />Address of Person filing report J..l" 0 ~ ~ 1''('1/'/ tw !hLJ.f, N. <br />~1.).s"V"I\It~ In N 55'113 <br /> <br />Signature ~JU.(A.... ~ ~ <br /> <br />Period of time covered by this report: From l P I ~ 7 / Df, to I a../ I, / c ~ . <br />f' f I <br /> <br />All information in this report is public information. <br /> <br />(Over) <br />