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<br />... <br />.! <br />~ ~ <br />Z <br />M 1:: <br />N ~ <br />Ql <br /> <br />> <br />C <br />o <br />a <br />;:) <br />Ql <br />U <br />lE <br />o <br />... <br />o <br />LL <br /> <br />STATEMENT OF RECEIPTS AND EXPENDITURES <br />pursuant to the Minnesota Fair Campaign Practices Act, Minn. Stat. ~210A.27, Subd. 1 <br /> <br />o{- r~V <br />,\) ~ <br />~~ <br />\~ <br />I <br /> <br />This STATEMENT OF RECEIPTS AND EXPENDITURES is to be used by candidates, committees, and corpora- <br />tions required by Minn. Stat. Ch. 210A to file such a report. These include candidates and committees in elections <br />for county office; municipal office in municipalities oiler 20,000 population; individuals, political committees, <br />associations, or corporations for bal/ot questions; and corporations spending more than $100 on certain activities to <br />encourage participation in precinct caucuses, voter registration, or voting. (For supplemental information, see page <br />four.) Candidates and committees for state constitutional office, state legislature, supreme court, district court, <br />county court, and committees for state constitutional amendments are not included; candidates and committees for <br />U.S. senate and U.S. representative in congress may file copies of their federally-required disclosures in lieu of this <br />statement. <br /> <br />This statement is to be filed with the filing officer designated in Minn. Stat. ~ ~210A.26, Subds. 2-4, and 210A.34, <br />Subd. 8; questions about completing and filing this statement may be directed to that filing officer. <br /> <br />~ <br />... <br />o <br />0. <br />Ql <br />a:: <br /> <br />Name of candidate, committee, or corporation _Do..., N. <br />Office sought by candidate M A '1 O-p.... <br />(if applicable) <br /> <br />1Z . W 1 ~K I <br />District ClT'1' "f 1ZD~VIu...6 <br /> <br />Identification of ballot question <br />(if applicable) <br /> <br />Type of report ~ Candidate report <br /> <br />_Party committee report <br /> <br />_ Personal campaign committee report <br /> <br />_Association or corporation report <br /> <br />_ Political committee report <br />Period of time covered by report: from ~~ <br /> <br />\ I "t61 to oct u.. {'} 67 <br />I I <br /> <br />SUMMARY STATEMENT TO DATE <br /> <br /> TOTAL FOR TOTAL FROM TOTAL <br /> THIS REPORT PREVIOUS REPORT TO DATE <br />Ql <br />u 5~ 0'" 5~ <br />lE RECEIPTS (Exhibit A) + <br />0 <br /> PROMISES OR PLEDGES <br /> RECEIVABLE (Exhibit B) <br /> EXPENDITURES ACTUALLY 5"" .... 5~ <br /> MADE (Exhibit C) + <br /> OBLIGATIONS INCURRED c>; ~ ~ <br /> BUT NOT PAID (Exhibit D) <br /> <br />I do swear (or affirm) that I am a candidate for public offi~ or an officer of the <br /> <br />and true statement pursuant to Minnesota Statutes Ch. 210A. <br /> <br />v:: i2"t;:;J;Z "po,,;,. ~II <br /> <br /> <br />(cand Idate or officer sign here) <br /> <br />Committee or corporate office held <br /> <br />":;;;:;;';;'~" MAR DELL I. OLESEN <br />i~ .l.!A.~ NOTARY PUOLlC. MINr-.IESOTA <br />\~n~~ ANOKA COUNTY <br />\~.t. . My Commission Expires Sept 9. 1991 <br /> <br />Address II /4 vV1Ac. k(}(~ <br />~6Vlu..e fVl JJ SS-' (3 <br />I <br />day of (Y~ :t ~(( Jr) 19..L2 <br />~ ~O 1.Le J- die td..t.-. Notary Public <br /> <br />Ql <br />E <br />l'<l <br />Z <br /> <br />Subscribed and sworn to before me this r=21" ~ <br /> <br />SC 00069-03 <br />