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<br />~~\~ <br /> <br />CAMPAIGN FINANCIAL REPORT <br />CERTIFICATION OF FILING <br /> <br />Each county, municipal or school district level candidate or treasurer of a committee <br />formed to promote or defeat a ballot question shall certify to the filing officer that all <br />reports required by Minnesota Statutes 211 A.02 have been submitted to the filing <br />officer or that the candidate or committee has not received contributions or made <br />disbursements exceeding $750 in the calendar year. The certification shall be <br />submitted to the filing officer no later than seven days after the general or special <br />election. (Minnesota Statutes 211A.05, subdivision 1) <br /> <br /> <br />Name of candidate orcommillee )~~, d-' (J~~) <br /> <br />Office sought by candidate (!;;tz{ (I /)--tA'~ .I Y <br />(if applicable) / <br /> <br />or <br /> <br />Identification of ballot question <br /> <br />Check appropriate box below: <br /> <br />1.><1 I certify that all campaign financial reports required by Minnesota Statutes <br />211A.02 have been submitted to the filing officer. <br /> <br />r-l I certify that campaign contributions or disbursements did not exceed $750 in <br />L-.J the calendar year. <br /> <br /> <br />) <br />of candidate or committee treasurer) <br /> <br />/.;? /:.s- /93 <br />(Date) <br /> <br />SC-00211-Q1 8-89 <br />