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CITY OF ROSEVILLE <br />CAMPAIGN FINANCE REPORT FORM <br />� ��C���1C�� <br />�SEP t 3 9�17 � � <br />J <br />R i;e1SE4' COI.�'eI 1 <br />F.LEC'TIOtiS <br />Committee Name: __ �' �^�,��t?5 �� ��-�t �-�-e'}� _ <br />-T <br />Office sought or held by candidate <br />or purpose of political committee: �� � C°u��-��' °` R oS�Vi 1J� �J� ___ <br />Type of Organization: ✓� Candidate Committee <br />Type of report: ____ Initial repor�t <br />_ Pre-primary __ <br />t/' Pre-general <br />Period of time covered by report: From _ 7�° %"Z to <br />MAJOR CONTRIBUTORS <br />Political (Action) Committee <br />_ Post-general <br />_ Year-end (January} report <br />_ Final report (closes committee account— <br />see M.S. Ch. 211A.03 for requirements) <br />i/l�/lZ.. <br />SUMMARY STATEMENT TO DATE <br />AL1 OTHER CONTRIBUTIONS RECEIVED <br />EXPENDITURES <br />Total For This <br />Report <br />1 �DD <br />9'� <br />Total From Total To <br />Previous Report Date <br />+ �vv _ j}3oc� <br />+ o = �5, <br />1`T��.2q + 2�a�= 1 ��� <br />SUMMARY OF EXPENDITURES AND CONTRIBUTIONS FOR THIS PERIOD <br />Itemize all contributions made during the previous 365 days by an individual or committee that are greater than $SO in the <br />aggregate on a separate sheet. Itemization must provide amount, date, name, address, employer or� occupation if self- <br />employed for all contributors. <br />An itemized list of all expenditures must also be provided. This must include date, purpose, and amount for each <br />expenditure. <br />� <br />Contributions less than/equal to $50 -3 � � <br />Contributions between .$51 and $.300 3 f��� __ Check here if within the previous year <br />no individual, committee or organization has made one or more contributions that in the aggregate are greater than $50 <br />Expenditures J % 4� 'Z. � Z � <br />Current Balance a 7 �l • � � <br />List the name and address of all depositories <br />holding this committee's deposits ,�r�e�m�r �a�. � �U� � <br />��u.�-� �`'s�v►' ►�" 6�n �I 5 S( � <br />� <br />Committee treasurer <br />; l,� . � _ (/� • 1� -- � <br />��°�/z. <br />Date <br />Email (note if you want it redacted before form becomes public): �� 1��{?(�� �G�1q�.�r ��,�S�PJ% vtX- i(T}�li <br />