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Committee Name: <br />CITY OF ROSEVILLE <br />CAMPAIGN FINANCE REPORT FORM <br />� , <br />�� <br />., -; : <br />Office sought or held by candidate <br />or purpose of pofitical committee: <br />���:: <br />Type of Organization: '� }� Candidate Committee <br />Type of report: <br />Initial report <br />Pre-primary <br />Pre-general <br />Period of time covered by report: From <br />MA)OR CONTRtBUTORS <br />Potitical (Action) Committee <br />Post-general <br />Year-end (January) report <br />F1118� P"2p01"t (closes committee account— <br />see M.S. Ch. 211A.03 for requirements) <br />t0 <br />SUMMARY STATEMENT TO DATE <br />ALL OTHER CONTRIBUTIONS RECEIVED <br />EXPENDITURES <br />Total For This <br />Report <br />� <br />Total From <br />Previous Report <br />� � - � <br />+ � - <br />� <br />+ ' _, , _ _ <br />+ - <br />Total To <br />Date <br />:, �� <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 $50 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 />Contributions less than/equal to $50 - <br />Contributions between $51 and $300 �' 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 <br />Current Balance _ __ _ <br />List the name and address of all depositories <br />holdir�g this committee's deposits <br />, ' `_ <br />Committee treasurer <br />Email (note if you want it redacted before form becomes public): <br />,, <br />Date <br />;i-�, <br />