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CiiY Q� ROSEViLtE <br />CA99JIPAIGN fiNAiVCE REPQRT �ORM <br />Committee Name: ���`'�f�� � � ����""��Lm • <br />Office sought or held by candidate , <br />or purpose of politicai committee: �-����°`� � ��' �°' � � � � � �°' i � <br />Typ� of Organizatian: Candidate Commsttee Political (Action) Committee <br />Type of report: Initial report Post-general <br />Pre-primary Year-end �January) report <br />Pre-general Fifla� 1'e�Ot't {cioses committee account— <br />see M.S. Ch. 211A.03 for requirements) <br />Period of time covered by report: From �� �"~�� °� � � to � °�. �'� °� � � <br />SUNIMARY STAI'ENIEN7 TO DATE <br />TQtal For This Total From Tota! To <br />Report Previous Report Date <br />MAJOR CONTRIBUTORS <br />ALL OTHER CONTRiBUTBONS RECEIVED <br />EXPEND(TURES <br />SUtVINlARY O� EXPENDlTURES AIVD COlVTR18UTIONS FOR TH1S PERiOD <br />itemize a[I contributions made during the previous 3b5 days by an individua9 or commitCee that are greater than $50 in the <br />aggregate on a separate sheet. ltemization must provide amount, olate, name, address, employer or occupation if seff- <br />employed for all contributors. <br />An itemized list of al( expendit�res must aiso be provided, This must include date, purpose, and amount for each <br />expenditure. <br />Contributions less than/equa( to $SO <br />Contributions between $51 and $600 <br />Check here if within the previous year no individual, committee or organization has made one or more contributions that in the <br />aggregate are greater than $50. <br />Expenditures <br />Current Account Balar�ce <br />List the name and address of a!) depositories <br />holding th'ss �o x�t�i tee's deposits <br />Signature <br />Date: �'� . � � � <br />Printed 1Vame: �' � � �"i � ' � Email: ��� �a �° � �.� �# �'��►s � a� � <br />Address: �� � '� s� �. � `� � � �°'�"' �t�� �°S � �� Phone: � � �. `��� � � � � <br />Revised 7/2014 <br />