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CITY OF ROSEVILLE <br />CAMPAIGN CONTRIBUTION REPORT <br />A candidate for office must file with the City Clerk. <br />Within the previous year no individual, coinmittee or organization has made <br />one or more contributions that in the aggregate are greater than $50; or <br />�_Within the previous year the following individual(s), corrunittee(s) or <br />organization(s) has (have) made one or more contributions that in the aggregate is <br />(are) greater than $50. <br />Date of Amount Name of individual, Address Employer or occupation <br />contribution committee or organization if self employed <br />�j/y7 �G�1a� Y�� �� 1,�; t�tu..� ��.2;d..�.a ZS3z N�lr�. w.,� �`�-_ <br />(Use additional sheets, if needed.) <br />Name of Candidate �� l.v ; �� � S <br />Naine of Person filing report �.���, t,J<<\w,,�s <br />Address of Person filing report ZS3z- H� �� �- k� ^' ��<<�-''`'`"� �"3 <br />Signature <br />Period of tiine covered by this report: From 3�7�to�v to 7�y���Y <br />All infonnation in this report is public infonnation. <br />(Over} <br />