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F ON M c E �-�ae FAX NO G5 1 G45 2990 Oct. 2E 20 09 :25AN P1 <br />CITY OF ROSEVILLE <br />CAMPAIGN CONTRIBUTION REPORT <br />candidate fo offi must file with th zt r Cl <br />Within the previous year no 1nj.U, coinnuttee or Or ganization <br />one or mo co n tributions that Am the a ggega te are eater than o r <br />Within the previous year the it individual(s), committee r <br />organization(s) has (have) ma do one or more contrib utions that in the aggregate i <br />(are) greater: than $50 <br />Date of Amount a of individual, ddress Employer or occupation <br />c on tri ion committee #on if self emp loyed <br />Mse additional sheets, if ndd; <br />Name o f Cand r <br />Name of Person ffflng repot c <br />Address o f Person filing repot <br />Signer <br />Prod of covered by tbis report: From <br />All information this report public in <br />M is formation <br />(over) <br />