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CITE' OF 12OSEVILLE <br />CAMPAICsN CONTRIBUTION REPORT <br />A candidate for office must file with the City Clerk. <br />Within the previous year no individual, committee 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), omm *tte (s) o <br />organization(s) has (have) made one or more contfibutions that in the aggregate is <br />are) greater than $50. <br />Date of mo nt Name of individual Address <br />Employer r occupation <br />ti on o� tt r� o a x at o m o d <br />-contri <br />(Use additional sheets, if needed•) <br />Name of Candidate ,'J?/A-NS Qi)E; FV� <br />Name of Person filing repot <br />Address of ersor filing report Z o o F, <br />r <br />Si <br />Period of time covered b y this report: From I Z Z 09 to t Z <br />All i nfonnation in this report is public information. <br />(Over) <br />