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CITY OF ROSEVILLE <br />CAMPAIGN CONTRIBUTION REPORT <br />candidate for office must file with the C ity 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 fallowing individual(s), committee(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 Employe or occupa <br />ontri tion <br />�n tfie or or tan if self e mployed <br />(Use additional sheets, i f n eeded. <br />Name of Candidate M114d <br />Dame of Person filing report <br />Address of Person filing rep p q Ito6j <br />Period of time covered b y this report:' From. i" to <br />to <br />All inform ion in this report is public information, <br />(Over) <br />