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CAMPAIGN FINANCIAL REPORT CERTIFICATION F FILING <br />Each county munici-pal o school district candidate o r treasurer of a committee formed <br />to Promote or defeat a ballot question shall certify to the filing officer that all reports <br />required by Minnesota Si 2 1 02 have been submitted to the filing o fie r or th at <br />the candidate or committee has not receive contri-butions. o r made disbursements <br />exceeding $750 in the calendar {ear. The certification shall be submitted to the filin <br />officer not later than seven days after the general on special election. (Mi Stat <br />21 1A. 05, subdivision 1 <br />Name of candidate or committee <br />Office sought by candidate <br />(if applicable) <br />O r <br />Identification of ballot question <br />Cheek the appropriate box below: <br />X -1, I do swear or affirm) that all campaign financial reports required b <br />Minnesota Statutes 211 A. 02 have been submitted to the filing officer. <br />I do swear or affirm that campaign contributions or disbursements did not <br />exceed $750 in the calendar year. <br />Ah <br />Q.j 0a <br />N&W, <br />(Signature 7T <br />candidate or committee tr asurer) (Date) <br />O ffice of the Minnesota Secretary of State rev. May 2008 <br />