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CITY OF ROSEVILLE <br />CAMPAIGN CONTRIBUTION REPORT <br />candidate for office must file with the City Clerk. <br />no in dividual, committee or organization has made <br />ore or more contributions that in the aggregate are greater than $50; r <br />Within the previous year the following 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 Employer or occupation <br />contribution committee or organization if self employed <br />(Use additional sheets, if needed.) <br />Name of C <br />Marne of Person filing report <br />Address of Person filing report 2,9 .32- t-k, (j t, A /L/ <br />�5S <br />Signature <br />Period of time covered by this report: From g to <br />All information in this report is public information. <br />(Over) <br />