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12/08/08 08:47 FAX 9529498890 FARGO ELECTRONICS 991 <br />CAMPAIGN FINANCIAL REPORT CERTIFICATION of FILING <br />Each county, municipal or school district candidate or treasurer of a committee formed to promote or <br />defeat a ballot question shall certify to the filing officer that all reports required by Minnesota Statutes <br />21 1A.02 have been submitted to the filing officer or that the candidate or committee has not received <br />contributions or made disbursements exceeding $750 in the calendar year. The certification shall be <br />submitted to the filing officer not later than seven days after the general or special election. (Minneso <br />Statutes 211A. 05, subdivision 1) <br />.0 �'l Anso n <br />Name of candidate or committee v✓1 <br />Office sought by candidate <br />(if applicable) <br />or <br />Identification of ba llot question <br />Check the appropriate box below: <br />I do swear or affirm) that all campaign financial reports required by <br />Mi nnesota Statutes 21 1 A.02 have been submitted to the filing officer, <br />do swear (or affirm) that campaign contributions or disbursements did not <br />exceed $750 in the calendar year. <br />(Signature of candidate or committee treasurer) (Date) <br />