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CITY OF ROSEVELLE <br />CAMPAIGN CONTRIBUTION REPORT <br />A candidate for office must file with the City Clerk. <br />Within the previous year no intlavidual, 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), 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 N me of individual, Address Employer or occupation <br />contribution roan nittm or orord=tion I if self emloved <br />(Use additional sheets, if needed.) <br />Name of Candidate <br />Name of Person r r,L <br />Address of Person filing report S, I S 1Vj I l 1 w obrQ A <br />�<L,v i l l NUi/ S S 11 /3 <br />Signature <br />Period of time covered by this report: From M I to <br />All information in this repot# is public information. <br />(Over) <br />