HomeMy WebLinkAbout2006 Gary L. PetersonCAMPAIGN FINANCIAL REPORT CERTIFICATION OF FILING
Each county, municipal or school district candidate or treasurer of a committee formed to promote or
defeat a ballot question shall certify to the filing officer that all reports required by Minnesota Statutes
211A.02 have been submitted to the filing officer or that the candidate or committee has not received
contributions or made disbursements exceeding $750 in the calendar year. The certification shall be
submitted to the filing officer not later than seven days after the general or special election. (Minnesota
Statutes 211A.05, subdivision 1)
Name of candidate or committee ~ l_ .~!
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Office sought by candidate
(if applicable)
or
Identification of ballot question
Check the appropriate box below:
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re of candidate or committee treasurer)
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I do swear (or affirm) that all campaign financial reports required by
Minnesota Statutes 2'11A.02 have been submitted to the filing officer,
I do swear (or affirm) that campaign contributions or disbursements did not
exceed~750 in the calendar year.
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(Date)
Office of the Secretary of State 43 Last Updated: May 2004
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CAMPAIGN FINANCIAL REPORT
(All of the information in report is puBli~r-infel~mation)
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Name of candidate, committee, or corporatiottn ~-~ h+ + "TM ~%~`-°
Office sought or ballot question ~ Y(~ District ~ ~. `
Type of report Candidate report Period of time covered by report:
Campaign committee report f /
Association or corporation report ~`1 (~~
Final report from _to 1 ~L
ar~oiflAY _-__ ______ ~ I®~~
CONTRIBUTIONS RECEIVED
Give the total for all contributions received during the period of time covered by this report. Contributions should be
listed by type (money or in-kind) rather than contributor. (See note on contribution limits on the back of this form. Use a
separate sheet to itemize all contributions from a single source that are equal to or greater than $500 during the
calendar year.)
CASH $ :~~~
iN-KIND $
TOTAL AMOUNT RECEIVED $ ~~ ~
EXPENDITURES
Include every disbursement made for a political purpose during period of time covered by report. Attach additional
sneers it necessa
Date
Pu ose
Amount
~`L l {'.' G3 ~ t F~R.+f i C C'a l (1 r "''° J i AJ ~U ~°°tJ`
/ -- k art ! 1`~C i">YLi nr i j a~ C> Z ~ Cz Cs
TOTAL C ~ 'P ~
CORPORATE PROJECT EXPENDITURES
Corporations must list any media project or corporate message project for which contribution(s) or expenditure(s) total
more than $200. Submit a separate report for each project. Attach additional sheets if necessary.
Project title or description
Date Purpose Name and Address
of Recipient Expenditure or
Contribution
Amount
Total
I certify that this is a f¢uli and true statement:
Address ~, } i _ . E ~% ~'~ ~)
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Date
CAMPAIGN FINANCIAL REPORT
(All of the information in~ri;~ report is publip infq
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CONTRIBUTIONS RECEIVED
Give the total for all contributions received during the period of time covered by this report. Contributions should be
listed by type (money or in-kind) rather than contributor. (See note on contribution limits on the back of this form. Use a
separate sheet to itemize all contributions from a single source that are equal to or greater than $500 during the
calendar year.)
CASH $
IN-KIND } $ ~ , ' ~~
TOTAL AMOUNT RECEIVED $ ~ °~'~
EXPENDITURES
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Include every disbursement made for a political purpose during period of time covered by report. Attach additional
sheets if necessa
Date Pu ose Amount
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TOTAL
CORPORATE PROJECT EXPENDITURES
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Corporations must list any media project or corporate message project for which contribution(s) or expenditure(s) total
more than $200. Submit a separate report for each project. Attach additional sheets if necessary.
Project title or description
Date Purpose Name and Address
of Recipient Expenditure or
Contribution
Amount
Total
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I certify that this is a ful( and Prue statem~~ -.~
e Signature 1 " , ~ Date
Address 6 ~ t tU ~t. '~ ~~~. a ~. ~ a ,. ~ ~ _ .V ~t