HomeMy WebLinkAboutGary Peterson CAMPAIGN FINANCIAL REPORT CERTIFICATION OF FEELING
Each county, municipal or school district candidate or treasurer ofa 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 R. V^ L , \ e . c v g a ►-�
Office sought by candidate 1`,A C Li 0 v
(if applicable)
Or
Identification of ballot question
Check the appropriate box below:
I do swear (or affirm) that all campaign financial reports required by
Minnesota Statutes 211A.02 have been submitted to the filing officer.
V I do swear (or affirm) - are. • paign contributions or disbursements did not
exceed $750 in the • • lendar y
JAE' )) - 0 b
(Signature of can idate or committee treasurer) (Date)
Office of the Minnesota Secretary of State rev. May 2008
CAMPAIGN FINANCIAL REPORT
(All of the information in this report is public information)
Name of candidate, committee, or corporation
Office sought or ballot question District
Type of report Candidate report Period of time covered by report:
Campaign committee report
Association or corporation report
Final report from to
CONTRIBUTIONS
a 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 exceed $100 during the calendar year. This itemization must
include name, address, employer or occupation if self - employed, amount, and date for these contributions.
CASH $
IN -KIND $
TOTAL AMOUNT RECEIVED $ C✓
EXPENDITURES
Include the amount, date, and purpose for all expenditures made during the period of time covered by this report.
Attach additional sheets if necessary.
0
Date A
. '" Purpose Amount
F-1 ran
TOTAL 5f0
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.
co
Z
Project title or description
Date Purpose Name and Address Expenditure or
of Recipient Contribution
Amount
a
Total
0
I certify that this is a full and true stpetri n A d ■ L '16
0 . Signature Date
Printed Name ( IJ h 1 tt Telephone 6 1. 4)214/52 Email (if available)
Address ` 1(Z 1,1 Nit vU 'S '` � 6 L ''t, /4k) • I. Z
Revised May, 2008