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CAMPAIGN FINANCIAL REPORT CERTIFICATION OF FILING
Instructions
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).
Campaign Information
Name of candidate or committee 14 U -e'1. 70 k_
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Office sought by candidate (if applicable) ( , �c j,�0-(--i1 I
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Identification of ballot question (if applicable)
Certification
Select the appropriate choice below, and sign:
'm I do swear(or affirm)that all campaign financial reports required to date by Minnesota
A Statutes 211A.02 have been submitted to the filing officer.
7j .I do swear(or affirm)that campaign contributions or disbursements did not exceed
' !'l $750 in the calendar year.
7 IISignature of candidate or committee treasurer ./i/ I ' AEI
Date 2-- c'E1 1
Office of the Minnesota Secretary of State
2018 Campaign Manual
71