Fridley Citizens for a New City Hall - Report 1 RECEIVED DEC 0 6 2016
CAMPAIGN FINANCIAL REPORT
(All of the information in this report is public information)
Name of candidate,committee or corporation Fr.../A,.7 cf Ti Z } . t... } 4-61-4-%- '-I 111 ALL--
Office sought or ballot question District
Type of Candidate report Period of time covered by report:
report X Campaign committee report
Association or corporation report from i - to /IAA--
Final report
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
a 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
a) from a single source that exceeded$100 during the calendar year.This itemization must include name,address,employer or occupation if
cc
self-employed,amount and date for these contributions.
CASH $ x.11. C i TOTAL CASH-ON-HAND $ 5-al • �"
IN-KIND + $
TOTAL AMOUNT RECEIVED _
- $ L&
DISBURSEMENTS
Include the amount,date and purpose for all disbursements made during the period of time covered by report.
Attach additional sheets if necessary.
v
Date Purpose Amount
u_
0
TOTAL
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.
v Project title or description
Date Purpose Name and Address Expenditure or
of Recipient Contribution
Amount
E
•
z
TOTAL
c
1.:0 �
Z
8 I certify that this is a full and true statement. _
ffillr
Sign-ture Da e
S fir7?t t�3 i2 i Ef t a T
o Printed Name .J U1 t Z'. Telephon4 Tc &lEmail(if available) Ci AA/1-14- . 4=tayk
L t
Address I UT 1i 14 i4'N fir V 1..i�N Fit i 0 t'`� ) c�a Iii vs°1 a
Office of the Minnesota Secretary of State-2016 Campaign Manual
69