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2016 Lund, Scott - Campaign Certification City Clerk's Office Date Received Il_2 Forward to __ . ..,.R. C2iiy to Office of the Minnesota Secretary of State 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 Se.-0-1- 440'0 Office sought by candidate (if applicable) 1)9 iniiyOk Identification of ballot question (if applicable) Certification Select the appropriate choice below,and sign: I do swear(or affirm)that all campaign financial reports required by Minnesota Statutes 1I 211A.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. Signature of candidate or committee treasurer /I# ` /01/k; 1 Date Office of the Minnesota Secretary of State-2016 Campaign Manual 71 T_