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<br />..'.1', <br /> <br />MINNESOTA AFFIDAVIT OF CANDIDACY <br />All information on this form is available to the public. <br />;: Selected information will appear on the Secretary of State's web site: www.sos.state.mn.us <br />.f Please print or type. <br /> <br />.... <br /> <br />'" Name (as it will appear on the ballot): <br /> <br /> <br />(bok <br /> <br />\\) o..,teK- v'Y\ a t'\ <br /> <br />Office Sought District # For Partisan Office: For Judicial Office: <br />c;~ CfiLLV1~ ( Political Party or Principle Name of Incumbent <br /> <br /> <br />55""\ , 2> <br /> <br />Campai n contact information optional): <br />Street address r #. ~ '"L~ ':l... <br />:7-355'" rO \ {oJ ,evJ -f"tv-e. ft- c:r--J -.".I <br /> <br />City, Stat~ ~ \f " t u. N rJ Ss-\ \ 3 <br /> <br />Phone nu ~~ .- 3'-t C( \ <br /> <br /> <br />{V\ <br /> <br />For all 0 ic s, I swear (or affir ) that this is my true name or the name <br />community. <br /> <br />If filing for a state or local office, I also swear (or affirm) that: <br />· I am eligible to vote in Minnesota; <br />· I have not filed for the same or any other office at the upcoming primary or general election; <br />· I am, or will be on assuming office, 21 years of age or more; <br />· I will have been a resident of this district for at least 30 days before the general election; and <br />· If a major political party candidate, I either participated in the party's most recent precinct caucus or intend to <br />vote for a majority of that party's candidates at the next general election. <br /> <br />If filing for one of the following offices, I also swear (or affirm) that I meet the requirements listed below: <br />· United States Senator - I will be at least 30 years old and a citizen of the United States for nine years on the <br />first Monday of next January, or if filled at special election, within 21 days after the election. <br />United States Representative - I will be at least 25 years old and a citizen of the United States for seven years <br />on the first Monday of next January, or if filled at special election, within 21 days after the election. <br />Governor or Lieutenant Governor - I will be at least 25 years old on the first Monday of next January and a <br />resident of Minnesota for one year on election day. I am filing jointly with <br />Supreme Court Justice, Court of Appeals Judge, District Court Judge, or County Attorney - I am licensed <br />to practice law in Minnesota. My Minnesota attorney license number is <br />State Senator or State Representative - I will be a resident of Minnesota at least one year and of this district <br />for six months on the day of the general or special election. <br />County Sheriff - I am a licensed peace officer in Minnesota. My Board of Peace Officer Standards and Training <br />license number is <br />School Board Member - I have not been convicted of an offense for which registration is required under Minnesota <br />Statutes, section 243.166. <br />Coun . ipal, School District, or Special District Office - I meet any other qualifications for that office <br />escribed by I . <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br /> <br />(-\~--O l <br />Date <br /> <br />Ca ate Signature <br />+k. <br />Sub~cribed and sworn before~e t~is I ~ - <br />vul J~. <br /> <br />Notary public r other officer empowered to ta e and certify acknowledgments. <br />Rev. 4/00 Minnesota Statutes, section 204B.06 $ ~ . C ~L <br />white copy - Filing Officer yellow copy - CFPD C C- <br /> <br />dayorSu...la aOO t <br /> <br />........&.&.&.&..&....4.....4&41 <br />l~........................".....' <br />ARQARer 1=1. DRISCOLL <br />NOTARY PUBLIC ~ MINNESOTA <br />My Comm. Expires Jen. 31,2005 <br />. . <br /> <br /> <br /> <br />goldenrod copy - Candidate <br /> <br />pink copy - Public Information <br />