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<br /> <br />MINNESOTA AFFIDAVIT OF CANDIDACY <br /> <br />All information on this form is available to the public. <br />Selected information will appearon the Secretary of State's web site: www.SOs.state.mn.us <br />Please print or type. <br /> <br />I <br /> <br />Name (as it will appear on the ballot): <br />~j,Y1 " }(J' /(vsy /YC-ZYh <br /> <br />I <br /> <br />Office Sought District # For Partisan Office: For Judicial Office: <br />C, t-y CoU""~' .j Political Party or Principle Name of Incumbent <br /> <br /> <br />Campai n contact information optional): <br />Street address <br /> <br />City, State, Zip <br /> <br />Phone number <br /> <br />For all offices, I swear (or affirm) that this is my true name or the name by which I am generally known in the <br />community. <br /> <br />It tiling tor 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 />It tiling tor one ot the tollowing 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 ot 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 />County, Municipal, School District, or Special District Office - I meet any other qualifications for that office <br /> <br />~V <br />7 Candidat gnature <br />ribed and swo 15 <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />7//S/o3 <br /> <br />. <br />Date <br /> <br /> <br />~/y <br />, <br /> <br />.AMt/c,V.~J""'h..VN^V"'-hW.A. <br />I AAGAREr H. DRISCOLL' <br />NOTARY PUBLIC - MINNESOTA <br />My Comm. Explres Jan. 31, 2005 <br />. . <br /> <br />Notary public or other officer empowered to take and certify acknowledgments. <br /> <br />Rev. 4100 Minnesota Statutes. section 2048.06 <br /> <br />white copy . Filing Officer <br /> <br />(Notary stamp) <br /> <br />yellow copy . CFPD <br /> <br />goldenrod copy . Candidate <br /> <br />pink copy . Public Information <br /> <br />- <br /> <br />