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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 appear on the Secretary of State's web site: www.sos.state.mn.us <br />Please print or type. <br /> <br />C ft\ i <br /> <br />Name (as it will appear on the ballot): <br />KJtt IASi() <br /> <br />Office Sought <br /> <br />District # <br /> <br />For Partisan Office: <br />Political Party or Principle <br /> <br />For Judicial Office: <br />Name of Incumbent <br /> <br /> <br />Campai n contact information optional): <br />Street address <br />.J'e'l h) e. <br />City, State, Zip <br />J me <br />Phone nu ber <br />~- <br /> <br />For all office, I swear (or affirm) that this is my true nameorthe name by which I am generally known in the <br />community. <br /> <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 />· County, Municipal, School District, or Special District Office - I meet any other qualifications for that office <br />p-rescribed~y I w. <br /> <br />~, ~ ' 71/~-.? <br /> <br />/ Candidate Ignature Date <br /> <br />Slbscribed andswom before me this I~:t dayo! {Ldjt '1-. MERRILEE C. SMITH ,. <br />e U NOTARY PUBLIC-MINNESOTA <br />My Comm. Expires Jan. 31, 2005 <br />blic or other officer empowered to take and certify acknowledgments. . _ <br /> <br />Rev. 4100 Minnesota Statutes, section 2046.06 (Notary stamp) <br /> <br /> <br />white copy - Filing Officer <br /> <br />yellow copy - CFPD <br /> <br />goldenrod copy - Candidate <br /> <br />pink copy - Public Information <br />