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<br /> <br /> <br />MINNESOTA AFFIDAVIT OF CANDIDACY <br />All in!Qrmation on this foim is available to the public. <br />Se/ectlldin!Qnnation will appearon the Secretary of State's web site: WMIW.sos.state.mn.us <br />Please print orty,.. <br /> <br />Name (as it".,iUappear o.n the ballot): <br /> <br />I fl fYl~ tr I-ILl1iA; <br /> <br />I <br /> <br />District # <br /> <br />For Partisan Office: <br />Political Party or Principle <br /> <br />For Judicial Office: <br />Name of . Incumbent <br /> <br />c Av"- <br /> <br />Camai n contact information <br />Street address <br /> <br /> <br />City, State, Zip <br /> <br />hh~}n~m!035 -91 52. W.. bl:J - $3,7- <br /> <br />For all offices,. I swear (or affirm) that this is my true name or the name ~y which I am generally known in the 89/0 <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 offic~s, I also swear (or affirm) that I meet the reqUirements listed beloW': <br />· UnitedStatesSenator-1 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 vviUbe 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 />SchoolB()ardMember - 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 DistrictOffice,- I meet any other qualifications for that office <br />~cribedby law. <br />/ J Q/.JL <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br /> <br /> <br />JU/j /'-1) ;)o().~ <br />Date <br /> <br /> <br />Candidate Signature ~ <br /> <br />~"f"J.wornbelorem'this~daYof ' , lc0' "JU.J5. <br />({~( ,\, kt\ '~2l,- v <br />powered to take and certify acknowledgments. <br /> <br /> <br />Minnesota Statutes, section, 2048,06 <br /> <br />white copy - Filing Officer <br /> <br />yellow copy - CFPD <br /> <br />goldenrod copy - Candidate <br /> <br />pink copy - Public Information <br />