Laserfiche WebLink
<br /> <br /> <br /> <br />· MINNESOTA AFFIDAV.IT.OF CANDIDACY <br />All information on this fQrmissvailable to the pUblic. <br />Selected inf()rmation will appear on the Secretary of State's web site:www.sos.state.mn.us <br />I Please print or type. <br /> <br />J--ram <br /> <br />Narne (as it wiU appear. on the ballot): <br /> <br />d.1( C7&ke.~ <br /> <br /> <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 beat least 30 years old and a citizen of the United States for nine yearsonthe <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 />Go.vernor 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 -lam licensed <br />to practice law. in Minnesota. My MinnesotCi attorney license number is <br />State Senator or State Representative - I will be a resident of Minnesota at least one year and oHhis 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 />StCitutes, section 243.166. <br />County, Municipal, School. Oistrict, or Special District Office -I meetany other qualifications for that office <br />prescribed by law. <br /> <br />\~llkf' ...... Sf"71; I /:Z'/:~ <br />\ . ca... ndidate Signatur. e .. (,,' _ <br /> <br />s~~. a.nd s~ ~o.r~ meth' I ~ day of 2) i l (, I ,;) Dc)? <br /> <br />Q ctt\ III 0:. j .{ ( '011 \ v <br />NotarYPl:lb cor otheroffi~er empow red to take and certify acknowledgments. <br /> <br /> <br /> <br />District # <br /> <br />For Partisan Office: <br />Political Party or Principle <br /> <br />For Judicial Office: <br />Name of Incumbent <br /> <br />(it) u wJ <br />Le alresidenceaddress <br />Street ~ddress <br />" ~4 <br /> <br /> <br /> <br />eam ai n contact information <br />Street address <br /> <br />13 <br /> <br />City, State, Zip <br /> <br />Phone number <br />t1 5'- f., t./ 5'. z tj 7.3 <br /> <br />For all offices, I sw r(or affirm) that this is my true name or the name by which I am generally known in the <br />community. <br /> <br />If filing for a state or local office,1 also swear (or affirm) that: <br />· I am eligible to votein Minnesota; <br />· I have not filed for the same or any other office at the upcoming primary or general election; <br />· lam, 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 />· Ita 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 />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />-+//7 Jus.~ <br />. Date <br /> <br /> <br />I <br /> <br /> <br />Rev. 4100 Minn.esota Statutes, section 204B. <br /> <br />white copy - Filing Officer <br /> <br />yellow copy - CFPD <br /> <br />pink copy - Public InfOrmation <br /> <br />goldenrod copy- Candidate <br />