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<br /> <br /> <br /> <br />Sub <br /> <br />· MINNESOTA AFFI.DAVITOF CANDIDACY <br />All information on this form is.availableto the pUblic. <br />Selet:ted information will appear on the sec:f9tary of State's web site: www.$Os.state.mn.us <br />Please print or type. <br /> <br />Name (as it will appear on the ballot): <br /> <br />~ ~~t~ <br /> <br />I <br /> <br />n <br /> <br />District # <br /> <br />For Partisan Office: <br />Political Party or Principle <br /> <br />For Judicial Office~---- <br />Name of Incumbent <br /> <br />eam ai. n contact information <br />Street address <br /> <br /> <br />City, State,Zip <br /> <br /> <br />()"\$ 1\1 . '\' <br /> <br />For allofjces,1 swear r 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, 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 />.. votefor.a majority of that party's candidates at the next general election. <br /> <br />IUilin'g fo.r one o.f the following offices,1 also swear (or affirm) that I meet the requirements listed below: <br />· United States. Senator -I will beat least 30 years old and acitizen 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 beat 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 aUeast 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 underMinnesota <br />Statutes, section 243.166. <br />County, Municipal, School District, or Special District Office - I meet any other qualifications for that office <br /> <br />;P;JLW5~~, 7-lL-ij. - <br /> <br />/ Candidate Signature Date <br />t( .. .-- I <br />ar.Jswombelor7r'h~_i1!r?~lLt ~o05 <br /> <br /> <br />other officer empowered to take and certify acknowledgments. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br />. <br /> <br /> <br />I <br /> <br /> <br /> <br />RaY. 4100 Minnesota Statutes, section 2046.06 <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 />