2004 Affidavit of Candidacy - City Council Special Election

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MINNESOTA AFFIDAVIT OF CANDIDACY All information on this form is available to the public. Selected infonnation will appear on the Secretary of State's web site: www.sos.state.mn.us Please print or type. Name (as it will appear on the ballot): A(V):f IHLAw' Office Sought G~ CatAVl G4. I Le al residence address optional): Street adcjressc- ..L. b ~ J 1\ 171 ~ .:;:)-1 ~t'\ n 0 ~"..V(. cks~~e~ /le.. mAJ ~$"113 Web site and/or e-mail address Cc.m ,hlQV\ ~ o-r' District # For Partisan Office: Political Party or Principle For Judicial Office: Name of Incumbent eam ai n contact information (optional : Street address City, State, Zip Phone n ~rl) '"''3> S _ ~ 1$"2-, For all offices, I swear (or affirm) that this is my true nameorthe name by which I am generally known in the community. If filing for a state or local office, I also swear (or affirm) that: · I am eligible to vote in Minnesota; · I have not filed for the same or any other office at the upcoming primary or general election; · I am, or will be on assuming office, 21 years of age or more; · I will have been a resident of this district for at least 30 days before the general election; and · If a major political party candidate, I either participated in the party's most recent precinct caucus or intend to vote for a majority of that party's candidates at the next general election. If filing for one of the following offices, I also swear (or affirm) that I meet the requirements listed below: · United States Senator - I will be at least 30 years old and a citizen of the United States for nine years on the first Monday of next January, or if filled at special election, within 21 days after the election. United States Representative - I will be at least 25 years old and a citizen of the United States for seven years on the first Monday of next January, or if filled at special election, within 21 days after the election. Governor or Lieutenant Governor - I will be at least 25 years old on the first Monday of next January and a resident of Minnesota for one year on election day. I am filing jointly with Supreme Court Justice, Court of Appeals Judge, District Court Judge, or County Attorney - I am licensed to practice law in Minnesota. My Minnesota attorney license number is State Senator or State Representative - I will be a resident of Minnesota at least one year and of this district for six months on the day of the general or special election. County Sheriff - I am a licensed peace officer in Minnesota. My Board of Peace Officer Standards and Training license number is School Board Member - I have not been convicted of an offense for which registration is required under Minnesota Statutes, section 243.166. County, Municipal, School District, or Special District Office - I meet any other qualifications for that office prescribed by law. ~ J-0t-a- Candidate Signature 'OiL I .- Subscri . . . . . . . ~. I~ :;loa y Date ayof r~rLA.ttV ~ J ~{)D.tf er officer empowered to take and certify acknowledgments. Rev. 4100 Minnesota Statutes, section 2048.06 white copy - Filing Officer yellow copy - CFPD pink copy - Public Information goldenrod copy - Candidate