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): /'14((1< HZ.' ~5'AAAJY Office Sought District # For Partisan Office: Political Party or Principle For Judicial Office: Name of Incumbent jJ UW./lC-I~ I al residence address optional): eam ai n contact information optional): Street address Street address ~.zS- L T-'1 VI T:. City, State, Zip f) /(OrEvrLL-E /-1-V S-S "3 Web site and/or e-mail address J,)~. I'A . ;'....-t::. -"f"i S~ For all offices, I swear (or affirm) that this is my true name or the 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. Subscribed an Candidate Signature ~1 {.-'E A :;}.~ Date icer empowered to take and certify acknowledgments. Rev. 4100 Minnesota Statutes, section 2046.06 (Notary stamp) white copy - Filing Officer yellow copy - CFPD goldenrod copy - Candidate pink copy - Public Information