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~FTHEg?. <br />Pv,. ~,,p,Le uU,y a~~ <br />F ~ ~°~ Office of the Minnesota <br />w - r ;:-=r-:~ <br />~~ == -~-~~~ Secretary of State <br />~,~.. = yon <br />'~*185$y.~d <br />Affidavit of Candidacy <br />All information on this form is available to the public. Information provided will appear on the Secretary of State's website at <br />www.sos.state. mn.us. <br />Note: If filing for partisan office and not a major party candidate, you must file both an affidavit of candidacy and a nominating petition: "Candidates <br />for any partisan office who do not seek the nomination of a major political party shall be nominated by nominating petition as provided in sections <br />204B.07 and 204B.08, and ...shall file an affidavit of candidacy as provided in section 204B.06." (Minn. Stat. section 204B.03). <br />YleaSe UI'lIlt Ot' h'Ue. <br />ter-- ~Oh n~ -- <br />Name (as it will appear on the ballot): 1 ~ /~-'1 <br />Office Sought: ~~~ ~ Y~2~W~ ~ District #: <br />For Partisan Office Provide Political Party or Principle: <br />For Judicial Office Provide Name of Incumbent: <br />Legal Residence Address <br />Street Addr s: ~~~0/ ~1G~'ti ~- <br />City: ~ ~ ~ State: ~`~ Zip: -~~~ ~ ~_ <br />Campaign Contact Information <br />Street Addres ~ 6~ <br />City: ~/`~~ State: Zip: ~j ~ <br />Website: '"'}"`i''''1 ~/,0 h ~l SO n IrU~PrU ~ ~ ~ Email: ~ ~ -- ~ a ~ ~~ ~. J~1- C~~/~ <br />Phone Number: ( l/ S~ 1 Z~~- ~ ~- ~D~J <br />r ur an uu~ces, t swear for atttrml that tnts is my true name or the name by which 1 am generally known in the community. <br />If Tiling 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 maintained residence in 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 caucuses or intend to vote for a majority of that party's <br />candidates at the next general election. <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 be an inhabitant of this state when elected and I will be at least 30 years old and a citizen of the United States for not <br />less than nine years on the next January 3rd, or if filled at special election, within 21 days after the election. <br />• United States Representative - I will be an inhabitant of this state when elected and I will be at least 25 years old and a citizen of the United States <br />for not less than seven years on the next January 3rd, 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 the next January and a resident of Minnesota for not less <br />than 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 learned in the law and licensed to practice <br />law in Minnesota. My Minnesota attorney license number is and a copy my license is attached. <br />• State Senator or State Representative - I will be a resident of Minnesota not less than one year and of this district for six months on the day of the <br />general or special election. <br />• County Sheriff - I am a licensed peace officer in Minnesota. My Board of Peace Officer Standards and Training license number is <br />and a copy of my license is attached. <br />• School Board Member - I hav t been convicted of an offense for which registration is required under Minnesota Statutes, section 243.166. <br />County, Mu , Scho istrict, or Special District Office - I meet any other qualifications for that office prescribed by law. <br />Subscribed and sworn11before me this <br />Candidate Signature ~ d y of ~I~..Lt._ ~~~ <br />~ /~ ~ Q~ ~'" ~~~~E MARGARET H. DRISCOLL ' <br />_ =Notary Public-Minnesota ~• <br />Date ~ .„: ~ + cgnmbaip~ ra Jan 31, 2oio Notary blic or other office empowered to <br />take and certify acknowledgments. <br />Filing # <br />Cash/Check # <br />Amount $ <br />Rev. 5-08 <br />white copy -Filing Officer yellow copy - CFPD Board goldenrod copy -Candidate pink copy -Public Information <br />