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vOF TH E ST9T <br />Fo Filin # <br />F~~~ ~~ Office of the Minnesota g <br />Cash/Check # <br />w ~ `_ 4 <br />d`'~~- =_ - -~ Secretary of State Atnount~ <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 />Please grlnt or <br />Name (as it will appear `{on the ballot): _ -J~~.~' ~' ~b ~1~$ a I~ <br />Office Sought: C 1't H Gp~ rN E, ~ ~ eta. ~~U District #: <br />For Partisan Office Provide Political Party or Principle: <br />For Judicial Office Provide Name of <br />Legal Residence Address <br />Street Address: ~ ~T~_l'~~~},i ~[, ~. ~/ ~ ~ ~,,,J <br />City: ~b S $KI~~~ G State: Mxl Zip <br />Campaign Contact Information <br />Street Address: '~ ~q ~ ~~UC i? 1r e ~ , <br />City <br />Wel: <br />Phol <br />r or an viuces, i swear for arnrm~ ><nar ems ~s my true name or the name by whtch 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 ntilmber is <br />and a copy of my license is attached. <br />• School Board Member - I have not been convicted of an offense for which registration is required under Minnesota Statutes, section 243.166. <br />County, Municipal, School District, or Special District Office - I meet any other qualifications for that office prescribed by law. <br />Subscribed and sworn before me this <br />s~. ( Obg' <br />Can i e i ature day of _- `~~ <br />D~/-~/-~-~ NOIIMy P1bb~#~11ftiNOfa ~~ ~~ <br />a e OawiYiMon J~nl1 !01st No public or othe fficer em veered to <br />otary s amp t e d certify acknowledgment . <br />Rev. S-08 <br />white copy -Filing Officer yellow copy - CFPD Board goldenrod copy -Candidate pink copy -Public Information <br />