HomeMy WebLinkAboutA003 - Affidavit of Candidacy - Robert Shaffer Form 2-M (Rev.95)[45.3]
Prescribed by the
Iowa Secretary of State
STATE OF IOWA
AFFIDAVIT OF CANDIDACY
School and City Elections
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For the office of
(Include district number,if any)
Check here if election is to fill a vacancy.
Date of Election:
Name (exactly as you
want it to appear on the ballot):
Home Address: 4/ L)g ;�-7�
City and Zip Code: 5
County: %�M �'�
I swear or affirm that the information I have provided above is correct. I am a candidate for the office indicated
above and request that my name be printed on the official ballot for this election. I am eligible to hold the office for which
I am a candidate; if I am elected I will qualify by taking the oath of office. I know that I cannot hold a public office if I have
been convicted (and never pardoned) of a felony or other infamous crime.
I know that I am required to organize a candidate's committee which shall file an organization statement and
disclosure reports if my committee or I receive contributions, make expenditures, or incur indebtedness in excess of five
hundred dollars ($500) in a calendar year for the purpose of supporting my candidacy for public office. [This paragraph
does not apply to candidates for federal offices.]
I know that I cannot be a candidate for more than one office to be filled at this election. If I have filed nomination
papers for more than one office I must file with the officer who accepted my nomination papers an affidavit indicating for
which office I choose to be a candidate. I understand that if the affidavit is not filed by the last day candidates can file
nomination papers, I cannot be a candidate for any office on the ballot at this election. [This does not apply to county
agricultural extension council, soil and water conservation district commissioner, or regional library trustees.]
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Signed:
Signed anCswom o (or affirmed) before me on — `�S (date) by
1 . r— (print candidate's name).
��a cep r,,:, ;- Signature of Notes Public(for o er offs {authorized to witness oaths)
= fry ` Official Title: �L�,l ( If✓L�: `fF1 AGc���J.e
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My commission expires:
Form 59
—11 1-11011{SONS CO,H'Aflticia,K, D35 0.559 (Revised July 1990)
(Choptor 45,code of Iowa)
STATE OF IOWA
Nomina-11"ion Petition
For Nonpartisan Nominations and Nonparty Political Organizations
For the office of
I, the undersigned eligible elector of the State of Iowa, do hereby
��� / <^ r (If applicable,district or other division)
nominate Y// ` CZ of /"z 2 /U Iowa,
(Nome of candidate) (Address)
as a candidate of_. for the
.1 (Name of nonporly Political organization, if any)
office of `7r 6G��I�`c� Chi �1 i,,Z to be voted for
at an election to be held on
N A M E RESIDENCE (Add School District, if needed)
(Signature), STREET AND NUMBER, IF ANY Y DATE SIGNED
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(OVER)
Form 59 —J
mnrr uortorr s sari co.,wAr[noo,aws D95 0-559 (Revised July 1990)
(Chapter 45.code of Iowa)
STATE OF IOWA
Nominc Lion Petition
For Nonpartisan Nominations and Nonparty Political Organizations
For the office of �/ �A/p�� �4"4c//
I, the undersigned eligible elector of the State of Iowa, do hereby
// / V (If applicable,district or ocher division)
nominate oaCJ�✓" /L sG�Cl ✓ — of 1�Z "V,, /Z/- Iowa,
(Name of candidate)
(Address)
as a candidate of for the
(Noma of nonparty political organization,if any) I
office of-
to be voted for
at an election to be held on �v- 19 Yam`
N A M E RESIDENCE (Add School District, if needed)
(Signature) STREET AND NUMBER, IF ANY CITY DATE SIGNED
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(OVER)
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