HomeMy WebLinkAboutA007 - Affidavit of Candidacy - Dale Messenger e
Form 2-M(Rev.95)[45.31
Prescribed by the
Iowa Secretary of State
STATE OF IOWA
AFFIDAVIT OF CANDIDACY
School and City Elections
Forthe office of "ary Greeley Medical Center Trustee
(Include district number,if any)
MCheck here if election is to fill a vacancy.
Date of Election: it - Sf
Name (exactly as you want it to appear on the ballot):
Dale E . Messenger
Home Address: 2022 Greeley
City and Zip Code: Ames 50014
County: Stor_
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.
which shall file an organization statement and
I know that I am required to organize a candidate's committee
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.]
Signed: i.
Signed and sworn to (or affirmed) before me on
C�f- P-j�N �,�1Z Zco I ( (date) by
E SS V- G.C--SZ--. (print candidate's name
Signatur of Notary Public(or other office uthorized to witto �
ss o s)
WNHARD K.FRIEDRICH Official Title: �oTAR�/ c�TVRy °
My COMMISSION EXPIRES ! p 4
Z'`I q(o My commission expires: A Plzl L ZI
Y
r . ." L-::
Form 59` .,..on s s n co,w,nnoo.p , w, 0.559 (Rovlsed July 1990)
(Chople(45,code of Iowa)
STATE OF IOWA
Nomination Petition
For Nonpartisan Nominations and Nonparty Political Organizations
For the office of Mary Gr-eelev "edical Center "'rustee
I, the undersigned eligible elector of the State of Iowa, do hereby
(If applicable,district or ocher division)
nominate Dale E . ?`lessen-er of 2022 Creele-17 Ames Iowa
(Name of condidoie) (Address)
as a candidate of for the
(Nome of nonporly polilicol or9oni:olion, if ony)
office of Trustee to be voted for
at an election to be held on November 7 1¢)5
N A M E RESIDENCE (Add School District, if needed)
(Sign ure) -7 STREET AND NUMBER, IF ANY CITY DATE SIGNED
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(OVER)
Forrn,59
w "too. ^ DJs o-559 (Revised July 1990)
. (Chapter 45,code of Iowa)
STATE OF IOWA
(Nomination Petition
For Nonpartisan Nominations and Nonparty Political Organizations
For the office of Mary Greeley ',Iedical Center '7rustee
I, the undersigned eligible elector of the State
of Iowa,
Da 1 e r . "�essen�er (If applicable,disuicl or other division) d0 hereby
nominate
(Name of condidole) of 2022 (,reele-,7 Ames Iowa
as a candidate of (Address) i
office of Trustee (Nome of nonparty political or9anlimion, if any) for the
to be voted for
at an election to be held on November 7 1¢�S
N A M E RESIDENCE (Add School District, if needed)
(Signature)
STREET AND NUMBER, IF ANY CITY DATE SIGNED
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Form 59
� M.rr r.••ort s sor+s co.,w.nnoo.pws D35 0.559 (Rovised July 1990)
(Chapter 45,code of Iowa)
STATE OF IOWA
Nomination Petition
For Nonpartisan Nominations and Nonparty Political Organizations
For the office of Mary Greeley TTedical Center Trustee
I, the undersigned eligible elector of the State of Iowa, do hereby
(If applicable,district or other division)
nominate Dale E . Messenger of 2022 (rreele-V Ames Iowa,
(Name of candidate) (Address)
as a candidate of for the
(Name of nonpony pohGcol organization, if any)
office of Trustee
to be voted for
at on election to be held on November 7 1¢a 5
N A M E RESIDENCE (Add School District, if needed)
(Signature) STREET AND NUMBER, IF ANY CITY DATE SIGNED
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(OVER)
Form 59
.w.n r..ron A sa.n co.,w.nnoa.io.,,A 075 0-559 (Rovisod July 1990)
(Chapter 45,code of Iowa)
STATE OF IOWA
Nomination Petition
For Nonpartisan Nominations and Nonparty Political Organizations
For the office of _Vary Greelev '"Tedical Center -rustee
I, the undersigned eligible elector of the State of Iowa, do hereby
(If oppliwble,district or other division)
nominate Dale E . 1�essen-er of 2022 Creelev Armes
(Name of candidate) Iowa,
(Address)
as a candidate of
(Nome of nonparty political orgonisotion, if any) for the
office of Trustee
to be voted for
at an election to be held on November 7 lcf�5
N A M E RESIDENCE (Add School District, if needed)
(Signature) STREET AND NUMBER, IF ANY DATE SIGNED
CITY
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(OVER)
Form 59
r v.n.�•ron z sers co.,w,nnoo.aws D35 0.559 (Revised July 1990)
(Chopter 45,code of Iowa)
STATE OF IOWA
)Nomination Petition
For Nonpartisan Nominations and Nonparty Political Organizations
For the office of Mary Gr_eelev ',edical Center Trustee
I, the undersigned eligible elector of the State of Iowa, do hereby
(If applicable,distriu or ocher division)
nominate Dale E . Messen-er of 2022 Greeley Ames
(Name of candidate) (Address) r Iowa, f
as a candidate of _for the
(Name of nonporty political organization,if any) _ -------
office of Trustee to be voted for
at an election to be held on November 7 1c 5
N A M E RESIDENCE (Add School District, if needed)
f (Signature) STREET AND NUMBER, IF ANY CITY DATE SIGNED
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(OVER)
Form 59
w...n.eoon s s s co.,wennoo.rowe D35 0-559 (Revised July 1990)
(Chapter�5,code of Iowa)
STATE OF IOWA
Nomination Petition
For Nonpartisan Nominations and Nonparty Political Organizations
For the office of Vary Greelev -"edical Center '7rustee
I, the undersigned eligible elector of the State of Iowa,
(I(applicable,disvict cr other division) r d0 hereby
nominate Dale E . ?�essenrrer
(Nome of c.nd.dole) of 2022 Greeley Ames Iowa,
(Address)
as a candidate of
(Nome of nonporty political orgoniioGon, if any) for the
office of Trustee
to be voted for
at an election to be held on 'November 7 1�5
N A M E RESIDENCE (Add School District, if needed)
(Signature) STREET AND NUMBER, IF ANY CITY DATE SIGNED
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(OVER)
Form 59
MAtr PA*lpif t$0i Co.w jftoo,IOV/A D35 0.559 (Revised July 1990)
(Chapter 45,code of Iowa)
STATE OF IOWA
(Nomination Petition
For Nonpartisan Nominations and Nonparty Political Organizations
For the office of 1119,rg r'e'2,/-, /1'(a,�_--�1,�10
I, the undersigned eligible elector of/ the State of Iowa, do hereby
T�1 � I (If applicable,district or other division)
nominate .[�[i 6 ��p�SS iJ1 442_v— /}
of;lQ�� [-Yy �� � Iowa,>t10
(Name of candid ) (Add ss) �
as a candidate of for the
(Name of nonparty poiilicoi organization, if any) .-
office of to be voted for
at an election to be held on Aliv m- f7a-r 7 19 J
N A M E RESIDENCE (Add School District, if needed)
(Signature) STREET AND NUMBER, IF ANY CITY DATE SIGNED
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