HomeMy WebLinkAboutA005 - Affidavit of Candidacy - Ann Campbell e
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2-M(Rev.95)[45.3]
cribed by the
Secretary of State
STATE OF IOWA
AFFIDAVIT OF CANDIDACY
School and City Elections
For the office of Gl �,� C, � c�-/ _ j� 7V,L /'
(Include district number, if any)
❑ Check here if election iS to fill a vacancy.
Date of Election: � ZL)
Name (exactly as you want it to appear on the ballot):
Home Address: f,.s J�
City and Zip Code:
County:
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.]
Signed: v
Signed and
sworn to (or affirmed) before me on <'— I L2af5 11927
f4L (print candidates name). v (date) by
Signature of Nc a.ry Pi;blic(or other offi authorized to witness oaths)
Official Title: ,,,
v
My commission expires: A-1 /� / -7 pw
Form 59 rAAn—krill 5 SCM CO.WAt[ktaa.toWA 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 13
I, the undersigned eligible elector of the State of Iowa, 09 Am!Ls do hereby
(If applicable,district or other divi on)
nominate — .. D Q of �`a�' a r 5e j Je • A)M61�:i, Iowa,
ame of candidate) (Address)
as a candidate of for the
(Name of nonpart political orgonization, f qny/)
�G
office of to be voted for
at an election to be held on_/Lc� 1q
NAME RESIDENCE (Add School District, if needed)
(Signature) STREET AND NUMBER, IF ANY CITY DATE SIGNED
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