HomeMy WebLinkAboutA012 - Receipt for Nomination Papers - Casey Harvey RECEIPT FOR NOMINATION PAPERS
FILED WITH THE CITY CLERIC
AMES, IOWA
Delivered by: Date &-Time:
Received by: Title: .
i
For election to be held on:
I i
The following nomination papers have been accepted for filing:
PAPERS FILED
OFFICE OF CANDIDATE'S NAME NOM. PETITION AFFIDAVIT
7 c� /1) TY � ,
FORM 2-N(Rev-03)[44.41
Presai-bed If you fax your Affidavit,you must .
loyv cretat'If stat I;_I'r also mail the originals by the
filing deadline.
State of Iowa
Affidavit of Candidacy
[pt City Elections (Chapter 44)
0041
For the Office of: (OU tic A+- La rr4 e, Dir. Dist./Ward
((Include district if
❑
Check here if election is to fill a vacancy.
[The seat is on the ballot before the end of the regular term,usually because of a death or resignation.]
Date of Election 9 _ 00s
Name: C L ('
(Exacdy as you want it to peas on the ballot)
Home address: a32 ;S CJallA J Arc 13
City, State and Zip Code: _ 4iti.c s . TA S 01 U
County: ,>~�r Telephone: (�!i� )233-Qo']8(Optional,will be published)
Name of Nonparty Political Organization:
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 as a
candidate of the organization named above. 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 of a felony or other infamous crime and my rights have not been restored by the
governor or by the president of the United States.
I know that I am required to organize a candidate's committee that shall file an organization
statement and disclosure reports if my committee or I receive contributions, make expenditures, or incur
indebtedness in excess of seven hundred-fifty dollars ($750) in a calendar year for the purpose of
supporting my candidacy for public office.
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 nom' ation papers; I nnot be a candidate
for any office on the ballot at this election.
State of -L o w4 signed:
County of
This instrument was subscribed and sworn or affirmed before me on SP�(�iin� 1414 2033
by C45fV L /'Rk yey Date
game(s)ofPetson(s)
Signature of Nobly Public d�,
Tit/e: /� �� �p c JILL L. RIPPERGER
rCOMMISSION ft 409
MY COMMISSION F.XPI S
tows
This Ai�davit must be filed 3_ 17_D
With your nomination papers, Notary Seal
Forms prescribed by the Iowa Secretary of State:
2001 Update FORMS2.V97
City Elections 2H(03g � �
t7esortbed by the „ - = An Affidavit of Candidacy
Iowa Secretary of Snt Must accompany this petition.
STATE OF IOWA
Nomination Petition
q�q� For City Elections
_4a19 4drMSy SIX 4e'1�
❑ Check if to Fill a Vacancy District #
(If Applicable)
I, the undersigned, an eligible elector of the State of Iowa, hereby nominate CAS f�Ll-^
(N a of candidate)
of.32 S' cjAlnx4�IVe,*I3 Ar c Iowa, who is a resident of the City of AhLQS
(Address)
and a candidate for C;_ (OU qc Imo_ to be voted for at the City Election on
Tuesday ►ew�er �y ,1
(Date) (year)
Residence Date
Si ned
Name
Street Number, (if any) city
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Prepared in the office of the Iowa Secretary of State Page of
Prreesai ( _ I�4 i°"a secrefa tate =Affidavitf Candidacy
STATE OF IOWA any this petition.
Nomination Petition n
�1
For C'ty Elections
❑ a I(
H
C e
District #
I, the undersigned, an eligible elector of the State of Iowa, hereby nominate Q5 OfApplicabie)
Of 1 � �n u - # (N of candidate)
(Address)
P ��� Iowa, who is a resident of the City of_ A me-5.
and a candidate for
el to be voted for at the City Election on
Tuesday Al
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(Date) - (year) �_
Residence Date
Name Si ned
Street Number, (if any) city
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City Elections 2H(03)
cr bye An Affidavit of Candidacy
Iowa se«�tary $ t Must accompany this petition.
- STATE OF IOWA
Nomination Petition
For City Elections
❑ Che4' if to Fill a VacancyDistrict #
If
I, the undersigned, an eligible elector of the State of Iowa, hereby nominate �Q5e .,pPlirable) 1AM
of 1 (N�e of candidate) 1 to
4�1y� -A �i I�, r4; Iowa, who is a resident of the City of
mes '1
(Address) ,
and a candidate for C3 r -/�cq to be voted for at the City Election on
Tuesday 1
(Date) (year)
Residence Date �
Name Signed
Street Number, (if any) City
as .
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Prepared in the office of the Iowa Secretary of State Page `� of 5
Oty Elections ZN
_.._m.
Presoibed by the �(
Iowa Secretary of tt An Affidavit of Candidacy
4- STATE O F I O WA Must accompany this petition.
Cr'� t ,,�� hI', -
` Nomination Petition
For City Elections
❑ Che �)� District #
I, the undersigned, an eligible elector of the State of Iowa, hereby nominate CQ5 'plicable)
ffQ
of.,I- (N a of candidate)
- (Address) Iowa, who is a resident of the City of �-��.
and a candidate for
to be voted for at the City Election on
Tuesday
(Date) (year)
Residence Date
Name Si ned
Street Number, (if any) Ci
1.
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Prepared in the office of the Iowa Secretary of State page $ of 5