HomeMy WebLinkAboutA018 - Receipt for Nomination Papers - Matt Denner ' RECEIPT FOR NOMINATION PAPERS
FILED WITH THE CITY CLERIC
AMES, IOWA
Delivered by: Ifi6t ' Date &Time: -S'0 ,rr
Received by: % ', Title:
2
For election to be held on:
The following nomination papers have been accepted for filing:
PAPERS FILED
OFFICE OF CANDIDATE'S NAME NOM. PETITION AFFIDAVIT
If you fax your nomination
FORM 2 M(Rev-01)[45.3J papers,you must also file the
Prescribed by the original'�bythe�j l n `e I e"
Iowa Secretary of State !
State of Iowa '
Affidavit of Candidacy j 6 . - 3
School and City Elections y .2m
'i
S *�
For the Office of . C t Co�nC � FQ_r-th Dir. Dish rd
❑ Check here if election is to fill a vacancy.
[The seat is on the ballo
t before the end of the regular term, usually because of a death or resignation.]Date of Election: , w- 4,- )I �.�)u-�
Name: V �iii enn r
(exactly as you want it to appear on the ballot):
Home address: ) j (39 0okW 5�
City, State and Zip Code: 1 ► r*5 -TP1 ECO 1�
County: StC)(-� Telephone: (S IS ) 5 77 70) (Optional, wi//be pub/ishea)
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 of a felony or other infamous crime and my
rights have not been restored by the governor or by the presidat of the United States.
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 ($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 nomination papers, I cannot be a candidate for any office on the
ballot at this election State of n W c, Signed. Oqa1t_� , 21M/tk/Ci
Countyof S�n C'/
This instrument was subscribed and sworn or alirlmed before me on -1 ►+- /�, v7 J�,
Rae
/G"� Date
by
Name(s)of Person(s�
Signature/of Notary Public
Title: /EGG R"L
o� L. RIPPERGER
Z
This Affidavit must be Fled COMMISSION#146549
MY COMMISSION EXPIRES
With your nomination papers W A S- -7-O
Notary Sea
Forms prescribed by the Iowa Secretary of State:
2001 Update FORMS2_V97
atrny �J)-Prescrtbedip
I(Y'a se«eta)y {st �.s.- - An Affidavit of Candidacy
Must accompany this petition.
STATE OF IOWA
Nomination Petition
For City Elections
❑ Crack if to File a Vacancy District #
(If Applicable)
I, the undersigned, an eligible elector of the State of Iowa, hereby nominate_ -- nP,nnQr
(Name of candidate)
of 31 O lj CDoAs\4 St A r,cS Iowa, who is a resident of the City of ArjjQ S
(Address)
and a candidate for C ;ty C,.vnc;� . F,,(`th W e,(� to be voted for at the City Election on
Tuesday N<�ye.r,% fh 1003
(Date) (year]
Residence Date
Si ned
Name
Street Number, (if any) Ci
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Prepared in the office of the Iowa Secretary of State Page of Z
City
PfPSgI by ff1C)
ell,
An Affidavit of Candidacy
bwa Secretary of
STATE
OF
I D Y Y Q Must accompany this petition.
f
Nomination Petition
For City Elections
❑ Check if to Fill a Vacancy District #
I, the undersigned, an eligible elector of the State of Iowa, hereby nominate_ M'�,t+(If Applicable)
1)o.nne r
/�
of �O dg�a�� 5t A1,c�S Iowa, who is a resident of the City of An ,,,(Name of candidate)
(Address) i
and a candidate for C;ty "-v ncl , (^o vrth W exi to be voted for at the City Election on
Tuesday No•yer""b0C 4 fh 9L,oD3
(Date) (year)
Residence Date
Name Signed
Street Number, (if any) city
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