The URL can be used to link to this page

Home My WebLink AboutA005 - Receipt of Nomination Papers - Justin Dodge State of Iowa Receipt of Nomination Papers Receipt Number: ��"C'�' Office Received In: A im.r's CAA, Received By: �-V-I c�E�l�'��❑S Delivered By: " <<S I I i ) Dojof- Date and Time Delivered: J /p.m. Candidate's Name: cj c15 ❑ �6_ Sought: �� ' cb 6 -1 Office District (if any): Election Type and Date: ❑ General on / 1 ❑ Primary on / / City on ❑ School on / 1 ❑ Special on / ! Documents Received: (check all that apply) Affidavit of Candidacy Faxed? ❑ Yes No Nomination Petition Number of pages (approx): i15 � ❑41 �� t^F ❑� ❑ Certificate of Nomination by Convention for Non-Party Political Organization ❑ Certificate of Nomination by Convention for Political Parties Person to contact if there are questions about this filing: Name: ❑l ❑ �1 -�� C'� Phone: �� - — � �� G Nomination papers are available for public inspection. Objections tot e qualifications of candidates and the legal sufficiency of nomination papers may be filed until: ` � This receipt acknowledges the date and time the nomination papers were received. It does not necessarily mean the papers will be accepted for filing. Nomination papers will be carefully checked to be sure they meet basic requirements. The papers will be returned to the candidate if they are rejected. Give original to the candidate and keep a copy for the office. Prepared by the Iowa Secretary of State's Office Revised 7109 State of Iowa Affidavit of Candidacy AUG�I 2 6 2013 Candidate's Name (exactly as it should appear on the ballot—no titles,parentheses,or quotation marks): a 16 I �9_A LA C i! Justin Dodge nF :ni Candidate's Name Sounds Like (phonetic spelling): Office Sought:Ames City Cound District or Ward (if any):Ward 1 Vacancy— Is the candidate running to fill a vacancy due to the death, resignation, ❑ Yes No removal, or temporary appointment of an office holder? Type and Date of Election: ❑ Primary on / / ❑ General on / / ❑✓ City on 11 /05 /13 ❑ School on / / ❑ Special on Candidate's Affiliation (only complete for partisan offices or Ch.44 city nominations): ❑ Democratic ❑ Republican ❑ Not affiliated with any organization ("Nominated by Petition"will be listed with the candidate's name on the ballot.) ❑ Name of Non-Party Political Organization: No more than 5 words and exactly as it should appear on the ballot. Candidate's Home Address: 1204 Stafford Avenue Ames IA 50010 Story Street(no P.O.boxes) City State Zip County Candidate's Mailing Address (if different than above): Street City State Zip County Candidate's Phone:515-520-2478 Email:-0rdodge23 amail com Candidate's Affirmation I swear(or affirm) that the information provided on this form is correct. I will be qualified to hold this office and if I am elected, I will qualify by taking the oath of office. I know that I cannot hold 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. 1 know that/am required to organize a candidate's committee, which shall file an organization statement and disclosure reports if I(or my committee) receive contributions, make expenditures, or incur indebtedness in excess of$750 in a calendar year for the purpose of supporting my candidacy for public office. (This does not apply to candidates for federal office.) I know that I cannot be a candidate for more than one office to be filled at this election (except in the case of county agricultural extension council or soil and water conservatio dis r fission). Candidate's Signature: Must be sigi4ed in the presence f, a notary. State of:i yot County of: St 0�" Signed and sworn (or affirmed)before me on date of: T I_ -a DANIEL HALVERSON Commission Number 761171 By: Sty St My Commission Expires Print Candidate's Name ow December 15, 2015 Notary Signature: Prescribed by the Office of the Iowa Secretary of State Revised 112013 0 L C State of Iowa Nomination Petition for Non-Partisar ff ceAUG 2 6 2013 Candidate Information ` (0, y_-)' AVO Name of Candidate: Justin Dodge CITY CLERK 9 Office Sought: Ales City 8iiVWM IMA Candidate's County of Residence: Story Candidate's City of Residence: Ames Type and Date of Election: General on_/ / Special on / ! School on / / [E'City on 11 / 05 ! 13 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? 0 No ❑ Yes F For School Elections Onchool District: School Director District(if any): For City Elections Only For Other Elections Only Office Ward(if any):Jqm .S Ward 1 Office District(if any): We,the undersigned eligible electors of the appropriate county, city,school district,school or community college director district,or other district as established by law,and the state of Iowa hereby make the nomination outlined above. If the candidate named above accepts the nomination, we believe the candidate is or will be a resident of the appropriate county, city,school district, school or community college director district,or other district established by law as required by law. Sign your name Address where you live in Iowa House number and street City Tod Date 1. �--h • 711 (, AV n ve- ate. 2.3. 20 <S 90 Vffl, AyyzpS 7 130 o � Or /itr l 9 S'Tizfl"ord' A✓ � 7 �- s (v L . �. 3 / a// ekrf 1-2t� 5'f, �}.k s 7- IX • 13 s. � A��til s s. ((�� bry -r'� A .x-�r 7 /s 1.7 e0.1LCrK ��3p 54L,Zo,r-dt IqV AMQS 10. '1/ta/ t3 11. 12. Qe _ M00 014fxel¢ Avg 1 I C rc, 15. `3O J t 1 kii es / /3 Am(f_�) - 1 Prescribed by the Iowa Secretary of State State of Iowa Nomination Petition for Non-Partisan I i e AUG 2 6 2013 Candidate Information «'' �� Ak—( Name of Candidate: Justin Dodge a.FRK 9 Office Sought: A es CityC�tMr W rd wn Candidate's County of Residence:_Story Candidate's City of Residence: Ames Type and Date of Election: []General on_/_/ ❑Special on School on / / — ❑ [jv'City on 11 / 05 / 13 Is the candidate running to fill a vacancy due to the death,resignation.removal,or temporary appointment of an office holder? 2 No ❑ Yes For School Elections Only F chool District: School Director District(if any): F For City Elections Only For Other Elections Only Office Ward(if any):�ymes Ward 1 Office District(if any): We, the undersigned eligible electors of the appropriate county, city,school district,school or community college director district the nomination, ,or o ther dist ct ri as established by law, and the state of Iowa hereby make the nomination outlined above. If the candidate named above acce we believe the candidate is or will be a resident of the appropriate county, city, school district,school or community college director district, or other district established by law as required by law. Sign your name Address where you live in Iowa House number and street Today's City Date 1. � u cos 2 222q 54w rn 2. 12 3. u ( C Gl s 7 ur,3 . IsCAg�5. �.l 1� - 13 203 r 2C7 2 J13 013 N 2 02 Ken M am 1 RA. ?I t 3 zoi 3 7. 8. , /bw s �- 9. w(� _ 10.11. l33S LJ ,Yso,% Av c- 7/.,Ly ol3 12. -/3201 14. 15. i Prescribed by th(!Iowa Secretary of State s State of Iowa Nomination Petition for Non-Partisan O e AUG 2 6 2013 Candidate Information `- I ,y-)-A&i Name of Candidate: Justin Dodge IL Office Sought: Ames i Coun CITY CLERK Candidate's County of Residence: Story Candidate's City of Residence: Ames Type and Date of Election: F]General on / / ❑Special on / - ❑School on Q'City on 11 / 05 / 13 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? 0 No ❑ Yes For School Elections Only F chool District: School Director District(if any): For City Elections Only For Other Elections Only Office Ward(if any):Jamec Ward 1 i Office District(if any): We,the undersigned eligible electors of the appropriate county, city,school district, school or community college director district,or other district as established by law, and the state of Iowa hereby make the nomination outlined above. If the candidate named above accepts the nomination, we believe the candidate is or will be a resident of the appropriate county, city,school district,school or community college director district,or other district established by law as required by law. Sign your name Address where you live in Iowa House number and street Today's City Date '�d 3 Aa uic v c �•,c c 5 7 3 2. D 0 S /1 33. '�iSf'/tie 1 y09 M4ku)pcl jilae 5 is� 'sw 6. r7er5 * S� . ie 7DAIC � Are• e s 7 �r3 ` 6 jqWeWL 207 F ,2-e-h .S-t• A yhe5 r s. a aD� Visit/10. 5/= 4k s r e. 4e_ or tivr� _ / _ 3 i2. 13. �u5 14. 15. ''4- Prescribed by th<!Iowa Secretary of State State of Iowa Nomination Petition for Non-Partisan Mile AUG 2 6 2013 Candidate Information Name of Candidate: _ Justin Dodge _ Office Sought: Ames Cit&ouncil In CL RK Candidate's County of Residence: Story — Candidate's City of Residence: Ames Type and Date of Election: ❑General on / / ❑Special on / / School on / / - ❑ ['City on 11 / 05 / 13 !s the candidate running to fill a vacancy due to the death,resignation,rem.,val,or temporary appointment of an office holder? 0 No Yes For School Elections Only F chool District: School Director District(if any): FFor City Elections Only For Other Elections Only OOffice Ward(if any): Ames Ward 1 Office District(if any): We,the undersigned eligible electors of the appropriate county, city,,school district,school or community college director district,or tither district as established by law,and the state of Iowa hereby make thb nomination outlined above. If the candidate named above accepts the nomination, we believe the candidate is or will be a resident of the appropriate county, city, school district,school or community college director district,or other district established by law as required by law. Sign your name Address where you live in Iowa House number and street Tod City Date 1 2 2od t'- s� 4• /�- RoG,��-f 5 4;2 6 - T 'Co✓oo � q 7. s. C -I- h .r� >< 9. � lei 10. 11 --1 p( ovd 13. 5�I 14. �Ba ,rh 14-c•� •-Z Zd l 15. �155 Prescribed by the Iowa Secretary of State 0 L State of Iowa Nomination Petition for Non-Partisan of i AUG 2 6 2013 Candidate Information Name of Candidate: Justin Dodge Office Sought: Arne City CoureaA, '� ;;L^RK^ AIA Candidate's County of Residence: Story Candidate's City of Residence: Ames Type and Date of Election: General on_/ / Special on / / �School on / / C3i'City on 11 / 05 / 13 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? B No Yes F For School Elections Onchool District: School Director District(if any): F For City Elections Only For Other Elections Only ffice Ward(if any):_AmeS Ward 1 Office District(if any): We, the undersigned eligible electors of the appropriate county,city,school district,school or community college director district,or other district as established by law,and the state of Iowa hereby make the nomination outlined above. If the candidate named above accepts the nomination, we believe the candidate is or will be a resident of the appropriate county, city, school district,school or community college director district,or other district established by law as required by law. Sign your name Address where you live in Iowa House number and street Today's City Date 1. ! a3 A A X 6J E�,L 4 l� AM ES 2. ��.:., /j67 �jk try% . 7- 4. 6 ��• "O/XM. K• 1 4me s o/ 2oi 3 7. CoriRtn S 9. V e._ 10. 13 7-�;O' J 11. 12. 13. 14. 7 0 15. ' g CAS 13o 5•Riv¢�i �. AOe- 9 f 3 Prescribed by the Iowa Secretary of State