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HomeMy WebLinkAboutA013 - Receipt of Nomination Papers - Austin Woodin, MGMC Board of Trustees State of Iowa Receipt of Nomination Papers Receipt Number: 2-02 1 ��q% Office Received In: kS OT1 Ce- Received By: v SS Delivered By: T) . kA Date and Time Delivered: Candidate's Name: �,� �.� �. _ ����crcAt L1 Office Sought: !v� C���G C �4 �,lS\ DES Office District (if any): Election Type and Date: ❑ General on / / ❑ Primary on / I City on /Cam/ZdZ ❑ School on / / ❑ Special on —/ / Documents Received: (check all that apply) Affidavit of Candidacy Faxed? ❑ Yes �No Nomination Petition Number of pages (approx): q ❑ 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: 1 Name: A tit ��1. ��,���0j t ►� Phone: Nomination papers are available for public inspection. Objections to the qualifications of candidates and the legal sufficiency of nomination papers may be filed until: 9 / ?--I /Z 0Z { 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 a U= IF. State of Iowa Affidavit of Candidacy SEP 16 2021 Candidate's Name(exactly as it should appear on the ballot—no titles,parentheses,or quotation ma Austin D. M. Woodin LELLl E>�'`� 4`t nn Tv OF AMES IOWA CI Candidates Name Sounds Like (phonetic spelling): Office Sought: Municipal Hospital Trustee District or Ward (if any): Vacancy—Is the candidate running to fill a vacancy due to the death, resignation, ❑ No ❑E Yes removal, or temporary appointment of an office holder? Type and Date of Election: ❑ Primary on / / ❑ General on ❑� City/School on 11 /02 /2021 ❑ Special on Candidate's Affiliation (only complete for partisan offices or Ch.44 city nominations): ❑ Democratic ❑ Republican ❑� Not affiliated with any organization Name of❑ Non-Party Political Organization: No more than 5 words and exactly as it should appear on the ballot. Candidate's Home Address: 55775 160th St Story City IA 50248 Story Street(no P.O.boxes) City State Zip County Candidate's Mailing Address (if different than above): Street CityState Zip Count p Y Candidate's Phone:(515) 450-1781 Email:awoodin1604@gmail.com Candidate's Affirmation 1 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 1 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 l am required to organize a candidate's committee, which shall rile an organization statement and disclosure reports if I(or my committee)receive contributions, make expenditures, or incur indebtedness in excess of$1,000 in a calendar year for the purpose of supporting my candidacy for public office. (This does not apply to candidates for federal office.) 1 know that I cannot be a candidat more than office to be filled at this election, except as otherwise provided by law. Candidate's Signature: Must be signed in the presence of a notary. State of:1 P County of: bf (Stamp) Signed and sworn (or affirmed)before me on date of: ANGEL TEJEDA By: lLsftlo �„ �'� , �1j�Ct(110 a COMMISSION NUMBER 812861 Print Candidate's Name MY COMMISSION EXPIRES Notary Signature: o ary B.10 Prescribed by the Office of the Iowa Secretary of State Revised 1012019 _ 0ILME State of Iowa -- Nomination Petition for Non-Partisan Offi EP 16 2021 Candidate Information Name of Candidate: Austin D. M. Woodin Office Sought: Mary Greeley`Medical Ce-in ; rusee Candidate's County of Residence: Story Candidate's City of Residence: 6tory Type and Date of Election: General on / / 0 Special on / / 0 City/School on 11 /02 /21 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? No Fo Yes For School Elections Only F chool District: School Director District(if any): Fffi For City Elections Only For Other Elections Only ce Ward(if any): 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. Address where you live in Iowa Sign your name Today's House number and street City Date 2t l Ill. 3 n , 4 r t —j 5. IU 7 6.4r 6. s. ���, l Lkv"L, Ci -2 10.t 13. . 14. ( 15. Prescribed by the Iowa Secretary of State Revised 412021 I lL. IE State of Iowa Nomination Petition for Non-Partisan Offi S+_EP 16 20{21 c Candidate Information _ Name of Candidate: Austin D. M. Woodin Office Sought: Mary Gr eley MeditSafFtA&Wyustee Candidate's County of Residence: Story Candidate's City of Residence: Story L Type and Date of Election: ]General on / / Special on ( / .]City/School on 11 102 121 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? No © Yes F For School Elections Only school District: School Director District(if any): FFor City Elections Only For Other Elections Only— ffi ce Ward(if any): 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. Address where you live in Iowa Sign your name Today's House number and street City Date ID s. � r— 'Zl 01 Lan 1 � 2l Ave-fAve- ��r,e , -13 11 _ 1 , A ry 14. 11 11l 2C I lt ; o j� r roc ( 3 - 2 I 15. Prescribed by the Iowa Secretary of State Revised 4/2021 r 4"i State of Iowa 0 E' [E Nomination Petition for Non-Partisan SEP 16 2021 Candidate Information Name of Candidate: Austin D. M. Woodin Office Sought: Ma Gree ey may , tee C.i - .:1�E J0vVA Candidate's County of Residence. Story Candidate's City of Residence: Type and Date of Election: General on / / Special on / / Ma City/School on 11 /02 /21 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? No © Yes F For School Elections Only school District: School Director District(if any): F For City Elections Only For Other Elections Onlyffice Ward(if any): 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. Address where you live in Iowa Sign your name Today's House number and street City Date 1. r� 3�1ti f2�r 2�-• at�i Cct:�- C_C� Gx_ ( A C�AS f Zl 3. Z�0�'l va►,rr C I VC L d . V►1Q.S 4. r� s. �67 1 G- I, it 7. 1 i C,f wiz �h i i l $. �i ► , �e� -s �c�� 1� 1�n,,o 1 A -6 �2 ai 10. E 16o ��� J� f�1,r-Z 'V' 7 11. 12.- /Ln e ' _zlln 13. 14. _T�CGv�Y1 yE lJ -2clj � lqu- G( G 15. 15-Z s � Prescribed by the Iowa Secretary of State Revised 412021 State of Iowa FE Nomination Petition for Non-Partisan 10 FSP ��16�2021 Candidate Information Name of Candidate: Austin D. M. Woodin Office Sought: MafGre , a ter rustee Candidate's County of Residence: Story Candidate's City of Residence: y ' Type and Date of Election: ❑General on / / Special on / / City/School on 11 102 121 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? F1 No ■Q Yes FFor School Elections Only School District: School Director District(if any): Foffice For City Elections Only For Other Elections Only Ward(if any): 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. Address where you live in Iowa Sign your name Today's House number and street City Date 2. 1 3. 31 C,,�,,U 5. Vr�tl 2��� C� C ^Fj� C/ / 6. 7. 8 Jr Z a Ca f�� P / 21 9. l 10. 11. � ���� ,���� � `� �� � �• 1, 1 / 2-64' A�4'kA p r r.. —C t-3 ` 13 � 151 ' Prescribed by the Iowa Secretary of State Revised 412021 State of Iowa Nomination Petition for Non-Partisan Offi SEP 16 2021 Candidate Information Name of Candidate: Austin D. M. Woodin Office Sought: Mary Gre ley I` F• M S, IOWA Candidate's County of Residence: Story Candidate's City of Residen Type and Date of Election: ❑General on / / ❑Special on_/ / City/School on 111 102 121 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? 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): 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 Today's House number and street City Date 12114 3. 17 7. 8. 9. 10. 11. 12. 13. 14. 15. 9� Prescribed by the Iowa Secretary of State Revised 412021 State of Iowa 0 Nomination Petition for Non-Partisan Offi Candidate Information SEP 16 2021 a 71L Name of Candidate: Austin D. M. Woodin Office Sought: Mary Greeley capt S, IOWA Candidate's County of Residence: Story Candidate's City of Resid Type and Date of Election: (]General on / / Special on / / �. City/School on 11 /02 / 21 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? No Q Yes F For School Elections Only school District: School Director District(if any): F For City Elections Only r For Other Elections Only office Ward(if any): 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. Address where you live in Iowa Sign your name Today's House number and street City Date I&, Z 7 0 1, i 2. :1- lzc,J&C_-tt lv1 3. , l,A:C_ ' trot JC? /' tii�: Ct 5. 6. o i / 90 l 7. 8. 9. 10. 12. 13. 'rT-mod .:�'..�siL^/�u'r� -�.I /[r? zF G i. �✓C' l l.�- -, /-1-/.- 4- I + :J 14. 15 � - 1 L 2 _] ,' t.1nol4r r, E Prescribed by the Iowa Secretary of State Revised 412021 i State of Iowa Nomination Petition for Non-Partisan O Fe P 16 221 Candidate Information Name of Candidate: Austin D. M. Woodin office Sought: Mary eeley Med4d�N `Trustee Candidate's County of Residence: Story Candidate's City of Residence: tOry �y Type and Date of Election: General on / / Special on / / OCity/School on 11 102 121 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? No Q Yes F For School Elections Only chool District: School Director District(if any): FFor City Elections Only For Other Elections Only ffice Ward(if any): 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 Today s House number and street City Date Z -21 ot�S '�rt' (� , -MeS `1 IS -2 2. o,G 2q f C S5 r tTp S� z 3. en I ac I a n A - 5 _CDO 4. l 5. /� ZI nCn,46.1 I3 Ake - -Z 7. 8. `1 s 2 s. b' fi . i—X6 �'r�,5 /15/Zl 10. f ~`'�/J ,-�, 310�s tl�,�� f *z�� ice,; 12. v� i CI) 05Z-26 14. '� 321 Srcr. }t1nzz5 7//S %2 t 15. Prescribed by the Iowa Secretary of State Revised 412021 r State of Iowa Nomination Petition for Non-Partisan Offic 16 2021 Candidate InformationFFT�SEIP Name of Candidate: Austin D. M. Woodin Office Sought: Mary Gres ey Medical M�tee Candidate's County of Residence: Story Candidate's City of Residence: Tory Type and Date of Election: General on I / Special on ! 1 [j]City/School on 11 102 121 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? No Q■ Yes Ffor School Elections Only school District: School Director District(if any): FFor City Elections Only For Other Elections Only ffice Ward(if any): 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. Address where you live in Iowa Sign your name Today's House number and street City Date 1 2. 4. 5 6. 7. s. 10. 11. 12. 13. 14. 15. Prescribed by the Iowa Secretary of State Revised 4/2021 IL ME State of Iowa L Nomination Petition for Non-Partisan T , SEP _ 6 ?.G,1 Candidate Information � �ti iu , Get. -.o- i, Name of Candidate: Austin D. M. Woo Office Sought: Ma Greeley Medical Ce,, stee S, IOVVA Candidate's County of Residence: Story Candidate's City of Residence: Type and Date of Election: ❑General on / / Special on City/School on 11 / 02 / 21 Is the candidate running to fill a vacancy due to the death,resignation,removal,or temporary appointment of an office holder? ❑ No Q Yes For School Elections Only School District: School Director District(if any): F For City Elections Only For Other Elections Only office Ward(if any): 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. Address where you live in Iowa Sign your name Today's .l \/, House number and streets City Date c�� 2�' l t�2`�' P sti'�}nzn� %l 2. 3. n 4. � z C11 13 i z 1 & 7 8. 9. 10. 11. 12. 13. 14. 15. Prescribed by the Iowa Secretary of State Revised 412021 i�