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HomeMy WebLinkAboutJim DuLaney Office of the Minnesota Secretary of State AFFIDAVIT OF CANDIDACY �Fl /Check# • Instructions Amount$ All information on this form is available to the public.Information provided will be published on the Secretary of State's website.If filing for partisan office and not a major party candidate,you must file both an affidavit of candidacy and a nominating petition.(Minn.Stat.2048.03) Candidate Information Name and Office Candidate Name(as it will appear on the ballot), $t 5 U L AN t Office Sought �: 1 i Y C {J t t_ District For Partisan Office,Provide Political Party or Principle For Judicial Office,Provide Name of Incumbent, Residence Address Do not complete if residence address is to be private and checkbox below is marked.All address and contact information is optional for federal, judicial,county attorney,and county sheriff office candidates. Street Address 1064 -'E�ML-q X\ . .. .. � City Kc)�T 5 State` f1M ,Zip Code 1:1My residence address is to be classified as private data.I certify a police report has been submitted or I have an order for protection for my (or my family's)safety,or my address is otherwise private by Minnesota law.I have attached a separate form listing my residence address. Campaign Address and Contact Candidate Phone Number(Required) Campaign Contact Address(Required for those who have checked the box above). Street Address City 5-t,A State M Zip Codee<. •Website du16.fll\/4"v C��� CG,:%4)C �. co� Email �fN1�t�la�(iA y�� �ll.� :' M lo Affirmation For all offices,I swear(or affirm)that this is my true name or the name by which I am generally known in the community. If filing for a state or local office,I also swear(or affirm)that: • I am eligible to vote in Minnesota; • I have not filed for the same or any other office at the upcoming primary or general election(except as provided in M.S.204B.06,subd.1(2)); • I am,or will be on assuming office,21 years of age or more; • I will have maintained residence in this district for at least 30 days before the general election;and • If a major political party candidate,I either participated in the party's most recent precinct caucuses or intend to vote for a majority of that party's candidates at the next general election. If filing for one of the following offices,I also swear(or affirm)that I meet the requirements listed below: • United States Senator—I will be an inhabitant of this state when elected and I will be at least 30 years old and a citizen of the United States for not less than nine years on the next January 3rd,or if filled at special election,within 21 days after the election. • United States Representative—I will be an inhabitant of this state when elected and I will be at least 25 years old and a citizen of the United States for not less than seven years on the next January 3rd,or if filled at special election,within 21 days after the election. • Governor or Lieutenant Governor—I will be at least 25 years old on the first Monday of the next January and a resident of Minnesota for not less than one year on election day.I am filing jointly with • Supreme Court Justice,Court of Appeals Judge,District Court Judge,or County Attorney—I am learned in the law and licensed to practice law in Minnesota.My Minnesota attorney license number is and a copy of my license is attached. • State Senator or State Representative—I will be a resident of Minnesota not less than one year and of this district for six months on the day of the general or special election. • County Sheriff—I am a licensed peace officer in Minnesota.My Board of Peace Officer Standards and Training license number is and a copy of my license is attached. • School Board Member—I have not been convicted of an offense for which registration is required under Minn.Stat.243.166. • County,Municipal, ool D' is, Special District Office—I meet any other qualifications for that office prescribed by law. Candidate ig ature J Date ✓ I 2 Subs 'be d or ore me this day of ,20 r Lori J.Hensen • to NOTARY PUBLIC MINNESOTA No p lic or th icer empowered to take and certify acknowledgement WttLtafWi>SaM*,s Jan.31,2027 White Copy—Fil Officer Yellow Copy—CFPD Board Pink Copy—Public Information Goldenrod Copy—Candidate Rev.5/2015 4TnEST9r, �v- OFFICE OF THE MINNESOTA SECRETARY OF STATE CANDIDATE NAME PRONUNCIATION FORM Candidate's Name(clearly print): Du L A rl Office Filed For(clearly print): l y�' v f L"' Type of District(circle one): Federal State Judicial County S&WCD City Township School Hospital Park Other District District District District's Name(clearly print): A Kz P E Candidate Name's Pronunciation: Additional Notes: Info of Staff Member completing this form: Name and Title: Name of Your Jurisdiction: Date completed: Date submitted to County Auditor's Office: Date submitted to ERS Data-Entry Staff Member: Date entered into ERS: Form updated 5/18/2020 CAMPAIGN FINANCIAL REPORT (All of the information in this report is public information,) Name of candidate,committee or corporationT Y Office sought or ballot question c�� (�'!�G L District Type of Candidate report Period of time covered by report: report Campaign committee report �g Association or corporation report from to Final report CONTRIBUTIONS RECEIVED Give the total for all contributions received during the period of time covered by this report. Contributions should be listed by type (money or in-kind) rather than contributor. See note on contribution limits on the back of this form. Use a separate sheet to itemize all contributions from a single source that exceeded$100 during the calendar year.This itemization must include name,address,employer 0 or occupation if self-employed,amount and date for these contributions. 0- a) CASH $ TOTAL CASH-ON-HAND $ IN-KIND + $ TOTAL AMOUNT RECEIVED = DISBURSEMENTS Include the amount,date and purpose for all disbursements made during the period of time covered by report. Attach additional sheets if necessary. Date Purpose Amount ;Pw A)is I , (Z S V//VI� _� 6?�. C .0 _ / d 0 TOTAL '/06 CORPORATE PROJECT EXPENDITURES Corporations must list any media project or corporate message project for which contribution(s) or expenditure(s) total more than $200. Submit a separate report for each project. �1Attach additional sheets if necessary. Project title or description /�— Date Purpose Name and Address Expenditure or of Recipient Contribution Amount Q) E TOTAL ro Z ' v� - Z I certify that this is a full and true statemen — Signature I Da j /J 9 Sots�"D .S l� QJ Printed Name 1 // GL Telephone mail (if available) calf" o Address 0 CAMPAIGN FINANCIAL REPORT (All of the information in this report is public information) Name of candidate,committee or corporation � �� �� �5`� al f Office sought or ballot question G( T`/ (�O�-S l�C (�-- District Type of Candidate report Period of time covered by report: report Campaign committee report Q Association or corporation report from "! to L _ 0.0 Final report CONTRIBUTIONS RECEIVED Give the total for all contributions received during the period of time covered by this report. Contributions should be listed by type (money or in-kind)rather than contributor. See note on contribution limits on the back of this form.Use a separate sheet to itemize all contributions from a single source that exceeded$100 during the calendar year.This itemization must include name,address,employer oor occupation if self-employed,amount and date for these contributions. a a) CASH $ TOTAL CASH-ON-HAND $ IN-KIND001 + TOTAL AMOUNT RECEIVED $ DISBURSEMENTS Include the amount,date and purpose for all disbursements made during the period of time covered by report. Attach additional sheets if necessary. Date Purpose Amount v U v- w 0 TOTAL CORPORATE PROJECT EXPENDITURES Corporations must list any media project or corporate message project for which contribution(s) or expenditure(s) total more than $200. Submit a separate report for ach project. Attach additional sheets if necessary. 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