HomeMy WebLinkAboutZiyad Abdi Office of the Minnesota Secretary of State Filin #
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AFFIDAVIT OF CANDIDACY h
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Instructions `4
information on this form is available to the public.Information provided will be published on the Secretary of State's website.If filing for
artisan 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 r
Candidate Name(as it will appear on the ballot)
Office Sought! —S�Ik—,O c � i ► 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 Addre s
City d �" ., ....State,„�. Zip Code ^
My 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 Addr ssy
Cit State Zip Code
Y,..�a.. u;...;. �.
Qesiter—b _...� � Email
ffirmation
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.20413.06,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
r„ 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,School District,or Special District Office—I meet any other qualifications for that office prescribed by law.
6andidate Signatur Date D O
scribed a d s to or is day of 14ff&4d111 20
Lon J.Hensen
NOTARY PUBLIC
Notary p er i r empowered to take and certify acknowledgement (Nota►pyilsNWTA
My Catmussiai Spires Jin.31,2027
White Copy—Filing Officer Yellow Copy—CFPD Board Pink Copy—Public Information Goldenrod Copy
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OFFICE OF THE MINNESOTA SECRETARY OF STATE
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CANDIDATE NAME PRONUNCIATION FORM
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Candidate's Name (clearly print): 2 / Y-A /
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Office Filed For(clearly print): 61 .� C,C�Lr�7 G1-
Type
1fType of District(circle one):
Federal State Judicial County S&WCD City Township School Hospital Park Other
District District District
District's Name (clearly print):
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:
SDate entered into ERS:
Form updated 5/18/2020
CAMPAIGN FINANCIAL REPORT
(All of the information in this!reort i public information)
Name of candidate,committee or corporation 1
Office sought or ballot question �� I un ell, District
Type of v Candidate report Period of time covered by report: I
report Campaign committee report o�0�1 [t4/ 31
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Association or corporation report from "�tl
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.
CL
CASH $ 300 - 012 TOTAL CASH-ON-HAND $
IN-KIND +
$ 2 Y Sv•�
TOTAL AMOUNT RECEIVED = $ Z S•O
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
O O v 0 ✓ • mo 6
0 p tom. 6 h �l O
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TOTAL 3 S 3 2-
CORPORATE
CORPORATE PROJECT EXPENDITURES
Corporations must list any media project or corporate message project for which contribution(s) or expenditures) total
more than $200. Submit a separate report for each project. Attach additional sheets if necessary.
Project title or description
Date Purpose Name and Address Expenditure or
of Recipient Contribution
Amount
v
M TOTAL
Z
oI certify that this is a full and true statement. _
cam, Signature Date
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Printed Name eq,' Telephone .Email (if available)
0 Address I Z r 01 S ! ` Ya �T 1A__
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INSTRUCTIONS
(Reference:Minnesota Statutes,Chapters 211A and 2118
This CAMPAIGN FINANCIAL REPORT is for use by candidates and committees for county,municipal,school district and special
district office who receive contributions or make disbursements of more than$750 in a calendar year;committees or corporations
spending more than$750 for or against a ballot question in a calendar year;and corporations spending more than$200 on
activities to encourage participation in precinct caucuses,voter registration or voting.
Where to file this report:
Hospital Districts The municipal(city or town)clerk—same place where filed affidavit of candidacy
Park Districts The county auditor or municipal clerk—same place where filed affidavit of candidacy
School Districts School district clerk
Townships Town clerk
Cities City clerk
Soil&Water Conservation Districts County auditor
Counties County auditor
Candidate or committee report:The initial report must be filed within 14 days after the candidate or committee receives contributions
or makes disbursements of more than$750 in a calendar year.Subsequent reports must be filed.
During an Election Year-An"election year"is any year in which the candidate's name or a question appears on the ballot.
In such a year(if an initial report has been filed)reports are required to be filed:
* 10 days before the primary or special primary * 30 days after a general election or special election
* 10 days before the general election or special election * By January 31 of each year following the year when the initial report was
filed.
During a non-election year-By January 31 of each year following the year when the initial report was filed.
Once a final report*is filed,no further subsequent reports are required to be filed.
CONTRIBUTIONS: Means anything of monetary value that is given or loaned to a candidate or committee for a political purpose.
"Contribution"does not include a service provided without compensation by an individual. Each candidate or committee must list the
total amount of cash-on-hand designated to be used for political purposes as of the close of the reporting period.
CONTRIBUTION LIMITS: Candidates or candidate's committees for county,municipal,school district offices may not accept aggregate
contributions in excess of$600 in an election year or in excess of$250 in a non-election year made or delivered by an individual or
committee. However,candidates seeking election from districts with a population in excess of 100,000 may not accept aggregate
contributions in excess of$1,000 in an election year and$250 in a non-election year.
BALLOT QUESTIONS: Any political committee,association or corporation that makes a contribution or expenditure to promote or defeat
a ballot question as defined in Minnesota Statutes,section 211A.01 shall file reports with the filing officer responsible for placing the
question on the ballot. Reports must be filed within 14 days of receiving contributions or making disbursements of more than$750 in one
calendar year,using the same schedule as above.
CONGRESSIONAL CANDIDATES: Candidates for election to the United States House of Representatives and Senate and any committee
raising funds exclusively on behalf of any one of those candidates may file copies of the reports required by federal law in lieu of those
required by Minnesota Statutes Chapter 211A.
CORPORATE ACTIVITIES TO ENCOURAGE PARTICIPATION:Corporations may contribute to or conduct public media projects to encourage
individuals to attend precinct caucuses,register or vote if the projects are not controlled by or operated for the advantage of a candidate,
political party or committee.The total amount of expenditures or contributions for any one project greater than$200,together with the
date,purpose and the names and addresses of the persons receiving the contribution or expenditures must be reported.Reports must be
filed with the Secretary of State,180 State Office Building,St.Paul, MN 55155-1299,using the same schedule as above.
*FINAL REPORT: A final report may be filed any time after the candidate,committee or corporation has settled all debts and disposed of
all assets in excess of$100 in the aggregate.Check final report under"type of report".
PROHIBITED TRANSFERS: Candidates for county,municipal,school district or special district offices may not accept contributions from
the principal campaign committees of any candidate for legislative,judicial or state constitutional office. In addition,a candidate may not
make contributions to the principal campaign committee of any candidate for legislative,judicial or state constitutional office unless the
contributions are made from the candidate's personal funds.
STATE CANDIDATES: Candidates and committees for state constitutional offices,the state legislature,supreme court,court of appeals,
district court and committees for state constitutional amendments are governed by Minnesota Statutes Chapter 10A.Contact the State
Campaign Finance and Public Disclosure Board for further information at(651)539-1180.
Note: The filing officer must restrict public access to the address of any individual who has made a contribution that exceeds$100 and
who has filed with the filing officer a written statement signed by the individual that withholding the individual's address from the
financial report is required for the safety of the individual or the individual's family.
Updated 711812014
Office of the Minnesota Secretary of State
CAMPAIGN FINANCIAL REPORT CERTIFICATION OF FILING
Instructions
Each county, municipal or school district candidate or treasurer of a committee formed to promote or defeat a
ballot question shall certify to the filing officer that all reports required by Minnesota Statutes 211A.02 have been
submitted to the filing officer or that the candidate or committee has not received contributions or made
disbursements exceeding$750 in the calendar year.The certification shall be submitted to the filing officer not later
than seven days after the general or special election. (Minnesota Statutes 211A.05, subdivision 1)
Campaign Information
Name of candidate or committee
Office sought by candidate(if applicable) uvl G
Identification of ballot question (if applicable)
Certification
Select the appropriate choice below,and sign.
I do swear(or affirm)that all campaign financial reports required by Minnesota Statutes 211A.02 have been
submitted to the filing officer.
0 1 do swear(or affirm)that all campaign contributions or disbursements did not exceed$750 in the calendar
year.
Signature f ca didate or committee treasurer
DateWT v
Revised 2/2014