HomeMy WebLinkAbout01. Theis, JoeOffice of the Minnesota Secretary of State
AFFIDAVIT OF CANDIDACY
Instructions
Filing #
Ca,hCheck
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. 204B.03)
Candidate Information
Name, Office, and Party
Candidate Name (as it will appear on the ballot)
Office Sought ''))- r', „,,`
Political Party or Principle (State or Federal offices only)!
Name of Incumbent (Judicial seats only)
Contact Information
District #
Required (federal, judicial, county attorney, and county sheriff candidates are exempt) Check box if you do not have an email address n
Phone number ( ,( w7„,. Email (non -government issued)
Address Information
Residence Address Required (unless box is checked; federal, judicial, county attorney, and county sheriff candidates are exempt)
My residence address is to be classified as private data.
I certify a police report has been submitted, an order for protection has been issued, or I have a reasonable fear 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.
Residence Address (0 I ,L ir )
City 17)4;1:P r
Campaign Contact Information (Address required if box above is checked)
Campaign Address p f L/4, -
City
Campaign Website
Affirmation
State
y�.
State ,,, Zip Code
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 authorized by Minn. Stat. 204B.06, subd. 9;
• 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.
• Supreme Court Justice, Court of Appeals Judge, or District Court Judge — I will not turn 70 years of age before the first Monday of next January.
• State Senator or State Representative — I will have maintained residence in Minnesota not less than one year and in 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, School District, or Special District Office — I meet any other qualifications for that office prescribed by law.
Candidate Signature
S s,p ed nd s orn o befpe me this JQ � " day of " t,
N tary public pt'other officer empowered to take and certify acknowledgement
Date
Lary J. Fiensen
NOTARY PUBLIC
MINNESOTA
mission Expires Jan, 31, 2027
Rev. 5/2024
FFICE OF THE MINNESOTA ECRETARY OF TATE
2024 CANDIDATE NAME PRONUNCIATION FORM
Candidate's Name (clearly print):
Office Filed For (clearly print):
Type of District (circle one):
Federal State Judicial County S&WCD (City ,1 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:
Date entered into ERS:
Form updated 5/1/2020KJM