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HomeMy WebLinkAboutMatt Lehman . Office of the Minnesota Secretary of State Filing#�_ AFFIDAVIT OF CANDIDACY Cash/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.204B.03) Candidate Information Name and Office Candidate Name(as it will appear on the ballot) �Y 6 t� '"r JLC {� ✓� Office Sought C I t-`` eo-^C , ` 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 15 ��b`O-�"" �L City rkLY - State >vVti Zip Code �57 ❑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 Sf 15- Y+- t:— Candidate Phone Number(Required) Campaign Contact Address(Required for those who have checked the box above): Street Address City State Zip Code Websiteyo Ail-eo,, Email' 144 h i+ Leh/Vt 0.ti5t'C'�l��.n �'4;l- , 4,e 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 parry 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 n offense for which registration is required under Minn.Stat.243.166. • County,Municipal,School District,or pecoal Di tri ffice-I meet any other qualifications for that office prescribed by law. Candi to ignature �t`v Date ��U )t�� to a re me this day of 20� wwvrwvw �Jblto 'publ' or er empowered to take and ce i acknowledgement (NMR 3tPEI§EN White Copy-Filing Officer Yellow Copy-CFPD Board Pink Copy-Public Information Goldenrod C NTARYW34 /INNJESOTA My COmmmsim Expires Jan.31.2022 (Aft of the kl f Dt7IxWon in this repwt is QttbriC&fDlfl'[atkn) Name of candidate, committee or corporation 6'\,-,-f f Le'k rV%f, ,,\ Office sought or ballot question S Nr- ._ C S+f /*zy in c-•l District Type of Candidate report Period of time covered by report: report Campaign committee report Association or corporation report from 7-5y-20 to 9- 11 Final report CONTRIBUTIONS RECEIVED Give the total for all contributions received during the period of time covered by this report. Contributions should be fisted by typ (money or in-kind) rather than contributor. See note on contribution limits on the back of this form. Use a separate sheet to itemize a contributions from a single source that exceeded $100 during the calendar year.This itemization must include name,address,employe or occupation if self-employed,amount and date for these contributions. 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 73vz� 5 . �1 :�a —�� S u TOTAL S 5 CORPORATE PROJECT EXPENDITURES Corporations must list any media project or corporate message project for which contribution(s) or expenditures) tot, more than $200. Submit a separate report for each project. Attach additionalsheets if necessary. Project title or description Date Purpose Name and Address Expenditure or of Recipient Contribution Amount v T©TAl ertif� xhat this is`a full true statement_ Signature Date rb sa !-eJ��`A„5� h '` �'1 Telephone S 0'- H� X70 Email ( available) P ' "� Name c P _( ilif ilbl � -- CAMPAIGN FINANCIAL REPORT (All of the information in this report �is,public information) Name of candidate,committee or corporation VV f,4 i�41M Pi`s Office sought or ballot question District Type of Candidate report Period of time covered by report: report Campaign committee report Association or corporation report from ,'Jto 11 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 aor occupation if self-employed,amount and date for these contributions. 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 0 1'.1 l•.-. I Fez_ L f e J c i ' ,Pc•r t o � Yc P �L c.l v X wit. S H.a,kt'f%'�✓I.s�.�5� TOTAL I S S 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. Attach additional sheets if necessary. Project title or description Date Purpose Name and Address Expenditure or of Recipient Contribution Amount a E Z TOTAL I certify that this is a full and true statement. I t /C v h ^ Signature Date Printed Name d A A T� �...t,k `��r� L/�� `,10E`j l�hf��`�Z� Telephone Email(if available)(y►.art a4,.a 0 Address 15- ted'- Vi.�-e— � �j 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 1 ^��, ' , �'-�►dl's Office sought by candidate(if applicable) 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. I do swear(or affirm)that all campaign contributions or disbursemer7ts did not exceed$750 in the calendar year. Signature of candidate or committee treasurer DateL/ Revised 2/2014