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05-Reynolds, Pam - Ward 2 �.���'k;�� Office of the Minnesota Secretary of State F°'"g � � � ��i' AFFIDAVIT OF CANDlDACY Cash ecktl , �'!��'�,�� Amount$ !�' �` Instructions 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) �AM �,�v y���,�,5 Office Sought ��V�G�` Y�Q-vv`bQ,J�. �p,,,('r� �., 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 federai, judicial,county attom�y,and county sheriff office candidates. Street Address (��"'I' l �Q(���1 �� � � CitY �"r11 O,'�y State ! � I�J Zip Code 5��3p'� � 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 regarding my safety or my family's safety,and I have attached a separate form listing my residence address. Campaign Address and Contact Candidate Phone Number(Required) �� 3 °' �a,�"' �3�� Campaign Contact Address(Required for those who have checked the box above): Street Address City State Zip Code Website �, ,e.y 11�D�US��r �N 1�-y��I.GClJUD��Email T V� D0.-YV`� Y�\W���`. e.8'Y✓1 � t 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.2046.06,subd.1(2)); • I am,or wili 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�ext 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 lanuary 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 oid 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 filingjointly 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,School District,or Special Distr' Office—I meet any other qualifications for that office prescribed by law. Candidate Signature u— Date �/3 CJ r' Subscribed d sworn to befor e this J day of � N� _,20�. Nota p ' o o er of er m we ed to take and certify acknowledgement ���. LO�,�S�i GENT `', s i �l�`i1PE'i„Ji?'y"i':irif��;i;t:E'Y 1'f'r(;?t1;'{�UTi;+ .. ��t.Yp:;(s �'�t/tr i�(?f:',.' '}'('.iti�i!�j.7��.'��C.�,-,i7?'i i�(',_r.�� ••.\����MY CO MISS ON�XP�R S 01/31/18 ��� _l � C OUNTY OF ANOK:A � OFFICE OF ELECTIONS 8L VOTER REGISTRATION AN�� 325 EAST MATN STREET•ANOKA,MiNNESOTA 55303 COUNTY PxoNE: (763)323-5275 Fax: (763)422-7526 2014 AutoMARK Pronunciation Form In 2006, a second voting system was adopted which is specifically designed to assist voters with physical disabilities—the AutoMARK. The AutoMARK is a ballot marking device that individuals with physical disabilities may use to vote privately and independently. One of the unique characteristics of the AutoMARK is that it is programmed to speak each candidate's name. As a result, we are asking candidates to provide a phonetic spelling to ensure that the AutoMARK pronounces each candidate's name correctly. Name of Candidate: �� �- � � S c� r� O��5 Phonetic � � �e O � � Spelling: �� Office ' I , � sought: � UW�.G1 �MQ�WI� Q�. Vl1(9-�� � � �t � `� � ,V � � I Date: '� �`� �� MINNESOTA SECRETARY OF STATE ELECTION CANDIDATE INFORMATION FORM (VOLUNTARY DISCLOSURE) Please type or print clearly You are invited to complete this form and leave it with the filing office for public information. The Secretary of State does not edit the information submitted. Information submitted by state and federal candidates will be scanned and placed on the Secretary of State's web site: vcn��.sos.state.mn.us. If you are filing for state or federal office at a county,please FAX a copy of this complete form to us at 651-296-9073 if you wish this information to be published on the web. Your Name: ���, ���/ 1(� D��S Age: �� Your address: �"�'��t�r�V� �� • 'v � �'t (k i e.�( . ' l I V cJ���� TelephoneNumber: ��p 3 — ��.�.' � 3g� E-Mail: � � If� `� ` o- � W1 Web site: I�,e Y�a l4 ( �� ClrL ti�C.e.��) ' Occupation and employer:�Q��^� �'�� �D n e..U w e.ll� Office Sought: � � (�,r U, ` V�lQ�vv�,�� �G�.�(� (�t d� Political party or principle: Current office held: First year elected or appointed: Previous elected or appointed public offices: Endorsements: Comments or filing statement(use this space only): ify that the inform tion vided on this form is true. �� �`��� ' Candidate Signatur Date If you have any questions,please contact the Elections Division at 651-215-1440. Please submit this information: Fax: 651-296-9073 Mail: 180 State Office Building, 100 Rev Dr Martin Luther King Jr.Blvd,St.Paul,MN 55155 � � F p�y City of Fridley Nomination Petition �'Vc,the undersigned,registered voters of the City of Fridley,hereby nominate F�2 11.0 I�5 whose residence is �'a��p�pyt �Q, �� ,for the office ofe.oi.t,n�� �ww.m�w. �2,.°�`to be voted for at the election to be held on the 4th day of November 2014, and we individually certify that we are registered voters and that we have not signed more nomination petitions of candidates for this oftice than there are persons to be elected thereto. Birth Year: Printed Full Name and Signature Address \ � \ �,u ` �2y3 N���m �,LI�� l�f yy SA�ic�EL l��ta�Tat�t pv�1�1�. S � � �' w � �G� I �/�c. C re�6Cl�..� 7 • �'G���s ��,tj ( 3� �4-b/e .5!-�Uc r.��/y.�r�. S 6 fls�- � G��II�s� � �'�,'� le� 6 0 6 r�—L �"V� s ���,� �',�d , �1 �y�o o�o,���q,� s��,.�.f�i,y, a....rs�/3L l9`-f� � "h la�'f �o�h p�ve ,N�. (0 2 c.� s�� T� J�¢/' ,�c,�. �i �� � � � ,a�� r�£ I 'c�r E�� �� ►�6� 73� �v�� �1�E. �E 2 re1L�being duly sworn, depos s and ays, `I am the circulator of the foregoing petition paper containing signatures and that the signatures appended thereto were made in my presence and are the genuine signatures of the persons whose names they purport to be." I wish my name appear on the ballot exactly as follows: �1�r-� �eY No�c�S (Please Print Name) This petition,if found insufficient by the City Clerk, shall be ret�uned to��M IC.e.v��� �5 at 4 , ►J� ,Fridley,Minnesota. I hereby indicate my wili ngness to accept the office of Councilmember Ward if duly elected thereto. � � �- � (Signature of minee) Subscr� ed and sw to before me this J�ay of <t�G� ,2014. ���� �t1(a�N D SARGENT �,..� �, o a ublic �';y � � ' NQ1rAlRS�PUBUC•MINNESOTA ��'`�';`'' MY COMMISSION D(PIRES 01/3t/18 � G��II� � � � � � , �� r � ��P �' ��y�3 �� �- �� � �3�0 ,�t,� ,d�. � � wp�,y City of Fridley Nomination Petition We,the undersigned,registered voters of the City of Fridley,hereby nominate N� � �l�`j- whose residence is �,`i��0�"p U\�Q, N G�, for the office o�w,n[.���,n� 'Z ,to be voted for at the election to be held on the 4th day of November 2014, and we individually certify that we are registered voters and that we have not signed more nomination petitions of candidates for this o�ce than there are persons to be elected thereto. Birth Year: Printed Full Name and Signature Address �1�3 D�Ssc.� �CI�t-1-C� ���— ��'�J GLcvt�_�1 S f.� �M `���f tr�o�� , being duly sworn, deposes and says, "I am the circulator of the foregoing petition paper containing signatures and that the signatures appended thereto were made in my presence and are the genuine signatures of the persons whose names they purport to be." I wish my na to app r on the ballo exactly as follows: �A�"� QY t�.o��S (Please Pr�nt Name j This petition,if found insufficient by the City Clerk, shall be retw-ned to ��}N\ �Zy h0`d 5 at ��.,�,`���y��Q �� ,Fridley,Minnesot�. I hereby indicate my wi in ss to accept the office of Councilmember Ward�jf duly elected thereto. (Signature of ominee) Subscrib and sw to before me this ��day of �t1��,2014. � N�, LOGAN D SARGENT (N a ublic, ;��"' NOTAR��IC-MINNESOTA ���''� MY COMMISSION D(PIRES 01I31/18 /D a�n.�� = ��,c.,�t �Cw� Skogen, Deb From: Teri McMahon [Teri.McMahon@co.anoka.mn.us] Sent: Tuesday, June 03, 2014 1:58 PM To: Skogen, Deb Subject: RE: Anderson and Reynolds Nominating Petitions All are ok for John Anderson. I have one that is not currently registered at the address given for Pam Reynolds petition. Christopher Dewitt—6320 Able St NE Fridley MN (1975).Just a side not on Christopher, his registration is showing the address of Andrea Dewitt— 1243 Norton Ave NE. But as listed on the petition he wrote the address provided above. Not sure if this is something you need or want to know. Teri From: Skogen, Deb [mailto:Deb.SkogenCa�fridleymn g.ov] Sent: Tuesday,June 03, 2014 1:45 PM To: Teri McMahon Subject: Anderson and Reynolds Nominating Petitions Attached is one additional page for John Anderson with 3 signatures And A nominating petition from Pam Reynolds with 11 signatures. If you could verify if they are registered and get back to me that would be great. I really appreciate your help. ��. .��, �x�e City Clerk,City of Fridley 6431 University Avenue NE Fridley, MN 55432 763-572-3523 deb.sko�en@fridlevmn.�ov Fax: 763-502-4981 Click here to report this email as spam. NOTICE: Unless restricted by law, email correspondence to and from Anoka County government offices may be public data subject to the Minnesota Data Practices Act and/or may be disclosed to third parties. i City of Fridley Public Disclosure Statement By City Council Members or City Council Candidates Name: �F��f`� 1�� Y`O l�S Date �� � " � y' Position Title: ('p�.,Y�L���¢� Q�, _ � In conformance with Section 5.04 of the Fridley City Code, I hereby make the following declarations regarding my financial and personal interests: 1. Names of all business corporations, partnerships, other business enterprises,or governmental agencies doing business with the City of Fridley or located within the Ciry of Fridley. a) With which �have a financial interest. (As used in Chapter 5,the tertn financial interest shall be deemed to include ownership of more than 10%o£ the outstanding stock in a corporation, an interest in a partnership, proprietorship, or other business entity, or an interest in real property. Financial interest shall apply to real or personal properties owned by one person making the disclosure and by said person's spouse.) b) With which i have a personal interest. (As used in Chapter 5,the term personal interest shall be deemed to apply whenever a person required to make a disclosure under this code of ethics shall be associated with a business as an employee, officer, director,trustee,partner,advisor or consultant.) Name of Business, Address Financial Personal Interest Partnershi , Etc. Interest (use additional paper if necessary) 2. A list of the non-homestead real property located within the City of Fridley in which I currently have a financial interest: Non-Homestead Real Property Address (use additional paper if necessary) City of Fridley Public Disclosure Form Page 2 3. A list of the non-homestead real property located within the City of Fridley in which I have had a financial interest within the proceeding three years. Non-Homestead Real Property Address (use additional paper if necessary) 4. A list of names and nature of business of all corporations, partnerships, or other business enterprises with which I have a financial interest and in which I know one or more other persons covered by this code of ethics also having a financial interest in said enterprise. (This list shall indicate the name or names of such persons or persons having such interest in said enterprise.) Nature of Business—of All Corporations, Names Partnershi s, or Other Business Ente rises (Use additional paper if necessary) I do swear(or affirm)that this report is a full and true statement pursuant to Section 5.04 of the Fridley City Code. w (Si ture) Note: This statement must be filed annually or when there is a material change in financial interest or in position held.