Hardy, Adam - Ward 2 FORM(REVISED 7980)MILLER-DAVIS CO.,ST.PAUL,MN
AFFIDAVIT OF CANDIDATE & RECEIPT FOR FILING
TOWN OR CITY ELECTIONS
State of Minnesota. No. -2-
SS.
County o
I,
(Print name as wanted on ballot)
swear (or affirm) that I am qualified under the Constitution and Laws of the United States and State of Minne-
sota to seek the elective public office indicated below. I am a qualified voter in the subdivision where I seek
election. I will be 21 years of age or more on assuming office. I will be a resident of my election district for at
least 30 days by election day. I have not filed for any other office at this election.
I am seeking election to the office of AUiA P (, MA,&.jAex�
I reside in the City or Township of ri
My post office address is
(Zip) —
f (Sign nam wanted A ballot)
Subscribed and sworn to before me this /. day o , 19 !19
,iM■ ,
� RO ERT 1NS own), (City lerk Not P blit
NOTARY PUBLIC-MINN�OIA
1111111 11 --
ANOKA COUNTY ounty,Minn.
My comm.Exp.Ja►.01 '000
NOMINATION PETITION
We, the undersigned, registered voters of the City of Fridley,
Nearby nominate _�_fU� lb� , whose residence. is
C�M4iFoIJ104 r AAM for the office of
o-14U to be voted for at
d
the election to be held on the ?J� day of too 0,
and we individually certify that we are registered voters and that
we have not signed more nomination petitions of candidates for this
office than there are persons to be elected thereto.
DATE NAME STREET AND ADDRESS
OK 7-9 7�
o� � -�
OV, — `'� _ 7� /�
0� �� � ��
4 �� �� 6A AM 0 I&W � T
being duly sworn, deposes and says, "I am
( ame of Ci u Mr)
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. 11
I wish my name to appear on the ballot exactly as follows:
(Please Print)
(Signat re of Nominee)
Subs criluad---m nd sworn to bef a me this .- day ALAN VV Cs"OOACKE
8OTARK PUBLIC MINNESOTA
O f 19 _ MY COMMISSION EXPIRES
UANUARY 31,2000
(Notar Public)
This etition, if found insufficient by the City Clerk, shall •be'returne
to �� , at Number _toWS— (TkOOO/ Street.
I hearby indicate my willingness to accept the office of Oil&
0 if duly elected thereto.
(Signature of N inee)
6/94
NOMINATION PETITION
We, the undersigned, register voters of the City of Fridley,
hearby nominate O-, whose residence. is
�a�i�►e� N 'Cl for the office of
1,15
b , to be voted for at
the election to be held on the day of Iy ill. , 192T
and we individually certify that we are registered voters and that
we have not signed more nomination petitions of candidates for this
office than there are persons to be elected thereto.
DATE NAME STREET AND ADDRESS
ISAuAllr�3 1� d _-R&
being duly sworn, deposes and says, "I am
(Name of Circulator)
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 to appear on the ballot exactly as follows:
(Please Print)
(Signature of N)ofninee)
Subscribed am sworn to before e �'�this � day ..........., ALAN W. dORACKE
o f 19
NOTARY PUBLIC-.MINNESOTA
MY COMMISSION EXPIRES
JANUARY 31,2000
04 04 04 014
(Notary Pu 1c)
This petition, if found insufficient by the City/Clerk, shall be returned
lam
toy! , 7�J� , at Number �' � l' L NF� �� Street.
I hearby indicate my willingness to accept the office of I�
t� if duly elected thereto.
(Signature of Nominee)
6/94