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Rolstad, Valerie - Ward 2 �'TRES 0............9 y:etonn u,y �' Office of the Minnesota F','ng# Cash/Check# Secretary of State Amount$ !l a*iesa+� Affidavit of Candidacy All information on this form is available to the public.Information provided will appear on the Secretary of State's website at www.sos.state.mn.us. Note:If filing for partisan office and not a major party candidate,you must file both an affidavit of candidacy and a nominating petition:"Candidates for any partisan office who do not seek the nomination of a major political party shall be nominated by nominating petition as provided in sections 204B.07 and 20413.08,and. . .shall file an affidavit of candidacy as provided in section 204B.06."(Minn. Stat.section 2048.03). Please print or type. Name(as it will appear on the ballot):Valaci e.�Q kcE6— Office Sought: Ck T l'0IAY)r-1 ' District#: For Partisan Office Provide Political Party or Principle: For Judicial Office Provide Name of Incumbent: Legal Residence Address I Street Address: //00 Lu/ d,(P. l" City: State: Zip: Campaign Contact In ormation Street Address: l l ot) 1-"vl d g City: (r l State: m Zip: Website: Email: VAr('©�l� 11Y1° C�Yh Phone Number: (--7&3 ) c�7� � � ©�(D 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; • 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 • 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 • School Board Member-I have not been convicted of an offense for which registration is required under Minnesota Statutes,section 243.166. County,Municipal,School District,or Special District Office-I meet any other qualifications for that office prescribed by law. x Subscriibed n worn before me this , Candidat Signature - day of 01—' 0� Notay AA -Mir,,, J�1 Mr, ary public or other officer empowered to (Notary stamp) take and certify acknowledgments. Rev.4-06 white copy—Filing Officer yellow copy—CFPD Board goldenrod copy—Candidate pink copy—Public Information � ��� sto�i°'A'ai� �,rc�w City of Fridley Nomination Petition QIYOF FRIDLEY We, the undersigned,registered voters of the City of Fridley,hereby nominateQer�f, &&�4d whose residence is l)Db /-a P r , for the office of GOc7.- , to belvoted for at the election to be held on the�_ day of 2006; 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: Printed Name and Sign ure Address —17 ` -O(P C �- t �Q `�N�� �f 18/x6 /11 rcN 4EL l�tir2 //30 zYWI Awl _ /� 5— go- �/ Yl O hk\ � LtO LI, W—' M t h. MYO cam,np(k c,� CU-�--- 0-�'3 7-4? 16 TTacK) Gv7ide pri Y� 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 by name to appear on the ba of exactly as follows: (Please Print Name) Th's etitio if found insuffi 'e by the Pity Clerk, shall be returned to at , Fridley, Minnesota. I hereby indicate my willingness to accept the office of (,J if duly elected thereto. (Sign eof Nominee) u cribed a sworn to b re this p day of , 2006. otary Public) 1 MAlICBlE o, Notary Public-Minnseota •..: MY Commission Expires Jan 31,2010 M� 31BOW IMR"� t: ri City of Fridley Nomination Petition CIIYOF FRIDL.EY We,the undersigned,registered voters of the City of Fridley,hereby nominate - 44 whose residence is )CD8 l.u►v,. . i{ , for the office of Q�oh ^\ �, , to bLyvoted for at the election to be held on the -7 day of u , 2006; 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: Printed Name and Signature Address iA7x.Tz1:1 91-'Y Z-YA11L 9A , C4 r 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 wishm b n e to appear n the ballotexactly as follows: U �Pde. nkiLad (Please Print Name) This petit i , if found insufficient b the City CI c, shall be returned to at //a , Fridley, Minn sota. I hereby indicate my willingness to acdept the office of if duly elected thereto. � (Signa e ominee) S cribed d sworn to efor me this le day of , 2006. (Notary Public) 1 NH MA1iCEl1.E E11EpETtE Notary pubiic-Minneeots ;„; Commis w E)V—Jan 31,2010 a v a. ♦v }y t'Fi City of Fridley Public Disclosure Statement By City Council Members or City Council Candidates Name: ��lQ�("j e, Rd6M Date /g-O6, Position Title: (�,j� L4C�XIOC.1 l Lit)Ckc d 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 City of Fridley. a) With which I have a financial interest. (As used in Chapter 5, the term financial interest shall be deemed to include ownership of more than 10% of: 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 Partnership, Etc. Interest I V1 (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) 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 Partnerships, or Other Business Enterprises (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. ignature) Note: This statement must be filed annually or when there is a material change in financial interest or in position held.