Reynolds, Pam - Ward 2 Office of the Minnesota Secretary of State Filin #
AFFIDAVIT OF CANDIDACY
LCas eck#
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 parry candidate,you must file both an affidavit of candidacy and a nominating petition.(Minn.Stat.2046.03)
Candidate Information
Name and Office f
Candidate Name(as it will appear on the ballot) PQ ox e y 6 C►S 'L -�/
Office Sought cpliyt<<IM�rr�pr� „wd A
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 l?LAI Nv r�v yl RNe NE,
City Vi( �A`e”, State M Al Zip Code S54 3
TMy 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 « y 1 ►�lor-dor. A;"j f,a��� l M iJ 5543 2. PAM Rey h��as
Candidate Phone Number(Required) 1105 ci35?6
Campaign Contact Address(Required for those who have checked the box above):
Street Address
City State Zip Code
{�
Website 9_jv c, N1D �Y ���Lv/ �� �jppk\/Email iA YV\ �n
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 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.
• 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 District Office-I meet any other qualifications for that office prescribed by law.
Candidate Signature Date �
' '' O
Subscribed and sworn to before me this day of —,T-un-e— 20 -
Notary or cer e0op-owerdid to take and certify acknowledgement 0016H DURAND
White Copy-Filing Officer Yellow Copy-CFPD Board Pink Copy-Public Information Goldenrod Copy JrNOTA11"�MINNESOTA
My COMMISSION EXPIRES 0113112021
Office of the Minnesota Secretary of State
ELECTION CANDIDATE INFORMATION FORM (VOLUNTARY DISCLOSURE)
Instructions
Federal and State candidates are invited to complete this form in whole or in part.Submit it through the filing officer
or by sending it to the Secretary of State via email(elections.dept@state.mn.us)or mail:
180 State Office Building, 100 Rev. Dr. Martin Luther King,Jr. Blvd.,St. Paul,MN 55155-1299
Information submitted on this form will be published on the Secretary of State's web site.The Office of the
Secretary of State does not edit the information submitted.Additional sheets will not be published.
Candidate Information
Candidate Name PA M 41 nb
Office Sought -„ Cp�,�nul Me^he,-- k �Ld Z y � �` MA)
Political Party or Principle � \ r
Address 1_1y j ii�or--or\ Ave, � � 1�^Y i U e;V i M N 55-43.-
Preferred mailing address(if different)
Telephone 1�p�J ' aa-x— q�* Fax 1
E-Mail (,O Web site Reyi,'?1dSGY- f; t,A ey
Occupation and Employer Q, "�'(`CA Age
Current Office Held First Year Elected or Appointed
Previous Elected or Appointed Public Offices
Endorsements
Comments or Filing Statement(use this space only)
I certify that the infor ion provided o this form is true.
� Y
Candidate Signature & • Date & — 4
� b
Revised 3/2014
i
IF-*A -
COUNTY OF ANOKA
OFFICE OF ELECTIONS & VOTER REGISTRATION
ANOKA
COUNTY
2018 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: Pavlv\
�e S
Phonetic 90\0N �� �f �1y A-L
Spelling: rM 1�
Office
sought: /l
Date: 6A — i 0
City of Fridley
. Frim Public Disclosure Statement
By City Council Members or City Council Candidates
Name: PA �7 to CC, e,-,, S Date 6 - 4 — 1 12�
Position Title: W a--c A .-nc;, \ ip -c' o h
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
P2qgsI2' , 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 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.
Signature)
Note: This statement must be filed annually or when there is a material change in financial
interest or in position held.
AVW
Fridley City of Fridley Nomination Petition
We,the undersigned, registered voters of the City of Fridley, hereby nominate L G
whose residence is /1for the office of ,Z (cuu',+,ria..ynMto be voted
for at the election to be held on the 6th day of November 2018, 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.
Birth Printed Full Name and Signature Address
Year:
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i I -5 u 5G h -1,J;.D T(
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1 VA M R e 4 K p ' Ae-j , 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 in name to appear on the ballot exactly as follows:
(Ple se Print Name) 1 f
This petition, if found insufficient by the City Clerk, shall be returned to%melt I� �ey hykl5
at �� Nl;t"" on Ptie Icy.. Fridley, Minnesota. I hereby indicate my willin ess to accept
the officeof�ay' a(;,� o?�'Ti�Lt� . ,1 if duly electedthe reto�
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(Signature o ominee)
Subscribed and sworn to before me this 5 day of J � ,2018.
+'Vt/VNVY
BRANDON JOSEPH DURAND of ubLc)
i •' .z°' NOTARY PUBLIC•MINNESOTA
.,= MY COMMISSION EXPIRES 0113112021