HomeMy WebLinkAboutAffidavit of candidacy Prescribed by the Office of the Iowa Secretary of State Revised 6/2014
State of Iowa
Affidavit of Candidacy
Candidate’s Name (exactly as it should appear on the ballot – no titles, parentheses, or quotation marks):
Candidate’s Name Sounds Like (phonetic spelling):
Office Sought: District or Ward (if any):
Vacancy – Is the candidate running to fill a vacancy due to the death, resignation, Yes No
removal, or temporary appointment of an office holder?
Type and Date of Election:
Primary on ____/____/____ General on ____/____/____ City on ____/____/____
School on ____/____/____ Special on ____/____/____
Candidate’s Affiliation (only complete for partisan offices or Ch. 44 city nominations):
Democratic Republican
Not affiliated with any organization
Name of Non-Party Political Organization: No more than 5 words and exactly as it should appear on the ballot.
Candidate’s Home Address:
Street (no P.O. boxes) City State Zip County
Candidate’s Mailing Address (if different than above):
Street City State Zip County
Candidate’s Phone: Email:
Candidate’s Affirmation
I swear (or affirm) that the information provided on this form is correct. I will be qualified to hold this office and if I am elected, I
will qualify by taking the oath of office. I know that I cannot hold public office if I have been convicted of a felony or other
infamous crime and my rights have not been restored by the governor or by the president of the United States.
I know that I am required to organize a candidate’s committee, which shall file an organization statement and disclosure reports
if I (or my committee) receive contributions, make expenditures, or incur indebtedness in excess of $750 in a calendar year for
the purpose of supporting my candidacy for public office. (This does not apply to candidates for federal office.)
I know that I cannot be a candidate for more than one office to be filled at this election (except in the case of county agricultural
extension council or soil and water conservation district commission).
Candidate’s Signature: Must be signed in the presence of a notary.
State of: ____ County of: _______________
(Stamp)
Signed and sworn (or affirmed) before me on date of: _____________
By:
Print Candidate’s Name
Notary Signature: Notary Title: