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Prescribed by the Office of the Iowa Secretary of State Revised 12/2022 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, No Yes removal, or temporary appointment of an office holder? Type and Date of Election: Primary on General on City/School on Special on Candidate’s Affiliation (only complete for partisan offices or Ch. 44 city nominations): 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 $1,000 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 as otherwise provided by law. 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 Public or authorized notary under §9B.10 Republican Democratic Libertarian Not affiliated with any organization Name of Non-Party Political Organization: