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Home My WebLink AboutBiome Michael Ericksen-Complete Candidate Filing SEL 101 Major Political Party or Nonpartisan rev.1/12 ORS 249.031 0 This information is a matter of public record and maybe published or reproduced. A16 Original O Amendment Filing Officer: \ O Secretary of State O County Elections Official of County Mail or Deliver to County Elections Office City Recorder(Auditor),City of Candidate Information O Democratic Party O Republican Party Nonpartisan O Incumbent Judge Candidate Legal Name* Candidate Name(As it should appear on ballot)* KiErT�t P'(C�AV-i, F-RtcKSv/V f310KE Filing for Office of* District and/or Position(if applicable)* t44,46tq or_ t;ftl Residence Address,Street/Route* 1W 949,&A b i/L 6 ST City* State* Zip* County of Residence* /A Shir d off, 1 �4cv,swt/ Home Phone Work Phone Cell Phone Fax Sti)--1i/-2S`i'3 Email* � Website Raw >`1�� 6�v►21 Ce <--vr�, Mailing Address(All correspondence will be sent to this address)* City* State* Zip* *Indicates a required field.At least one phone number is also required. O Filing by Declaration,with the required filing fee Office Filing Fee Office Filing Fee United States President n/a County Judge $50 United States Vice President n/a MSD Executive Officer,MSD Auditor $100 United States Senator $150 MSD Councilor $25 United States Representative $100 County Office $50 Statewide Offices $100 City Office set by charter or ordinance State Senator or Representative $25 Justice of the Peace n/a Circuit Court Judge 0 District Attorneys q�G `s V42 Prospective Petition with proprol�Pig sh— - etition circulato ill be p V�a k O ne) OYes ANO Com leted Petition with certified signature S�tP g`( 2012 Fling Dates Primary Election May 15,2012 Candidate Filing State Voters'Pamphlet Filing Candidate Withdrawal September 8, 2011 to September 8, 2011 to March 6,2012 March 8, 2012(for paper filing) March 9, 2012 or March 12, 2012(for electronic filing) General Election November 6,2012 May 30,2012 to May 30, 2012 to August 28,2012 August 28,2012(for paper filing) August 31, 2012 or August 30, 2012(for electronic filing) (continued) Required Information(If no relevant information list none or n/a) Occupation (present employment—paid or unpaid)(required) ��L�� Pla.�� PfdRu,ct�.v�� 'erv�«✓� - PA)� �4�vrDs� P ►� - �t�4 FOM Occupational Background(previous employment—paid or unpaid)(required) AAF7 61' CAA-)' - JNPh71J CnOK - PA-i 0 CAR P FAri E P- l Roo Fi5K - _PA 10 Educational Background(schools attended, if necessary use attachment)(required) Name of School(no acronyms) Last grade Level Diploma/Degree/Certificate Course of Study Completed (AA, BA, BS, MA, PhD accredited) (optional) Not honorary — ANN `a A-fiE uk a jP_S r%.�l S°P;{c�nw�E —'� G _ br'ch""str Ej'q- 5-rAUL)'S L'Al;✓&2S(T� Prior Governmental Experience(elected or appointed)(required) n 1q By signing this document /hereby state that: 4 1 will accept the nomination for the office indicated above 4 1 will qualify for said office if elected 4 if not nominated, I will not accept the nomination or endorsement of any political party other than the one named 4 1 have been a member of said political party,subject to the exceptions stated in ORS 249.046,for at least 180 days before the deadline for filing a nominating petition or declaration of candidacy(ORS 249.031) 4 all information provided by me on this form is true to the best of my knowledge and 4 no circulators will be compensated based on the number of signatures obtained by the circulator on a prospective petition Check the applicable box(not applicable to candidates for federal office-US Senate and US Representative): By marking this box, I certify I do not have an existing candidate committee and I do not expect to spend more than $750 or receive more than$750 during each calendar year. I understand I must still keep records of all campaign transactions and if total contributions or total expenditures exceed$750 during a calendar year, I must follow the requirements detailed in the 2012 Campaign Finance Manual By marking this box, I certify that I have already filed or will soon file a Statement of Organization for Candidate Committee(SEL 220). For detailed instructions, see the 2012 Campaign Finance Manual. AWaming Supplying false information on this form may result in conviction of a felony with a fine of up to$125,000 and/or prison for up to 5 years.(ORS 260.715).A person may only file for one lucrative office or not more than one precinct committee person at the same election. Unless the person has withdrawn from the first filing,all filings are invalid.(ORS 249.013 and ORS 249.170) Ca didate's Signature Date Signed For Office Use Only Initials Approval Code/Receipt Number CERTIFICATE FOR VOLUNTARY CONTRIBUTION & SPENDING LIMITS CITY OF ASHLAND AMC 2.41 PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK Candidate ❑ Political Committee ❑ Primary 20_ General 20 If Z ❑ Other Election Date CO t r Political Comm' ee Name Committee Identification Number [ILA Q Fswl It It Telephon Treasurers Full Name tuber(day) �— Addres (street or route, city, stipte,zip code) J 190 Office of I certify that if I am signing as a candidate, I will not make attributable exp. ures for this election in excess of $3,352.00 (including expenditures of my principal campaign committee), or, if I am signing as a treasurer of a ittee rganized exclusively to support or to oppose a candidate, I certify that the committee will not make attributable expenditures in this election in exc s of$3,352.00. C didate or treasurer's signature Date Signed [NOTE: If the candidate or committee treasurer elects NOT to be bound by the expenditure limitations,the following line should be signed instead of the line above.] I elect not to be limited to the attributable expenditures specified in this certificate and city ordinance. Candidate or treasurer's signature Date Signed (Authorized Use) The City Recorder is authorized to publish a statement in the City, indicating whether or not the candidate has agreed to limit expenditures. D xv If the City Recorder or the City Attorney finds that a candidate filing a declaration of limitation on expenditures has exceeded �� the applicable expenditure limit, at the next election at which the candidate is a candidate for election to public office, the City AUG Recorder shall publish a statement, in the City, indicating that the candidate violated a previous declaration of limitation. 720 12 BY CITY OF ASHLAND August 7, 2012 "Biome"Michael Erickson 180 Hargadine Street Ashland OR 97520 A prospective petition has been completed and filed with the City Recorder's Office for City of Ashland Mayor. A petition JV9 been approved for circulation. Barbara Christensen City Recorder CITY RECORDERITREASURER Tel:541.488-5307 20 E Main Street Fax:541-552-2059 Ashland,Oregon 97520 TTY: 800-735-2900 www.ashland.or.us CITY OF ASHLAND August 13, 2012 Biome Erickson 180 Hargardine Street Ashland OR 97520 A completed petition, with the required signature sheets properly certified by the county elections office has been received and is filed with the City Recorder's Office for City of Ashland Mayor. Please let me know if I can be of any further assistance during this upcoming election time. Barbara Christensen City Recorder/Treasurer CITY RECORDERITREASURER Tel:541-488-5307 �. 20 E Main Street Fax:541-552-2059 Ashland,Oregon 97520 TTY: 800-735-2900 www.ashland.or.us County: JACKSON Petition Processing Statistics Report Date : 8/10/2012 8:11:20 AM User Name : Hvall, Marty W Number :Ash2012-10 Title :City of Ashland Mayor Keith Michael Erickson Petition Information Petition Name : City of Ashland Mayor Keith Michael Erickson Petition Date : 08/07/2012 Date Filed : 08/07/2012 End Circulation Date : 08/08/2012 Minimum Signatures Required : 25 Accepted Of Minimum : ( 140% ) Total Signatures Processed : 35 Processing Summary Sample: All Total Accepted Signatures : 27 (77% ) Of Those Processed Total Rejected Signatures 8 (23% ) Of Those Processed Accepted Reason Total (% Rejected) Valid Signature 27 (100%) Rejected Reason Total (% Rejected) Out of District 1 (12.5%) Inactive Due to Moving 1 (12.5%) Signatures Do Not Match 6 (75%) Oregon Centralized Voter Registration Page : 1 c . ' Candidate Signature Sheet - Nonpartisan Petition ID _ Petition circulators will be paid: 0 Yes D&II No (Mark one) �Sf This is a candidate nominating petition.Signers of this page must be active registered voters in the following county: Note to Candidate: Petition signatures must be verified before the petition can be filed with the filing officer. Submit the petition in ample time for the process to be completed before 5pm on the filing deadline day. _ Ca didate's Name Office District or Position Number if applicable el ��w 0�4 4WjV)(— To the Appropriate Filing Officer,We,the undersigned voters, request the candidates name printed above, for nomination to the office indicated, be placed upon the appropriate ballot at the next election following the filing of this petition. 4 Signers must initial any changes that they or the circulator makes to their printed name, residence address or date they signed the petition Signature Date Signed mm/dd/yy Printii Name Residence or Mailing Address street,city,zip code Precinct#optional ✓1 �_ ��2- Tom' q i5r)L&IIII lew tf-f/�v y/�i�v£ 57-45hic'n s Circulator Certification This certification must be signed by the circulator! I hereby certify that I witnessed the signing of the signature sheet by each individual whose signature appears on the signature sheet, and I believe each individual is an elector qualified !, to sign the petition. (ORS 249.061) I also certify that compensation I received, if any,was not based on the number of signatures obtained for this petition.Warning! Falsely signing this �0.nnn .a/.,..,.Ic fnr..n to 5 vear-, (ORS 260.715) 1 statement ma result in conv ction of felony with a fine of up to GJ,wv aniuwi prison r -- CircuI r Signature Date Signed mm/dd/yy tka Printed Name of Circulator Circulator's Address street, city, zip code County Elections Official Certification , J I hereby certify signatures on this petition are those of active registered voters inp County, Oregon. 1 ro I 2012 Signature of County Elections Official Date Certified mm/dd/yy Sheet Number SEL 121 —1n2 ORS 249.012 Petition ID Candidate Signature Sheet - Nonpartisan Petition circulators will be paid O Yes No (Mark one) This is a candidate nominating petition.Signers of this page must be active registered voters in the following county: Note to Candidate: Petition signatures must be verified before the petition can be filed with the filing officer. Submit the petition in ample time for the process to be completed before 5pm on the filing deadline day. a dida�t.�e('�s Name Office District or Position Number if applicable C To the Appropriate Filing Officer,We, the undersigned voters, request the candidate's name printed above,for nomination election following the filing of this petition. to the office indicated, be placed upon the appropriate ballot at the next -)Signers must initial any changes that they or the circulator makes to their printed name, residence address or date they signed the petition Signature Date Signed mm/dd/yy Print Name Residence or Mailing Address street,city,zip code Precinct#optional r �..., `a 7�L 2 :!/ � �G _ C �1/esse * � � r C •�. �� 11 Cam° S� � ��-� ✓s �_1...c.n�ss�-�5 �e Q 2-0 00-l` S-� ASS tc.,d �l 0 C� f ^' Circulator Certification This certification must be signed by the circulatorl j each individual whose signature appears on the signature sheet, and I beli�ve each individual is an elector qualified I hereby certify that I witnessed the signing of the signature sheet by to sign the petition.(ORS 249.061) 1 also certify that compensation I received, if any,was not based on the number of signatures obtained for tljis petition.Warning! Falsely signing this statement may result in onviction of a felony with a fine of up to$125,000 and/or prison fnr-1 to 5 years. (ORS 260.715) `8 X12 Circul for Signature Date Signed mm/dd/yy rr,, ` lf�b 1�.�9>12G.4•J�1�y� S� A Sh 1ac� ��r S'Zo utTh /f Fr cl' Printed Name of Circulator Circulators Address street, city,zip code County Elections Official Certification r, I hereby certify la signatures on this petition are those of active registered voters in Ili i� )_fa�.ICSUN County, Oregon. tlI G�,t 17�f 1 �-1 S�►o l 2��y � Signature of County Elections Official Date Certified mm/dd/yy Sheet Number SEL121 —V12 ORS 2n9.ni2 Candidate Signature Sheet - Nonpartisan Petition ID Petition circulators will be paid: O Yes No (Mark one) This is a candidate nominating petition.Signers of this page must be active registered voters in the following county: ,+y1 Note to Candidate: Petition signatures must be verified before the petition can be filed with the filing officer. Submit the petition in ample time for the process to be completed before 5pm on the filing deadline day. Cj did�ate{'�s Namfie 1� Office District or Position Number if applicable nt" To the Appropriate Filing Officer,We, the undersigned voters, request the candidate's name printed above, for nomination to the office indicated, be placed upon the appropriate ballot at the next election following the filing of this petition. -)Signers must initial any changes that they or the circulator makes to their printed name, residence address or date they signed the petition Signature Date Signed mm/dd/yy Print Name Residence or Mailing Address street,city,zip code Precinct#optional ,r2 1�l i/Z- bj g g ��/� �A MGS t /�,cL y 641 A �. A/ V -&4 3 1- 5E/I A�, j G� `1 S•7 p 4 #f5 �A-eck ik e-r L--r)�t�1c 2 e�v v� '`�5 l �� to c� t OIL rJ �55c- ! (o %�ja `�r- ( _ Circulator Certification This certification must be signed by the circulatorl I hereby certify that I witnessed the signing of the signature sheet by each individual whose signature appears on the signature sheet, and I believe each individual is an elector qualified to sign the petition.(ORS 249.061) 1 also certify that compensation I received, if any, was not based on the number of signatures obtained for this petition.Warning! Falsely signing this t .._y with I 'li f to$125,nnn nnri/nr prignn fnr urn,to 5 years: (ORS 260.715) i s tatement may result in c r1Vl( lull ui a iei�iiy vvitn o une v^ up (ORS / Circulator Signature Date Signed mm/dd/yy ST Printed Name of Circulator Circulators Address street city, zip code County Elections Official Certification JJ__,, ..�� JJ I hereby certify � signatures on this petition are those of active registered voters in IW Gr'�'!.f ob 1C 1(�Y � � County, Oregon. •JJ Signature f County Elections Official Date Certified mm/dd/yy Sheet Number SEL 121 —a12 ores 249.072 Candidate Signature Sheet - Nonpartisan Petition ID Petition circulators will be paid. O Yes No (Mark one) This is a candidate nominating petition.Signers of this page must be active registered voters in the following county: Note to Candidate: Petition signatures must be verified before the petition can be filed with the filing officer. Submit the petition in ample time for the process to be completed before 5pm on the filing deadline day. Ca didate's Name Office i District or Position Number if applicable To the Appropriate Filing Officer,We, the undersigned voters, request the candidate's name printed above, for nomination to the office indicated, be placed upon the appropriate ballot at the next election following the filing of this petition. Signers must initial any changes that they or the circulator makes to their printed name, residence address or date they signed the petition Signature Date Signed mm/dd/yy Print Name Residence or Mailing Address street,city,zip code Precinct#optional r_. � 2 .,) 7 L/C a 44ni�ev) `✓gjt 2 � y 0+ 2 l 5ceou C, S'l�C (cr �tT ✓'S 2 L I NJ D4 OAK`s t', /'Is (--WAN 1� 47 Chrr'D� 15 _ 1 r I I► _a I( ,vfj y ptk TO Circulator rtificatio his certification must be signed by the circulatorl I hereby certify that I witnessed the signing of the signature sheet by each individual whose signature appears on the signature sheet, and I believe each individual is an elector qualified to sign the petition. (ORS 249.061) 1 also certify that compensation I received, if any, was not based on the number of signatures obtained for this petition.Warning! Falsely signing this statement may result in conviction of a felony with a fine of up to$125,000 and/or prison for up to 5 years.(ORS 260.715) C i r c u or Signature Date Signed mm/dd/yy M Erl coca /90 H-Ia6401AIE 9752-0 Printed Name of Circulator Circulator's Address street, city, zip code County Elections Official Certification 1 hereby certif y signatures on this P etition are those of active re g istered voters in Ph�'_d � � \\\JJJ County, Oregon. uaj .4 Signature o County Elections Official Date Certified mm/dd/yy Sheet Number SEL 121 -1112 ORS 2,M012