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HomeMy WebLinkAboutJackie Agee-Completed Candidate Filing - J E0 V/ , SEL 101 Major Political Party or Nonpartisan AGG C 2012 rev 7/12 ORS 249.031 BY This information is a matter of public record and may be published or reproduced ©-.(;riginal 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)* F'lin f Offi of* District and/or Positi (if applicable)* Residen Address, t Street/Route* f City* State* Zip* County of Residence* FjZ Home Phone Work Phone Cell Phone Fax ,4j1- �7ug- � {1- 77 - 91-f =52 3 ---- Email* Website Mailing�ddre8�)(All correspondence will be sent to this address)* /&19 b-C)Lk�)-r 1�. City-,/4--::;,k state*OZ zip* IL *Indicates a required field.At least one phone number is also required. fling by Declaration,with the required filing fee I e 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 $50 n District Attorney $50 ��, 44tv r 14 11 ospective Petition with proposed signature she �''�etition circulators will be paid(Mark One) OYes 40 - - - mpleted Petition with signature sheets .-� 4- 2 Filing 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) Occupational Background(previous employment-paid or unpaid)(required) L�V-� �.� -�-/� �"'��"�1�✓y�l_ �4_e¢ �31G!.�2^...C1�C_��s�?� �-,sC.�.-�"1 Q-S C� C� l'- p�Pty�-t-j- Educational Background(schools attended,if necessary use attachment)(required) � a�� Name of School(no acronyms) Last grade Level Diploma/Degree/Certificate Course of Study Completed (AA, BA, BS, MA,PhD accredited) (optional) Not honorary Other: U Prior Governmental Experience(elected or appointed)(required) By signing this document, /hereby state that: I will accept the nomination for the office indicated above - I will qualify for said office if elected if not nominated,I will not accept the nomination or endorsement of any political party other than the one named I 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) all information provided by me on this form is true to the best of my knowledge and - 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. 0 Warning 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) C id e' S Jpiature Elite Signed For Office Use Only Initials Batch Sheet/CC Approval Code/Receipt Number Candidate Filing SEL 101 Major Political Party or Nonpartisan rev.1/12 ORS 249.031 This information is a matter of public record and may be published or reproduced. ryCt_Original O Amendment Filing Officer: V O Secretary of State O County Elections Official of County Mail or Deliver to County Elections e tCity Recorder(Auditor),City of Candidate Information O Democratic Party O Republican Party 13 Nonpartisan O Incumbent Judge Candidate egal Name* Candida a Name(As it should appear on ballot)* 0qAddr t4-e l iq � kcF% AL--- j & Filing for G� District and// r Position(if a cable)* Residen ,Street/Rout e* /&i g � -kz� . 7 Cit * State* Zip* County of Residence* 51, 1 r7�:- 9.7 k- J Home Phone Work Phone ���/I Cell Phone Fax q1- -70 8— C JC"5 7;�'5-6 965 Email* Website Mailin Addfess(All correspondence will be sent to this address)* City* ;�5 Pt Gt�F' State* '�—ZiP* 7 5 C� *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 $50 ��� District Attorney $50 v 2p12 prospective Petition with proposed signature sheet Petition circulators will be paid(Mark Ong OYo9 0 8� U Completed Petition with certified signature sheets 2012 Filing 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 612012 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) dZ � 7 J Occupational Background(previous employment-paid or unpaid) (required) A L.L 'P,/ D AA 1J..e-- 0,9 P7'Le_�. I l��C-1 o Y _ .7y,— i1- 4 Ti�r !emu 11ZI i Educational Background(schools attended, if necessary use a achment)(requiretiS Name of School(no acronyms) Last grade Level Diploma/Degree/Certificate Course of Study Completed (AA, BA, BS, MA, PhD accredited) (optional) Not honorary Prior Governmental Experience(elected or appointed)(required) By signing this document,1 hereby state that. 4 1 will accept the nomination for the office indicated above --> I 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 -> I 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 -> 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. C 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. 0 Waming 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) a idat'4nat Date i Z For Office Use Only Initials Approval Code/Receipt Number CERTIFICATE FOR VOLUNTARY CONTRIBUTION & SPENDING LIMITS CITY OF ASHLAND AMC 2.41 r -- -- Llr Cf� E2 V 10.1 01 Af`I!10.11! Candidate ❑ Political Committee ❑ Primary 20_ General 20�Z ❑ Other Election Date Candidate or Political Committee Name Committee Ide ' 'cation Number Treasurer's F�("ame (� U p"_"_ Telephone Number(day) Address (street or route,city, stat ,zip code) vo Gtr . l a o Office of Filing I certify that if I am signing as a candidate, I will not make attributable expenditures for this election in excess of $3,352.00 (including expenditures of my principal campaign committee), or, if I am signing as a treasurercess o ltical com organized exclusively to support or to oppose a candidate, I certify that the committee will not make attributable expenditures in this election in a f$3,352.00. Date Si ned n date or t urer' nature 9 [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 The City Recorder is authorized to publish a statement in the City, indicating whether or not the candidate has agreed to limit (Authorized U�s ��� expenditures. O 20 If the City Recorder or the City Attorney finds that a candidate filing a declaration of limitation on expenditures has exceeded JUL 1 the applicable expenditure limit, at the next election at which the candidate is a candidate for election to public office, the City Recorder shall publish a statement, in the City, indicating that the candidate violated a previous declaration of limitation. gY: CITY OF ASHLAND July 16,2012 Jackie Agee 168 Crocker Street Ashland OR 97520 A prospective petition has been completed and filed with the City Recorder's Office for Council Position #1. A petiti as been approveed�for circulation. Barbara Christensen City Recorder CITY RECORDERITREASURER Tel:541-488-5307 20 E Main Street Fax:541-552-2059 Ashland,Oregon 97520 TFY: 800-735-2900 www.ashland.or.us CITY OF ASHLAND August 14, 2012 Jackie Agee 168 Crocker 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 Council Position#l. 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:54IA88-5307 20 E Main Street Far::5 -2059 Ashland,Oregon 97520 TTY: 800-73 800-735-2900 www.ashland.or.us County: JACKSON Petition Processing Statistics Report Date : 8/13/2012 2:10:12 PM User Name : Hvall, Marty W Number :Ash2012-11 Title :City of Ashland City Counil Pos 1 Jackie Agee Petition Information Petition Name : City of Ashland City Counil Pos 1 Jackie Agee Petition Date : 07/16/2012 Date Filed : 07/16/2012 End Circulation Date : 08/09/2012 Minimum Signatures Required : 25 Accepted Of Minimum : ( 140% ) Total Signatures Processed : 35 Processing Summary Sample: All Total Accepted Signatures : 34 (97% ) Of Those Processed Total Rejected Signatures 1 (3% ) Of Those Processed Accepted Reason Total (% Rejected) Valid Signature 34 (100%) Rejected Reason Total (% Rejected) Signatures Do Not Match 1 (100 0/0) Oregon Centralized Voter Registration Page : 1 CITY OF ASHLAND Memo DATE: August 9, 2012 TO: County Elections Office FROM: City of Ashland Recorder's Office RE: Verification of Petitions Please find attached petitions for verification on signatures on the following: Jackie Agee—Council Position 41 Please call my office at (541) 488-5307 once the petitions have been processed and I will pick them up. Thank you! City Hall City Recorder's Office Tel:541488-5307 ��, 20 E Main Fax:541-552-2059 Ashland,Oregon 97520 TTY:800-735-2900 www.ashland.or.us Candidate Signature Sheet - Nonpartisan Petition circulators will be paid: O Yes KNo (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. I f the rocess to be completed before 5pm on the filing deadline day. Petition ID / Submit the petition in amp e Ume or p Candidate's Name Offic Distrigt j( or Position Number if applicable \ � ( c�6� I To the Appropriate Filing Officer,We,the undersigned voters, request th candidate's npme printed above,for nomination to the office indicated, be placed upon the appropriate ballot at the next ( Z vl 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 Sign ure Date Signe mm dd/yy Print Name �'Residence or Mailing Address street,city,zip code Precinct#optional Resident `. -Q 7�1��,( � L �` kcl 7%d 0�� { c� u►'►1�v10��f� % �' I#- - f J lag 6Y- 1,5 _l ill (> / -11567 (av,A ,c/� �( /SSG ✓3 4th - volii 17q 5 (1�0,Aa�� **3 46J,0A, I;P�-2 14A4 e . WALt4 i ;T' ASI4zF+A--Jn a2 .✓ � 7N� V� � C (`[ �r?5�( Y ��s. < r- y I 5 e / 3, !14, 1/9 IS 14ee4444- 9 AY I'l-s�14wq1" OR I - C /� � ,5 vi 10 Circulator Certification This certification must be signed by the circulator! 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 si n 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.Warningl Falsely signing this lfl Q 260 795) ate ent may result in cony of a felony with a tine of up to$125,000 and/or prison for up to 5 year`�� ��r Ci ula r Signature Date Sign dd mm/dd/yy Printed Name of Circulator Circulators Address street, city, zip co e County Elections Official Certification / I I hereby certify 1 signatures on this petition are those of active registered voters in � _hjkt l�GtC R%c5pi�1 County, Oregon. �.:.,._.► ,r�--_ter, 8/13 I2oIZ Signature oil County Elections d icial Date Certified mm/dd/yy SEL121 rev1/12 ORS zd9.n72 Sheet Number Candidate Signature Sheet - Nonpartisan Petition ID Petition circulators will be paid: O Yes KNo (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. Candidate's Name � �I � Offic � Distri t or Position Number if applicable To the Appropriate Filing Officer,We,the undersigned voters, request t candidate's me printed above,for nomination to the office indicated, be placed upon the appropriate ballot at the next UZ% ? 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 Sign ure �4 ' ✓s • Date Signed mm/dd/yy Print Name Residence or Mailing Address street,city,zip code Precinct#optional r: �ca,G�,er Z, y j tVel /lG�n�J_ >.%Cfj n/ of Circulator Certification s 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 ! 1 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.Warningl Falsely signing this r i_i__.. a:__ s cox nnn ,ai..� .,fir to fro C Zan 71Fi I Stat- Tl i may rBSult In convic VII of a ICIUIIY VVitll a It of up to,V ILJ,VVV anuivi pnso .:p ..years• frc or Signature /Date signed mm/dd/yy Printed Name of Circulator j Circulator's Address street, cify,zip code County Elections Official Certification I hereby certify signatures on this petition are those of active registered voters in TIV J--VskAJ4Lk1A T�County, Oregon. N l Z Signature of County Elections Official Date Certified mm/dd/yy SEL121 mvin2 ORS 249.R72 Sheet Number Candidate Signature Sheet - Nonpartisan 9 P 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. Candidate's Name Officf � � Distrigt or Position Number if applicable To the Appropriate Filing Officer,We,the undersigned voters, request th andidate's rime printed above,for nomination to the office indicated, be placed upon the appropriate ballot at the next %' ���1( 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 Signpfure ,, Date Signed mm/dd/yy Print Name Residence or Mailing Address street,city,zip code Precinct#optional 1 1 V3/� 3 %/4 ,j(5 17 ' ""_---- , J,. �' '�t1j c�; . ~C,> (' --,J lfC .�tt ! n j 2� I tlov\i°. �o� k� p `� �,v.�,,,�r S t /` �, Of—_TS7s> SV� Z 1\10,q ik+" _ Ff� W L ( e(ZS �` �© C 'UcIC die AC ho. 8 =tr/ y'jei,�TCj.Y..� 1/� r i i h%(01.0"4 GV2 S/ rk�yQu lS,-v,)� /!s'// 7S.�G Irror� 6e,* M. 4kkd Circulator Certification This certificatio 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.Warningl Falsely signing this Star ^t may r�� 4 i -o �icti�n^f a felony with a fine of up to$12�000 and/or prison fo, up to 5 years. (ORS 60,71 Cir or Signature 1014 Sign mm/dd/yy f� Printed Name of Circulator Circulator's Address street, city, zip code County Elections Official Certification I hereby certify signatures on this petition are those of active registered voters in Ilia , �k6+` sickaki Signature of County Elections Official Date Certified mm/dd/yy SEL 121 —1112 ORS 249.012 County, Oregon. irA Sheet Number 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. Candidate's Name Offic / Distri t or Position Number if applicable To the Appropriate Filing Officer We,the undersigned voters, request t candidate's me 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 Date Si N L street,city,zip code Precinct#optional r Acs ✓g } �__.�/�.,�=-r– /`�/ `���� �"S � •'1' f�� L 'T" Ac^� c 'C! cry-` ` - ' �" `- /,lc�< /� l- 1 , `11/ 7'}G 1� T �<-flii� ��1,.h �✓ %%"f1X �L p << r • t 'r %;j�IL rru •; 7 �✓8 (ZLzI ,:"� '�zc �4' cf" !j l i O t��f LJ( �/bi c(C ti l� 9 �� ``� L E -` 4-C-� C#eCCc��c, S r Vstf (.� ,/ 10 ) ifn Circulator Certific 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) 1 also certify that compensation I received, if any, was not based on the number of signatures obtained for this petition.Warningi Falsely signing this stat�sz,c,t may result;,, n: t,o„of a felony with a fine of up±o g12F n00 andior pr, n fe, p to 5 ye ,s. (ORSr2a0 715) ` 'l • i Date Signe Cir 1; t ignature dL—mm/dd/yy Printed Name of Circulator Circulator's Address street,city, zi code County Elections Official Certification I hereby certify a signatures f r on this petition are those of active registered voters in (� (ah�i�e ounty, Oregon, i Signature of County Elections Official Date Certified mm/dd/vv SEL 121 -1/11 ons 249 072 Sheet Number