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HomeMy WebLinkAboutBiome_Michael_Erickson Candidate Filing SEL 101 34 rev Major Political Party or Nonpartisan ~`QZ end I ORS S 249 249.0.031 Filing Dates Candidate Filing State Voters, P ,cg andidate Withdrawal Primary Election May 20, 2014 Filed electronicall using ORESTAR First Day to File September 12, 2013 January 20, 2014 Last Day to File March 11, 2014 March 13, 2014 March 14, 2014 General Election November 4, 2014 First Day to File June 4, 2014 July 7, 2014 Last Day to File August 26, 2014 August 26, 2014 August 29, 2014 ® All information must be completed or the form will be rejected. This filing is an IlDriginal ❑ Amendment Filing Officer VV ❑ Secretary of State ❑ County Elections Official vda-City Recorder (Auditor) Candidate Information Name of Candidate First MI Last Suffix Title e"'1 --ri C k-So A/'` How you would like your name to appear on the ballot First MI Last suffix /3 loopa& ^c Candidate Residence/Route Address Street Address cir City State Zip County Zo a St O~ s-~zo 4-~ o Candidate Mailing Address Street Address or PO Box City State Zip Contact Information: Only one phone number is required. Work Phone Home Phone Cell Phone Fax SLrl - 19y/ -2";,9 3 Email Address csh /a / ~0 ✓►'l 4 y0✓` lei Web Site, if applicable Y/ V Gt~l~ly 5 I r Paying by Declaration or Petition: ❑ Declaration, with the required fee Office Filing Fee Office Filing Fee United States President n/a District Attorney $50 United States Vice President n/a County Judge $50 United States Senator $150 MSD Executive Officer, MAD Director $100 United States Representative $100 MSD Councilor $25 Statewide Offices $100 County Office $50 State Senator or Representative $25 City Office Set by charter or ordinance Circuit Court Jude $50 Justice of the Peace n/a rospective Petition Petition circulators will be paid ❑ Yes N~Ko 14 Continued on the reverse side of this form SEL 101 Office Information Filing for Office of: District, Position or County: ~ S. 4- ZT' Party Affiliation: ❑ Democratic Party ❑ Republican Party Nonpartisan Incumbent Judge: ❑ Yes ❑ No ❑ Nondisclosure on file Occupation (present employment) If no relevant experience, None or NA must be entered. Pn,4d,, Aclkfcd l/ laltlal-6 Occu tional Background (previous employment) If no relevant experience, None or NA must be efTtered. Educational Background (schools attended) If no relevant experience, None or NA must be entered. Complete name of School no acronyms) Last Grade completed Di loma/De ree/Certificate Course of Stud f F~ Educational Background (other) Attach a separate sheet if necessary. r, Prior Governmental Experience elected or appointed) If no relevant experience, None or NA must be entered. /1/+ Campaign Finance Information (not applicable to candidates for federal office) Candidate Committee ❑ Yes, I have a candidate committee. ~No, 1 do not expect to spend more than $750 or receive more than $750 during each calendar year. I understand I must still keep ecords 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 Campaign Finance Manual. ❑ No, but will be filing a Statement of Organization for Candidate Committee (SEL 220). By signing this document, I hereby state that 1 will accept the nomination for the office indicated above I will qualify for said office if elected all information provided by me on this form is true to the best of my knowledge and -i no circulators will be compensated based on the number of signatures obtained by the circulator on a prospective petition For Major Political Party Candidates 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) 0 blaming Supplying false information on this. farm 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) Candidate's gnature Date Signed 19V - For Office Use Only Initials Batch Sheet/CC 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_ GanAral 20-4❑ Other Election Date Candidate or Political Committee Nome Commit Ioeptification Number Treasurer's Full Name Telephone Number (day) Address (street or route, city late, zipcods) Z/,-/- Office of Filing I certify that if I am signing as a candidate, I will not make attributable expenditures for this election in exce of $:j-5 2.00 luding expenditures of my principal campaign committee), or, if 1 am signing as a treasurer of a political committee organized exclusively to suppo oppose candidate, I certify that the committee will not make attributable expenditures in this election in excess of $3,352.00. Ca a e 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 The Cit Recorder is authorized to ublish a statement in the Ci (Authorized e) y p ty, indicating whether or not the candidate has agreed to limit expenditures. ~t If the City Recorder or the City Attorney finds that a candidate filing a declaration of limitation on expenditures has exceeded O C~~V the applicable expenditure limit, at the next election at which the candidate Is a candidate for election to public office, the City Rannrriar shall nnhliah a etatanmant in tha Pit, indi-tinn that the nondidatn • nlnted pre..,,..,, dnn.l.,.e.oW...,...,, tion of lim Wtinn . _ . .....,......e..,,..,, %6 CITY OF -ASHLAND August 5, 2014 Biome Michael Erickson 208 Hargadine #4 Ashland OR 97520 A prospective petition has been completed and filed with the City Recorder's Office for City Council Position #4. Petition 1D CC-4 has been approved for circulation to obtain the required 25 signatures for this position. Deadline to submit petitions to the Election Officer is August 21, 2014. l Barbara Christensen City Recorder CITY RECORDERRREASURER Tel: 541-488-5307 20 E Main Street Fax: 541-552-2059 Ashland, Oregon 97520 TTY: 800-735-2900 ,S www.ashland.orms Candidate Signature Sheet I Nonpartisan Petition ID 'l - Signatures for this petition are being gathered by ❑PAID Circulators *VOLUNTEER Circulators This is a candidate nominating petition. Signers of this page must be active registered voters in the county listed. Signatures must be verified by the appropriate county elections official before the petition can be filed with the filing officer. Jackson J Candidates should allow ample time for the verification process to be completed before 5pm on the filing deadline day. County Candidate Information Name Office n:_ RA:-1---1 f_"...1. t~ifii -f AeF,l.~r~rf DIUIfIC IVIIL:IIClGI GIGKJVIII v.Ly v1 Election District or Position Number 2014 General Elections Council Position #4 To the Secretary of State of Oregon/County Elections Official/City Recorder, We the undersigned voters, request the candidate's name be placed on the ballot at the election listed above for nomination to the office indicated. A Signers must initial any changes 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 2 3 4 5 6 7 8 9 10 Circulator Certification This certification must be completed by the circulator and additional signatures should not be collected on this sheet once the certification has been signed and dated) 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 person is a voter qualified to sign the petition (ORS 249.061). 1 also hereby certify that compensation I received, if any, was not based on the number of signatures obtained for this petition. Circulator Signature Date Signed mm/dd/yy Sheet Number Sheet will be numbered by group submitting the petition. Printed Name of Circulator Circulator's Address street, city, zip code SEL 121 rev o1/14 oRS 249.072 County Elections Officials provide a separate certification to attach to the petition.