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Home My WebLink AboutJim Lewis Completed Candidate Filing SEL 101 Major Political Party or Nonpartisan rev 09/15 ORS 249.031 Filing Dates Candidate Filing State Voters' Pamphlet Candidate Withdrawal Primary Election May 17, 2016 Filed electronically using ORESTAR First Day to File September 10, 2015 January 18, 2016 Last Day to File March 08, 2016 March 10, 2016 March 11, 2016 General Election November 8, 2016 First Day to File June 1, 2016 July 11, 2016 Last Day to File August 30, 2016 August 30, 2016 September 2, 2016 0 All information must be completed or the form will be rejected. This filing is an Original ❑ Amendment Filing Officer ❑ Secretary of State ❑ County Elections Official City Recorder (Auditor) Office Information G t 4~ O4 Ask',pNA Filing for Office of: el T !NVOIN District, Position or County. 9 A If :5 C, Io Y VM 1: a Party Affiliation: ❑ Democratic Party ❑ Republican Party ❑ Independent Party XNonpartisan Incumbent Judge: ❑ Yes ❑ No 7 Nondisclosure on file 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 Judge $50 Justice of the Peace n/a Prospective Petition Petition circulators will be paid El Yes No Candidate Information Name of Candidate First MI Last Suffix Title 1 1 ,-~4 M -E:~> 'D How you would like your name to appear on the ballot J l fVA L ~ 4 l 5 Candidate Residence/Route Address Street Address City ' State Zip County (,L~o A Candidate Mailing Address Street Address or PO Box City State Zip A A C) p MC MET) JUN - 8 2016 Continued on the reversed side of this form BY ' " 7i Contact Information: Only one phone number is required. Work Phone I Home Phone Cell Phone Fax 5~ ~ - Q~ ~-220 'S ~ t-1- I • ~ •Z-Z(o5' Email Address Web Site, if applicable I M t.Aw t 3 3 t V~ CZ MAti • covh Occupation (present employment) If no relevant experience, None or NA must be entered. N/A Occupational Background (previous employment) If no relevant experience, None or NA must be entered. Educational Background (schools attended) If no relevant experience, None or NA must be entered. Complete name of School no acronyms) Last Grade completed Diploma/Degree/Certificate Course of Stud l c_ L e V LEL. AZ:~ k~r ~%'Se-bvo Educational Background (other) Attach a separate sheet if necessary. Prior Governmental Experience (elected or appointed) If no relevant experience, None or NA must be entered. PARK<3 ~o v11~ v1n ovti~ r-, Campaign Finance Information (not applicable to candidates for federal office) Candidate Committee ❑ s, I have a candidate committee. VV No, 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 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: I 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 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). Does not apply to candidates filing for the office of US President. A 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 y only file for one lucrative office or not more than one precinct committee person at the ame election. Unless the person as thdrawn from the first filing, all filings are invalid.(ORS 249.013 and ORS 249.170) Candidate's Signature Date Signed Office Use Onl : Initials J Batch Sheet/CC Approval Code/Receipt Number 2016 CERTIFICATE FOR VOLUNTARY CONTRIBUTION & SPENDING LIMITS CITY OF ASHLAND AMC 2.41 PLEASE TYPE OR PRINT LEGIBLY IN BLACK INK General Election November 8, 2016 Candidate or Political Committee Name \ , l Email address ,,-)A l J IW1 I euk.>lS 31100 e6a lL. vv,, Treasurer's Full Name Telephone Number (day) Address (street or route, city, state, zip cod Office of Filing PARKS Covv~vv\ i s -.5 l V\ I certify that if I am signing as a candidate, I will not make attributable expenditures for this election in excess of $3,581.00 (including expenditures of my principal campaign committee), or, if I am signing as a treasurer of a political committee organized exclusively to support or to oppose a candidate, I certify that the committee will of make attributable exp ures in this election in excess of $3,681.00. Candi to or treasurer's si nature Date Signed S l [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 Use) expenditures. If the City Recorder or the City Attorney finds that a candidate filing a declaration of limitation on expenditures has exceeded JUN ° 8 201F, 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. B Y: CITY OF ASHLAND June 8, 2016 Jim Lewis 640 A Street Ashland OR 97520 A prospective petition has been completed and filed with the City Recorder's Office for Parks Commission Position #2. Petition ID PC2-2016-01 has been approved for circulation to obtain the required 25 signatures for this position. Deadline to submit petitions to the Elections Officer is August 12, 2016. 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.onus Candidate Signature Sheet I Nonpartisan Petition ID C - oZpl Lo , d 1 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. 1 Signatures must be verified by the appropriate county elections official before the petition can be filed with the filing officer. 70,ck-s Candidates should allow ample time for the verification process to be completed before 5pm on the filing deadline day. County (.)V-\ Candidate Information Name Office J + Le,w~ Darks Core NM I SS On Election District or Position Number Cxen~,ra.l ck ;w, fl.o/ F~ ~olO 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. 9 Signers must initial any changes the circulator makes to their printed name, residence address or date they signed the petition. Si nature Date Signed mm/dd/yy Print Name Residence or Mailing Address street, city, zip code 1 ~j A l5 5S1c~ ,fir, l S2o 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. L[ 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 01/14 ORS 249.072 County Elections Officials provide a separate certification to attach to the petition. CITY OF ASHLAND July 25, 2016 Jim Lewis 640 A 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 Parks Commission #2. 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: 541488-5307 20 E Main Street Fax: 541-552-2059 Ashland, Oregon 97520 TTY: 800-735-2900 www.ashland.orms Jackson County, Oregon COUNTY CLERK miz K ChristineWalker (541) 774-616147 COUNTY CLER ELECTIONS (541) 774-6148 July 19, 2016 Barbara Christensen City of Ashland Re: Petition: AshParksComm#2-1, Jim Lewis, Ashland Parks Commission #2 ~'15~er~Se~t~ Dear Ms. mss, We have completed the signature verification for the above named petition. I hereby certify that the above named petition contains no less than 27 signatures of active registered voters in the City of Ashland. Art C. Harvey, C.E.A. Date Elections Program anager Jackson County Fax (541) 774-6140 Elections 1101 W. Main St., Suite 201 Medford, Oregon 97501 County: JACKSON Date : 7/19/2016 3:38:27 PM User Name :Harvey, Art C Petition Signers Report Number :AshParksComm#2-1 Title :Jim Lewis, Ashland Parks Commission #2 COUNTY : A -K ON SUBMITTAL :Submittal 1 SAMPLE Page Line Voter Id Name Current Residence Current Precinct Status Verification Reason 1 1 18123546 LEWIS, JAMES D 640 A ST 004 Accepted Valid Signature 1 2 100474259 PERILLAT, SUSANNAH 523 CLAY ST 4 013 Accepted Valid Signature 1 3 17913829 ROYLE, MELANIE J 161 B ST 004 Accepted Valid Signature 1 4 100423760 COOPER,HANNAH LOUISE 175 NEIL CREEK RD 018 Rejected Out of District 1 5 18095785 SMITH, MERRILL LUCIAN 2345 MORADA LN 013 Accepted Valid Signature 1 6 18118868 SELIGMAN, JOHN S 248 N 3RD ST 004 Accepted Valid Signature Rejected Illegible Signer Information 1 7 1 9 18153919 NOVAK, CLEMENT B 264 SHERIDAN ST 002 Accepted Valid Signature 2 2 18123545 LEWIS, CHERYL L 640 A ST 004 Accepted Valid Signature 2 3 300396069 LEWIS, HELEN HANSON 640 A ST 004 Accepted Valid Signature 2 4 18194801 MCGRATH, ROBIN D 240 N LAUREL ST 004 Accepted Valid Signature 2 5 18139549 WHITE, JEROME 253 N 3RD ST 004 Accepted Valid Signature 2 6 18139802 MCCORD, DAVID A 458 WILLIAMSON WAY 004 Accepted Valid Signature 2 7 18138103 CHASMAR, DAVID A 468 N LAUREL ST 004 Accepted Valid Signature 2 8 18118868 SELIGMAN,JOHN S 248 N 3RD ST 004 Rejected Rejected - Duplicate 2 9 18121085 FIELDS, JOHN R 845 OAK ST 004 Accepted Valid Signature 2 10 18195309 HEINE, ELLEN V 1230 KIRK LN 007 Accepted Valid Signature 3 2 18128617 JOHNSON,CONRAD C 507 WILSON RD 018 Rejected Out of District 3 3 100235253 MILLER, MATTHEW DENNIS 1290 GREENMEADOWS WAY 013 Accepted Valid Signature 3 4 18096309 GARDINER, MICHAEL A 349 ORANGE AVE 004 Accepted Valid Signature 3 5 200058841 SHAW, VANSTON 608 DRAGER ST 004 Accepted Valid Signature 3 6 18096608 LANDT, RICK S 468 HELMAN ST 004 Accepted Valid Signature 3 7 18208990 CARSON, MARJORIE CARSON 455 B ST 004 Accepted Valid Signature 3 8 300312490 REBHAHN, TANJA C 381 GLENN ST 004 Accepted Valid Signature Page : i Oregon Centralized Voter Registration County: JACKSON Date : 7/19/2016 3:38:27 PM User Name :Harvey, Art C Petition Signers Report Number :AshParksComm#2-1 Title :Jim Lewis, Ashland Parks Commission #2 COUNTY : A K ON SUBMITTAL : Submittal 1 _ SAMPLE . l Page Line Voter Id Name Current Residence Current Precinct Status Verification Reason 3 9 18132036 TREIGER,JAY 1950 ASHLAND MINE RD 018 Rejected Out of District 3 10 18204989 EATON, KELLY 865 HENRY ST 007 Accepted Valid Signature 4 2 18131485 SEIBER, SUZANNE J 880 C ST 004 Accepted Valid Signature 4 3 18192395 RINEHART,SHERRILL L 448 TUCKER ST 002 Rejected Signatures Do Not Match Rejected Not Registered 4 4 4 5 18188621 FAIRBANKS, DIANA SUSAN 306 PATTERSON ST 004 Accepted Valid Signature 4 6 300087763 ROELSE, DAMI NELLIE 350 PHELP ST 004 Accepted Valid Signature 4 7 18097590 CRAWFORD, JEAN M 923 HARMONY LN 007 Accepted Valid Signature 4 8 200102888 MACRORY, CECILY 981 B ST 004 Accepted Valid Signature ELIZABETH 4 9 18122481 FRENCH,PAULT 615 GLENWOOD DR 007 Rejected Signatures Do Not Match 4 10 300310228 PALZEWICZ, MICHAL 2542 OLD MILL WAY 013 Accepted Valid Signature Page : 2 Oregon Centralized Voter Registration County: JACKSON Date : 7/19/2016 3:38:27 PM User Name : Harvey, Art C Petition Signers Report Number :AshParksComm#2-1 Title :Jim Lewis, Ashland Parks Commission #2 Summary Results For Petition AshParksComm Petition Title Jim Lewis, Ashland Parks Commission #2 Circulation Start Date : 06/08/2016 Circulation End Date 07/19/2016 Signature Count Required 25 ACCEPTED 27 REJECTED 8 Total 35 • Page : 3 Oregon Centralized Voter Registration Candidate Signature Sheet I Nonpartisan Petition ID p G a - 001 to • O 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. O Signatures must be verified by the appropriate county elections official before the petition can be filed with the filing officer. County 70.c ks ov-\ Candidates should allow ample time for the verification process to be completed before 5pm on the filing deadline day. Candidate Information Name Office arks l.~ W ► Co IM m S SS • on Election District or Position Number (l.o>r ~ oZOI~ pOS 4iUY~ 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. Si nature Date Signed mm/dd/yy Print Name Residence or Mailing Address street, city, zip code S 1 ~ • S l t~ ~ l S ~ 5~- ~Sl~~ ~~..~r. 2o ~K~ 5a3~G S a~~g 2 6) X4" 5 rrill ~j4a 87 :5 *1A np- 6 /i„ o S i MU 2 i t A/ 8 a~~~ ST 9 z~ l / - , yryl/ 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 he by ce ify that I witnessed the signi o e signature sheet by each individual whose signature appears on the signature sheet, and I believe each person is a voter qualified to sign the p ition (OR 249.061). 1 also hereby ce fy that ompensat' n I received, if any, was not based on the number of signatures obtained for this petition. Circulator ignature Date Signed mm/dd/yy Sheet Number Sheet will be numbered by ` /1 < y group submitting the j W J U 04va - petition. Printed Name of Circulator Circulator's Address street, city, zip code SEL 121 rev 01/14 ORS 249.072 County Elections Officials provide a separate certification to attach to the petition. Candidate Signature Sheet I Nonpartisan Petition ID C oZ - d01 Lo - 0 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. 4 Signatures must be verified by the appropriate county elections official before the petition can be filed with the filing officer. Candidates should allow ample time for the verification process to be completed before 5pm on the filing deadline day. County QLS UV1 Candidate Information Name Office rVj l_~ w ; marks Cory%Y-n I SS ' UYZ 5+ .Election District or Position Number C~en.cro~.l ~ l.e.c~ ~ w, (1.o V ~ c~Ol~ AOS i~' i UYl -iil 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. Si nature Date Signed mm/dd/yy Print Name Residence or Mailing Address street, city, zip code 1 V ~3 to - to- t (I Lit w i (o `E o A: 6 f is (a Y- `t a s 4 c 1~=1~ obtti. c~i a~O N Lf'~~RE ST 5aa 5 (o - 1 4 sfw ME W H ITe 2S 3 1a•`TWF-D ST ARC (,A*Jot 0 0- 71'57-0 6 8 10 ~~j l St or q~S~ 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 dat dl ereb ertify that I witnessed the signing f the sl ature sheet by each individual whose signature appears on the signature sheet, and I believe each person is a voter qualified to sign the petition ( RS 249.061).1 also hereby certif that comp nsation I received, if any, was not based on the number of signatures obtained for this petition. a r - / - / 62 Circulator S gnature Date Signed mm/dd/yy Sheet Number Sheet will be numbered by J group submitting the petition. Printed Name of Circulator Circulator's Address street, city, zip code SEL 121 rev 01/14 ORS 249.072 County Elections Officials provide a separate certification to attach to the petition. Candidate Signature Sheet I Nonpartisan Petition ID C a - 001 to - O ) 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. O Signatures must be verified by the appropriate county elections official before the petition can be filed with the filing officer. Candidates should allow ample time for the verification process to be completed before 5pm on the filing deadline day. County o'C'k-S UV's Candidate Information Name office rVI w; IJarks Corv% ,m i ss ' on Election District or Position Number C~en.e~o..l ~t~c~,w, (1ov ~ aotl~ AOSi•~'iU~/1 ~ 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. Si nature Date Signed mm/dd/yy Print Name Residence or Mailing Address street, city, zip code LLIzn, A.- 1 S • l -~v-. X20 2 C~ - f • LCP i v~1e 3 of L / t~ I ~2 V i 2x 4--KA4Am~z akp, (~~-agLgk 3~q 5 C) 7 - 8 7 An. 7 , 9 10 1 ?A 1 ('0 56,S7 Gl S Circu ator Ce i atiorl This certification must be completed by the circulator and additional signatures should not be collected on this sheet once th certification has been signed and dated! I e y ify that I nessed the signin of th ignature sheet by each individual whose signature appears on the signature sheet, and I believe each person is a voter qualified to sign the etition (OR 249.061).1 also he by cert that mpensation I received, if any, was not based on the number of signatures obtained for this petition. I Y / . l .3 q - t9 Circulator g ature Date Signed mm/dd Sheet Number Sheet will be numbered by < E 1w/ S group submitting the petition. Printed Name of Circulator Circulator's Address street, city, zip code SEL 121 rev 01/14 ORS 249.072 County Elections officials provide a separate certification to attach to the petition. Candidate Signature Sheet Nonpartisan Petition ID p e a - 4.01 Lo • O 1 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. 4 Signatures must be verified by the appropriate county elections official before the petition can be filed with the filing officer. J Candidates should allow ample time for the verification process to be completed before 5pm on the filing deadline day. County a-( ?-S U^ Candidate Information Name Office law; I arks Commission Election District or Position Number C~en~,ra..1 ~1.2v~~w, fl.oV ~ oZOI~ ~bSi~'iVYI D, 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. Date Signed mm/dd/yy Print Name Residence or Mailing Address street, city, zip code Si nature P 11 1 F 1 ~ ~~r b Qom/ V ~sr~~• Vl l'~-p1 ~ ~ 2 r1i5/ti. lD 110 S~Z~I/Y~1/~ e, J. - 1,r ei~t. u k ,J 874 st' a 4 rx S 6 N -5T cp. OL4,t - C A &&S, do 1 6 (2~ 35-0 h s N oC 7 7~4 I - 0F0-,► ~ -/lo •-16 jgan C YraAY-G r- C, 'j.2-3 5v1 IN N4)eUJ4 A IlIx M4, CeDr~ 8 IL - 1, 10 &L-- -I i NICJfAC. T&LzC01Q-, as`~z o~ r~~cc W 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 y certify that I witnessed the signi o e signature sheet by each individual whose signature appears on the signature sheet, and I believe each person is a voter qualified to sign the etitio ORS 249.061).1 also hereby c ify th compensation I received, if any, was not based on the number of signatures obtained for this petition. Circulate Signature Date Signed mm/dd/yy Sheet Number Sheet will be numbered by group submitting the IL) W J J Y ~ • petition. Printed Name of Circulator Circulator's Address street, city, zip code SEL 121 rev 01/14 oas 249.072 County Elections officials provide a separate certification to attach to the petition. Petition Submission SEL 338 rev 01/14 Candidate, Voters' Pamphlet OAR 165-010-0005,165-014-0005 This form must be completed and filed with each submittal of signatures. Filing Officer State 1-7 County for both county and district petitions city Election Type Year I] Primary eral ❑ Special Election 2014 016 2018 Petition Information Candidate Name or Measure Number d'~ rnn I ,,l Type of Filing Number of Signatures Submitted ndidate Nominating Petition -37 ❑ Voters' Pamphlet, Candidate ❑ Voters' Pamphlet, Measure Candidate -)o By signing this document, I hereby state that all information on the form is true and correct to the best of my knowledge. Name Contact Phone Email Address _JIM jeWLbSt-00-7p(~ S" natu Date Signed Measur Argument Filer 4 By si ing this document, I hereby state that all information on the form is true and correct to the best of my knowledge. Name Contact Phone Email Address Signature Date Signed Q ~ 1 B 2016 ~u~