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HomeMy WebLinkAboutMartin Kamenski Completed Candidate Filing SEL 101 Major Political Party or Nonpartisan ORS rev 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 9310riginal ❑ Amendment Filing Officer ❑ Secretary of State ❑ County Elections Official JRCity Recorder (Auditor) Office Information 11 " Filing for Office of: Gk-rj C ftVVrLtL. District, Position or County: 0. s (t, o N 3 Party Affiliation: ❑ Democratic Party ❑ Republican Party ❑ Independent Party Nonpartisan Incumbent Judge: ❑ Yes ❑ No 17- 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 ❑ Yes ❑ No Candidate Information Name of Candidate First MI Last Suffix Title How you would like your name to appear on the ballot f-'t !N KAivL(-- .J SK Candidate Residence/Route Address Street Address City State Zip County 4 X12. L,t N D- L._N ArS k}LA-Nn 0 2 7TA'r- ccu1 Candidate Mailing Address Street Address or PO Box City State Zip S AA C- Continued on the reversed side of this form Contact Information: Only one phone number is required. Work Phone Home Phone Cell Phone Fax SLf 15'5-Z~ Apo Email Address Web Site, if applicable t-t.4-t L- (-C~ tAA-e-Tt N 1~ BEN S~ t • M Occupation (present employment) If no relevant experience, None or NA must be entered. Cho 6~-M\t r~+ Occupational Background (previous employment) If no relevant experience, None or NA must be entered. Cu i2./Z. Tt-Y Q- E ~ o ©F' Qvs tNc--qS C.Ahtt-\ t~,j c-- C~ M PR ^Y P>R- ott/ W 4S 0,-o^364- Or- ~r ~T ~N ct ~2 ~4c-z ►c,~ ,m,,, C AAC A- uz fQA0 rt. , w ,ts C o N g. V L--rA l l rr-z. Pie.tc.c-w CPoVQ-~ 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 4,2 vE`~ztr L,#M ✓%M-5tz 1 162 "As 7-crej $coVU-t AJ /~~t262vG-`CZf N IVE~(LS.~ ~G~ /~.'FC fn 1 } a ui s 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. S E4..vG-+a ©A., 9pArc_67S bj*' t~ ! QEe tc%Q. g. (z AX47ZE-¢- ©A JC& C p AMAA-uy/ C O l.-(.. R-f3 C3 /Z~+GTt O N~ L, vi6r9-t.. -G.C.. j ,qy.~C~. Cqf= 4-C.: t tS-r s Campaign Finance Information (not applicable to candidates for federal office) Candidate Committee ❑ Yes, I have a candidate committee. ❑ 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. t9dVo, but will be filing a Statement of Organization for Candidate Committee (SEL 220). 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 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. 0 Warning Supplying false information on this form may result in conviction of a felony with a f rta of .uprt 125,000 and/or prison for up to 5 years. (ORS 260.715). A person may only file for one lucrative ,Ae a~ recinct committee person at the same election. Unless the person has withdrawn from the first filing, in s are +nvalid.(OR149.013 and ORS 249.170) Candidate's Signature Date Signed Office Use Only: Initials 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 Email address III A-A-"CfN ~ e-rVr,- A --I e f-~Tlpr Treasurer's Full Name Telephone Number (day) Sy I S~' z Lq Address (street or route, city, state, zip code) ~~Za 1A9Z r:-INAS L.nj 1 L-U 09- -Z Office of Filing C kt%-f C a u N3C LL..- 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 not make attributable expenditures in this election in excess of $3,581.00. A. Candidate 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.] 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. 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 Recorder shall publish a statement, in the City, indicating that the candidate violated a previous declaration of limitation. L it-il 2r,f: BY: CITY OF ASHLAND July 8, 2016 Martin Kamenski 482 Lindsay Lane Ashland OR 97520 A prospective petition has been completed and filed with the City Recorder's Office for City Councilor Position #3. Petition ID CC32016-03 has been approved for circulation to obtain the required 25 signatures for this position. Deadline to submit petitions to the Election Officer is August 12, 2016. Dana Smith Assistant to the City Recorder CITY RECORDEWREASURER Tel: 541-488-5307 20 E Main Street Fax: 541-552-2059 Ashland, Oregon 97520 TTY: 800-735-2900 www.ashland.orms Candidate Signature Sheet I Nonpartisan Petition ID cc, a 0l • 63 Signatures for this petition are being gathered by ❑PAID Circulators XVOLUNTEER Circulators This is a candidate nominating petition. Signers of this page must be active registered voters in the county listed. i 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 7o, (,K S 0 n Candidate Information Name Office C~ ky o ~ ~s~ 1~ Cow~.c,; to ~ Election District or Position Number 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. 0 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 1 g ~~O -"(~~IrJ k4m GNSic-( ~gZ LIN+DS LN A-SfL_AWU 02 n14SZC) 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. L4 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 18, 2016 Martin Kamenski 482 Lindsay Lane 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 Councilor Position #3. Please let me know if I can be of any further assistance during this upcoming election time. Barbara Christensen City Recorder/Treasurer CITY RECORDEWREASURER Tel: 541488-5307 20 E Main Street Fax: 541552-2059 Ashland, Oregon 97520 TTY: 800-735-2900 www.ashland.orms Jackson County, Oregon COUNTY CLERK COUNTY CLERK Christine D. Walker (541) 774-6147 ELECTIONS (541) 774-6148 July 15, 2016 Barbara Christensen City of Ashland Re: Petition: AshCouncil#3-3, Martin Kamenski, Ashland City Council #3 Dear Ms. Christensen, We have completed the signature verification for the above named petition. I hereby certify that the above named petition contains no less than 30 signatures of active registered voters in the City of Ashland. 7 Art C. Harvey, C.E.A. Date Elections Progr anager Jackson County Fax (541) 774-6140 Elections 1101 W. Main St., Suite 201 Medford, Oregon 97501 County: JACKSON Petition Processing Statistics Report Date : 7/15/2016 11:38:08 AM User Name : Harvey, Art C Number :AshCouncil#3-3 Title :Martin Kamenski, Ashland City Council #3 Petition Information Petition Name : Martin Kamenski, Ashland City Council #3 Petition Date : 07/07/2016 Date Filed : 07/07/2016 End Circulation Date : 07/14/2016 Minimum Signatures Required : 25 Accepted Of Minimum 120.00% ) Total Signatures Processed : 37 Processing Summary Sample: All Total Accepted Signatures : 30 (81%) Of Those Processed Total Rejected Signatures 7 (19%) Of Those Processed Accepted Reason Total Rejected) Valid Signature 30 (100%) Rejected Reason Total Rejected) Not Registered 3 (42.8%) Out of District 2 (28.5%) Signatures Do Not Match 2 (28.5%) Oregon Centralized Voter Registration Page : 1 Candidate Signature Sheet I Nonpartisan Petition ID C C,3 a 016 - 03 OLUNTEER Circulators Signatures for this petition are being gathered by ❑PAID Circulators V 9 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. QL~ S U O Candidates should allow ample time for the verification process to be completed before 5pm on the filing deadline day. County Candidate Information CO Name Office C", ~11 O ►VS\,~ ~W"' LX^ Election District or Position Number jt~e 3 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 f L A.5 7 /g /I (o MA-)P-T, W f 4m GNSfc / t{ $ 2 Lt N ~S s ry N I+L.h o 02 ~j y~sZO 1 `7l 3 u o 4-' 7 A~ 1A (a D irZ S Z Z) z Z -72,~ 1n avJ ~70 3 7A/ (o J vare 71/11 (0 Ali (o~ aiL9 cAA-Qv < tale APtaq ~ Q e-, G7 S~ 6 i~ l e ~(1e aGln~,m 5-10 ~6~\Lm tl c)( cl 7 5 2-6 9 -71t 2/~~O Dl QrYir /f?3r7 6r2-ct 757,1 to 1 Z (~4:~ S Circul r Certif ation 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 - t $ Z l~tND 45%c- c)~ group submitting the ~j✓tC~f 4 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.3 a o 16 - 03 OLUNTEER Circulators Signatures for this petition are being gathered by ❑PAID Circulators V 9 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. / Candidates should allow ample time for the verification process to be completed before Spm on the filing deadline day. County QExS 0Y,\ Candidate Information Name Office Mate-; r1 Kos-,n~, en s k'► C► +y o ►qs~ l coU-^6 to r Election District or Position Number 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 1 v I Z I b ~U~ 1, 0U-11-h-' OT` 61A(JC~-RR, AS44AN,Q. 9~ 5L4) 2 7// I';_ 3 12 1 (o usao, W[,(,I 1m o yc- l~ C, ~k L Uoi,j D/2- "l 7S-ZD -V _ 10&, 'L , & 6 7 m-1 1 3Z1 eA s.~ . 0Kc? 7s`2-0 7 7 G l L 44 A 8 9 7hl/ L- o . kwj& o R76ZO 10 I~ Mi c 1 e ka ~n~S~c u~ U Sa lane fl~n~~u,~ ~ o Circulator Certification This certification must be comple ed by the circulator and additional signatures should not be collected on this sheet once the certi ication has been signed and dated! Y I hereb c ify`that I w' nessed 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 titi S 249.061) also hereby certify that corylpensation I received, if any, was n based on the number of signatures obtained for this petition. Circulator Signature Date Signed mom/dd/yy Sheet Number n yn° 1y~ I C~ Sheet will be numbered by ' mca- ~GI 1~J1~1 a ~~J(ti aAf- t tJ' `A ~1 3" groupssueblmittingthe Printed Name of Circulator Circulator's Addre s 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.C 13 a D Ito • 63 Signatures for this petition are being gathered by ❑PAID Circulators N 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. ~o~~k U Candidates should allow ample time for the verification process to be completed before 5pm on the filing deadline day. County Candidate Information A Name Office u O T ~S yl ~i,~/1 C.1 16 Election District or Position Number oZOlto C- ene~~-l ~I.ec.+;t,►~ bs on 3 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. Signs re Date Sig ed mm/dd/yy Print Name t Residence or Mailing Address street, city, zip code 1 e 1 z CZ !o C-7 fr ~v ( ( F. .t~- ~~Zc7 3 l) Y 3 Yl n 4 V 47195 3 `4 r Zl cc S I,,., q r I SLc C ~.>a,_ c 0~- & s 711,3116 Yea-rJeY( 22R's~ Ar-alu 6 A,) J~ M~R~ 2 fNtw 71.eZ 9 to 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`t 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 petiti n RS 9. ]so hereby certify that compensation I received, if any, was not based on the number of signatures obtained for this petition. 31 3 Circulator Sign re Date Signed mm/dd/yy Sheet Number Sheet will be numbered by '`5~~ 1(P in I. 1 cky o ~1 n u~ 1X ~ group submitting the ~ 0 A VA l!! ljV ~ \ V tom- oC `1 ~L petition. Printed Name of Circ lator 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.C.3 a D 16 • b3 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 70'('V- U Candidate Information Name Office r ~lC~ i n K0.1M eln S k~~ U ~ O T ~Sy1 l~~ WU11Gi 10 Election 1 District or Position Number (5s on 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. Sign Date Signed mm/dd/yy Print Name Residence or Mailing Address street, city, zip code 1 Z. lcH A D L N AJ rv Sr 2 7 - -l6 CI- ! 7AWT14 VAO T RU 0 P 7 G> f~ ? /Ok 1 /o r '6,. '1 e Lo 4 c 7 a~90 .Q 5 16~~~~ ~S~ C S Yes liz l/G a m 6r d~ A 11 41~ 4~5c Aerk AEI F-AQJ> CQk bAdlbr 9 ? • I ~ ~ 1 L / 05ONJ 1162 TEn1N( F 10 I / J li r ~a, G Circulator Certi cation 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 ce 'that I witnessed the s! Wing 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 petitio RS 9.061). I also here o ensation I received, if any, was not based on the number of signatures obtained for this petition. ator 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 245.072 County Elections Officials provide a separate certification to attach to the petition. Petition Submission SEL 338 01/14 OAR 165-010-0005, 165-014-0005 Candidate, Voters' Pamphlet rev -0005 This form must be completed and filed with each submittal of signatures. Filing Officer F0 State F[] County for both county and district petitions City Election Type Year In Primary General Special Election 2014 2016 102018 Petition Information Candidate Name or Measure Number f~-tL-TI t.~ l~s~n~~scc t - L~^cy COV ►.TCIL n~ ~3 Type of Filing Number of Signatures Submitted Candidate Nominating Petition 34 ❑ Voters' Pamphlet, Candidate ❑ Voters' Pamphlet, Measure Candidate 4 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 tQALT b^1E ~ MAA L- G MAfzmc'iN FCAMr=+j 5cl. t-tt-- Signature ` Date Signed Measure Argument Filer 4 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 Signature Date Signed 4'r JUL 1 3 2016 BY :