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Candidate Filing SEL 191
rev 09/15
Major Political Party or Nonpartisan OR-5 249,031
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
® All information must be completed or the form will be rejected.
This filing is an (Original ❑ Amendment
f Filing Officer l
❑ Secretary of State ❑ County Elections Official } City Recorder (Auditor)
V
Office Information
Filing for Office of: Gt{' cou A-61,
District, Position or County: ~DS1+1oA-
Parry Affiliation: ❑ Democratic Party ❑ Republican Party ❑ Independent Party onpartisan
Incumbent Judge: ❑ Yes ❑ No O 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 Cid_No
Candidate Information
Name of Candidate' -
First MI Last Suffix Title
I
eens~iec(~ o, - Lon-ee,
How you would like your name to appear on the ballot J
Sort Cohen
Candidate Residence/Route Address
Street Address city State Zip County
Candidate Mailing Address
Street Address or PO Box City State Zip
Continued on the reversed side of this form
Contact Information: Only one phone number is required.
Work Phone Home Phone _ Cell Phone _ Fax
2a1~ u~j ~7~,
Email Address Web Site, if applicable
occupation (present employment) If no relevant experience, None or NA must be entered.
Oc,~ Hill Bel ~
Occupational Background (previous employment) If no relevant experience, None or NA must be entered.
X//6-
Educational Background (schools attended) If no relevant experience, None or NA must be entered.
Com lete name of School no acronyms) Last Grade completed Diploma/Degree/Certificate Course of Stud
n nor\ C {I~b~l 2CS t v~ (6o, es~ - F c n
V_
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.
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.
❑ 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.
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 ` mmittee person at the
same election. Unless the person has withdrawn from the first filing, all filings are in, nd'ORS 249.170)
D 12 0~~ ~ z
Vandidate's Signature ate igned
Office Use Only: Initials Batch Sheet/CC Approval Code/Receipt Nun%X
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 j
Treasurer's Full Name Telephone Number (day)
Address (street or route, city, state, zip code S `
) 2:~12 J I-A .iL
Office of Filing & +4 0 C~QV A
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
no ake attrib tabl expenditures in this election in excess of $3,581.00.
C ndidate or trea urer'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. MULam,y -9
If the City Recorder or the City Attorney finds that a candidate filing a declaration of limitation on expenditures has exceeded V
the applicable expenditure limit, at the next election at which the candidate is a candidate for election to public office, the City JUL 1 2016
Recorder shall publish a statement, in the City, indicating that the candidate violated a previous declaration of limitation.
6 Y:
CITY OF
-AS H LA N D
July 12, 2016
Jon Cates
2234 Siskiyou Blvd
Ashland OR 97520
A prospective petition has been completed and filed with the City Recorder's Office for City Councilor
Position #1.
Petition ID CC 12016-03 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.
Barbara Christensen
City Recorder
CITY REC TREASURER Tel: 541488-5307
20 E Main Street Street Fax: 541--552552- -2059
9
Ashland, Oregon 97520 TTY: 800-735-2900 Ira ME
www.ashiand.or.us
Candidate Signature Sheet I Nonpartisan Petition ID
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.
`:.J 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
Candidate Information
Name p O ~ /7 LC.~.7 Office
Election District or Position Number
To the Secretary of State of Oregon/County Elections Official/City Recorder, 'WW`je~ttheAundersigned 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/W Print Name 1 Residence or Mailing Address street, city, zip code
1 C~
41 (7
2 9
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 01/14 ORS 249.072 county Elections officials provide a separate certification to attach to the petition.