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Election Info: Chris Hearn
City of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) November 9, 2002 Committee to Elect Chris Heam Martin H. Levine, CPA - Treasurer 167 East Main Street Ashland, OR 97520 I have examined your Post-Election contribution and expenditure report for the General Election of November 5, 2002 and found the following: Your committee report is sufficient. If you have any questions regarding this examination letter, please feel free to contact my office. Barbara Christensen City Recorder/Treasurer Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Candidate or Political Committee Name (use full name): Committee to Elect Chris Hearn Mailing Address as it Appears on Statement of Organization (street, route or box number. c/o Martin Iq. Levine, CPA P.O. Box 465 Ashland, OR 97520-0016 Treasurer's Name: Martin H. Levine, CPA PC 1 Rev. 12/01 Page 1 of 2 Committee ID Number: N/A Committee Type, Measure Number or Office: Ashland City Councilor #6 [] Original [--] Amendment [--I Primary 20__ [~ General 2002 I--I Other__ I-'l 1 st Pre-election I-] 2nd Pre-election [~ Post-election I-'l September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS l. Cash Contributions 50.00 50.00 (Accounting Period Total from PC 2) 2. Loans Received (Non-Exempt) + 0.00 + 0.00 (Accounting Period Total from PC 2) 3. Total Cash Contributions = 50.00 = 50.00 (lines 1+ 2) 4. In-Kind + 50.00 + 50.00 (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS = 100.00 -- 100.00 (lines 3 + 4) EXPENDITURES . . Cash Expenditures (Accounting Period Total from PC 3) Loan Payments (Non-Exempt) (Accounting Period Total from PC 3) 50.00 50.00 0.00 + 0.00 + 8. Total Cash Expenditures = 50.00 = 50.00 (lines 6 + 7) 9. In-Kind + 50.00 + 50.00 (Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES = 100.00 '- 100.00 (lines 8 + 9) CASH BALANCE 11. 0.00 Beginning Cash Balance (Ending Cash Balance from previous report) 12. Total Contributions + 100.00 (line 5) 13. Other Receipts + 0.00 (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) + 0.00 (Accounting Period Total from PC 4A) 15. CONTRIBUTION SUBTOTAL = 100.00 (lines 11 + 12 + 13 + 14) 16. Total Expenditures 100.00 (line 10) 17. Other Disbursements + 0.00 (Accountin~ Period Total from PC 4B) 18. + 0.00 Loan Payments (Exempt) (Accounting Period Total from PC 4B) 19. EXPENDITURE SUBTOTAL (lines 16 + 17 + 18) 20. ENDING CASH BALANCE (line 15 minus line 19) = 100.00 = 0.00 FOR OFFICE USE ONLY PC 1 Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 2 of 2 Candidate or Political Committee Name: Committee ID Number: Committee to Elect Chris Hearn N/A ~ Original [-] Primary 20__ [5~] General 2002 [-I Other ___ [~] Amendment [--I 1st Pre-election [-] 2nd Pre-election [5~ Post-election ~1 September Supplemental LOAN SUMMARY 21. Beginning Outstanding Loans FOR OFFICE USE ONLY (Total Outstanding Loans from previous report) 0.00 22. Loans Received (Non-Exempt) + 0.00 (line 2) 23. Loans Received (Exempt) + 0.00 (line 14) 24. LOANS RECEIVED SUBTOTAL (lines 21 + 22 + 23) = 0.00 25. Loan Payments (Non-Exempt) 0.00 (line 7) 26. Loan Payments (Exempt) + 0.00 (line 18) 27. Forgiven Loans (Total loans forgiven during this accounting period) + 0.00 28. LOAN PAYMENT SUBTOTAL (lines 25 + 26 +27) = 0.00 29. TOTAL OUTSTANDING LOANS (line 24 minus line 28) = PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures 100.00 (line 36 of previous report) 31. Personal Expenditures + (Accounting Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL (lines 30 + 31) = 100.00 33. Personal Expenditure Reimbursements (Total expenditures on PC 3 with purpose code R) 50.00 34. Forgiven Personal Expenditures + 50.00 (Total personal expenditures forgiven this acctg, period) 35. REIMBURSEMENT SUBTOTAL = 50.00 (lines 33 + 34) 36. OUTSTANDING PERSONAL EXPENDITURES = 0.00 (line 32 minus line 35) FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD 37. Ending Cash Balance (line 20) 0.00 38. Accounts Receivable + 0.00 (Accounting Period Total from PC 5) 39. SUBTOTAL = 0.00 (lines 37 + 38) 40. Total Outstanding Loans (line 29) 0.00 41. Outstanding Personal Expenditures + 0.00 (line 36) 42. Accounts Payable + 0.00 (Accounting Period Total from PC 6) 43. SUBTOTAL = 0.00 (lines 40 + 41 + 42) 44. BALANCE/DEFICIT [ (line 39 minus line 43: indica !e + or - balance) = 0.00 / I, ~v_~__~~ (nan~e of can/ffidate or treasurer), hereby certify that the above statement and the attached supporting reOo~Is ~,re tnl ¢ an~4,,corgect. ~ I Signature of can&date or ~reas~rer ! Date signed PC 2 Cash Contributions, Loans Received and In-Kind Candidate or Political Committee Name: Committee ID Number: Committee to Elect Chris Hearn N/A Page 1_ of! Election: ['-] Primary 20__ [~ General 2002 E~] Other ~_ Report: r-] 1 st Pre-election [-] 2nd Pre-election [~ Post-election ~ September Supplemental SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS CODE 1' Contributor Type CODE 2: Contribution Type B Business Entity CA Cash C Political Committee (includes business and union PACs) CO Cosigner Obligation F Candidate's Immediate Family (includes candidate) IK In-Kind I Individual LR Loan Received L Labor Organization O Other P Political Party Committee Line # Name and Address of Contributor Amount of I In-Kind Purpose Contribution (see manual for suggested purpose codes) Occupational Information, Contributing Contributor I Date Received Committee's IDt¢, or Description if Code ~ is "0" Aggregate Code 1 Code 2 I Miscellaneous Contributions $50 and Under 1. $ 50.00 10/23/02 $ 50.00 I I CA I Chris Hearn 2. 350 Wimer Street $ 50.00 Forgiven Personal Expenditure 11/11/02 Attorney at Law $ 50.00 F I IK 3. $ $ 4. $ 5. $ Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and See contribution type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1.) Instructions on Back and Cash (CA) $ 50.00 Cash (CA) $ 50.00 in Campaign Enter on Summary Statement, Column A, Line 1 Finance In-Kind (IK) $ 50.00 In-Kind (IK) $ 50.00 Manual Enter on Summary Statement, Column A, Lines 4 and 9 Loans Received (LR) $ __ Loans Received (LR) $ __ PC 2 Enter on Summary Statement, Column A, Line 2 PC 3A Personal Expenditures for Reimbursement Rev. Candidate or Political Committee Name: Committee ID Number: Committee to Elect Chris Hearn N/A Page 1_of l_ Election: I--] Primary 20__ ~ General 2002 [-I Other ~_ Report: I~ 1 st Pre-election I-'] 2nd Pre-election I-'1 Post-election I--] September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) A Agent N Newspaper and Other Periodical Advertising B Broadcast Advertising (Radio, TV) O Other Advertising (yard signs, buttons, etc.) C Cash Contributions P Postage F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Z Preparation and Production of Advertising Amount of Line # Date Payee's Name Purpose Expenditure 1. $ 2. $ 3. 4. $ 5. 6. $ 7. $ 8. $ 9. $ 10. $ Page Total Accounting Period Total (Complete only for last page and See transfer this amount to the Summary Statement, PC 1.) Instructions Personal Expenditures $100.00 on Back and Personal Expenditures $100.00 in Campaign Enter on Summary Statement, Line 31 Finance Manual PC 3A City of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) November 5, 2002 Committee to Elect Chris Heam Martin H. Levine, CPA - Treasurer 167 East Main Street Ashland, OR 97520 I have examined your 2nd Pre-Election contribution and expenditure report for the General Election of November 5, 2002 and found the following: ~V~Your committee report is sufficient. If you have any questions regarding this examination letter, please feel free to contact my office. ~Barbara Christensen ~ City Recorder/Treasurer PC 1 Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 1 of 2 Candidate or Political Committee Name (use full name): Committee to Elect Chris Hearn Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code): c/o Martin H. Levine, CPA P.O. Box 4~5 Ashland, OR 97520-00~ Treasurer's Name: Telephone Number (day): Martin H. Levine, CPA 54~/482.780'1 Committee ID Number: Committee Type, Measure Number or Office: N/A Ashland City Councilor #6 [5~] Original [--] Primary 20 [5~ General 2002 [--] Other [--] Amendment [--] 1st Pre-election [5~] 2nd Pre-election [--] Post-election [-] September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions 0.00 0.00 (Accounting Period Total from PC 2) 2. Loans Received (Non-Exempt) + 0.00 + 0.00 (Accounting Period Total from PC 2) 3. Total Cash Contributions = 0.00 = 0.00 (lines 1+ 2) 4. In-Kind + 0.00 + 0.00 (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS = 0.00 = 0.00 (lines 3 + 4) EXPENDITURES 6. Cash Expenditures 0.00 0.00 (Accounting Period Total from PC 3) 7. Loan Payments (Non-Exempt) + 0.00 + 0.00 (Accounting Period Total from PC 3) 8. Total Cash Expenditures = 0.00 = 0.00 (lines 6 + 7) 9. In-Kind + 0.00 + 0.00 (Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES = 0.00 = 0.00 (lines 8 + 9) CASH BALANCE 11. Beginning Cash Balance (Ending Cash Balance from previous report) 0.00 FOR OFFICE USF ONLY 12. Total Contributions + 0.00 (line 5) 13. Other Receipts + 0.00 (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) += 0.000'00 (Accounting Period Total from PC 4A) __ 15. CONTRIBUTION SUBTOTAL (lines 11 + 12 + 13 + 14) 16. Total Expenditures (line 10) 0.00 17. Other Disbursements + 0.00 (Accounting Period Total from PC 4B) 18. Loan Payments (Exempt) + 0.00 (Accounting Period Total from PC 4B) __ 19. EXPENDITURE SUBTOTAL (lines 16 + 17 + 18) = 0.00 -- 20. ENDING CASH BALANCE = 0.00 (line 15 minus line 19) PC 1 Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 2 of 2 Candidate or Political Committee Name: Committee ID Number: Committee to Elect Chris Hearn N/A ~] Original ['-I Primary 20 [Y~] General 2002 r-] Other ['-] Amendment I--I 1 st Pre-election [~ 2nd Pre-election [-'] Post-election ['-] September Supplemental LOAN SUMMARY -- FOR OFFICE USE ONLY 21. Beginning Outstanding Loans (Total Outstanding Loans from previous report) 0.00 22. Loans Received (Non-Exempt) + 0.00 (line 2) 23. Loans Received (Exempt) + 0.00 (line 14) 24. LOANS RECEIVED SUBTOTAL = 0.00 (lines 21 + 22 + 23) 25. Loan Payments (Non-Exempt) 0.00 (line 7) 26. Loan Payments (Exempt) + 0.00 (line 18) 27. Forgiven Loans + 0.00 (Total loans forgiven during this accounting period) 28. LOAN PAYMENT SUBTOTAL = 0.00 (lines 25 + 26 +27) 29. TOTAL OUTSTANDING LOANS -. (line 24 minus line 28) PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures 100.00 (line 36 of previous report) 31. Personal Expenditures + (Accounting Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL = 100.00 (lines 30 + 31) __ 33. Personal Expenditure Reimbursements 0.00 (Total expenditures on PC 3 with purpose code R) 34. Forgiven Personal Expenditures + 0.00 (Total personal expenditures forgiven this acctg, period) 35. REIMBURSEMENT SUBTOTAL = 0.00 (lines 33 + 34) 36. OUTSTANDING PERSONAL EXPENDITURES (line 32 minus line 35) = ~ 00.00 FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD _ 37. Ending Cash Balance (line 20) 0.00 38. Accounts Receivable (Accounting Period Total from PC 5) + 0.00 39. SUBTOTAL (lines 37 + 38) = 0.00 40. Total Outstanding Loans (line 29) 0.00 41. Outstanding Personal Expenditures + ~ 00.00 (line 36) 42. Accounts Payable (Accountinl~ Period Total from PC 6) + 0.00 43. SUBTOTAL = ~00.00 (lines 40 + 41 + 42) 44. BALANCE/DEFICIT (line 39 minus line 43: indi or - balance) = -~ 00.00 I, Mart:in H. I~evlne (n tme c~' candidate or treasurer), hereby certify that the above statement and the attached supporting r~~; are ~rue and correct. / / S Igr~at~re 0f car~dic[ate or treasurer' ' ( Date signed / City of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) October 8, 2002 Committee to Elect Chris Heam Martin H. Levine, CPA - Treasurer 167 East Main Street Ashland, OR 97520 I have examined your 1 st Pre-Election contribution and expenditure report for the General Election of November 5, 2002 and found the following' Your committee report is sufficient. If you have any questions regarding this examination letter, please fee][ free to contact my office. Sincerely, City Recorder/Treasurer PC 1 Summary Statement of Contributions and Expenditures ~v. Please type or print legibly in black ink. Page 1 of 2 Candidate or Political Committee Name (use full name): Committee to Elect Chris Hearn Mailing Address as it Appears on Statement of Organization (street, route or box number, city, state, zip code): c/o Martin H. Levine, CPA P.O. Box 465 Ashland, OR 97520-0016 Treasurer's Name: Telephone Number (day): Martin H. Levine, CPA 541/482.7801 Committee ID Number: Committee Type, Measure Number or Office: N/A Ashland City Councilor #6 [~] Original I--] Primary 20 [~] General 2002 F-] Other [-] Amendment [~ 1 st Pre-election I-'l 2nd Pre-election [--1 Post-election F"] September Supplemental A-TOTALS FOR THIS B-CUMULATIVE TOTALS ACCOUNTING PERIOD FOR THIS ELECTION CONTRIBUTIONS 1. Cash Contributions 0.00 0.00 (Accounting Period Total from PC 2) 2. Loans Received (Non-Exempt) + 0.00 + 0.00 (Accounting Period Total from PC 2) 3. Total Cash Contributions = 0.00 = 0.00 (lines 1+ 2) 4. In-Kind + 0.00 + 0.00 (Accounting Period Total from PC 2) 5. TOTAL CONTRIBUTIONS = 0.00 = 0.00 (lines 3 + 4) EXPENDITURES 6. Cash Expenditures 0.00 0.00 (Accounting Period Total from PC 3) 7. Loan Payments (Non-Exempt) + 0.00 + 0.00 (Accounting Period Total from PC 3) 8. Total Cash Expenditures - 0.00 = 0.00 (lines 6 + 7) 9. In-Kind + 0.00 + 0.00 (Accounting Period Total from PC 2) 10. TOTAL EXPENDITURES = 0.00 = 0.00 (lines 8 + 9) CASH BALANCE 11. Beginning Cash Balance (Ending Cash Balance from previous report) 0.00 FOR OFFICE USE ONLY -- 12. (line Total5)Contributions + 0.00--/~'L"- / 13. Other Receipts + 0.00 (Accounting Period Total from PC 4A) 14. Loans Received (Exempt) + 0.00 -7~,: (Accounting Period Total from PC 4A) 15. CONTRIBUTION SUBTOTAL = 0,00 / /d . (linesll+12+13+14) ~ : , .... 16. Total Expenditures 0.00 ~, ' ' (line 10) 17. Other Disbursements + 0.00 (Accounting Period Total from PC 4B) 18. Loan Payments (Exempt) + 0.00 (Accounting Period Total from PC 4B) 19. EXPENDITURE SUBTOTAL = 0.00 (lines 16 + 17 + 18) __ 20. ENDING CASH BALANCE = 0.00 (line 15 minus line 19) PC 1 Summary Statement of Contributions and Expenditures Please type or print legibly in black ink. Page 2 of 2 Candidate or Political Committee Name: Committee ID Number: Committee to Elect Chris Hearn N/A [5~] Original [--i Primary 20 ~ General 2002 I~ Other [-] Amendment ~ 1st Pre-election [-] 2nd Pre-election [-] Post-election [-] September Supplemental LOAN SUMMARY -- FOR OFFICE USE ONLY 21. Beginning Outstanding Loans 0.00 (Total Outstanding Loans from previous report) 22. Loans Received (Non-Exempt) + 0.00 (line 2) 23. Loans Received (Exempt) + 0.00 (line 14) 24. LOANS RECEIVED SUBTOTAL = 0.00 (lines 21 + 22 + 23) 25. Loan Payments (Non-Exempt) 0.00 (line 7) 26. Loan Payments (Exempt) + 0.00 (line 18) __ 27. Forgiven Loans + 0.00 (Total loans forgiven during this accountin~ period) 28. LOAN PAYMENT SUBTOTAL = 0.00 (lines 25 + 26 +27) 29. TOTAL OUTSTANDING LOANS .. (line 24 minus line 28) PERSONAL EXPENDITURE SUMMARY 30. Beginning Outstanding Personal Expenditures 0.00 (line 36 of previous report) 31. Personal Expenditures + ~ 00.00 (Accounting Period Total from PC 3A) 32. PERSONAL EXPENDITURE SUBTOTAL = 100.00 (lines 30 + 31) 33. Personal Expenditure Reimbursements 0.00 (Total expenditures on PC 3 with purpose code R) 34. Forgiven Personal Expenditures + 0.00 (Total personal expenditures forgiven this acctg, period) 35. REIMBURSEMENT SUBTOTAL = 0.00 (lines 33 + 34) 36. OUTSTANDING PERSONAL EXPENDITURES = 100.00 (line 32 minus line 35) FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD __ 37. Ending Cash Balance (line 20) 0'00~ 38. Accounts'Receivable (Accounting Period Total from PC 5) + 0.00 39. SUBTOTAL (lines 37 + 38) = 0.00 40. Total Outstanding Loans (line 29) 0'00__ 41. Outstanding Personal Expenditures + 100.00 (line 36) 42. Accounts Payable + 0.00 (Accounting Period Total from PC 6) 43. SUBTOTAL (lines 40 + 41 +42) ~ = 100.00 44 BALANCE/DEFICIT/ ·[~ +~ = -100.00 (line 39 minus line 43: in~p,~ate r - balance) / I, Mart:±n,,H. I~ev±ne laame ot]candidate or treasurer), hereby certify that the above statement and the attached supporting rapa~t~ are[me andc°rrx~'~C~IvA,~-~, " Signature J _~,...~~.~~~ C~ ~_-"1/ ~ %------ of candidate or treasurer Date signed' PC 3A Personal Expenditures for Reimbursement .~v, 12/01 Candidate or Political Committee Name: Committee ]iD Number: Committee to Elect Chris Hearn N/A Page 1_ of 1_ Election: [-'] Primary 20 [5~] General 2002 [--] Other Report: [~ 1 st Pre-election r-] 2nd Pre-election [-] Post-election [-] September Supplemental PURPOSE CODES (see back of form for instructions and code definitions) A Agent N Newspaper and Other Periodical Advertising B Broadcast Advertising (Radio, TV) O Other Advertising (yard signs, buttons, etc.) C Cash Contributions P Postage F Fundraising Event Expenses S Surveys and Polls G General Operational Expenses (describe if over $50) T Travel Expenses (describe if over $50) I Interest Payment U Utilities L Literature, Brochures, Printing W Wages, Salaries, Benefits M Management Services Z Preparation and Production of Advertising Amount of Line # Date Payee's Name Purpose Expenditure 1. 09/05/02 Jackson County Clerk's Office N - Voter's Pamphlet Fee $ 100.00 2. $ 3. $ 4. $ 5. $ 6. $ 10. $ Page Total Accounting Period Total (Complete only for last page and See transfer this amount to the Summary Statement, PC 1.) Instructions Personal Expenditures $100.00 on Back and Personal Expenditures; $100.00 in Campaign Enter on Summary Statement, Line 31 Finance Manual PC 3A FILING OF CANDIDACY FOR NONPARTISAN NOMINATION PLEASE TYPE OR LEGIBLY PRINT IN BLACK IN][(. NOTE: This information is a matter of public record and may be published or reproduced. F--] INCUMBENT FOR OFFICE OF JUDGE NAME OF CANDIDATE NAME SHOULD APPEAR ON BALLOT AS FOLLOWS TELEPHONE (HOME) FAX TELEPHONE (WORK) EMAIL FILING FOR OFFICE OF DISTRICT, DEPARTMENT OR POSITION NUMBER RESIDENCE ADDRESS (STREET/ROUTE, cnn', STATE, ZIP CODE) COUNTY OF RESIDENCE; MAILING ADDRESS WHERE ALL CORRESPONDENCE WILL BE SENT WEBSITE ]SECRETARY OF STATE OF OREGON FILING OF CANDIDACY BY DECLARATION, WITH THE REQUIRED FILING FEE (ORS 249.056). FILING FEES FILING OF CANDIDACY BY DECLARATION STATE VOTERS' PAMPHLET (ORS 249.056) (ORS 251.095) OFFICE STATEWIDE OFFICES $100 $1000 CIRCUIT COURT JUDGE $ 50 $300 DISTRICT ATTORNEY $ 50 $300 MSD EXECUTIVE OFFICER, MSD AUDITOR $100 $_3_0~0_ JUSTICE OF THE PEACE NONE ~l[Lll~ N/A *Set By Charter or Or&nance ..... ** For C,hes W,tha -- f 50,000 or More L'ORS 251.0~]1~. ~i ~ ~/Filing of candidacy by PROSPECTIVE petition, with t4~~ ~~ment o e or more circulators will or will not be paid (SEL 30 /~ "' ~' ~/{J/~ 2 ..~ .pD£D._erl r Id b the a ro hate coun elections [~ Filing of candidacy by COMPLETED petition, witht~l~.~!;a~/urfs~~(p tffrt~ y pp p' ty ' officials (ORS 249.020, 249.064). Primary Election 20(J~al Election Filing For Candidacy: First Day April 1, 2001 Filing-~idacy: First Day September 17, 2001 Filing For Candidacy: Last Day March 12, 2002 Filing For Candidacy: Last Day August 27, 2002 Deadline to Withdraw Candidacy: March 15, 2002 Deadline to Withdraw Candidacy: August 30, 2002 Filing For State Voters' Pamphlet: March 14, 2002 Filing For State Voters' Pamphlet: August 27, 2002 FOR OFFICE USE ONLY INITIALS CASH OR CHECK NUMBER RECEIPT NUMBER CANDIDATE ID NUMBER OFFICE NUMBER PRINCIPAL CAMPAIGN COMMITTEE ID # SEL 120REV. 11/01 ORS249.03l STATEMENT ONE OR MORE PETITION CIRCULATORS WILL BE PAID I/We hereby declare one or more petition circulators will 'be paid money or other wduable consideration for obtaining signatures of active registered voters on the attached petition or certificate. I/We understand the filing officer must be notified not later than the tenth day after I/we first have knowledge or should have had knowledge that no petition circulator will be paid for obtaining signatures. Identify Petition (Name of Candidate or Minor Political Party on Prospective Petition; or Subject of Initiative, Referendum Petition or Name of Officeholder on Recall Petition) Signed* Date signed Date signed Date signed *Statement must be signed by one of the following: · candidate for nomination; · all chief petitioners for initiative or referendum petition; · chief petitioner for recall petition; · chief sponsor for certificate of nomination; or · chief sponsor for minor political party formation petition. STATEMENT NO PETITION CIRCULATORS WILL BE PAID I/We hereby declare no petition circulator will be paid money or other valuable consideration for obtaining signatures of active registered voters on the attached petition or certificate. I/We understand the filing officer must be notified not later than the tenth day after I/we first have knowledge or should have had knowledge that one or more petition circulators will be paid for obtaining signatures. Identify Petition (Name of Candidate or Minor Political Party on Prospective Petition; or Subject of Initiative, Referendum Petition or ,~ Name of Officeholder on Recall Petition) Signed*~~ Date signed Date signed D *Statement must be signed by one of the following: · candidate for nomination; · all chief petitioners for initiative or referendum petition; · chief petitioner for recall petition; · chief sponsor for certificate of nomination; or · chief sponsor for minor political party formation petition. SEL 300 REV 11/01 ORS 248.008, ORS 249.061, ORS 249.078, ORS 249.740, ORS 249.865, ORS 250.045, ORS 250.165, ORS 250.265, ORS 255.135 0 ~ O Z O © Z Z © Z © -SEL 220 ORS 260.037 Rev. ,,,0, Candidate's Statement of Organization ors 260.039 ORS 260.041 Please type or print legibly in black ink. 1 Primary 20 General 2002 Other election date [--] Will exist for more than one year 2 This filing is an: [~] Original [--I Amendment [--] Discontinuation 3 Name of principal campaign committee Committee to Elect Chris Hearn Committee address (street/route, city, state, zip code) - no post office box numbers c/o Martin H. Levine, CPA- Treasurer 1 67 East Main Street Ashland, OR 97520 Name of treasurer Martin H,, Levine, CPA Mailing: address to which all committee correspondence will be sent c/© Martin H. Levine, CPA - Treasurer PO Box 465 Ashland, OR 97520-001 6 Work phone number Home phone number Fax number E-mail address 541/482-7801 541/482-5430 541/482-5101 info@mhlcpa, com 4 Name of candidate Christian E. "Chris" Hearn Residence address (street/route, city, state, zip code) - no post office box numbers 350 Wimer Street Ashland, OR 97520 Mailing a_4dre~..s to which al_~l candidate correspondence will be sent 350 ~lm~ St:m~e Ashland, OR 97520 Work phone number Home phone number Fax number E-mail address 541/482-3111 541/482-0338 xf~:,~ ~--. z~~" cehearn@aol, com Occupation of candidate Attorney / ~ ~--~-.~ ~?~,~ Name of office sought (include county, position, department or zone number, if applicable) ~ Ashland City Councilor 5 Additional ad~~ion political publications (post office box or street/route, city, state, zip code) -t. 6 l~[filiation (complete 0nly it~i~lror partisan office) [~~cmfic ~~'~'~ L~rtarian [-] Pacific Green ~ Not a member of a party [-] Other 7 Poll~ll~llllllllffi%7 intends to solicitfunds by (mark all that apply): [-~ ~'~rectmail [-~ Personal contact ['-] Radio [-'] Television ~ Events ~ Newspaper [~] Website [-'] Other Please complete and sign the back side of this form. 8 Committee Directors (if any) Name Address (including zip code) Occupation Phone Number If~o or more directors of this political co~i~ee ~re ~lso directors of another political co~i~ee, list the n~mes of those directors and the name and address of the other political co~ee. . _ By si~ing this document I ac~owledge that: I am personally liable for any pena ~ties i~posed under ORS 0. Candidate's silage T 8eptmr 9~ 2002 8optm~r 6 ~ 2002 Date si~ed ~ate si~ed Important: Both the candidate and treasurer of a principal campaign com~ttee must sign the Statement of Organization, ...... Instructions Filin~ an original 8tatomont of Or~ani~ation lbo completod form must bo filod within throe businoss days of first roceivin~ a contribution or makin~ an expondituro. stampod copy, which includos your idontification numbor, will bo returned to you as an acknowlod~mont of your filing. can0i0ato may havo only oho principal campaign commi~oo. ~ eandidato who ~ a~ th~ treasurer A candidato may oithor so~o as tho candidato's own troasuror or may appoint a soparato troasuror. A candidato who se~es as thoir own troasuror and who doos not oxpom to rocoivo or spond moro than $300 for tho ontiro oloction Statoment of Organization or contribution and oxpondituro ropo~s. Howovor, if at any timo thoy oxcood $300 in oithor contributions or expondituros, thoy must thon filo a Statomont of Organization and contribution and oxpondituro ropods. ~mondin~ information on thi~ form Any chan~e in tho information on this form must bo filod within ton (~0) days of tho chan~o. To noti~ tho filin~ officor of information, submit this form, complotod in its ontiroty, and mark tho "Amondmont" box. ~iseontinuin~ ~ You must filo a final contribution and oxpendituro ropo~ that shows a zoro balance, alon~ wi: the "Discontinuation" box marked. The final repo, may be filed at any time. ~7~~ · ?.... . ~. ,.,.,,, .,.., .. .. ..... ,. . · , .. .... ... · : . . ...:.:.,~=. ~.~.~,,~;..,~:~.~...~,~:~..;, '.~ .... ~,~..,.: ,,....,..~ . ... '.' .... 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