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Home My WebLink AboutElection Info: Ken Hagen CAN Dt 0 MlZ D ~Cr;:fJse 1) 1/2.1/1 'g SEL 120 REV. 9197 FILING OF CANDIDACY FOR NONPARTISAN NOMINATION ORS 249.031 PLEASE TYPE OR LEGIBLY PRINT IN BLACK INK. FILING FOR OFFICE OF D INCUMBENT FOR OFFICE OF JUDGE NAME OF CANDIDATE IL~}-J fffl-6 F)J evV )-J(~i L_ NAME SHOULD APPEAR ON BALLOT AS FOLLOWS K6P /1J9-6~;J TELEPHONE (HOME) t/-gg ,- 5&~ :S5 TELEPHONE (WORK) 4gg ~~h 3iJ COUNTY: T~~~ MAILING ADDRESS TO WHICH ALL CORRESPONDENCE WILL BE SENT .~'Ig J2-(J) (~ t:- c:;;r: #-~ . ~ f) OJ;!... 9.7520 TO THE D SECRETARY OF STATE OF OREGON D COUNTY ELECTIONS OFFICIAL OF COUNTY IZI CITY RECORDER (AUDITOR), CITY OF Jh; h,1cuIc;l D FILING OF CANDIDACY BY DECLARA nON, WITH THE REQUIRED FILING FEE (ORS 249.056). FILING FEES FILING OF CANDIDACY BY DECLARA nON (ORS 249.056) STATE VOTERS' PAMPHLET OFFICE STATEWIDE OFFICES CIRCUIT COURT JUDGE DISTRICT A TIORNEY MsD EXECUTIVE OFFICER, MsD AUDITOR MsD COUNCILOR COUNTY OFFICE CITY OFFICE JUSTICE OF THE PEACE $100 $50 $50 $100 $25 $50 .. $300 $100 $100 $100 $100 $100 ....$100 ~}\ (/ c./ U NONE "SET BY CHARTER OR ORDINANCE ....FOR cmES WITH A POPULATION OF 50,000 OR MORE (ORS 251.(05) FILING OF CANDIDACY BY PROSPECTIVE PETITION, WITH THE REQUIRED PROPOSED SIGNATURE SHEE CANDIDATE (SEL 121) AND STATEMENT ONE OR MORE CIRCULATORS WILL OR WILL NOT BE COMPENSA (ORS 249.020). FILING OF CANDIDACY BY PERFECTED PETITION, WITH THE REQUIRED SIGNATURE SHEETS i~RL Y CERTIFIED BY THE APPROPRIATE COUNTY ELECTIONS OFFICIALS (ORS 249.020, 249.064). . ~ 1998 FILING DATES BIENNIAL PRIMARY ELECTION FILING FOR CANDIDACY: FIRST DAY THURSDAY, SEPTEMBER 11, 1997,8:00 A.M. GENERAL ELECTION WEDNESDAY, JUNE 3, 1998, 8:~~ 'to/+.. 'WO" TUESDAY, AUGUST~, 1998,5:00 P.M. FILING FOR CANDIDACY: LAsT DAY TUESDAY, MARCH 10, 1998,5:00 P.M. FILING FOR STATE VOTERS' PAMPHLET THURSDAY, MARCH 12,1998,5:00 P.M. TUESDAY, AUGUST 25,1998,5:00 P.M. u REQUIRED INFORMATION (ORS 249.031) OCCUPATION (PRESENT EMPLOYMENT - PAID OR UNPAID) D 1'~A-&~6f) OCCUPATIONAL BACKGROUND (PREVIOUS EMPLOYMENT - PAID OR UNPAID) 0LJ c.1}2..!)/)J J17;a,K- F~~ TM#J2-~ + Jt)SE" Y'I-I/.A-JE etJf)jVT/F-:>j /'OME VlfLLel c.Ol)j)(!-,)L. ClJ 6dll~, /tUlbrEC7V4L /Jr=>I6-AJ~1 ?'c/!-,AJAJEZ /!.E(!j! ~U.AJ 6 EDUCATIONAL BACKGROUND (SCHOOLS ATTENDED; LAST GRADE COMPLETED; DEG~E(S), IF ANY) If;Jk;r~ f)E~e-E/ /!;1Z.l3;f;n::a-T2JAC/ U AJ ~ tJ/~ ~M~.f?-s J)Etk:,/2bc/ /))f)lJ>r~/fL n e.H; L/,J!} 'J u.J/~JJSJ)J PRIOR GOVERNMENTAL EXPERIENCE (ELECTED OR APPOINTED) 1t51tt-/l-JS 1) elTJ t!tJ {);J @./L NOTE: This information is a matter of public record and may be published or reproduced. By signing this document, I hereby state: THAT I shall accept the nomination for the office indicated above; THAT I shall qualify for sclid office if elected; THAT all information provided by me on this fo"", including my occupation, educational and occupational background, and prior governmental experience, is true to the best of my knowledge. ~ l1L1pplies any information on this form. knowing it to be false, is subject upon conviction to 1m ~m~ . No penon shall file a ~g petition or declaration of candidacy for more than one lucrative office before the date of the primary election. unless the person first flies a written withdrawal with the officer who accepted the initial filing (ORS 249.160). SEL 220 Rev. 9/97 Candidate's Statement of Organization ORS 260.037 ORS 260.039 ORS 260.041 Please type or print legibly in black ink. A candidate who serves as the candidate's own treasurer does not need to fill out sections 3 and 8. Primary 19 _ General 19 -!.1-!l- Other election date o Will exislt for more than one year 2 This filing is an: Original o Amendment o Discontinuation 3 Name of principal campaign committee (5tJ /J!Jf)/l;1{eF .{O /lf~&L~eP~T' {-GAl 1-b7' lfb)J Committee address (street/route, city, state, zip code) - no post office box numbers (LtJ 6)~ Sf D (J)Z M& 6)J 7 S ;;;J. cJ Name of treasurer ~j-J Telephone numbers 'Ii t '-5~3" Mailing address to which all committee correspondence will be sent :) ~K f!-IJClc- ~>r .5/) 11= S- L"-- P S;-~9 4 Name of candidate ~z;';J Mt0 E jJ Residence address (street/route, city, state, zip code) - no post office box numbers ~iL 12~~ ST ~ D ~12- Mailing address to which all candidate correspondenc~.,-ilI be sent 5c.J-6 "e~ $'T tF~ /f :7. L~ D 15/1-/5 LED 5*AJ Occupation of candidate Oft?- 1.7~;-2d Telephone numbers " f . .- / .-:::- '-/-88 -5~'s: iJg-s~~-:> Filing committee for office of (include county, position, department or zone number, if applicable) 6 Additional address that may be US~7; publications (post office box or street/route, Ci~' state, zip code) Party affiliation (complete only if filing for partisan office) o Democratic 0 Libertarian 0 Natural Law 0 Pacific 0 Reform 5 o Republican o Socialist o Not a member of a party o Other 7 Political committee intends to solicit funds by (mark all that apply): o Direct mail .18'('personal contact 0 Radio o Banquet 0 Newspaper 0 Other A 0 Televis>'Y' .L ~....I- . eJ(' b~ td ("J-n., ~ I PletlSe complete and sign the back side of this form. 8 Name Committee Directors (if any) Address (including zip code) Occupation If two or more directors of this political committee are also directors of another political committee, list the names of those directors and the name and address of the other political committee(s). By signing this document I acknowledge that I am personally liable for any penalties imposed under ORS chapter 260. I I -- 7Ai1g D~WSiineY Important: Both the: candidate and treasurer of a principal campaign committee must sign the Statement of Organization. Instructions Filing a new Statement of Organization Three (3) copies of thi:s completed form must be filed before any contributions are received or expenditures made. A date stamped copy, which includes your identification number, will be returned to you as an acknowledgment of your filing. A candidate who se"ies as the treasurer A candidate may either serve as the candidate's own treasurer or may designate a principal campaign committee and appoint a separate treasurer. A c;andidate who serves as the candidate's own treasurer does not need to complete sections 3 and 8 of this form. NOTE: A candid,ate may have only one principal campaign committee. Amending infonnaticln on this fonn Any change in the information on this form must be filed within ten (10) days of the change. To notify the filing officer of a change in information, submit three (3) copies of this form, completed in its entirety, and mark the "Amendment" box. Discontinuing You must file a final contribution and expenditure report that shows a zero balance along with a completed SEL 220 with the "Discontinuation" box marked. . For Office Use Only Initials Committee ID Number ~ JU[ tv 30f!J "98 Office Number Candidate ID Number SEL 300 REV. 9/97 STATEMENT ONE OR MORE PETITION CIRCULATORS 'WILL BE COMPENSATED ORS 248.00H ORS 249.061 ORS 249.078 ORS 2.9.740 ORS 249.865 ORS 250.045 ORS 250.165 ORS 250.265 ORS 255.135 I/We hereby declare one or more petition circulators will be paid money or other valuable consideration for obtaining signatures of 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 no petition circulator is being 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 Da te signed Da te signed "'Statement must be signed by one of the following persons or groups: - candidate for nomination; - all chief petitioners for initiative or referendum petition; - chief petitioner for recall petition; - chief sponsor for certificate of nomination; - chief sponsor for minor political party formation petition. ------------------------------------------------------..--------------- STATEMENT NO PETITION CIRCULATORS WILL HE COMPENSATED I/We hereby declare no petition circulator will be paid money or other valuable consideration for obtaining signatures of registered voters on the attacned 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 one or more petition circulators is being paid for obtaining signatures. Kc)) !I7l0e-JJ 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) ~A~~ Signed * r. -'/" , 7~ Date signed Date signed Date signed "Statement must be signed by one of the following persons or groups: - candidate for nomination; - all chief petitioners for initiative or referendum petition; - chief petitioner for recall petition; - chief sponsor for certificate of nomination; - chief sponsor for minor political party fonnation petition. RECD JUl 3 tv . 0 7998 City of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) July 30, 1998 Ken Hagen 548 Rock Street #5 Ashland, OR 97520 APPROVAL OF PETITION FOR CIRCULATION: City Hall 20 E. Main 51. AsWand, Oregon 97520 (541) 488-5311 (fax) Petition for Nomination of City Office has been received in the Office of the City Recorder/Treasurer on Julv 30, 1998. reviewed and approved for circulation. ~/~~ Barbara Christensen City Recorder/Treasurer Date CERTIFICATE OF LIMITED EXPENDITURES (ASHLAND CANDIDATES ONLY) PLEASE lYPE OR PRINT LEGIBLY IN BLACK INK :I? 19_ Primary ()~ #S-. street or route, CI 5 certify that if I am signing as a candidate, I will not make attributable expenditures for this election in excess of $2,500 (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 $2,500. '1 instead of line should be signed the following limitations, limited to the attributable expenditures specified in this certificate and city ordinance to be bound by the expenditure C/') = rr1 ~ Z C ~ t::d rr1 :::a rJ'J~ -::e C')_ ZrJ'J m< Om ~~ ~- ~"Tj ::e- m(") (")~ - - ~O (")Z C ~~ ~C OrJ'J ~~ . ~ m /'} /."..,/ , ~'1:-/" l' b r-: --:) ,-) d r-. -. () c~ c;f--< 4"- *''1""- '-:--~ ;:f- (;;{'-'f'-(:1'~ -::-c:;~ '2.... +.~.c'~ ~ ~ ~~F~~~~t~i\;;J~~&::~~\~ ~ :-- ~~ ~ \ ~'~(='t ~ ~~' ;'J~J ~.~ ,gJ o ~~ ~~:$ ~~~ Lt-- ~ ~;:!~! ~ t> C') ~ ""'~ ..> ~ ~t~' ~~R'-~I~\c.'\ ~~ r~~ ~I~ ~ ~ f ~ ~r ' 6. ~~"" ~ ~ ~ ~~ i' c 2:: 1'- ~ ~ ~?/ ~;':.ot. ~ t" ') ~'~ ~.~ ~ ~ ::J (... )4;J" s: (10-.. ~ ~'~[ (") I ~ (, . ~""'~ I~""", I l~ ~ ~<< ~ ~ - ) .~~~ ~ o \ I ~ Z % ~ A 1-..- ~'IS. ~ ~~, tv ~~ ~ ~ oQ <:X.\ 0\. ~ I~ OQ.. ~ J:C .~,~~~~r~. ~:~~ ,,-~.J: k ~~~'j;-~~ ~~ ~ ~ ~ ~ ~ ~ % ~'~ ~ ~ I~~~~' ~ ~ ~ ~ ~ ~ ~~ ~~ ~ ~ ~ ~ [ g t ~~ K ~ ~~ ~~f?'(l'.\I~~ ~i""'-~tr ~ ~ --i:;tl o~. ~ (t ~ ~ h ~ ~. ::> f 5 ~ 0- ~ ~,' :r~, o tr1 S' ~ 0 C' ___ IE"t. ~ , ~,,:)") ~ ~ ~r.s- Ii' \ ~ ~ ~ ~ ~_ ~ ~ rt,'" c.: ~ ~ rr.\ C-t 12 ~L 4: f" r(:;' ~ ~ ~ 2:: g;i3 ~ ~ 0 ~~J ~ =-t; >- ...,~ i T. ~'.J~ ~ ~)J ~ ~ 0 ~ ~ :;tI 8 ~ 3 ~ ~ J ..) l^- 'J ~ ~ . \) ~\I"", <:. )> f' \ \ '0' Z rn r< ~ ~ ~ ~ ~ J ~.. ~\ ~"~ ~ ~ P-- _11"- \ J.\ > i ~ ~~~l)~z \~~,~=f.9.c>z.sr~...-~~~,o~VJ~3'~~~ ~ ~:;tI f\: ~;1 r:::) -3 i,:" ' ~ -" ~ ~ a , 0" Z '=. ~ .- f"\ \.l) (~~ ~ \ /' " -.....l g ~ --- t- :\ ~ ,,~ V V> ~ '> l' I~ ; ~ E- ~ .~ Cr, ()J'~ .J -.D~~ ~ ~ y (}IV} ~ ~ - -J _ "d "d Ie::::- 0 v ~ P.'. ......\ 6" ~ ~,.JI .:'~).~, N n-4 ~ ~. ~ ~ t ~ ~ I~ Z ~ ~ J ~N '>< - ,.,.... '-J \..h ...... v. ~ \.- . ~. ~ ~- ~ - , <D I~ ~. i~ ~ () ~ 11] }- f \) ~ K ~~( ~,- ~ '? ~ +, ~ ~ ~~ ';:!: .0 -- -~ lJ\ ~ ~ ~ ( K F-~ ~ ~ ~ ~ 1\' ~ 1 ~ ~ U v') ~ ~ ~ t~ ~ r ~l ~ ~ '.' ~ l!.\ ~ \f) J'. -\ ~ ~~ ( ~ ~ "" 1\ \) t_~ I. !' ;;p ~ f '\ 4' -+ "'" ~ ,. <II ~ 0 ~r tJ F::.~, ~~ E?\ I~ ~ I (0' ~ Sf ~ ~ I~ '-- ~ ~ ~ i t t~.C\ ~ ~~~...,.. 1~~, ~tt >-.~~ f ~~~ ~ o ~ ~ -- y"" ~ ~ Ir--. ~ ~ ~ ~~. ~- r- ~ \ 0 ~ lr~? I~~ J..~~ ~~~~ ~- ~.l~ ~ ~ ~ ~ ~ c... ~ 0 ~i l~ , ~ ~ ~ ~ 1'""1 V :11 ~ ~ t1 v 'V.~ > ).- 'oJ Q ~ ~ (3 ~ .f) It...>> _D -I.' -1) ..f) ~ ~ ,,) ~'- -C0 ~:::5""" ~ ~ ...1} ~ N ~5 ~~~~~d~~~:~~~~~~~~8 ~ ~. ~~ ~ ~i ~ 0 ~ ~ ~ .~) ~ ~ ~ ~ ~' ~ to' ~ g ~ ~ 'oJ '-( )J \ ;i: ~ ~ . ___ J I , ,~ _. _ jl If\ \ ..) _. ~. ._,:) - \ , }\. -.:) r- - ~ ~ .. ~. \ -- ~, ~ ~ I hereby certify \, signatures o~s petition are those of registered voters in \ \-<\ (\ \L..l\1\Y\ County, Oregon. DATE CERTIFIED { ill OA 1.1\ * ~ j Cf1~ 'U} f\ SIGNATURE OF COUNTY ELECTIONS OFFICIA~~ _~ -' Q '~ ~\. V\A Q 0 h ~ 11 1 It L .... I ' , t1 NOTE TO CANDIDATE: PETITION SIGNATURES MUST BE VERIFIED BEFORE A PETITION CAN BE FILED. BE SURE YOU -- SUBMIT YOUR PETITION IN AMPLE TIME FOR THIS PROCESS TO BE COMPLETED BEFORE 5:00 P.M. ON THE FILING DEADLINE DAY. ~ S:> ~ tTI~ ()'"OO r-'O OtT1Z gtTI ..-.j ~::j tTI ::z= '"O::j tTI tT100 OCI'J (J)ZZ~ ZtTI CI'J~ ~O:::: O~ tT1~O ~~ 98~ 5~ ~ >-< 8~ ~O ~ ~ ~ S ~~ ~~ o ~ ~ z ~O tT1~ ~ ~ ..,...J ~ ~ -t-'n .. >< 1(") m ~ S2 :> ::j -i ;oa m_ ~~ ~ (~ ~ \1' ~ m -i ~ (5 12 ~_z Z 0 ;;j t!J o :> :> ;oa ~ ~ ~ g "T'I 0 o ;oa ; ~ o Z ~ m Z Z :> c m -i ~ ~ (5 m g ~ ;oa o 0 Z -i ~ ~ 5 ~ :E :!! Z Q C) _ -i Z J: 0 m n :!! :> ~ ~ C) - .~ ~ -i ~ ! ~ V> n ~ m ~ 0 :::; c 6 (3 ~ Z -i J: m :> .., ~ :>:J o ~ :>:J ;;: -i m ~"'.., tTltTI:I: ~~(j) o(j) ~> (j')() 0> zz <tTlCJ O~a 7jO> UJ"Y1.., .......,tTI ()Z:I:z o V;o c: "'3:: Z >..... :! C)z tTI> o 3::'" Z c:..... r' (j')Z ~ ..,C) :;OV'J ~S -DN ......- -D ~ o G! N ~ -D o ;:J ~ rr1 ~ 10-4 ~ 10-4 o Z "Tj o ~ ~z C)o Zz ~~ ~~ .-.. 'J cnlo-4 ::I:trJ rr1> rr1Z ~z o ~ 10-4 Z ~ 10-4 o Z 'i:I tT1 :j ::j o z - ~ ~ , ,:...}, c'\ sheet did so in my presence and I believe each person is a qualified voter of the state of Oregon (ORS 249.061, ~ C THIS VERIFICATION MUST BE 0 249.072). ~ be "'" Q) SIGNED BY THE CIRCULATOR. Q) 0 u SIGNATURE OF CIRCULATOR >. >. - ..J:I I of-~ Q) 1:: SHEET NUMBER "'" ~ Q) CIRCULATOR'S ADDRESS (street, city and zip code) ..r::: 0 - - u .1 S-/ll/j/V P, 07\ 15. - 16. - 17. - 18. - 19. - 20. - CIRCULATOR'S VERIFICATION PETITION FOR NONPARTISAN NOMINATION I, (print circulator's name) 'N~~ hereby verify every person who signed this ~ < o 8 ~ >- :::J LL1 0 eo: < :> LL1 IJ) 0 LL1 () c:c z o ;J LL1 LI. ,...J LL1 u: :t LL1 f-o IXJ Z ~ c: u ~ z p,,; 8$ ~~ 0.. eo: < 5: LL1 LL1 eo: IXJ &: 0 LL1 LL1 IXJ ~ o ,...J LL1 0.. u: ~ Q2 0 LL1 U > LL1 LL1 IXJ IXJ 0 !:i1 f-o :> IJ) ~ l{J l{J ~ eo: eo: :> 0.. f-o IJ) ~ ~ () eo: Vi 0 Z LI. o LL1 - ~ t: - ~ ~ p.. ,...J 0.. .. ~ ~ < I-< Z -< - o z - 0 o - Z f-o < ~ U ~ 0:> !-< ~ ~ t: I-< ~ o IXJ z~ TO THE SECRETARY OF STATE/COUNTY ELEcnONS OFFICIAUCITY RECORDER: WE, THE UNDERSIGNED VOTERS, BALLGr AT THE NEXT FOR NOMINATION TO THE OFFICE INDICATED, BE PLACED UPON THE ELECTION FOLLOWING THE FILING qF THIS PETITION. ONE OR MOR~CIRCLE ONE)I 01 l PETITION CIRCULATORS WILL BE OFFICE /I - -" CaMPEN SA TED. tkt J.1 wl (f) lJ t'\ (I, ~ , ., ........~ .... '- ........--- -.... ~ " DISTRICT, POSITION, DEPARTMENT OR ZONE NUMBER ~O.5. '-I NAME PRINTED ABOVE, THIS IS A CANDIDATE NOMINATING PETITION. SIGNERS OF THIS PAGE MUST BE RE VOJERS IN I I~ COUNTY ONLY. SEL 121 REV. 9/97 ORS 249.072 CANDIDATE'S NAME PETITION FOR NONPARTISAN NOMINATION SIGNATURE SHEET PETITION I.D. C) ~ ~;;:- :;~ ~~ z o ~ ~ z ~ ~ o. Z ~ o ~ u < o .... ~ '.t.". .. r'\ .tf.'y, ~ ;t.....-...., Z .. ~~o< ~ .. ~ ,..'.:; ~ t:~ ~ :~' ~ ~ o ::r: E-t ..... ~ ,,,",,,,,"_ ....2'. . g~' ;:\'~::"" ~~~~ ~>N'" ,. ' """'.'. "." .I"ir"':" .;-:--.. .,..,... . ...... yi~~:~':. .., ~;D:.. ~~.~ . :~J~':' ~ - ":.' :!JiJ';., :'" ;;.:. ~'J~; ;j~~ :.f~' ~~t ~:J',";' !~C) ~~.;:Q.. t.fkI lfjIn'.'.1. ..... .' ' -. I~:. \ . . .~,' :W~1 ~:.,I '?,i: .. ~ Z -. ..- >- ~: f-t .' ~ < Po. ~ < U ~ " :J o ~ J ~ ~ ~ Q {.J .' "J ~ GJ()-.. c 8 11.0 N, . N _: . tr1 () . ~ I;; . 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N -'--\J 1:.N~ \S I - \'-\\ \'J i~ .~ ~ ~ fII' I' \y - \ \ I' ~q ~ ~ I hereby certify ~ signatures op\this petition are those of registered voters in ~ (\ t l\..tsn ~ ; County, Oregon. DATE CERTIFIED t \. \.. 1 QA l ~ i ( , ~ 9~ U _) 0 Z ~ SIGNATURE OF COUNTY ELECTIONS OFFICIA~ -".I.' (.\' b(\ h VV\ C1. II L - ~ JJ .f\ 11 " A ~ .... 1 PI , 1- ~ . NOTE TO CANDIDATE: PETITION SIGNATURES MUST BE VERIFIED BEFORE A PETITION CAN BE FILED. BE SURE YOU ~ SUBMIT YOUR PETITION IN AMPLE TIME FOR THIS PROCESS TO BE COMPLETED BEFORE 5:00 P.M. ON THE flUNG DEADlINE DAY. ~ trI fJ) := tr.I ~ Z c: :: ~ tr.I ~ '. , o-f ()'1:IO o QtTlZ ""i 3:::jf!1 ::r:= '"tJ::j f!1 rr1QO (I) ~Z" f!1 n ~Os:: " rr1~O ~ Of)" ~ . ~ )! ~ ~ ., l'''' [!! r-'o f) tJ:Iz ~ Q\f ~ ~ ~ C~ a . > -j 41.. ~ ~ C:) ~ .!".~ ~ -j X trI c: Z a trI ~ C5 Z I:! < ~ ~ a ~ '" ~ "&~ ~3 ~~ ~~ .3~ s:: trI ~~ ~ Z trI Z C s:: CII trI '" tJ:I'"tJ....j tT1tT1::c ~::!- M....j(f) 8ov; ;2:> ~(f)n Me;)> ~ZZ 0f!10 ....j~a triO> 'Y1....j _....jtT1 nZ::CZ o ViO ~ '"tJ3:; ....j >- -< OZ o ~~ Z c:- l' (f)Z :< ....je) ~VI ~~ \DN ~... o ~ N ". \D ~ ~ rr.I ~ ..... ~ ..... o z ~ o ~ ~z G10 Zz ~~ ~~ en..... =cn rn> rnz ~z o a: ..... z ~ ..... o z 'i:I tr1 :j :j o Z - 9 PETITION FOR NONPARTISAN NOMINATION I, (print circulator's name) J c e C, 'r c k.h Q Yd:\ hereby verify every person who signed this sheet did so in my presence and I believe each person is a qualified voter of the state of Oregon (ORS 249.061, 249.072). SIGNATURE OF CIRCULATOR THIS VERIFICATION MUST BE SIGNED BY THE CIR~:f!tOR SHEET NUMBER CIRCULATOR'S ADDRESS (street, \-/~ city and zip code) SIGNATURE :'::~~~DA~~~:se: 15. 16. 17. 18. 19. 20. CIRCULATOR'S VERIFICATION ~ ~ANDIDATE'S ONE OR MOR INO IRClE ONE) . PETITION CIRCUL ORS WILL BE OFFICE COMPENSATED. (if. In..A I --. -J TO THE SECRETARY OF STATFJCOUNTY WE, THE UNDERSIGNED VOTERS, ELECTIONS OmOAUCITY RECORDER' BALLOT AT THE NEXT DATESICNED MOJDA YfYR. ~MJ of- ~C01~ CtJMW DISTRICT, POSITION, DEPARTMENT OR ZONE NUMBER fb~l(jYJ if NAME PRINTED ABOVE, IDA TE'S THIS IS A CANDIDATE NOMINATING PETITION. SIGNERS OF THIS PAGE MUST BEREG~~IN COUNTY ONLY. FOR NOMINATION TO THE OFFICE INDICATED, BE PLACED UPON THE APPROPRIATE ELECTION FOLLOWING THE FILING qF THIS PETITION. ~ < o :> 1.11 o ~ >- ..J 1.11 0 ~ ~ I/) 0 1.11 tJ CQ z ':3 @ Ei: IE !I! 1.11 .... IC Z ~ ~ u ~ Z c.: 08 Eli) !;j 1.11 c.. CI: < ~ ~ 1.11 ~ ~ 1.11 1.11 IC !;j o ..J 1.11 c.. ~ ~ 1.11 U > 1.11 1.11 IC IC 0 !;; .... < :>~ tJ ~~ tl: ~CI: ~ CI: c.. o ~I/) < X o CJ') z.... ~ (:) 5 ~ ~ 2!:: (:: ~~ I\S ~ U - ~ ~ t-' ~ I:f: .... ~ ~ ~ 1.11 ~~~~ ~~ ~::> < ~ (:) 0 Q z u .0 . ~ Q E ~80 Z!;j ~ bO~ <c.. ~ ~ ~ U CI: QJ u::> 0:> ~ >.~ f-~ ]u~~ Z~~ _ CJ') I/) - SEL 121 REV. 9197 ORS 249.072 PETITION FOR NONPARTISAN NOMINATION SIGNATURE SHEET PETITION I.D. .2 :a ~ a. tn 0 cu- .cStn tn._ ~ Q) ts 0 S Q)'S; ~O)Q) -g,-5. Q) .e cu 0.Q)"O X _ Q) Q)cu_ C:::2J!! o "0 0 c:: ffi 'S; .2 0 Q) - - cu cu cu ~E tn :2 .- "0 ~Q)c:: 'OlOrJ c:: :2 Q) 0"O.c .- c:: _ lOcu_ '-Ocu cuQ).c o.c- Q) - 0 "0 .c .5 0- cu :c rJ ~3::o ~-c:: It: cu.- Q) c:: ~ 10 0._ "O~U :OQ)Q) C::-.c cuQ)- Ox .5 cu Q) ~ _C::c cu Q) Q) :5:5E tn _ Q) "OculO c:: ~_ It:~tn ~Ecu Q)~.c EQ)tn O'-~ ~~..c <( :s 5- ~i= .- a. cu Ux.c Q) Q) tn =~Q)c '-..0"00 orJo:; Q):a.~~ "E a. a:: 5 Ocu :.... o ~_ Q) Q).- 0 a::=uc:: ~"O~~ .- Q) - cu U"O .'- Q)mQ)J!! .c000 -x!EQ) :=Q)O"O I. '- . 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