Candidate Filing
MAR 0 9 ZCi5
SEL 190
District
0
revOl/14
ORS 255.235
All information must be completed or the form will be rejected.
[CI Amendment
~Original
This filing is an
Candidate Information
.
Name of Candidate
1Ml
First
t
~Y-td
1- •
TLast U
/,
/ Suffix
/ Title
Mr.
nq, 1nGZ
How you would like your name to appear on the ballot
Fir~v-e.d
1
LastV
{,
T\Cl 1¥\ct
Candidate Residence/Route Address
Candidate Mailing Address
Street Address or PO Box
~.o.
Box
Contact Information: Only one phone number is required.
Work Phone
.541)1~3-~(a<gj
1
Home Phone
Cell Phone
~41)5 3 9 -~ rqo
I Fax
Web Site, if applicable
Email Address
Filing Information
.
ll[ Filing with the required $10.00 fee
[1--Prospective Petition
Office Information
Filing for Office of:
Occupational Background (previous emoioyment) If no relevant exoerience, None or NA must be entered.
JJ/Pl
- Non..t..
Continued on the reverse s1de of this form
SEL190
Educational Background (schools attended) if no relevant experience, None or NA must be entered.
Last Grade completed
Diploma/Degree/Certificate
Complete name of School (no acronyms)
I
I
Course of Study
!
II
!.A
;v; H
-
'" I
IV() f) f!__.
l
I
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 appllcabl~ to candidates for ~eral office)
candidate CQmmittee
Yes, I have a candidate committee.
'"?
!ifNo, I do not expect to spend more than $750 or receive more than $750 during each calendar year. I understand I must still keep
I - 'records of all campaign transactions and if total contributions or total expenditures exceed $750 during a calendar year, I must
follow the requirements detalled in the Campaign Finance Manual.
0
No, but will be filing a Statement of Organi>ation for Candidate Committee (SEL 220).
By signing this document I hereby state that:
I will qualify for said office if elected
all information provided by me on this form is true to the best of my knowledge
0
Warning
Supplying false information on this forrn 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 at the same election.
(ORS 249.013 and ORS 249.170)
Date Signed
For Office Use Only
Initials
CC Approval Code/Receipt
Numbec_.q_~--------
MAR 0 9 201~
Candidate Filing
SEL 190
revOl/14
District
0
ORS 255.235
All information must be completed or the form will be rejected.
I0
[g) Original
This filing is an
Amendment
Candidate Information
Name of Candidate
I Ml
First
1?.
L~.:s
I Suffix
! Last~t L(_ V"t'J'L
I Title
Mr.
How you would like your name to appear on the baHot
First
I Las-s-tu. r
I Suffix
Mr.
rn
Candidate Residence/Route Address
City
Street Address
3V, I d-1 s-t.~St\1\ ~oo..d
Zip
State
Mo../;tl
Candidate Mal!ing Adaress
City
Street Address or PO Box
~a.li
Contact Information: Only one phone number is required.
Work Phone
I Web Site, if applicable
Email Address
Filing Information
.
jg Filing with the required $10.00 fee
![ I Prospective Petition
.
Office Information
.
.. •
Filing for Office of:
District, Position or County:
f\1\o._ \i \"\ ....-Ku..yo._ I ~iY'.Q..
\)1.-r-t,t;LoY' ?o"';>it.ion
t'rat.et.l;ion
#5
b
i~tYi r...:6
Occupation (present employment) If no relevant experience, None or NA must be entered.
NJFt · No Y\-.e_
Occupational Background previous employment) If no relevant experience, None or NA must be entered.
fJjA - NonJL
Continued on the reverse side of this form
SEL 190
Educational Background (schools attended) If no relevant experience, None or NA must be .entered.
Complete name of School (no acronyms)
f I ''"
IH
fV
I Last Grade completed
Diploma/Degree/Certificate
Course of Study
AI
/VUTI'-'0
I
'
Educational Background (other} Attach a separate sheet if necessary.
Nfi:J - No Y'l..f<...
Prior Governmental Experience (elected or appointed) If no relevant experience, None or NA must be entered.
Campaign Finance lnfQrm;ttion (not applicable to candldlites fOr fectetaJ office)
Candidate Committee
~-J
Yes, ! have a candidate committee.
B' Wo, 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
fallow the requirements detailed in the Campaign Finance ManuaL
0
No, but will be filing a Statement of Organization for Candidate Committee (SEL 220).
By signing this document, I hereby state that:
I will qualify for said office if elected
all information provided by me on this form is true to the best of my knowledge
0
Warning
Supplying false information on this form may result in conviction of a felony with a fine of up to $125,000 and/or prison for
up to 5 years. (ORS 260.715). A person may only file for one lucrative office at the same election.
(ORS 249.013 and ORS 249.170)
Date Signed
For Office Use Only
Initials
CC Approval Code/Receipt
Numbe,__q_~'-'=-'{_pO------
·~~
.
MAR 0 9 2015
Candidate Filing
SEL 190
rev 01/14
ORS 255.235
District
8
All information must be completed or the form will be rejected.
~Original
This filing is an
[LI Amendment
.·. .
Cllndidate Information
Name of Can.didate
First
I Ml
<fr-t~
.
..
I Suffix
Mr.
/Last
\}J.
M~~u../1-t~
j Title
I Suffix
vt{ r-.
Candidate
R~encllf:l!o~Ad(jress
Street Address
oL)t1
Candldate.Malling Address
City
Street Address or PO Box
?.o.~x
5o4
MoJih
Contac:t Information: Only one phon.e number
isre~uired.
I Fax
Work Phone
8$
Email Address
Filing lnformatl'l!'
,
.·
[lg. Filing with the required $10.00 fee
rn
Prospective Petition
Office .Information
Filing for Office of:
Nan--e..
-,
Occupational Background (previous emplOyment} -Jf ne relevant experience, None or NA must be entered.
;JjA
J/on-L
Continued on the reverse side of this form
SEL190
·-·
•
Educa:ti<>nal Background
{sch~ a~) lfo.Q rele\la<>t exp~~nce,
'N9ne or NA.must be E!ntered.
.
.
Complete name of School (no acronyms)
/\II V.
I
v
Diploma/Degree/Certificate
Course of Study
I
'
I
Last Grade completed
I
·~ lf'l I/'\ _/1
/ V_ V I j_""<......-_
Educational Background (other) Attach a separate sheet if necessary.
.
Prior Goverttmental'l!xperience !elected or appointed) If no relevant experience, None or NA must be entered.
Campaign
FJnan~!!UorJ'IIIItlon iiJiot a~;ill~abl.... c~teijlljf!l' I.
Candjlllate Committee
r-:- Yes, I have a candidate committee.
JrJ
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, 1must
follow the requirements detailed in the Campaign Finance Manual.
0
No, but will be filing a Statement of Organization for Candidate Committee (SEL 220).
By signing this document, 1 hereby state that:
->
I will qualify for said office if elected
all information provided by me on this form is true to the best of my knowledge
--'>
0
i>'
:::~:g fa•lse inf~rmation on this fi>rm may result in~onvictlon of a felony with a fine of up to $125,000 and7~r prl~~~ ts'r:
up to 5 years. (DRS 260.715). A person may only file for one lucrative office at the same election.
(DRS 249.013 and DRS 249.170)
Candidate'
For Office Use Only
Initials
0-"Lp-'-----
CC Approval Code/Receipt Numbec__q_5{)
__