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Home My WebLink About2026 04 30 P-R Levy - Committee Members FormName of Jurisdiction/Proposition No.: ____________________________________________ Jurisdiction Contact Name: _____________________________________________________ Email: ___________________________________________Phone: _____________________ Jurisdiction’s responsibility: •Email completed form to elections@co.jefferson.wa.us on or before the resolution submission deadline. •Provide committee members with statement requirements and deadlines. •Committees are solely responsible for submitting voters’ pamphlet statements to the election division. Requirements and deadlines are located on pages 20- 23 in the Election Guide for Jurisdictions. Questions? Email elections@co.jefferson.wa.us or call (360) 385-9117 Information for inclusion in voters’ pamphlet: “For” Committee (1-3 members): 1st Committee Member is responsible for contact with Election Coordinator on behalf of the committee. Name: ________________________________ Phone: ____________________________ Email: _____________________________ Website: ___________________________ Committee Name: ______________________ 2nd Committee Member: Name: _______________________________ Phone: ________________________________ Email: ________________________________ 3rd Committee Member: Name: _______________________________ Phone: ________________________________ Email: ________________________________ “Against” Committee (1-3 members): 1st Committee Member is responsible for contact with Election Coordinator on behalf of the committee. Name: ________________________________ Phone: ____________________________ Email: _____________________________ Website: ___________________________ Committee Name: ______________________ 2nd Committee Member: Name: _______________________________ Phone: ________________________________ Email: ________________________________ 3rd Committee Member: Name: _______________________________ Phone: ________________________________ Email: ________________________________ Committee “For” and “Against” Appointment Form Jefferson County Josh D. Peters, County Administrator jdpeters@co.jefferson.wa.us 360-385-9100 Shellie Yarnell 603-203-9331 shellieyarnell@gmail.com Devon Buckham 360-774-0591 buckhamdevon@gmail.com