The Council Applicants Questionaire.

[Jim O'Bryan]

A copy of the questions being asked council candidates.

Full name

Street address in Lakewood

Length of residence in Lakewood

Preferred mail address

Phone numbers home cell

Current employer occupation and employer city

Are you a registered voter? Yes No

Have you voted in an election for Lakewood municipal officials? Yes No

PROFESSIONAL AND CIVIC ACTIVITIES
Please list or describe your contributions to the Lakewood community and your involvement in civic related issues that you believe are relevant to your council application

Please list all civic charitable cultural or community related organizations in which you have
held membership or been a participant within the past 10 years whether in Lakewood or not including any titles you have held and the activities in which you have been engaged or are engaged in each such organization

SUPPLEMENTAL INFORMATION
Do you plan to run for office in 2011 to have the chance to serve beyond the remainder of the unexpired term to which you have applied for appointment? Yes No Unsure

Are you now under any charge for any crime excluding traffic offenses and minor misdemeanors? Yes No
If yes please identify

Have you ever as an adult been convicted of any crime excluding traffic offenses and minor misdemeanors that has not been expunged? Yes No
If yes please identify

Has any civil protection order or restraining order or emergency custody order relating to domestic violence or any other subject ever been entered against you? Yes No
If yes please identify

Are your municipal income taxes current Note For the purposes of this question if you are
paying past due taxes under a payment plan approved by the city your taxes are current? Yes No
If no please identify the amount of delinquency and the tax year of any delinquency

Do you have or have you had any personal financial or business interest or dealings that might present a conflict of interest with your appointment as council member? Yes No
If yes please identify

Do you now belong or have you ever belonged to any organization that discriminates on the basis of race, gender, gender identity, or expression sexual orientation, disability, ancestry, or religion through either formal membership requirements or the practical implementation of membership policies? Yes No
If yes please explain

Is there anything in your background that others might perceive as demonstrating bias with respect to race gender gender identity or expression sexual orientation disability ancestry religion marital status or economic status? Yes No
If yes please explain

Identify and describe any other information or situation that others might perceive as a conflict of interest with your proposed appointment or which might cause embarrassment to city council should you be appointed as a council member

BRIEF ESSAY QUESTIONS Please answer in 100 words or fewer

If you had to choose which would you be more inclined to advocate as an approach to addressing the city's budget needs Maintaining current tax levels and seeking ways to cut administrative costs Or increasing taxes in order to continue expand or reinstate city services?

Why?

Which initiatives or city services should be areas of highest priority when determining how to allocate budget dollars?

How might you proceed if you found that you had no support from other members of council or the administration for an initiative you wanted to advance?

What do you see as our city's weaknesses and strengths?

What actions do you believe that council members can or should take to leverage Lakewood strengths?

What other issues or problems would you want to tackle during your service on council? Why and how would you go about pursuing them?

What skill sets do you bring that would benefit our council team for example accounting management, law, others?

What role on council do you envision playing For example if you are familiar with council committees what committee assignments would you work well in?


CERTIFICATION
I certify that all of the answers and statements on this form are true complete and correct to the best ofmy knowledge and recollection and are made in good faith I understand that my responses to this questionnaire have been submitted voluntarily and are not required by law or council mandate I further understand that any information provided in response to this questionnaire may be a public record under Ohio laws

Signature of Applicant
NOTE If you are returning a digital version of this

questionnaire your typewritten name following the
notations above constitutes your written signature