HomeMy WebLinkAbout2020 Candidate Intention Statement REDate Stamp gi I CEIVE® •�. .
Check One: itial ❑ JUN 2 5 Amendment (Explain) 202ff For Official Use Only
�17Y CLERKS DEPT.
1. Candidate Information:
NAME OF CANDIDATE (Last,First Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER(optional) EMAIL(optional)
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STREETADDRESS CITY STATE ZIP CODE
OFFICE SOUGHT(POSITION TITLE) NAME
XENCYDISTRICT NUMBER,if applicable. N-PARTISAN OFFICE
C% i SL"C1 J s PARTY PREFERENCE:
OFFIC RISDICTION
(Check one box,if applicable.)
❑State (Complete Part 2.) RIMARY/GENERAL
Cit Count Multi-County: �C� vl t _ ,�
u y ❑ y ❑ (Name of Multi-County Jurisdiction) (Year of Election) SPECIAL/RUNOFF
2. State Candidate Expenditure Limit Statement:
(CalPERS and CaISTRS candidates,judges,judicial candidates,and candidates for local offices do not complete Part 2.)
zbox)
accept the voluntary expenditure ceiling for the election stated above.
❑I do not accept the voluntary expenditure ceiling for the election stated above.
Amendment:
p 1 did not exceed the expenditure ceiling in the primary or special election held on / / and I accept the voluntary expenditure
ceiling for the general or special run-off election.
(Mark if applicable)
❑ On, _/� I contributed personal funds in excess of the expenditure ceiling for the election stated above.
3. Verification:
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on CJ/�"S/J-Q Signature
month,day,year) (Candidate)
FPPC Form 501 (August/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov