HomeMy WebLinkAbout2020 Candidate Intention Statement Date Stamp •- '
RECEIVED •-
Check One: 0/initial ❑Amendment (Explain) JUL 16 20 For Official Use Only
ITY CLERKS DEFT
1. Candidate Information:
NAME OF CANDIDATE (Last,First Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER(o tional) EMAIL(optional)
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STREETADDRESS CITY STATE P CODE
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OFFICE SOUGHT(POSITION TITLE) AGENCY NAME DISTRICT NUMBER,if applicable. NON-PARTISAN OFFICE
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OFFICE JURISDICTION (Check one box,if applicable.)
❑State (Complete Pan 2.) �^n ^ T PRIMARY/GENERAL
City ❑County ❑ Multi-County: (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.)
(Check one box)
❑I accept the voluntary expenditure ceiling for the election stated above.
❑I do not accept the voluntary expenditure ceiling for the election stated above.
Amendment:
O 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 7/ 16 O/( 2 O Signature
(montf,day,year) (Candidate)
FPPC Form 501 (August/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov