HomeMy WebLinkAbout2020 Candidate Intention Statement Date Stamp .- '
RECEIVE®
Check One: nitial ❑Amendment (Explain) JUL 1620 For Official Use Only
COY CLERKS
1. Candidate Information:
NAME OF CANDIDATE (Last,First Middle 1 itial) DAYTIME TELEPHONE NUMBER FAX NUMBER(optional) EMAIL(optional)
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� �1 �� 1 — C�C�/y/C C/ STATE ZIPyScO�J
OFFICE SOUGHT(POSITION TITL AGENCY NAME TRICT NUMBER,if applicable. NON-PARTISAN OFFICE
ftJ 11 1 DIS PARTY PREFERENCE:
OFFICE JURIS CTION `(Check one box,if applicable.)Pq
❑State (Complete Part 2.) 7 �\ .PRIMARY/GENERAL
ity County ❑ Multi-County: (Name of Multi-County Jurisdiction) (Year of Election) /LJ SPECIAL/RUNOFF
2. State Candidate Expenditure Limit Statement:
(Ca1PERS and Ca1STRS 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:
Q 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, 1 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 Stat rn a is true and correct.
Executed on O� ( � 2 Za Signature
(month,day,year) (Candidate) FPPC Form 501 (August/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov