HomeMy WebLinkAbout2017 Candidate Intention Statement EDE CALIFORNIA
ORM 501
MAR 3 0 2W F
Check One: AvoeJa�6 Fran. oFAt( For Official Use Only
Initial mendment (Explain)
CITY CLERKS DEP .
1. Candidate Information:
NAME OF CANDIDATE (Last,First.Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER(optional) E-MAIL(optional)
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STREET ( ) fYllrhaPln�cfRy('KPf ('nYCowt l(d
ADDRESS ( CITY STATE
ZIP CODE
3OIZ Cn E PAV)CA T&-mr-cf_)cA (A l WSS9 Z
OFFICE SOUGHT(POSITION TITLE) AGENCY NAME DISTRICT NUMBER, n applicable. �ON-PARTISAN
C 1-1 7 cour1clt roerrocf T6-MECU t PARTY
OFFICE JURISDICTION
❑State (Complete Pen 2.)
City [I County ❑ Multi-County: ' '��L��� MulwCe�Vn myon) (Year 0 Ele6dion)
2. State Candidate Expenditure Limit Statement:
(CalPERS and Ca1STRS candidates,judges,judicial candidates,and candidates for local offices do not complete Part 2J
(Year of Election) (Year
Primary/general election fEkcGon) Speciallrunotf election
o
(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: J—J and I accept the voluntary expenditure ceiling for
the general or special run-off election.
(Mark i/applicable)
❑ On __JJ , 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 Q 3� y` 9JaOl- Signaturefl
a
(month,day,year) (Candidate) FPPC Form 501 (Jan/2016)
FPPC Advice:advice@fppc.w.gov(866/275-3772)
www.fppc.ca.gov