HomeMy WebLinkAboutDHINDSA 501 8/8/14CANDIDATE
Candidate Intention Statement Type or Print in Ink. Date Stamp .. i
CALIFNIA '
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For Official Use Only
Check One: 09Initial ❑Amendment (Explain) Z 114 AUG -8 AM 8' 4
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1. Candidate Information:
NAME OF CANDIDATE (Last, Fir t, Middle Initial) DAYTIME TELEPHONE NUMBER FA &N R.WpwnaU -. r AA(1;. (optional)
nduo. S (& c
STREET ADDRESS CITY STATE ZIP CODE
OFFICE 7
SOUGHT (POSITION TITLE AGENCY 7 Y NAME DISTRICT NUMBER, if applicable. K NON- PARTISAN
( ."JI (Y A A r II An. A Ct , to �JA:�FSST(t ! PARTY:
❑ State (Complete Part 2.)
NCity ❑ County ❑ Multi-County: (Name of Multi -County Jurisdiction) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(CalPERS and CalSTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
(Year of Election Primary/general election (Year of Election) Special /runoff election
)
(Check one box)
❑ 1 accept the voluntary expenditure ceiling for the election stated above.
litI do not accept the voluntary expenditure ceiling for the election st above.
Amendment:
0 1 did not exceed the expenditure ceilin a primary or special election held on: 1.�.
the general or special run -off e i n.
(Mark if applicable)
and I accept the voluntary expenditure ceiling for
❑ 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 o I g I I 'l ` c
Signature I `�
(month, day, year) (Candidate) FPPC Form 501 (April/2011)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)