HomeMy WebLinkAboutPOWELL 501 INITIAL 02/20/13Candidate Intention Statement
Check One: Initial ❑Amendment (Explain)
OF CAN 7 DATE
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formation:
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Type or Print in Ink.
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DAYTIME TELEPHONE NUMBER FAX NUMBER (optional)
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STATEMENT
� 3 FEB 21 AM 10: 58 I
nAKER iLt .0 :I 'i CLERK
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STREET ADDRE S CITY s IAl t cIF wut r
OF E SOUGHT (POSITION TITLE) AGENCY NAME DISTRICT NUMBER, I applicable NON- PARTISAN
FI vI a I &k / � t /"t /`"� `nP�vL PARTY:
OFFICE JU ISDICTION
❑ State (Complete Part 2.)
'5d,Clty ❑ County ❑ Multi-County: (Name of Multi- County Jurisdiction) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(CalPERS and CaISTRS 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)
❑ 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 ' Signature
(ro nth, day, year) (Candidate) FPPC Form 501 (April /2011)
FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772)