HomeMy WebLinkAboutHANSON 501 00 andidate Intention Statement
Check One: ~lnitial [] Amendment
Type or Print in ink,
CANDIDATE INTENTION
1. Candidate Information
FULL NAME OF CANDIDATE (LAST, FIRST, MIDDLE)
ADDRESS iNC. AND STREET)
2. Office Sought
STATE
OFFICE SOUGHT (POSITION TITLe)
PUBLIC A~ENCY NAME '
ZIP CODE
DAYfiME PHONE
FAX E-MAIL (OPTIONAL)
DISTRICT NUMEiER I~O I
N-PARTISAN YEAR OF ELECTION
~ ' i I PA"TY= I ~'~LO 0 0
JURISOICTION OF I~ECTIVE (JFFIcE~)UGHT ~heck One)
TYPE OF ELECTION (Check One if Applicable)
[] Special [] Recall
r~ STATE [] COUNTY O~
3. Verification
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executedon ~!r~'~ ~0 By ~ L. ~
FPPC Form 501 (8/99)
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