HomeMy WebLinkAboutTITUS 501 INITIAL 7/24/14Candidate Intention Statement
Check One: &itial ❑Amendment (Explain)
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CANDIDATE INTENTION
1. Candidate Information:
NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E -MAIL (optional)
CITY
❑ State (Complete Part 2.) &Loi r j
,�Ity ❑ County ❑ Multi- County: —�-- e� w ' �a (•offf Multi- County Jurisdiction) WAar of E ction)
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 (Year of Election)
/general 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: I and I accept the voluntary expenditure ceiling for
the general or special run-off election.
(Mark if applicable)
❑ On I I contributed personal funds in excess of the expenditure ceiling for the election stated above.
3. Verification:
I certify under p-e� /n/Jalltty` /off /f /perjury under the laws of the State of California that the foregoing is true and correct.
Executed on Signature - — --
(month, day, year) (Candidate)
FPPC Form 501 (Apri1/2011)
r FPPC Toll -Free Helpline: 866 /ASK -FPPC (8661275 -3772)