HomeMy WebLinkAboutBRAKEBILL 501/502 andidate Intention Type or Print in Ink.
Check One: ~ Ini~al [] Amendment [] TerrpJnaido~
I Candidate Information
FULL N&ME OF CANDIDATE (LAST. FIRST, MIDDLE)
CANDIDATE INTENTION
CALIFORNIA
,998Fo. 501
Office Use Only
ADDRESS (NO AND STREET)
II Office Sought
OFFICE SOUGHT (POS}TION TITLEI
JURiSDiCTiON OF ELECTIVE OFFICE SOUGHT ICheck One}
[] State [] County of
[] MuitJ~'.oiJnty [~ City of
III Verification
I cer6ty under penalty of perjury un~ier the laws of the State of California that the foregoin ig.[~rue an~lp~ect.
PROVI~ONS Of: THE POt IlICAL REFORM ACT
FPPC Form 501 (2/98)
For Technical Assistance: 916/322-6660
Campaign Bank Account Type or Print in Ink. CAMPAIGN BANK ACCT.
Check One: ~li~]niliaJ I-IRedesignatetheAccountforFutureElectiontotheSameOffice CALIFORNIA ~.,~'0p, a1
1998 FORM -
[] Amendment [] Termination (Note: In addition, file a Form 501 if you are no longer
soliciting or receiving contributions.)
Office Use
I Candidate Information
II Account Information
FINANCIAL INS~TU~ON ACCOUNT
Verification
I certify under penalty of perjury under ~he laws of the State of California that the fore~illU is tru~ a~ correct.
Executedon ~ ~//,~,~C' ~/qd~ By ~ ,.~'~
For Technical Assistance: 9161322-6660