HomeMy WebLinkAboutSALAS 501 8/1/11Candidate Intention Statement
Check One: 0Initial ❑Amendment (Explain)
1.
NAME OF CANDIDATE (Last, First, Middle Initial)
Type or Print in Ink.
Date Stamp
CANDIDATE
11 AUG - I FM 11: 35
DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E-MAIL
Jib FRICT NUMBER, if applicable. IPARTY:
O NON-PARTISAN
Ward 1 ® City ❑ County Kern County 2014
❑ Multi-County:
(Name of Mu1G-County Jixisdiction) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(Ca/PERS and C&ISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
(Year of Election) Primary/general election Special/runoff election
(Year of ' n)
(Check one box)
❑ 1 accept the voluntary expenditure ceiling for the election stated above.
10 1 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.
I Verification:
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on 7' ~8~ l I
Signature
(month, day, yeah (a»ddate)
FPPC Form 601 (AprIU2011)
FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772)