HomeMy WebLinkAbout501 - 08/01/2022_ Redacted (SC)Candidate Intention Statement
Check One: Initial ❑ Amendment (Explain)
1. Candidate Information:
Date Stamp
RECEIVE
AUG 1 2 22
CrrY OF ARCAD{A
Ci CLERK
For Official Use Only
NAME OF CANDIDATE (Last, First Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) EAIL (optional)
STREETADDRESS CITY STATE ZIP CODE
OFFICE SOUGHT (POSITION TITLE) AGENCY NAME IDISTRICT NUMBER, if applicable. I FkNO N-PARTI SAN OFFICE
U41) GotkAa
OFFICE JURISDICTION
❑ State (Complete Part 2.)
9City ❑ County ❑ Multi -County: (Name of Multi -County Jurisdiction)
2. State Candidate Expenditure Limit Statement:
(CalPERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
(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.
P
PARTY PREFERENCE:
(Check one box, if applicable.)
❑ PRIMARY I GENERAL
2-
(Year of Election) ii SPECIAL/ RUNOFF
Amendment:
Q 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 / 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 "`/ 2`i l ZD _ —) Signature f .
(month, day, year) (Candidate) FPPC Form 501 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov