501 Amendment
ij)E
or Print In Ink.
~pe
Candidate Intention Statement
I
For 01IIcI0I Uoo On~
L_.
PEATINO CITY CLER
00 Amendment (Explain)
change in e-mail address
Initial
o
Check One:
E-MAIL (optional)
orrin_for _ counciI@comcast.net
ZIP CODE
FAX NUMBER (optIonaIJ
DAYTIME TELEPHONE NUMBER
L
CITY
1. Candidate Information:
NAME OF CANDIDATE (Lut, Am, Middle InitIIII)
Mahoney, Orrin
STREET ADDRESS
o NON-PARTISAN
PARTY:
STATE
DISTRICT NUMBER, If appbbIe,
AGENCY NAME
OFFICE SOUGHT (POSITION TITLE)
2..
o County
"'"
OFFICE JURISDICTION
o Stete (0-
o City
(YNr of EIIIctIon)
(NameofItfulØ..COUIIf)'JutIadicIJøn)
2. State Candidate Expenditure Limit Statement:
(CelÆRS CMdidates, jud(Jes, judlcieJ candidatN, and cancldatea for local otfIces at8 not required to complete Part 2.)
o Multi-County:
_ SpeclaVrunoff o/ectJon
(YeerofE/ectJon)
PrllrHJtylgenefB/ election
(Y..rolElectlon)
(Check one box)
1111 accept
o
eccept the voluntary expenditure ceiling for the
and
----1----1_
voluntary expenditure ceiling for the
do not accept the voluntary expenditure ceiling for
Amendment:
o I did not exceed the expenditure ceiling in the primary or special election held on:
general or special run-off election.
above.
above.
the election stated
election etated
the
(MarlfIf.ppNcebltt)
o On ----1----1_,
above.
of the expenditure ceiling for the election stated
in excess
contributed personal funds
correct.
FPPC Form 501 (JanuarylO¡
FPPC Toll-Free Helpllno: 868/ASK-FPPC (8881276C3772
Verification
certify under penally
3.
of California
the Stale
of
the laws
perjury under
9/28/05
(month, day. yea"
of
IB¡
Signature
on
Executed