501
Check One: ~Initial
o Amendment (Explain)
Date Stamp
Candidate Intention Statement
Type or Print In Ink.
LOOZ t l AV~
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1. Candidate Information:
NAME OF CANDIDATE (Last, First, Middfe initial)
DAYTIME TELEPHONE NUMBER
(~~ ~ -y \\..\ ~
CITY
FAX NUMBER (optional) E-MAIL (optional)
(~~"7-l\b OJ-~r V\~lA.O--\a.\I\\S ~ CJ=,~.",~-
STATE ZIP CODE
N \~ A~.,J' 1'-1\ fl\ '"""' es.. H
STREET ADDRESS
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OFFICE SOUGHT (POSITION TITLE)
C ,,-y u.~ 12n-L
OFFICE JURISDICTION
o State (Complete Part 2.)
Q'City 0 County 0 Multi-County:
c.uP€~ ~
VA qyt:)\
DISTRICT NUMBER. if appticable. 0 NON-PARTISAN
PARTY:
\.- 'y. 0 t=- eM. 1'1 ~ 1"\ t'V ~
(Name of MuHi-Counly Jurisdiction)
:20 c -:r
(Year of Election)
2. State Candidate Expenditure limit Statement:
(CaIPERS candidates. jvdges. judicial candidates. and candidates for local offices are not required to complete Part 2.)
Primary/general election
(Year of Election)
SpeclaUrunoff election
(Year of Election)
~~ ~y~, ~ :07~ ~
(C~ne box) .
Efl accept the voluntary expenditure ceiling for the election stated above.
CUPERTINO CITY CLERK
o I do not accept the voluntary expenditure ceiling for the election stated above.
Amendment:
o I 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)
o On ~~_, 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 th
Executed on ~ S- ',I I Signature
(/TK)n~ ye"; ~
FPPC Form 501 (January/OS)
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