501 Candidate Intention Statement - Initial for 2018Candidate Intention Statement
Check One: 59 initial
1. Candidate
[]Amendment (Explain)
MAY 3 1 2018
M,
NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optionai) E-MAIL (optio")
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STREET ADDRESS CITY STATE Z)P CODE
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=FICE JURISDICTION
❑ State (Gomplete Part 2.)
V1 City ❑ County
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CV �QY Vm0 JO�K
❑ Multi -County: (Name of Multi -County Jurisdiction) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(CalPERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
Primary/general election-Special/runofif election
(Year of Election) (Year of Elecn'on)
PARTY:
(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.
Amendment:
0 1 did not exceed the expenditure ceiling in the primary or special election held on: I and I accept the voluntary expenditure ceiling for
the general or special run-off election.
(Mark if appficabfe)
❑ On 1 1. 1 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
FPPC Advice: advlce@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov