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C <br />Can"idate Intention Statement <br />Check One: Xinitial ❑Amendment (Exptam) <br />1. Candidate Information: <br />NAME OF CANDIDATE (Last. Fest. Middle bnoap <br />KFU <br /> <br />❑ State (template Part 2 ) <br />)$City ❑ County ❑ Multi -County: <br />DAYTIME TELEPHONE NUMBER <br />CITY <br />������^nn <br />A� 1N1 1 A1vf� J <br />(Name of Multi -County Jurisdiction) <br />2. State Candidate Expenditure Limit Statement: <br />(CaIPERS and Ca/STRS candidates, judges, )utlmtal candidates, and candidates for local offices, do not complete Pad 2 ) <br />(Year o/ Primary/general election (Year ofEleckonf Special/runoff election <br />Elacben) <br />(Check one box) <br />❑ I accept the voluntary expenditure ceiling for the election stated above. <br />RFr.FIVFn <br />Date Stamp <br />JAN 17 2010 <br />City of Reawooa City <br />City Clerk <br />FAX NUMBER (.puma) E-MAIL (optsnap <br />c > —D)A[�F <br />Je7D9o'7 � t� <br />m)�, <br />STATE Llp �ijb <br />DISTRICT NUMBER, dapp sable_ <br />NONPARTISAN <br />PARTY. <br />jYer of elect.) <br />❑ I do not accept the voluntary expenditure ceiling for the election stated above. <br />Amendment: <br />O 1 did not exceed the expenditure telling in the primary or special election held on. __JJ_ and I accept the voluntary expenditure ceiling for <br />the general or special run-off election. <br />(Mark if applicable) <br />❑ On —J�I contributed personal funds in excess of the expenditure ceiling for the election stated above. <br />3. Verification: <br />I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. <br />Executed on 'go /k Signature �/�tiC�.C_eF�l� <br />(month. day. year) (Candesco --' '-- FPPC Form 501 (Jan/2016) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />