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C DIDATE INTENTION STATEMENT <br /> Candidate Intention Statement Type or Print in Ink. , . , ( <br /> • - <br /> � - A U G 2 4 2 015 For Official Use Only <br /> Check One: ❑ Initial Amendment t�a�ei�> �` ti � <br /> �� C TY OF RED1tVOOD CITY <br /> � CITY CLERK <br /> / <br /> 1. Candidate Information: <br /> NAME OF CANDIDATE (Lest Flrst,Middle InlNaq DAYTIME TEIEPHONE NUMBER FAX NUMBER(opNonaq E-MAIL(opNonal) <br /> �rl c.�a e. c(� 20�Fl/-3� c > �c����".hor ���s- Cr'c��,��.5��fC t <br /> STREET ADDRESS CITY 3TATE ZIP CODE <br /> �'�� C' � �' �l G�� <br /> OFFICE SOUG (POSITION T1TLE) AGENCY NAME DISTRICT NUMBER,il epplkaWe. NON-PARTISAN <br /> C \ �4 C_ ` �C l�� � � �\ PARTY: <br /> OFFICE JURIS ICTION <br /> �Stat@ (Complete Pert 2.) � <br /> `[�ity ❑ County ❑ Multi-County: {'�`-Y��� �l� " �I� <br /> (NemeofMuMi-CounryJun ' 'on) (Yearo/Eledlon) <br /> 2. State Candidate Expenditure Limit Statement: <br /> (Ca/PERS candidates,judges,Judicial candidates, and candidates for/oca/ot/'ices ere not requlred to compfete Part 2.) <br /> Prlmary/genera/ e/ectfon Speclal/runoff electlon <br /> (Yearo/Election) (Yearo/ElecNon) <br /> (Check one box) <br /> ❑I accept the voluntary expenditure ceiling for the election stated above. <br /> ❑I do not accept the voluntary�expenditure ceiling for the election stated above. <br /> Amendment: <br /> Q i did not exceed the expenditure ceiling in the primary or special election held on:�_� and I accept the voluntary expenditure ceiling for the <br /> general or special run-off election. <br /> ..... <br /> (MaMc 11 appltcable) <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 th foregoing is true nd co ct. <br /> � <br /> Executed on �� °���� ���S, Signature � � <br /> (month,day,yea� (Can da <br /> FPPC Form 501(January105) <br /> FPPC Toll-Free Helpline:866/ASK-FPPC(866/275,3772) <br />