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Candidate Intention Statement <br />Check One: �nibal <br />1. Candidate Information: <br />NAME OF CANDIDATE (Last, First Middle Inhal) <br />121 <br />Amendment (Explain) /le Clee //✓� ZOTl� <br />Gu/r G� / ZCiZCJ <br />DAYTIME TELEPHONE NUMBER <br />RECEIVED <br />SEP 1 9 2019 <br />City Cleric <br />Official Use Only <br />Borgens, Janet B. ( ( <br />STREETADDRESS CITY STATE ZIPCODE <br /> <br />Redwood <br />Ca 94063 <br />❑ State (Complete Pan 2) <br />2020 FxJ PRIMARY/ GENERAL <br />®City ❑ County ❑ Multi -County: - (Name of Multi -County Jurisdiction) (rear of Election) ❑ SPECIAL/ RUNOFF <br />2. State Candidate Expenditure Limit Statement: <br />(CaIPERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2) <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 />O 1 did not exceed the expenditure ceiling in the primary or special election held on: <br />the general or special run-off election. <br />and I accept the voluntary expenditure ceiling for <br />(Markdapplicable) <br />❑ On _/_/ 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 C ' ornia that the foregoing is trueandcorrect. <br />Executed on Sept. 04, 2019 Signature ;) 2/� "'� <br />(month, day, year) (Candidate) FPPC Form 501 (August/2018( <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />