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CANDIDATE INTENTION STATEMENT <br /> , Candidate Intention Statement Type or Print in Ink. �- . ' <br /> �E����� .- <br /> Check One: [��nitial ❑Amendment (Explain) For Officiaf Use Oniy <br /> MAR 2 9 2013 <br /> 1. Candidate Information: <br /> CITY CLERK <br /> NAME OF CANDIDATE (Last.First.Mlddle Initlal) DAYTIME TELEPHONE NUMBER <br /> S' c l�.,.-, ; d��- . � �-,-� � �-. t ) <br /> STREET ADDRESS CITY STATE ZIP CODE <br /> ¢. 2 edt,�tsact L �-r-�l C � Q o � Z <br /> OFFICE SOUGHT(POSITION TITLE) AGENCY NAME DISTRiCT NUMBER, if applicable. �NON-PARTISAN <br /> C U' U✓1 '�-` � I IY�Q iM�'J Q i � �i� � �IZ.CCI(„9L"L� C 1T PARTY: <br /> OFFICE JURISDICTION <br /> ❑$tat8 (Comp�ete Part 2J <br /> .Z � �3 <br /> � C.Ity ❑ COUfIt}� ❑ MUItI-COUllty: (Name of Mu�U-County Jurisdictionj (Year of Election) <br /> 2. State Candidate Expenditure Limit Statement: <br /> (CaIPERS and CaISTRS candidates,judges,judicial candidates, and candidates(or local ofhces do not complete Part 2.J <br /> Primary/general election Specia!/runoff election <br /> (Year of E/edion) (Year o/Election) <br /> (Check one bozJ <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 /> � I did not exceed the expenditure ceiling in the primary or special election held on: _—/_� and I accept the voluntary expenditure ceiling for <br /> the general or special run-off election. <br /> (Mark i(appfice6leJ <br /> ❑ On ___.J__/ , I contributed personal funds in excess of the expenditure ceiling for the etection stated above. <br /> 3. Veri�cation: <br /> I certify under penalty of perjury under the laws of the State of California thai the foregoing is true and correct. <br /> Executed on ��a�C�'` 2� r �Za�3 , Si nature r �� <br /> 9 <br /> (month,day,yearJ (Candidate) <br /> FPPC Form 501 (April/2011) <br /> FPPC Toll-Free Helpline:866lASK-FPPC(866/275-3772) <br />