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_ _ <br /> Candidate Intention TypeorPrintinlnk. CANDIDATE INTENTION <br /> ' 1 <br /> CheCk One: � Initlal ❑ Amentlment ❑ Termination • • � <br /> I Candidate Information ���eUw�^�y <br /> FULL YE OF CANOIMTE (u6T,FIRST,MIDDLE) � <br /> � �� . <br /> ADDRESS (NO.AND STRE � DAYTIME PHONE � <br /> ' �� ( <br /> <br /> — � � <br /> II Office Sought <br /> OFFICE SOUONT(i051T10NTITLE) DISTRICT NUMBEP PAPTY II pic�ck) VEAR OF qELECTON <br /> \ <br /> PUBLIC AGEN Y NAME TYPE OF ELECTION 5 ��� �g�I <br /> C �y � (Chect One 0 ApphcaUle) ❑ P ❑ <br /> JURISDICTI OF ELECTIVE O FICE SOUGHT(CNCk On� <br /> ❑ Sute ❑ Counyof <br /> ❑ Multl-CouMy �Ciy of ��y� <br /> iil VerificaYion <br /> I cer�ily utWer penally of pet�ury under ihe laws of Ne State of Californie thet ihe fo/re9/o,ing is true and correct. /1 � <br /> ExacNetlon (n -- �/7 �' �9 _ ey `7f1.� , ln/���1// j/ C, S� <br /> � on —l�•3 swn � FcrwoiwTe <br /> FOflMORE1NFORMATIONREWIREDTOBEPROVIDE0TOY0UPUR5UANTTOTHEINFORMATIONPRACTICESACTOFIB"!].SEEI FOR TO O Oc pF <br /> n ocn1 vo ri oa nrr. FPPC Fo�m 501 (2/9B) <br /> ForTSehnical A�sl�taner 976/322•5660 <br /> Return Address of Filer I I (I P�� <br /> First Class <br /> Postage <br /> Here <br /> ^� ... _. � <br /> i _ ` :.1 / J <br /> � . , i <br /> Secretary of State <br /> Political Reform Division <br /> 1500 11 th Street <br /> P.O. Box 1467 <br /> Sacramento, CA 95812-1467 <br /> II�I„�I�I�I��I����II��I�I�,�II�I��I,II��1���1�11��1���1�1��11 <br />