501
~E C"lETV E
Type or Print in Ink.
Candidate Intention Statement
2005
9
1
JUL
(Explain)
o Amendment
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Check One:
E-MAIL (optional)
FAX NUMBER (optional)
DAYTIME TELEPHONE NUMBER
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ZIP CODE
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i! applicabJe_ IId'I'ifON-PARTISAN
STATE
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DISTRICT NUMBER,
PARTY:
Candidate Information
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\j '{\.,:\-! óì
C::CY NAME
.,\
2m5
(Year of Election)
NAME OF CANDIDATE
1)œ~
STREET ADORE
\0\1:D
OF'
1
(Complete Psrt 2.
(Name oIMuJ j-Q,untyJuris&ction)
Statement:
judiclat candidates, and candidates for local offices 8m not
o Multi-County:
2. State Candidate Expenditure Limit
(CafPERS candidates, judges,
o County
required 10 complete Part 2.)
Special/runoff election
(YearofEleclion)
(C/te{:k one box)
o I accept the voluntary expenditure ceiling for the election stated above.
Primary/general election
(YearolEklclion)
and I accept the voluntary expenditure ceiling for the
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the voluntary expenditure ceiling for the election stated above.
the expenditure ceiling in the primary or special election held on:
special run-off election.
do not accept
Amendment:
o I did not exceed
general or
o
ceiling for the election stated above.
(MaTkifappJir;abla)
---1---1_.
contributed personal funds in excess of the expenditure
On
o
EPPC Form 501 (January/OS)
FPPC TolI·Free Helpline: 866/ASK-FPPC (866/275-3772)
California
Signature
3. Verification
penalty of perjury under the laws of the State of
d\>.1 ~ S"
year)
\')
th, day,
1m
certify under
Executed on