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501Candidate Intention Statement - Initial
Candidate Intention Statement Check One: ©Initial ❑Amendment (Explain) M3_10 910Z V Z 83J 1. Candidate Information. NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E -MAIL (optional) Parth Bharwad ( ( STREET ADDRESS CITY STATE ZIP CODE Cupertino CA 95014 OFFICE SOUGHT (POSITION TITLE) AGENCY NAME DISTRICT NUMBER, if applicable. Q NON- PARTISAN City Council Member City of Cupertino PA PTV. OFFICE JURISDICTION ❑ State (Complete Pan 2.) ® City El County ❑ Multi-County: 2016 (Name of Multi- County Junsdiction) (Year of Election) 2. State Candidate Expenditure Limit Statement: (Ca/PERS and Ca/STRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.) Primary/general election Special /runoff election (Year of Election) (Year of Election) (Check one box) ❑ I accept the voluntary expenditure ceiling for the election stated above. ❑ I do not accept the voluntary expenditure ceiling for the election stated above. Amendment: O 1 did not exceed the expenditure ceiling in the primary or special election held on: —JJ and I accept the voluntary expenditure ceiling for the general or special run -off election. (Mark if applicable) ❑ On JI I contributed personal funds in excess of the expenditure ceiling for the election stated above. 3. Verification: I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on 02/23/2016 Signature (month, day, year) ( FPPC Form 501 (Jan /2016) FPPC Advice: advice @fppc.ca.gov (866/275 -3772) www.fppc.ca.gov