501 Candidate Intention Statement Candidate Intention Statement D �� �� q��s�r��l L�' u •. - � �
' � For Official Use Only
Check One: ,D�Initial ❑Amendment (Explain) �uG _ J 2016 �
^ .� -- �
1. Candidate Information: ��'�� � ���U �� � Y L�ERK
NAME OF CANDIDATE (Last,First,Middle Initial)
� � ' � / �� ( )
� CITY � STATE ZIP CODE
�%�S' �i�l i,�,c a-S `��'�- ���� ,�� :�,,.�7 C� c��� � �-
OFFI E�OUGHT(POSITION TITLE) AGENCY NAME � DISTRICT NUMBER,if applicable. pqRTISAN
�� � �� �L(Vt C � I � .� r-�.�— � \ 1 b c a 1'��7 I PARTY:
OFFICE JURISDICTION ' � \ � �
❑ St2Y@ (Complete Part 2.) �_� f �
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�CItY ❑ County ❑ MUItI-COUfItY: (Name of Multi-County Jurisdiction) � (Year of Election)
2. State Candidate Expenditure Limit Statement:
(Ca1PERS and CaISTRS candidates,judges,judicial candidates, and candidates for local o�ces do not complete Part 2.)
Primary/general election Special/runoff elecfion
(Year o/Election) (Year o(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:
� I did not exceed the expenditure ceiling in the primary or special election held on: �� and I accept the voluntary expenditure ceiling for
the general or special run-off election.
(Mark if applicableJ
❑ On —J� , 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
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