501 Candidate Intention Statement - Initial for 2018'p _c63wuv
SEP - s2017
CUPERTINO CITY CLERK I
Candidate Intention Statement
Check One:Initial ❑Amendment (Explaln)
NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E-MAIL (otion
pal)
Tqr S V G' Qi f Y �� 1'1 ttiY ( ( )
STREET ADDRESS CITY STATE ZIP CODE
CA 95014
... ,—'.—......... ��� .,..��.... ......�� lu,oinn. rvumocrt, neppnmoie. ®NON-PARTISAN
City Council PARTY:
❑ State (Complete Pad 2.)
® Ci ❑ County ❑ Multi -County: City of Cupertino 2018
City tY tY (Name of Mutii-County Judadidon) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(CeIPERS and CaISTRS candidates, judges, Judicial candidates, and candidates for local offices do not complete Part 2.)
(Year of Electlon)
Primary/general election (Year or Election) Speciallrunoff election
(Check one bax)
❑ I accept the voluntary expenditure ceiling for the election stated above.
❑ I do not accept the voluntary expenditure calling for the election stated above.
Amendment:
O 1 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 H appOcabk)
❑ On —J_l—, 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
advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov