501 Candidate Intention Statement - Initial Candidate Intention Statement Ete�a `9 E CALIFORNIA 501
FORM
Check One: For official Use Only
®Initial ['Amendment (Explain) MAR — 1 2016
CI IWFRTIAIf CITY CI FR<
1. Candidate Information:
NAME OF CANDIDATE (Last,First,Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER(optional) E-MAIL(optional)
Fung, David A ( ( )
STREET ADDRESS CITY STATE ZIP CODE
Cupertino CA 95015
OFFICE SOUGHT(POSITION TITLE) AGENCY NAME DISTRICT NUMBER,i(applicable. Q NON-PARTISAN
City Council Member City of Cupertino PARTY:
OFFICE JURISDICTION
0 State (Complete Part 2.)
4 City 0 County 0 Multi-County: (Name of Multi-County.mnsdicton) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(CaIPERS and Ca1STRS 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:
0 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 applicable)
❑ On , 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
FPPC Form 501 (Jan/2016)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov