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501 Gardner (08-03-09) Amendment R
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Candidate Intention Statement <br />Type or Print in Ink. <br />Check One: Initial to redesignate bank account for <br />❑ ❑x Amendment (Explain) <br />2011 election <br />CANDI <br />- <br />t <br />AUG 0 3 2009 For Official Use Only <br />1. Candidate Information: <br />NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER E -MAIL (optional) <br />Gardner, Mike <br />STREET ADDRESS CITY ZIP CODE <br />Riverside CA <br />OFFICE SOUGHT (POSITION TITLE) AGENCY NAME DISTRICT NUMBER, i /applicable. ® NON - PARTISAN <br />Riverside City Council City of Riverside - City Clerk 1 PARTY: <br />OFFICE JURISDICTION <br />❑ State (Complete Part 2.) <br />® City ❑ County ❑ Multi- County: 2011 <br />(Name orMutti- County Jurisdiction) (Year of Election) <br />2. State Candidate Expenditure Limit Statement: <br />(Ca1PERS candidates, judges, judicial candidates, and candidates for local offices are not required to complete Part 2.) <br />Primary/general election Special /runoff election <br />(Yearn /Election) (Year of Election) <br />(Check one box) <br />❑ I accept the voluntary expenditure ceiling for the election stated above. <br />❑ I do not accept the voluntary expenditure ceiling for the election stated above. <br />Amendment: <br />Q 1 did not exceed the expenditure ceiling in the primary or special election held on: —J —� <br />general or special run -off election. <br />and I accept the voluntary expenditure ceiling for the <br />(Mark if applicable) <br />❑ On I , I contributed personal funds in excess of the expenditure ceiling for the election stated above. <br />3. Verification: <br />I certify under penalty of perjury under the laws of the State of California that correct. <br />Executed on . � - )*—o � Signature <br />(month, day, year) <br />FPPC Form 501 (January/05) <br />FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) <br />
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