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Candidate Intention Statement Type or Print in Ink. Date Stamp <br />RECEIVED <br />Check One: 0 Initial E] Amendment (Explain) JAN 3 0 2013 <br />City of Riverside <br />Ci ' <br />1- Candidate Information: <br />NAME OF CANDIDATE (last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER foptionan F-MAII Mr <br />Soubirous, Michael P. <br />STREET ADDRESS CITY STATE ZIP CODE <br />Riverside CA <br />City Council Member City of Riverside I Ward 3 I PARTY: <br />OFFICE JURISDICTION <br />M State (Complete Part 2.) <br />0 City County [] Multi- County: City of Riverside 2013 <br />(Name of uns lc on ear of echon <br />2. State Candidate Expenditure Limit Statement: <br />(CalPERS candidates, judges, judicial candidates, and candidates for local offices are not required to complete Part 2.) <br />Primary /general election SpeciaUrunoff election <br />ear of Eection) ear of Election) <br />(Check one box) <br />n I accept the voluntary expenditure ceiling for the election stated above. <br />[DATE INTENTION STATEMENT <br />Use <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: and I accept the voluntary expenditure ceiling for <br />the general or special run -off election. <br />(Mark if applicable) <br />M On �_� 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 <br />Executed on l — "20 3 Signatur <br />(month, day, year) <br />FPPC Form 501 (Jan/03) <br />FPPC Toll -Free Helpline: 866/ASK -FPPC <br />866/275 -3772 <br />