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CANDIDATE INTENTION STATEMENT <br />Candidate Intention Statement Type or Print in Ink. t am v _ me ® r <br />Check One: ❑ Initial <br />❑X Amendment (Explain) Amending the form to update the <br />election year to 2015 <br />i' <br />For Official Use Only <br />1. Candidate Information: <br />NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E -MAIL (optional) <br />Soubirous, Michael P. <br />STREET ADDRESS CITY STATE ZIP CODE <br />Riverside CA _ <br />OFFICE SOUGHT (POSITION TITLE) AGENCY NAME DISTRICT NUMBER, if applicable. Q NON - PARTISAN <br />City Councilman City of Riverside Ward 3 PARTY: <br />OFFICE JURISDICTION <br />❑ State (Complete Part 2.) <br />2015 <br />® City ❑ County El Multi-County: (Name of Multi- County Jurisdiction) (Year of Election) <br />2. State Candidate Expenditure Limit Statement: <br />(CalPERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.) <br />(Year of Election) <br />Primary /general election (year of Election) Special /runoff election <br />(Check one box) <br />17-11 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 />O 1 did not exceed the expenditure ceiling in the primary or special election held on: I and I accept the voluntary expenditure ceiling for <br />the general or special run -off election. <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 pperjury under the laws of the State rect. <br />Executed on 7-30-14 Signature <br />(month, day, year) <br />FPPC Form 501 (April/2011) <br />FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) <br />