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Candidate Intention Statement <br />Check One: puluf Initial <br />1. Candidate Information: <br />0 Amendment (Explain) <br />JUN 0 4 2018 <br />City of Riverside <br />City Clerk's Office <br />For Official Use Only <br />NAME OF CANDIDATE (Last, First, Middle Initial) <br />1'u\ ti 5 e. ar, (-t . <br />STREET A DRESS CITY <br />111.11111111.1 R;VQcs�CQ2 <br />AGENCY NAME <br />DAYTIME TELEPHONE NUMBER <br />FAX NUMBER (optional) E-MAIL (optional) <br />( ) <br />Cc -[-j Co nct <br />OFFICE JURISDICTION <br />❑ State (Complete Part 2.) <br />riel City 0 County 0 Multi -County. <br />Riv2es_i�Q <br />P.r'S t ( P <br />(Name of Multi -County Jurisdiction) <br />STATE <br />C cl, <br />ZIP CODE <br />20 <br />(Year of Election) <br />la NON-PARTISAN <br />PARTY: <br />2. State Candidate Expenditure Limit Statement: <br />(CaIPERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.) <br />Primary/general election <br />(Year of Election) <br />Special/runoff election <br />(Year of Election) <br />(Check one box) <br />0 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 />0 I 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 />0 On -lam 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 St • true and correct. <br />Executed on )1(112-0 18 Signature <br />(monay, year) <br />FPPC Form 501 (Jan/2016) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />