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501 Rubio CC W3 (01-23-19)_R
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5/22/2019 3:46:00 PM
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Candidate Intention Statement <br />Check One: tlinitial ❑ Amendment (Explain) <br />1. Candidate Information: <br />NAME OF CANDIDATE (Last. First Middle Initial) <br />STREET ADDRESS <br />Date Stamp <br />. <br />CEIVE <br />JAN 2 3 2019 <br />City of Riverside <br />City uterk's oe <br />CALIFORNIA 50 <br />FORM <br />For Official Use Only <br />DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) EMAIL o tional <br />CITY STATE ZIP CODE <br />alp - <br />f Rl, JEEibC <br />OFFICE SOUGHT (POSITION TITLE) <br />esry <br />i;�uct <br />AGENCY NAME <br />atTy OF Vii✓eeSi.AE <br />!DISTRICT NUMBER, if applicable. <br />3 <br />ON -PARTISAN OFFICE <br />PARTY PREFERENCE: <br />OFFICE JURISDICTION <br />❑ State (Complete Part 2.) <br />City ❑ County ❑ Multi -County: <br />Aolq <br />(Name of Multi -County Jurisdiction) (Year of Election) <br />(Check one box, if applicable.) <br />RIMARY / GENERAL <br />0 SPECIAL / RUNOFF <br />2. State Candidate Expenditure Limit Statement: <br />(Ca/PERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.) <br />(Check one box) <br />❑ I accept the voluntary expenditure ceiling for the election stated above. <br />❑ 1 do not accept the voluntary expenditure ceiling for the election stated above. <br />Amendment: <br />Q 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 />(Mat* if applicable) <br />❑ 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 that the foregoing Is true and correct. <br />Executed on <br />z3/ aorq Signature <br />(month, day, year) <br />(Candidata) <br />FPPC Form 501 (August/2018) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />
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