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Candidate Intention Statement <br />Check One: Initial ❑Amendment (Explain) <br />1. Candidate Information: <br />FEB 01 2019 <br />City of Riverside <br />City Clerk's Office <br />NAME OF CANDIDATE (Last, First Middle Initial) <br />a,Keq STREET ADDRESS DAYTI T FAX NUMBER (optional) <br />> EMAIL (optional) <br />9e of cS ( j.S2 g <br />OFFIC <br />�E <br />S GHGHT ((PO TITLE)))�/� AGENCY NAME <br />OF`f�E JURISDIC o 1 Keb f di(3°F <br />"' `� 1 <br />❑ State (Complete Part 2.) <br />0 County ❑ Multi -County: <br />C <br />For Official Use Only <br />DISTRICT NUMBER, if applicable. ARTISAN OFFICE <br />PARTY PREFERENCE: <br />(Check one box, if applicable.) <br />(Name of Multi -County Jurisdiction) (Year of Eltion) <br />IMARY/GENERAL <br />El 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 />❑ 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. _ /_J and I accept the voluntary expenditure ceiling for <br />the general or special run-off election. <br />(Mark if applicable) <br />0 On / J 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 orrect. <br />Executed on <br />Qi 1 � eJ 1 <br />moot , day, year) <br />Signature <br />FPPC Form 501 (August/2018) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />