501 Avery CC W3 (02-05-19) Initial_R

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Candidate Intention Statement Check One: 1B -initial ['Amendment (Explain) 1. Candidate Information: NAME OF CANDIDATE (Last First Middle Initial) v ►2 -r J A M � tit) 1Z42- •S EE ADDRESS ITY DAYTIME TELEPHONE NUMBER OFFICE SOUGHT (POSITION TITLE) CITY C(7UNcl� OFFICE JURISDICTION ❑ State (Complete Part 2 ) [I -City 0 County 0 Multi -County: AGENCY NAME rat vE17—S10- AGENCY 7—S10- C- 1-r'r c F 12 V pa. s. t O E (Name of Multi -County Jurisdiction) 2. State Candidate Expenditure Limit Statement: (CaIPERS and CaISTRS candidates, judges, judicial candidates. and candidates for local offices do not complete Part 2.) (Check one box) ❑ I accept the voluntary expenditure ceiling for the election stated above. ❑ I do not accept the voluntary expenditure ceiling for the election stated above. Amendment: Q 1 did not exceed the expenditure ceiling in the primary or special election held on. the general or special run-off election. REGEBLED- i:EB 0 5 2019 Cfry of Riverside Ci y Clerk's office FAX NUMBER (optional) STATE CALIFORNIA 501 FORM �j EMAIL (optional) ZIP CODE For Official Use Only Crk DISTRICT NUMBER, if applicable. .NON-PARTISAN OFFICE bii lq- R-0 4 I PARTY PREFERENCE: (Check one box, if applicable.) 20 1 Cr (Year of Election) PRIMARY / GENERAL SPECIAL/ RUNOFF _/_/_ and I accept the voluntary expenditure ceiling for 'Mark if applicable) 0 On / / I contributed personal funds in excess of the expenditure ceiling for the election stated above. 3. Verification: I certify under penalty of perjury under the laws of the State of California that the foregoing is tru .. nd correct. Executed on Z / S /� Signatu (month, day yeah FPPC Form 501 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov