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Candidate Intention Statement <br />Check One: <br />[$Initial 0 Amendment (Explain) <br />1. Candidate Information: <br />Date Stamp <br />RECEIVE <br />FEB 11 2019 <br />City of Riverside <br />1.rIty E:Iei K S umce <br />For Official Use Only <br />NAME OF CANDIDATE {Last, First Middle India!) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) EMAIL (optional) <br />I t. lV4f 3—`500( ( ) <br />STREET D r SSS CITY STATE ZIP CODE <br />/t(/2�lLr _ <br />OFFICE SOUGHT (POSITION�TITITLE) <br />AGE CY NAME + �/J j ,�f�Q�% DISTRI T NUMBER, if applicable�N-PARTISAN OFFICE <br />_` / � L/,o`�iv� L 04 e vi` I / rz �cc '� f �C' I 7 PARTY PREFERENCE: <br />OFFICE JURISDICTION V <br />(Check one box, if applicable.) <br />O State (Complete Part 2) // 9 gpRIMARY / GENERAL <br />(Name of Multi -County Jurisdiction) (YearofElection) <br />pc,City 0 County 0 Multi -County: <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 />(Check one box) <br />❑ I accept the voluntary expenditure ceiling for the election stated above. <br />12 SPECIAL / RUNOFF <br />❑ I 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 />i Mark if apphcable) <br />0 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 at the fore oing is true and correct. <br />Executed on 211( ■ / 7 Signature <br />(month. day, year) (Candidate) <br />FPPC Form 501 (August/2018) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />