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Candidate Intention Statement <br />Check One: <br />[$Initial 0 Amendment (Explain) <br />1. Candidate Information: <br />NAME OF CANDIDATECA{Last, First Middle India!) <br />iw J-`soJ--sortSTREE ADDRESS <br />43 �r� iy r� <br />D2/ 6 - <br />OFFICE SOUGHT (POSITION TITLE) AGENCY NAME <br />(:/71/ <br />OFFICE JURISDICTION <br />❑ State (Complete Part 2 pc,City 0 County 0 Multi -County: <br />DAYTIME TELEPHONE NUMBER <br />Date Stamp <br />RECEIVE <br />For Official Use Only <br />FEB 11 2019 <br />City of Riverside <br />uty LAMS (Alice <br />FAX NUMBER (optional) �EEMAAILL ((optionnall)) J, _meq+ <br />L bC /VOA tita��� ' ' l <br />) <br />C 4Y <br />t(t / 2c <br />04 (SWC +3 e -/r9,1 4c/111AC <br />(Name of Multi -County Jurisdiction) <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 />❑ 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• <br />the general or special run-off election. <br />(DISTRICT NUMBER, if applicable. <br />STATE ZIP CODE <br />7 <br />N -PARTISAN OFFICE <br />PARTY PREFERENCE: <br />(Check one box, if applicable.) <br />„PRIMARY / GENERAL <br />El SPECIAL / RUNOFF <br />W9 <br />(Year of Election) <br />and I accept the voluntary expenditure ceiling for <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 <br />Executed on 211( ■ 17 Signature <br />(month. day year) <br />regoing is true and correct. <br />(Candidate) <br />FPPC Form 501 (August/2018) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />