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Candidate Intention Statement <br />Check One: Alnitial ❑ Amendment (Explain) <br />1. Candidate Information: <br />NAME OF CANDIDATE (Last, First Middle Initial) <br />STREE ADDRESS <br />OFFICE SOUGHT (POSITION TITLE) <br />DAYTIME TELEPHONE NUMBER <br />CITY <br />eXs <br />AGENCY NAME <br />FEB 13 2019 <br />City of Riverside <br />City Clerk's Office <br />For Official Use Only <br />FAX NUMBER (optional) EMAIL (optional) <br />( ) STATE ZfP CODEC <br />OFFICE JURISDICTION <br />❑ State (Complete Part 2.) <br />City ❑ County ❑ Multi -County: <br />DISTRICT NUMBER, if applicabl <br />tilart . <br />(Name of Multi -County Jurisdiction) <br />NON-PARTISAN OFFICE <br />PARTY PREFERENCE: <br />(Check one box, if applicable.) <br />PRIMARY / GENERAL <br />ion) ❑ SPECIAL / RUNOFF <br />(Year of E <br />2. State Candidate Expenditure Limit Statement: <br />(Ca/PERS and Ca/STRS 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• and I accept the voluntary expenditure ceiling for <br />the general or special run-off election. <br />(Mark if applicable) <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 that the foregoing is true and correct. <br />Ve19rk)ckor , <br />(month. day. year) <br />Executed on <br />Signature. <br />FPPC Form 501 (August/2018) <br />FPPC Advice: advice@fppc.ca.gov (866/275-3772) <br />www.fppc.ca.gov <br />