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Candidate Intention Statement <br />Check One: larinitial ❑Amendment (Explain) <br />/4t-77/6) - <br />JAN 2 2 2019 <br />City of Riverside <br />City Clerk's Office <br />For Official Use Only <br />1. Candidate Information: <br />NAME OF CANDIDATE (Last, First Middle Initial) ®� R FAX NUMBER (optional) EMAIL (optional) <br />DQ --N 91��?�� f 9r1 ry `LJ . ( ) <br />STREET ADDRESS / STATE ZIP CODE <br />OFFICE SOUGHT (POSITION TITLE) AGENCY NAME DISTRICT NUMBER, if applicable.,(ON-PARTISAN OFFICE <br />C-1 C, �' j L. L) A,U 7 PARTY PREFERENCE: <br />OFFICE JURISDICTION <br />❑ State (Complete Part 2.) <br />ity ❑ County <br />❑ Multi -County: <br />(Name of Multi -County Jurisdiction) <br />(Check one box, if applicable.) <br />6270 9 PRIMARY / GENERAL <br />(Year of Election) ❑ SPECIAL / RUNOFF <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 />❑ 1 accept the voluntary expenditure ceiling for the election stated above. <br />❑ 1 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 />❑ 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 <br />-L/ 2-0 <br />Executed on 0/ 72. 1 Signatur <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 />