;:, ,.. ....

Candidate Intention Statement Type or Print in Ink.

Check One: utlnitial 0Amendment (Explain) ---------------

1. Candidate Information: ~.,/(/

AGENCY NAME

OFFICE JURISDICTION

0 State (Complete Part 2. )

QlCity D County D Multi-County: (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.)

' ·C' - . Lt.. . Primary/genera/ election

(Check one box)

--,:-:-:-::~=" Special/runoff election (Year of Election)

)8\ 1 accept the voluntary expenditure ceiling for the election stated above.

D I do not accept the voluntary expenditure ceiling for the election stated above.

Amendment:

rF 4c i or rHt""cTf v cu: OAKLAND

1ft HAY 30 PH ~:56

oJ'i ·ear of Election)

CANDIDATE INTENTION STATEMENT

CALIFORNIA 501 FORM

For Official Use Only

0 NON-PARTISAN

PARTY:

0 I did not exceed the expenditure ceiling in the primary or special election held on: __j__j __ and I accept the voluntary expenditure ceiling for the general or special run-off election.

(Mark if applicable)

D On __j__j __ , 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 fore oing is true and correct.

Executed on /?2A-)12~ Signature (month, day, year) (Candidate) FPPC Form 501 (April/2011)

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