HomeMy WebLinkAbout2016_07_19 Form 501 - Dede SmullenCandidate Intention Statement
Check One: ❑X Initial ❑Amendment (Explain)
Date Stamp
RECEIVED
JUL 18 2016
CITY OF SARATOGA
CALIFORNIA 501
FORM
For Official Use Only
1. Candidate Information:
NAME OF CANDIDATE (Last, First, Middle Initial)
Dorothea Louise Smullen
DAYTIME TELEPHONE NUMBER
(
FAX NUMBER (optional)
E-MAIL (optional)
STREET ADDRESS CITY
Saratoga
OFFICE SOUGHT (POSITION TITLE) AGENCY NAME
City Council Member
City of Saratoga
OFFICE JURISDICTION
El State (Complete Part 2.)
►Z�
City 0 County 0 Multi -County.
STATE
CA
ZIP CODE
95070
DISTRICT NUMBER, if applicable.
(Name of Multi -County Jurisdiction)
2016
(Year of Election)
❑X NON-PARTISAN
PARTY:
2. State Candidate Expenditure Limit Statement:
(Ca1PERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Pan' 2.)
Primary/general election
(Year of Election)
Special/runoff election
(Year of Election)
(Check one box)
❑ I accept the voluntary expenditure ceiling for the election stated above.
❑ I do not accept the voluntary expenditure ceiling for the election stated above.
Amendment:
0 I did not exceed the expenditure ceiling in the primary or special election held on' and I accept the voluntary expenditure ceiling for
the general or special run-off election.
(Mark if applicable)
0 On , 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 Staff fo California that the foregoing is true and correct.
Executed on 07/18/2016 Signature //_�!'�
(month, day, year)
(Candidat
FPPC Form 501 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov