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HomeMy WebLinkAboutH Miller Form 501Candidate Intention Statement Check One: P Initial ['Amendment (Explain) 1. Candidate Information: NAME OF CANDIDATE (Last, First, Middle Initial) Miller, Howard A DAYTIME TELEPHONE NUMBER ( FAX NUMBER (optional) E-MAIL (optional) STREET ADDRESS CITY Memeber , City Council OFFICE JURISDICTION mplete Part 2.) 0 State (Co ® City ❑ County ❑ Multi -County: AGENCY NAME City of Saratoga STATE CA ZIP CODE 95070 DISTRICT NUMBER, if applicable. (Name of Multi -County Jurisdiction) 2016 (Year of Election) ® NON -PARTISAN PARTY: 2. State Candidate Expenditure Limit Statement: (CaIPERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 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) ❑ On _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 Californiathatthe fore•oing is true and correct. Executed on I/ 1 /-2-0[C, (month, day, year) Signature (Ca• ndidate) FPPC Form 501 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov