HomeMy WebLinkAboutFitzsimmons -Form 501Candidate Intention Statement
Check One: minitial ❑Amendment (Explain)
1. Candidate Information:
RECEIVED
<:ITY MANAGER'S OFFICE
2020 AUG ' 6 PM 12: 45
WhiT0GA, CA
Stamp
NAME OF CANDIDATE (Last. first Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) EMAIL (optional)
Fitzsimmons, Kookie ( ( )
STREETADDRESS CITY STATE ZIP CODE
Saratoga CA 95070
Council
OFFICE JURISDICTION
❑ State (Complete Part 2.)
For Official Use Only
NON -PARTISAN OFFICE
I PARTY PREFERENCE.
(Check one box, if applicat
2020 Iifl PRIMARY/GENERAL
iv City ❑ County ❑ Multi -County: (Name of Multi -County Jurisdiction) (Year of Election) ❑ SPECIAL / RUNOFF
2. State Candidate Expenditure Limit Statement:
(CalPERS and Ca1STRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
City of Saratoga
(Check one box)
❑ 1 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 1 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, _/_/ 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 foregoing Is true and correct.
Executed on 17 v 2 Signature
(month. day, year) ( FPPC Form 501 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov