HomeMy WebLinkAboutFitzpatrick Form 501Candidate Intention Statement
Check One: F Initial ❑Amendment (Explain)
1. Candidate Information:
Date Stamp OV
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MAINAGER'S OFF
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For Official Use Only
NAME OF CANDIDATE (Last, First Middle Initial)
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STREETADDRESS CITY STATE ZIP CODE
OFFICE SOUGHT (POSITION
/(
TITLE) -'
AG CY NAME DISTRICT NUMBER, if applicable. ON -PARTISAN OFFICE
C- CO v ' " C _ PARTY PREFERENCE:
OFFICE JURISDICTION (Check one box, if applicable.)
❑ State (Complete Part 2.) RIMARY / GENERAL
E216iy CountyMulti-County:G
❑ ❑ (Name of Multi -County Jurisdiction) (Year of Election) ❑ SPECIAL/ RUNOFF
2. State Candidate Expenditure Limit Statement:
(CalPERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
(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:
O 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
FPPC Form 501 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov