Steven Ly - 501Candidate Intention Statement Type or Print In Ink. Date Stamp 1 CALIFORNIA
T it FORM
CITY I; 4 0SE11IEAD Follicial Use Only
Check One: Initial ❑ Amendment (Explain) r°—
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1. Candidate Information: CI'T'Y CI ERR'S OFFICE
NAME OF CANDIDATE (Last, First, Middle Initial DAYTIME TELEPHONE NUMBE FAR NUMBER (optionaq E -MAIL (optional
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STR T ADDRESS CITY STATE ZIP CODE
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OFFICEI 1SOUGHT!(POSITION TITLE) / AGENCY NAME 1` ./� 1 - /� DISTRICT NUMBER, it applicable. NON - PARTISAN
MPMND! — '`140 r: � 1 n.�nr., T�.�PMPaN U T 1 OUAfi� PAR Y:
OFFICE JURISDICTION
❑ State ( complete Pen L)
,'City ❑ County ❑ Multi- County:
(Name ofMulb -Comly Junal iction/ (Year of Eleclion)
2. State Candidate Expenditure Limit Statement:
(CalPERS candidates, judges, judicial candidates, and candidates for local offices are not required to complete Pad 2.)
Primary/general election Special /runoff election
(YearofElecaon) (VeerofEleclion)
(Check one box)
❑ I accept the voluntary expenditure ceiling for the election staled 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 it 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 regoing is true and correct.
Executed on t 2" / eg/Loo $ Signature
(month, day, year) (
FPPC Form 501 (January/OS)
FPPC Toll -Free Helpllne: 866 /ASK -FPPC (866/275 -3772)