HomeMy WebLinkAbout2016.08.17_Cogan_Laura_Form 501Candidate Intention Statement
Check One: E[Initial ❑Amendment (Explain)
1. candidate information:
NAME OF CANDIDATE (Last, First, Middle Ini ial)
, k. "q l , LU PA
ADDRESS
RECEIVED
Administration
DAYTIME TELEPHONE NUMBER FAX NUMBER (optional)
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ICE JURISDICTION
❑ State (Complete Part 2.)
City ❑ County ❑ Multi-County: (Name of Multi- County Jurisdiction)
2. State Candidate Expenditure Limit Statement:
(Ca1PERS and Ca1STRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
(Year of Election)
Primary/general election (Year of Election) Special /runoff election
E -MAIL (optional)
ZIP CODE
v�� 2
it applicable. [
PARTY:
Zook
(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:
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 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 `� Signatur
year)
(month, day, ( FPPC Form 501 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov