HomeMy WebLinkAbout2016.08.12_Winholtz_Betty_Form 501Can,_ -,ate Intention Statement
U
Check One: ® Initial ❑Amendment (Explain)
RECEIVED
City of Morro Bay
Use Only
1. Candidate Information:
NAME �OF/ /
CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E-MAIL (optional)
STREET ADDRESS CITY STATE ZIP CODE
_ p o c13 L/.�
OFFICE oOU(bn I (POSITION TITLE) /AULNG Y NAME DISTRICT NUMBER, if applicable, W NON- PARTISAN
it ` r r r O 6 PARTY:
OFFICE JURISDIC ION
❑ State (Complete Part 2.)
City ❑ County ❑ Multi-County: Name of Multi -Count Jurisdiction
( y ) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(CaIPERS and CaISTRS 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
(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 1pi.L n Signature ,
, ` �
f (month, day, ear) ( FPPC Form 501 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov