HomeMy WebLinkAbout2018.07.06_Headding_John_Form 501Candidate Intention Statement
Check One: i3`Initial El Amendment (Explain)
Date Stamp
RECEIVED
City of Morro Bay
JUL —62018
Administration
CALIFORNIA 501
FORM
For
dal Use Only
1. Candidate Information:
NAME OF CANDIDATE (Last, First, Middle Initial)
1Jt C NI)
DAYTIME T .ONE NUMBER FAX NUMBER (optional) E-MAIL o Conal
(80S)
CITY S ATE ZIP C•DE
CA 3`Li2—
OFFICE SO GHT (P SITION TITLE) AGENCY NAME
�`/� t,i2 Ci C> _ I ciRRO Si CA- ` ? 4Z
OFFICE JURISDICTION
0 St e (Complete Part 2,)
City 0 County
❑ Multi -County.
(Name or ult-County Jurisdiction)
DISTRICT NUMBER, If applicable NON -PARTISAN
(Year of Election)
PARTY:
2. State Candidate Expenditure Limit Statement:
(CaIPERS and Ca1STRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
Primary/general election
(Year of Election)
(Year of Election)
Speclal/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:
0 I 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)
0 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 '3 true and correct.
Executed on .�lc ( B Signature
( onth, day, year)
FPPC Form 501 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275.3772)
www.fppc.ca,gov