Tom Fischer - Form 501Candidate Intention Statement
Check One: ED Initial ❑Amendment (Explain)
Datb $tamp
JAN _ a 2011
r.
NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E-MAIL (optional)
Fischer, Thomas, A ( 408 ) 847 -4716 ( ) plumberfisch @hotmail.com
STREET ADDRESS CITY STATE ZIP CODE
Gilroy Ca 95020
City Council Member.
OFFICE JURISDICTION
❑ State (Complete Part 2.)
® City ❑ County
NAME
2018
❑ Multi- County: (Name of Muti- County Jurisdiction) ear of Election)
2. State Candidate Expenditure Limit Statement:
(CaIPERS and CsISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Pan 2.)
sar d T1 Primary/general election mar of Election) Speclabninoff election
(Check one box)
❑ I accept the voluntary expenditure ceiling for the election stated above.
❑ 1 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: ---J---J
the general or special run -off election.
09 NON- PARTISAN
PARTY:
and I accept the voluntary expenditure ceiling for
(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 of
true and correct.
Executed on Jan. 9, 2017 Signature
(month, day, year) ( FPPC Form 501 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov