HomeMy WebLinkAbout2014 - Form 501 InitialCandidate Intention Statement
Check One: X Initial L Amendment (Explain)
Type or Print in Ink.
-&Dale Stamp
MAR 2414
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0034, GA
CANDIDATE INTENTION STATEMENT
1. Candidate Information:
NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E -MAIL (optional)
Fischer, , %AiornAs - A (W) 8y7- Y71/ c 914y �Xerf�-tcA eAo r,�A; • corn
STREET ADDRESS — CITY I STATE ZIP CEDE
❑ State (Complete Part 2.)
IN City ❑ County ❑ Multi- County: (Name of Multi-County Jurisdiction) (Year of El ction)
2. State Candidate Expenditure Limit Statement:
(CalPERS and Ca/STRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
Primarylgeneral election
(Year(Year o�ctknJ
(Year of Election) Speciailrunoff 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: I and I accept the voluntary expenditure ceiling for
the general or special run -off election.
(Mark ff appUcable)
❑ On I I contributed personal funds in excess of the expenditure ceiling for the election stated above.
3. Verification:
1 certify under
penalty
L of perjury under the laws of the State of California that the fore ing I true and correct.
Executed on 1 i19/4LlI 7 7 Signature
(month, day, year) (Candidate)
(8
FPPC Form (1275 - )
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