HomeMy WebLinkAboutTom Fischer - Form 501Candidate Intention Statement
Check One: ]Xlnitial L_ Amendment (Explain)
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STATEMENT
NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E -MAIL (optional)
SC,% can ` 77w"Rzy A ('/08) A @120t �A;L Goal
STREET ADDRESS CITY AT 21P CODE
`741<' Teo._,., r,�d.. r_;JiD^tJ r 1a FS0zC)
❑ State (Complete Part 2.)
PRO /
X City ❑ Coun ty ❑ Multi-County: (Name of Multi-County Jurisdiction) (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) Primarylgeneral election (Year of Election) Speciallrunoff election
(Check one box)
❑ 1 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 —J— t 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
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