Form 501 Intention Statement tip
Candidate Intention Statement
Check One: Q Initial ❑Amendment (Explain)
CANDIDATE INTENTION STATEMENT
Type or Print in Ink. Date Stamp
CITY OF FP CPJITt�.,. rF Cii i Y : I-EP \
20 111 MAY -5 P 14: 1 _.
1. Candidate Information:
NAME OF CANDIDATE (Last.First.Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E-MAIL(optional)
Graboi. Julie E (
CT NUMBER, it applicable. NON-PARTISAN
City Council City of I PART`!:
OFFICE JURISDICTION
❑ State (Complete Part 2.)
2014
dClty ❑ County ❑ Multi-County: (Name of Multi-County Jurisdiction) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(CalPERS and CalSTRS candidates,judges,judicial candidates, and candidates for local offices do not complete Part 2.)
Primary/general election Year of Election) Special/runoff election
(Year of 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:
the general or special run-off election.
se
and I accept the voluntary expenditure ceiling for
(Nark if applicable)
❑ On _—/__=_1 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 Signature
(month,day,year) (Candidate) FPPC Form 501 (April/2011)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)