Form 501 Candidate Intention 2010Candidate Intention Statement Type or Print in Ink. Date Stamp
Check One: I~I Initial ❑ Amendment (Explain)
11
2010 FEB -2 PM 1: 03
Use Only
1. Candidate Information:
NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E-MAIL (optional)
Teresa A. Barth ( 760 ) 634-3115 ( )
STREET ADDRESS CITY STATE ZIP CODE
2140-K Orinda Drive Card iff-by-the-Sea, CA 92007
HT (POSITION TITLE)
Councilmember
AGENCY
of Encinitas
PARTY:
OFFICE JURISDICTION
❑ State (Complete Part 2.)
® City ❑ County ❑ Multi-County: 2010
(Name of Multi-County Jurisdiction) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(CaIPERS candidates, judges, judicial candidates, and candidates for local offices are not required to complete Part 2.)
Primary/general election Special/runoff election
(Year of 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:
Q 1 did not exceed the expenditure ceiling in the primary or special election held on: -J~ and I accept the voluntary expenditure ceiling for the
general or special run-off election.
(Mark if applicable)
❑ On J , I contributed personal funds in excess of the expenditure ceiling for the election stated above.
3. Verification:
I certify under penalty of erjury under the laws of the State of California tha ~e~for VA true corr~eGt.~
Executed on +-el a~ o Signature Imo"` A \\~~`1ltt''
(month, day, year) (Candidate)
DISTRICT NUMBER, ifapplicable. JIM NON-PARTISAN
FPPC Form 501 (January/05)
FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)