CA Form 501 Candidate Intention Statement - Krista M. Johnson RECEIVE€)
Candidate Intention Statement CITY OF RANCFI� i v4`'
CALIFORNIA 501
FORM
'JUL' 117 2017 For Official Use Only
Check One: Jnitial 0 Amendment (Explain)
CITY CLEF K'S OF0 7E
1. Candidate Information:
NAME OF CANDIDATE (Last,First,Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER(optional) E-MAIL(optional)
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STREET ADDRESS CITY STATE ZIP CODE �/
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OFFICE SOUGHT
(POSITIONTITLE) AGENCY NAME / DISTRICT NUMBER,if applicable. 0 NON-PARTISAN
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PARTY: -om1.-
OFFICE
I.OFFICE JURISDICTION
❑State (Complete Part 2.)
R City ❑County ❑ Multi-County: (Name of Multi-County Jurisdiction) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(Ca1PERS and CaISTRS candidates,judges,judicial candidates,and candidates for local offices do not 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:
0 I 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_/_/_, I contributed personal funds in excess of the expenditure ceiling for the election stated above.
3.Verification:
I certify under penaltyofperjury under the laws of the State of
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www.fppc.ca.gov