CA Form 501 Candidate Intention Statement - Ken Dyda CANDIDATE INTEI' STATEMENT
Cans.. .ate intention Statement Typeor I• ...it in Ink. Date Stamp p CALIFORNIA _ 0 I
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Check One: ►,Initial flAmendment (Explain)
AUG 06 2015
1. Candidate Information: CLERR
CITY
NAME OF CANDIDATE (Last,First.Middle Initial) DAYTIME TELEPt-IONE NUMBER FAX NUMBER(optional) E-MAIL(optional)
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STREET ADDRESS CITY STATE ZIP CODE
9 V DR PA-111C/e P41,0_. 11-----7R b F-S (1,14 9'4a271/4--
OFFICE SOUGHT(POSITION TITLE) AGENCY NAME DISTRICT NUMBER, if applicable. NON-PARTISAN
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,�^ ^ //7/L J1 f 1-- g A- ✓GWO7J0 Lis PARTY:
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OFFICE JURISDICTION
❑ State (Complete Part 2.)
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(City ❑ County 0 Multi-County: (Name of Mutti-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.)
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.
0 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: ___/_/ and I accept the voluntary expenditureceiling for 0
the general or special run-off election.
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(Mark if applicable)
❑ On __J____J , 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.
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nth,day,year)" (Cand•/' ) /
FPPC Form 501 (April/2011)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)