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CA Form 501 Candidate Intention Statement - Susan Brooks CANDIDATE INTE •TATEMENT CanSte Intention Statement Type or in Ink. - vo z'Ti P Yp CALIFORNIA 501 CITY OF RANCHO PA RM JUL 1 3 2015 For Official Use Only Check One: ial ['Amendment (Explain) Gib at-Writs OFFitriE rmation: • NAME OF CANDIDATE (Last,First,Middle Initial) DAYTIME TELEPHONE NUMBER FAX NU ptional) E-MAIL(optional) 1-44Atert541-4.-- C) v Gf2 'f ( ) 3cfsa,r) -•b a^©c,A"3 d r 1�G4�, , STREET ADDRESS CITY STATE ZIP CODE /° C-6-4-4-7,----41.Le___, leari--e..--4-0 ,2 29 OFFICE SOUL (POSITION TITLE) AGENCY NAME DISTRICT NUMBER, if applicable. , NON-PARTISAN &f/9 -, C 9 0 PARTY: OFFICE JURISDICTION 0 State (Complete Part 2.) :g / / a / • . , .))12}1_0A..:....' 0 /5 it ❑ County ❑ Multi-Coal, unty:oun Y oun tY• f (N--e of Multi-County Jurisdiction) (Ye 9 r 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. ❑ I do not accept the voluntary expenditure ceiling for the election stated above. Amendment: 0 0 I did not exceed the expenditure ceiling in the primary or special election held on: ___I-__.l and I accept the voluntary expenditure ceiling for the general or special run-off election. (Mark if applicable) ❑ On _I__-_/ , 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. ./ ) ( FPPC Form 501(April/2011) FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)