CA Form 501 Candidate Intention Statement - Jerry Duhovic CANDIDATE INTE TATEMENT
Cante intention Statement Type or It in Ink. RECEIVED CALIFORNIA 601CI Y OF RANCHO PALOS FORM
For Official Use Only
Check One: itial ❑Amendment (Explain) 'JUL 16
•
.,__________
CITY , .......„......
1
1. Candidate Information:
NAME OF CANDIDATE„ (Last,First, i alai) DAYTIME TELEPHONE NUMBER FAX NUMBER(optional) E-MAIL(optional)
.c. (3ta,5-c*,.... 36 ( )
STREET ADDRESS CITY STATE ZIP Cinia....7 5,,
sa*CS-NOJA-WAS
OFFICE SOUGHT(PO TION TITLE) A NCY ME DIST: UMBER, if applicable.
` i
N-PARTISAN
ID
3 tt)4X,IltA ANQ4114201, &P Ratalilib AS / // ` PARTY:
OFFICE JURISDICTION
0 State (Complete Part 2.) Zif)IS.
?Dpity 0 County ❑ Multi-County: (Name of Multi-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 voluntar
t accept the voluntary expenditure ceiling for the election stated above.
Amendment:
O I did not exceed the expenditure ceiling in the primary or special election held on: _J-I 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 perjury under the laws of the State of California that th- ?r- o-
FPPC Form 501 (April/2011)
FPPC Toll-Free Helpline:866/ASK-FPPC(866/275-3772)