CA Form 501 Candidate Intention Statement - Michele Carbone ll
Candidate Intention Statement C OF I u ' . CALIFORNIA 501
� PALO _ .
FORM
AUG 6 9 2022 For Official Use Only
Check One: Retial ['Amendment (Explain)
CITY CLERK'S ciF
FICE
1. Candidate Information:
NAME OF CANDIDATE (Last,First Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER(optional) EMAIL(optional)
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STREET ADDRESS CITY STATE ZIP CODE
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OFFICE SOUGHT(POSITION TITLE) AGENCY NAME DISTRICT NUMBER,if applicable ❑NON-PARTISAN OFFICE
/(., 'h/1'it/'V PARTY PREFERENCE ,/)A
OFFICE JURISDICTION (Check one box,if applicable.)
❑State (Complete Part 2) [FRIMARY/GENERAL
City County Multi-County _ ® SPECIAL/RUNOFF
❑ ❑ (Name of Multi Count Jurisdiction) (Year of Election) ❑
Y
2. State Candidate Expenditure Limit Statement:
(CaIPERS and CaISTRS candidates,judges,judicial candidates,and candidates for local offices do not complete Part,2)
(Chepone box)
DI 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 _/_/_ 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 penalty of perjury under the laws of the State correct.
Executed on ("),S1/0 fr Signature
(month,day,year) (Candidate)
FPPC Form 501 (August/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov