CA Form 501 Candidate Intention Statement - George Lewis Candidate Intention Statement REOEIVE' CALIFORNIA
501
CITY OF RANCHO PALOS V; FORM
Check One: Initial For Official Use Only
Initial ❑Amendment (Explain) JUN 21 2024
CITY CL
OFFICE
1. Candidate Information:
NAME OF CANDIDATE (Last,First Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER(optional) EMAIL(optional) 4
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STREETADDRESS CITY STATE ZIP CO(41 ()(- iefLP)A ft- P. V. q 027
OFFICE SOUGHT(POSITION TITLE) AGENCY NAME DISTRICT NUMBER,if applicable. R4N-PARTISAN OFFICE
C.0 U u L 4 L_ PARTY PREFERENCE:
OFFICE JURISDICTION (Check ne box,if applicable.)
❑ State (Complete Part 2) �° RIMARY/GENERAL
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City County ❑ Multi-County: (Name of Multi-County Jurisdiction) (Year of Election) SPECIAL 1 RUNOFF
2. State Candidate Expenditure Limit Statement:
(Ca1PERS and CaISTRS candidates,judges,judicial candidates, and candidates for local offices do not complete Part 2.)
(Check one bcx)
El 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 of California that the foregoing is true and correct.
r /-21Executed on I Signature
(month,day,year) (Candidate)
FPPC Fc rm 501 (August/2018)
FPPC Advice:advice@fppc ca.gov(866/275-3772)
www.fppc.ca.gov