HomeMy WebLinkAboutForm 501- Mahmoud A.ShiraziG Ilk
Candidate Intention Statement Date CALIFORNIA
4 FORM
For Official Use Only
Check One: (0 Initial ❑Amendment (Explain)
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1. Candidate Information:
NAME OF CANDIDATE (Last, First Middle Initial) % DAYTIME TELEPHONE NUMBER '/ FAX NUMBER (optional) EMAIL (optional)
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STREETADDR SS CITY STATE ZIP CODE
OFF C SOUGHT (POSITION TITLE) AGENCY NAME DISTRICT NUMBER, if applicable. ❑ NON -PARTISAN OFFICE
PARTY PREFERENCE:
OFFICE JU DICTION (Check one box, if applicable.)
❑ State (Complete Part 2.)
PRIMARY / GENERAL
Cit County Multi -County: �_���/ ,"" SPECIAL/RUNOFF
y ❑ ❑ (Name of Multi-C my Jurisdiction) (Year o Election) ❑
2. State Candidate Expenditure Limit Statement:
(CalPERS and Ca1STRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
(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:
O 1 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
FPPC Form 501 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov