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HomeMy WebLinkAboutForm 501- Rachel Kertz for Board of Education 2018 InitialCandidate Intention Statement Check One: Z Initial []Amendment (Explain) . Candidate Information: oc�c�[E0W2��.,�,; Date Stamp i AUG G LL ,a ,1 CITY CLERK'S OFFICE NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E-MAIL (optional) kei rz. 1*cNe-z, k ( c STREET ADDRESS CITY STATE ZIP CODE OFFICE SOUGHT (POSITION TITLE) AGENCY NAME DISTRICT NUMBER, If applicable. II NON-PARTISAN 2USTC�G $,WV 6W W Eli L clrY PARTY: OFFICE JURISDICTION ❑ State (Complete Part 2.) dol£S City ❑ County ❑ Multi -County: (Name of Multi -County Jurisdiction) (Year of Election) 2. State Candidate Expenditure Limit Statement: (CaIPERS and Ca1STRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.) (Year of Election) Primary/general election (Year o/ Election) Special/runoff 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 1 did not exceed the expenditure ceiling in the primary or special election held on: I 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. Executed on 40 A // s ,, Signature �'�-f.�K-F' (month, day, year) (CandidaTej FPPC Form 501 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov