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HomeMy WebLinkAboutForm 501- Lucia Martel Dow for San Rafael School Board 2022Candidate Intention Statement []Amendment (Explain) 1. Candidate Information: NAME OF CANDIDATE (Last, First Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) EMAIL (optional) Martel Dow, Lucia ( STREETADDRESS CITY STATE ZIP CODE School Board OFFICE JURISDICTION ❑ State (complete Part 2.) x❑ City ❑ County ❑ Multi -County: Novato (Name of Muli-County Jurisdiction) 2. State Candidate Expenditure Limit Statement: (CaIPERS and CaISTRS 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. ❑ 1 do not accept the voluntary expenditure ceiling for the election stated above. CA 94949-5731 If applicable. M NON-PARTISAN OFFICE (Check one box, iI applicat © PRIMARY/ GENERAL 2022 (Year of Electlon) ❑ SPECIAL/ RUNOFF Amendment: Q 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 the State FPPC Form 501 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) wwwJppc.ca.gov