HomeMy WebLinkAboutForm 501- John Gamblin 2015Candidate Intention Statement
Check One: ® Initial ❑ Amendment (Explain)
Type or Print in Ink.
VGU CANDIDATE INTENTION
Date Stamp .
JUL -1 2015 '
For Official Use C
Time:
City ClerWS Office
r;ity of San Raf�F
1. Candidate Information:
NAME OF CANDIDATE (Last, First Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optionso E-MAIL (optional)
Gamblin, John A ( ( )
STREET ADDRESS CITY STATE ZIP CODE
San Rafael CA 94903
OFFICE SOUGHT (POSITION TITLE) AGENCY NAME IDISTRICT NUMBER, 1I applicable. to NON-PARTISAN
Councilmember
OFFICE JURISDICTION
❑ State (complete Pan 2.)
® City ❑ County ❑ Multi -County:
Of San Rafael
(Name olMuIU-County Jurisdiction)
2. State Candidate Expenditure Limit Statement:
(Ca1PERS candidates, judges, judicial candidates, and candidates for local offices are not required to complete Part 2)
(YearolElectlon)
Primary (Yearn/Electbn)
/general election SpeciaUrunoff election
(Check one box)
❑ I accept the voluntary expenditure ceiling for the election stated above.
2015
PARTY:
❑ 1 do not accept the voluntary expenditure ceiling for the election stated above.
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.
(Made 1I applicable)
❑ On _l—J 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 Califomi that the foregoing is trupand correct.
July 1, 2015
Executed on Signature
(month, day, year) (Candidate)
FPPC Form 501 (January/05)
FPPC Toll -Free Helpline: 866/ASK-FPPC (866/2753772)