HomeMy WebLinkAboutBallesteros Form 501 08-18-2015_RedactedCANDIDATE INTENTION
Candidate Intention Statement Type or Print in Ink. REGEWED
Check One: Initial
. Candidate Information:
❑Amendment (Explain)
AUG 18
CITY OF € UBLIN
I MANAGER'S OFI
NAME OF CANDIDATE (Last, First, Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E -MAIL (optional)
Ballesteros, Mona Lisa, F ( )
STREET ADDRESS CITY STATE ZIP CODE
)FFICE SOUGHT (POSITION TITLE) AGENCY NAME DISTRICT NUMBER, If applicable. [@ NON-PARTISAN
City Council Member City of Dublin PARTY:
)FFICE JURISDICTION
❑ State (Complete Part 2.)
2016
® City ❑ County ❑ Multi-County: (Name of Multi - County Jurisdiction) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(CalPERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
2016 primary/general election Speciallrunoff election
(Year or Election ) (Year or Efec on)
(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: II 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 S c o' is true and correct.
V15- Executed on v `� ` - Signatur
(month, day, year} (Can d a e) FPPC Form 601 (AprIV2011)
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