HomeMy WebLinkAboutCostello Form 501 08-12-2016_RedactedCandidate Intention Statement
Check One: 6nitial ❑Amendment (Explain)
rmat
Date Stamp
For
UrrlGt JuKlsulc I IUN
❑ state (complete Part 2.)
Ity, ❑ County ❑ Multi- County: (Name of MuIU -County JudsdlcUon) ocUon)
2. State Candidate Expenditure Limit Statement:
(Ca1PERS and CalSTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
(Year of Election)
Primary/general election (year of 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:
O 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 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 St at nd correct.
Executed on Lc. " / Signature
(month, day, year) (Candidate) FPPC Form 501 (Jan /2016)
FPPC Advice: advice @fppc.ca.gov (866/275 -3772)
www.fppc.ca.gov