HomeMy WebLinkAboutDan Carpenter - Form 501 - Initial - 01-23-2012Candidate Intention Statement
Check One: nitial ❑Amendment (Explain)
NAME OF CANDIDATE (Last, First, Middle Initial)
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Type or Print in Ink.
TELEPHONE NUMBER
7DSl -eSL
CANDIDATE INTENTION STATEMENT
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JAN 2. ; 1011!4
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SLO CITY CLER
FAX NUMBER (optional) E -MAIL (optional)
STREET ADDREISS x CITY CA—
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OFFICE SOUGHT (POS ON TITLE) j AGENCY NAME DISTRICT NUMBER, if applicable. )rr NON- PARTISAN
C, UKCc i1�G µ4 (Der PARTY:
OFFICE JURISDICTION
❑ state (Complete Part 2.) Zo
[City ❑ County ❑ MUltl- County: (Name of MuI&County Jurisdiction) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(CalPERS and Ca1STRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
(Year Of Election) Primary /general election (Year of Special /runoff election
Electon)
(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: J_J 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
FPPC Form 501 (April/2011)
FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -3772)