HomeMy WebLinkAboutHarmon, Heidi - Form 501 - 08-04-2016 - Initial StatementCandidate Intention Statement
Date Stamp
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Check One: Initial El Amendment (Explain)
For Official Use Only
AUG 04 2016
11-0 ClT ! CLLR
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1. Candidate Information:
A OF CANDIDATE (Last, First Middle Initial) DAYTIME TELEPHONE NUMBER
FAX NUMBER (optional) E-MAIL (optional)
f t ,it•ice (iYl -`V'�
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'!"7 0 41t� !
OFFICE SOUGHT (POSMOO+N TITLE) AGENCY NAME
M} / 0 1 l/�` Q _1CG�'r ! IN✓' S V Q
DISTRICT NUMBER, if applicable. NON-PARTISAN
PARTY:
OFFICE JURISD[ ION
❑ State (Complete Part 2 )
City ❑ County ❑ Multi -County: (Name of Multi -County Jurisdiction)
o�DlCP
(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.)
Primary/general election (Year of Election) Special/runoff election
(Year of 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:
/ 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 of Californi that the foregoing -it true and correct.
Executed on ' " � a � / � Signature
FPPC Form 501 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov