HomeMy WebLinkAboutDan Carpenter - Form 501 - Initial - 05-01-2012Candidate Intention Statement
Check One: X,
nitlal ❑Amendment (Explain)
Candidate Information:
nE OF CANDIDATE (Last, First, Middle Initial)
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Type or Print in Ink.
Date Stamp
RECEIVED
MAY 01 2012
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CANDIDATE INTENTION STATEMENT
DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) E -MAIL (optional)
CITY STATE ZIP
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vrrl�t SOUGHT (POSITION TIT! I f. /��('L �jj
f��/� r} /? JOE) AGENCY NAME DISTRICT NUMBER, if applicable NON - PARTISAN
i * A-y' O1 7r]' �� G`✓ 1 � �� PARTY:
OFFICE JURISDICTION
❑ State (Complete Part 2) f
unw-
City ❑ County ❑ Multi- Count : r
y (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.)
Primary/general election Special/runoff election
(Year of Election) (Year of Election)
(Check one box)
❑ 1 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 the State of California that the foregoing is true and correct.
Executed on !IQ Signatured�
(rr . cnth, da Year) ICarmkteteJ
FPPC Form 501 (April /2011)
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