HomeMy WebLinkAboutOren Levy Form 501 - Initial - 07-20-2012t
Cand, ie Intention Statement
Check One: L1(I Initial []Amendment (Explain)
N(tME OF CANDIDATE (Last, First, Middle Initiap
l
Type or Prii .n Ink.
DAYTIME TELEPHONE NUMBER
("5/ ) St(0-85o6
Date Stamp
JUL 202012
FAX NUMBER (optional)
E -MAIL (oplionap
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OFFICE SOUGHT (POSITION TITLE) AGENCY NAME DISTRICT NUMBER, K applicable.
..NON- PARTISAN
OFFICE JURISDICTION
❑ .State (Complele Part 2.)
City ❑ County ❑ Multi-County: (Name of Mu1VGOUnIy Jonstliction) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(CaIPERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
(Year of Election)
Primary/general election (Year of ElecGOn) Special /runoff election
(Check o 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 ff applicable)
❑ On — I 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 fore is true and correct.
2 0 _L
Executed on L, Signature
(month, day, year) antli ale)
FPPC Form 507 (April /2011)
FPPC Toll -Free Helpline: 8661ASK -FPPC (8661275 -3772)