November 3, 2020 Candidate Packet - Flipping Book Version

F. Form 501 – Candidate Intention Statement Before soliciting or receiving any contributions or making expenditures from personal funds, a candidate must file the Form 501 with the filing officer who will receive the candidate’s original campaign statements (i.e., city clerk or county elections). Judicial candidates file the Form 501 with the Secretary of State. A new Form 501 must be filed for each election, even if the candidate is running for reelection to the same office. The Form 501 is considered filed on the date it is postmarked or hand-delivered.

501

Candidate Intention Statement

CALIFORNIA FORM

Date Stamp

A

For Official Use Only

Check One:

Initial

Amendment (Explain)

1

1. Candidate Information:

NAME OF CANDIDATE STREET ADDRESS Cole, Rayna

EMAIL (optional)

DAYTIME TELEPHONE NUMBER

FAX NUMBER (optional)

(Last, First Middle Initial)

( ) 707 555-1235 rcole@gmail.com

707 555-1234

CITY ( )

STATE

ZIP CODE

1212 Fourth Avenue

CA 95443

Oakmont

DISTRICT NUMBER, if applicable.

OFFICE SOUGHT (POSITION TITLE)

AGENCY NAME

NON-PARTISAN OFFICE

City Council

City of Oakmont

1

PARTY PREFERENCE:

(Check one box, if applicable.) PRIMARY / GENERAL SPECIAL / RUNOFF

OFFICE JURISDICTION

State (Complete Part 2.) City County

20XX

Multi-County:

(Name of Multi-County Jurisdiction)

(Year of Election)

2

2. State Candidate Expenditure Limit Statement:

(CalPERS and CalSTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)

(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. the general or special run-off election. I did not exceed the expenditure ceiling in the primary or special election held on: Amendment:

and I accept the voluntary expenditure ceiling for

State candidates only

(Mark if applicable)

On

, I contributed personal funds in excess of the expenditure ceiling for the election stated above.

3

3. Verification:

I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

[Signature Required]

[Date Required]

Executed on

Signature

FPPC Form 501 (August/2018) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov

(month, day, year)

(Candidate)

Clear Page

Print

Fair Political Practices Commission advice@fppc.ca.gov

Chapter 1. 8

Campaign Manual 2 June 2020