HomeMy WebLinkAboutForm 501_03/14/19 Candidate Intention Statement Date Stamp CALIFORNIA 501
RECL-711t FORN
Check One: ®Initial 1:3Amendment (Explain) For•'cial Use Only
CITY (-1'.'.."'"."° 1:
1. Candidate Information:
NAME OF CANDIDATE (Last,First Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER(optional) EMAIL(optional)
Shelley Kaplan ( 617 ) 8421243 ( ) shelley_kaplan@aol.com
STREET ADDRESS CITY STATE ZIP CODE
67785 Foothill Rd Cathedral City CA 92234
OFFICE SOUGHT(POSITION TITLE) AGENCY NAME DISTRICT NUMBER,if applicable.®NON-PARTISAN OFFICE
Council Member Cathedral City One PARTY PREFERENCE:
OFFICE JURISDICTION (Check one box,if applicable.)
❑State (Complete Part 2.) 2019 o PRIMARY/GENERAL
®City ❑County ❑Multi-County: (Name of Multi-County Jurisdiction) (Year of Election) ❑X SPECIAL/RUNOFF
2. State Candidate Expenditure Limit Statement:
(CaIPERS and CaISTRS 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.
Amendment:
O I 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 Califor ':fr at the foregoing is true and correct.
Executed on 2/28/2019 Signature //AL
(month,day,year) /v '('di.ate) FPPC Form 501 (August/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov