HomeMy Public PortalAboutForm 501Candidate Intention Statement
[]Amendment (Explain)
1. canciildate intormatlon:
NAME OF CANDIDATE (Last, First Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) EMAIL (optional)
Wirick, Nicole M. ( 909 ) 407-2843 ( ) info@nicoleforclaremont.com
STREETADDRESS CITY STATE ZIP CODE
495 Notre Dame Rd. Claremont CA 91711
OFFICE SOUGHT (POSITION TITLE) AGENCY NAME DISTRICT NUMBER, if applicable. 0 NON-PARTISAN OFFICE
City Council Member City of Claremont District 5 PARTY PREFERENCE:
OFFICE JURISDICTION (Check one box, if applicable.)
❑ State (Complete Part 2.) 0 2020 PRIMARY/ GENERAL
® City ❑County ❑ Multi -County: (Name of Multi -County Jurisdiction) (Year of Election) ❑ 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)
[:11 accept the voluntary expenditure ceiling for the election stated above.
❑ I do not accept the voluntary expenditure ceiling for the election stated above.
Amendment:
Q 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 California that the foregoing is true and correct.
Executed on 01/09/2020 Signature
(month, day, year) (Candidate) FPPC Form 501 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov