HomeMy Public PortalAboutForm 501Candidate Intention Statement
AUG 0 3 2020
Check One: ®Initial ❑Amendment (Explain)
CUY CLERK
f OF C .AREI!!I( NT
1. Candidate Information:
For Official Use Only
NAME OF CANDIDATE (Last, First Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER (optional) EMAIL (optional)
Zachary Courser ( 617 ) 901-8787 ( ) zcourser@gmail.com
STREETADDRESS CITY STATE ZIP CODE
1 142 N Cambridge Ave
OFFICE SOUGHT (POSITION'
Claremont
CA 91711
NON-PARTISAN OFFICE
Councilperson City of Claremont 1 IPAR
OFFICE JURISDICTION
❑ State (Complete Part 2.)
T 2020
JZ] City ❑ County ❑ Multi -County: (Name of Multi -County Jurisdiction) (Year of Election)
2. State Candidate Expenditure Limit Statement:
(Ca1PERS and CaISTRS candidates, judges, judicial candidates, and candidates for local offices do not complete Part 2.)
(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.
PREFERENCE:
(Check one box, if applicable.)
VJ PRIMARY/ GENERAL
❑ SPECIAL / RUNOFF
Amendment:
❑ 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 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 t foregoing is true and correct.
Executed on g 3 2020 Signature
(month, day, year) (Candidate) FPPC Form 501 (August/2018)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov