RAY RUSSOM, CAREN - FORM 501 - CANDIDATE INTENTION STATEMENT RECEIVED
Candidate Intention Statement Date Stamp CALIFORNIA 50.1
MAR 0 3 2020 FORM
Check One: ®Initial D Amendment (Explain) For Official Use Only
CITY CLERK'S OFFICE
CITY OF ARROYO GRANDE
1. Candidate Information:
NAME OF CANDIDATE (Last,First Middle Initial) DAYTIME TELEPHONE NUMBER FAX NUMBER(optional) EMAIL(optional)
Russom, Caren Ray (
STREET ADDRESS CITY STATE ZIP CODE
Arroyo Grande CA 93420
OFFICE SOUGHT(POSITION TITLE) AGENCY NAME DISTRICT NUMBER,if applicable. ❑NON-PARTISAN OFFICE
Mayor City of Arroyo Grande PARTY PREFERENCE:
OFFICE JURISDICTION (Check one box,if applicable.)
❑ State (Complete Part 2.) 2020 Q PRIMARY/GENERAL
❑X City D 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)
❑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:
0 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)
0 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 . al' = l� t - he foregoing is true and correct.
Executed on 03/03/2020 Signature
(month,day,year) • (C. didate) FPPC Form 501 (August/2018)
FPPC Advice:advice@fppc.ca.gov(866/275-3772)
www.fppc.ca.gov