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RAY RUSSOM, CAREN - FORM 501 - CANDIDATE INTENTION STATEMENT Candidate Intention Statement RE 'P CALIFORNIA 501. FORM Check One: ®Initial ❑Amendment (Explain) MAY 2 3 2022 For Official Use Only • CTTY 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) Caren Ray Russom (805 ) ( ) 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.) 0 State (Complete Part 2.) 2022 ® 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) ❑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) ❑ On, / L 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/t51 alifdrnia he foregoing is true and correct. 5 24 2022 --- Executed on Signature (month,day,year) Candidate) FPPC Form 501 (August/2018) FPPC Advice:advice@fppc.ca.gov(866/275-3772) www.fppc.ca.gov