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Sullwold 460Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period 07/01/14 from through 09/30/14 ■IM■ a YA.0 Date of election if licable: (Month, Day, Year) CT OF ALAMEDA CITY CLERK'S OFFICE 11/04/14 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 2. Type of Statement: • Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee O Recall (Also Complete Part 5) O General Purpose Committee O Sponsored o Small Contributor Committee o Political Party/Central Committee 3. Committee Information 0 Primarily Formed Ballot Measure Committee o Controlled 0 Sponsored (Also Complete Part 6) 0 Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1349912 COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE) Jane Sullwold for City Council 2014 STREET ADDRESS (NO P.O. BOX) CITY Alameda STATE CA ZIP CODE 94501 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE OPTIONAL: FAX / E-MAIL ADDRESS jcs@janeforcouncil.com 4. Verification IN•■•■ AREA CODE/PHONE 510-864-7026 ZIP CODE AREA CODE/PHONE 0 Preelection Statement O Semi-annual Statement O Termination Statement (Also file a Form 410 Termination) O Amendment (Explain below) Treasurer(s) NAME OF TREASURER Robert T. Sullwold MAILING ADDRESS CITY Alameda NAME OF ASSISTANT TREASURER, IF ANY Jane Sullwold MAILING ADDRESS CITY Alameda OPTIONAL: FAX / E-MAIL ADDRESS jcs@janeforcouncil.com COVER PAGE CALIFORNIA Artn FORM 1 5 Page of For Official Use Only [I] Quarterly Statement 0 Special Odd-Year Report El Supplemental Preelection Statement - Attach Form 495 STATE ZIP CODE CA 94501 STATE ZIP CODE CA 94501 MIMIZIPMMI AREA CODE/PHONE 510-864-7026 AREA CODE/PHONE 510-864-7026 I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the information contained herein and in the attached schedules is true and complete. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 10/06/14 Date Treasurer 10/06/14 Date Executed on Executed on Executed on Executed on By Date Date By By . By Signature o Officeholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Lure of Controlling Officeholder, Candidate, State Measure Proponent Signature of Controlling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) State of California Recipient Committee Campaign Statement Cover Page — Part 2 Type or print in ink. 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE Jane Sullwold OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council. Alameda, CA RESIDENTIAL/BUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Alameda, CA 94501 Related Committees Not Included in this Statement: List any committees not included in this statement that are controlled by you or are primarily formed to receive contributions or make expenditures on behalf of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? LI YES [1] NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER COMMITTEE ADDRESS CITY CONTROLLED COMMITTEE? El YES 11 NO STREET ADDRESS (NO P.O. BOX) STATE ZIP CODE AREA CODE/PHONE ■•■■■ 11!7107111111■ NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION COVER PAGE - PART 2 CALIFORNIA A a FORM "II UP Page 2 5 of SUPPORT El OPPOSE Identify the controlling officeholder, candidate, or state measure proponent, if any. NAME OF OFFICEHOLDER, CANDIDATE, OR PROPONENT OFFICE SOUGHT OR HELD DISTRICT NO. IF ANY 7. Primarily Formed Candidate/Officeholder Committee List names of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD Attach continuation sheets if necessary SUPPORT OPPOSE LI SUPPORT LI OPPOSE Lil SUPPORT OPPOSE El SUPPORT I] OPPOSE 111■■■■■■■■=0.01111■ FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772) State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jane Sullwold for City Council 2014 Contributions Received Type or print in ink. Amounts may be rounded to whole dollars. 1. Monetary Contributions Schedule A, Line 3 $ 2. Loans Received Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 + 2 $ 4. Nonmonetary Contributions Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 + 4 Expenditures Made 6. Payments Made 7. Loans Made Schedule E, Line 4 Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS Add Lines 6 + 7 9. Accrued Expenses (Unpaid Bills) Schedule F, Line 3 10. Nonmonetary Adjustment Schedule C, Line 3 11. TOTAL EXPENDITURES MADE Add Lines 8 + 9 + 10 $ $ Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Line 16 $ 13. Cash Receipts Column A, Line 3 above 14. Miscellaneous Increases to Cash Schedule 1, Line 4 15. Cash Payments Column A, Line 8 above 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ If this is a termination statement, Line 16 must be zero. 11111.lain 17. LOAN GUARANTEES RECEIVED Schedule 8, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse $ 19. Outstanding Debts Add Line 2 + Line 9 in Column B above 0.00 0.00 0.00 0.00 0.00 599.00 0.00 599.00 0.00 0.00 599.00 5769.96 0.00 0.00 599.00 5170.96 0.00 ■11■111■11¢1, 0.00 0.00 $ Statement covers period 07/01/14 from through Column B CALENDAR YEAR TOTAL TO DATE 0.00 0.00 0.00 0.00 0.00 599.00 0.00 599.00 0.00 0.00 599.00 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your last report. Some amounts in Column A may be negative figures that should be subtracted from previous period amounts. If this is the first report being filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 09/30/14 SUMMARY PAGE CALIFORNIA 460 FORM 3 Page of I.D. NUMBER 1349912 5 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 20. Contributions 1/1 through 6/30 7/1 to Date Received 21. Expenditures Made Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election (mm/dd/yy) / / $ Total to Date *Amounts in this section may be different from amounts reported in Column B. FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule D Summary of Expenditures Supporting/Opposing Other Candidates, Measures and Committees SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jane Sullwold for City Council 2014 DATE 09/04/14 09/04/14 NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LE1TER AND JURISDICTION, OR COMMITTEE Frank Matarrese for City Council 2014 O Support 0 Oppose Frank Matarrese for City Council 2014 O Support 0 Oppose O Support 0 Oppose Type or print in ink. Amounts may be rounded to whole dollars. TYPE OF PAYMENT Q1 Monetary Contribution [] Nonmonetary Contribution [] Independent Expenditure []Monetary Contribution Nonmonetary Contribution [] Independent Expenditure []Monetary Contribution [] Nonmonetary Contribution [] Independent Expenditure DESCRIPTION (IF REQUIRED) 300 lawn sign stakes Statement covers period 07/01/14 from through 09/30/14 AMOUNT THIS PERIOD SCHEDULE CALIFORNIA 460 FORM of 5 .---- ----~~~.---=~■1101. CUMULATIVE nzDATE CALENDAR YEAR (JAN. 1 - DEC. 31) 500.00 500.00 375.00 875.00 SUBTOTAL $ 875.00 Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.) � 2. Unitemized contributions and independent expenditures made this period of under $100 � 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL $ PER ELECTION TO DATE (IF REQUIRED) 875.00 99.00 974.00 FPPC Form 460 (January/05) rppc Toll-Free *wpline:nasxuSmfppo(aonm7*-377o) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jane Sullwold for City Council 2014 CODES: If one of the following codes accurately GNP CNS CTB CVC FIL FND IND LEG LIT campaignparaphomm|ia/mksc. campaign consultants contribution (explain nonmonetary)* civic donations candidate fihing/baliot fees fundraising events ndependent expenditure supporting/opposing others (e legal defense campaign literature and mailings • Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period 07/01/14 from through 09/30/14 describes the payment, you may enter the code. Otherwise, describe the payment. xplain)* NAMEANDADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Frank Matarrese for City Council 2014 MBR MTG OFC FET P140 POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research pnstage, delivery and messenger services professional services (legal, accounting) print ads RAD RFD SAL TEL TRC TRS TSF VOT WEB SCHEDULE CALIFORNIA A FORM 5 Page of /.uwmwasn 1349912 5 J11111■16■11ii radio airtime and production costs returned contributions campaign workers salaries tx or cable airtime and production costs candidate travel, |odUing, and meals staff/spouse travel, |odQing, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (internet, e-mail) CODE OR DESCRIPTION OF PAYMENT CTB * Payments that are contributions or independent expenditures must also be summarized on Schedule D. AMOUNT PAID 500.00 SUBTOTAL$ 500.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) � 2. Unitemized payments made this period of under $100 � 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) � 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $ 500.00 99.00 0.00 599.00 FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)