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Chen 460Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period 01/01/2015 from through 06/30/2015 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 0 Officeholder, Candidate Controlled Committee o State Candidate Election Committee o Recall (Also Complete Part 5) El General Purpose Committee 0 Sponsored o Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information LI Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Part 6) 0 Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1349155 COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE) Stewart Chen for Alameda City Council 2016 STREET ADDRESS (NO P.O. BOX) CITY Alameda STATE ZIP CODE CA 94501 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE STATE ZIP CODE San Leandro CA 94578 OPTIONAL: FAX / E-MAIL ADDRESS lindajperry@hotmail.com 4. Verification 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-ar4correct AREA CODE/PHONE (510)465-7982 COVER PAGE Date of election if applicable: (Month, Day, Year) CITY OF ALAMEDA 11/08/2016 CITY CLERK'S OFFICE 2. Type of Statement: 11] Preelection Statement 0 Semi-annual Statement Termination Statement (Also file a Form 410 Termination) El Amendment (Explain below) For Official Use Only Quarterly Statement LI Special Odd-Year Report Supplemental Preelection Statement - Attach Form 495 Treasurer(s) NAME OF TREASURER Linda Perry MAILING ADDRESS CITY STATE ZIP CODE San Leandro CA 94578 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX / E-MAIL ADDRESS AREA CODE/PHONE (510)258-7787 AREA CODE/PHONE (510)258-7787 AREA CODE/PHONE Executed on Executed on Executed on Executed on 7/ 0 By Dal [77 ;L:7„Lta, Date Date Date By By By Sponsor Signature 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 (8661275-3772) State of California Type or print in ink. Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Stewart Chen OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member, City of Alameda 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 COMMITTEE ADDRESS CITY COMMITTEE NAME CONTROLLED COMMITTEE? YES El NO STREET ADDRESS (NO P.O. BOX) STATE ZIP CODE AREA CODE/PHONE I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? LI YES LI NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION LI SUPPORT 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 El SUPPORT • OPPOSE fl SUPPORT Lj OPPOSE [1] SUPPORT [l] OPPOSE • SUPPORT E] OPPOSE 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 Type or print in ink. Amounts may be rounded to whole dollars. Stewart Chen for Alameda City Council 2016 Contributions Received 1. Monetary Contributions Schedule A, Line 3 $ 2. Loans Received Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +x $ 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 Schedule F, Line 3 Schedule C, Line 3 Add Lines 8. SUBTOTAL CASH PAYMENTS 9. Accrued Expenses (Unpaid Bills) 10. Nonmonetary Adjustment 11. TOTAL EXPENDITURES MADE _ Current Cash Statement 12. Beginning Cash Balance Previous a um_ mo_ p_ Page, Line 16 � $ 13. Cash Receipts Column A, Line xabove 14. Miscellaneous Increases to Cash Schedule I, Line 15. Cash Payments Column A. Line oabove 16. ENDING CASH BALANCE Add Lines /o~m~14, then subtract Line /o $ If this isa termination statement, Line /n must uozero. 17. LOAN GUARANTEES RECEIVED Schedule 4 Part z $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents 18. Outstanding Debts See ins(ructions on reverse $ Add Line 2 + Line 9 in Column 13 above $ Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 0.00 0.00 0.00 0.00 0.00 3186.82 0.00 3186.82 0.00 0.00 3186.82 � Statement covers period 01/01/2015 from through Column B CALENDAR YEAR TOTAL TO DATE 3686.13 ' � 0.00 1.22 3186.82 500.53 0.00 2850.00 2850.00 0.00 2850.00 3186.82 0.00 3186.82 0.00 0.00 3186.82 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your Iast 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 0 for this calendar year, only carry over the amount from Lines 2, 7, and 9 (if any). 0 285000 FPPC Form 460 (January/05 06/30/2015 SUMMARY PAGE ISCAUFORMANIF 3 10 Page of uzwuwasn 1349155 ' ' ----- ----' Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 20. Contributions } Received � 21. Expenditures Made 1/1 through 6/30 7/1 to Date Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject m Voluntary Expenditure Limit) Date of Election (mm/dd/yy) L-----/ � / / � Total to Date *Amounts in this section may be different from amounts reported in Column B. Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Stewart Chen for Alameda City Council 2016 DATE RECEIVED Type or print in ink. Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITrEE, ALSO £NTER .0. NUMBER) CODE * Owm OCOM UOm UPTY []aoc []Imo OCOw O0H OPTY LJ000 []Iwo OCow LOTH OPTY []Soo []|wn Ooom []DT* [1] PTY []aCn []|wo OCom []oTH OPTY []GCC 11111.12a• IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOY D, ENTER NAME OF BUSINESS) SUBTOTAL $ Schedule A Summary 1. Amount received this period — itemized monetary contributions. (lnclude all Schedule A subtotals.) � 2. Amount received this period — unitemized monetary contributions of less than $100 � 3. Total monetary contributions received this period. (Add Lines 1 and 2. Eriter here and on the Sumrnary Page, Column A, Line 1.) TOTAL $ Statement covers period 01/01/2015 from through 06/30/2015 AMoU NT RECEIVED THIS PERIOD 0.00 SCHEDULE A 4 10 Page of /zzwuwasn 1349155 mUMmLATIvmDATE CALENDAR YEAR (JAN. 1 - DEC. 31) PER ELECTION TO DATE (IF REQUIRED) *Contributor Codes IND — Individua 0.00 COM — Recipient Committee (other than PTY or SCC) 0.00 OTH — Other (e.g., business entity) PTY— Political Party nCc— Small Contributor Committee 0.00 FPPC Form 460 (January/05 pppc Toll-Free *mpxne:oosoAamFrpc(xamzrs-3rro) Schedule B — Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Stewart Chen for Alameda City Council 2016 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Stewart Chen Alameda, CA 94501 t® IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Stewart Chen Alameda, CA 94501 tE7) IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Stewart Chen Alameda, CA 94501 t© IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Type or print in ink. Amounts may be rounded to whole dollars. IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF - EMPLOYED, ENTER NAME OF BUSINESS) Chiropractor Self- employed: Careplus Chiropractic Chiropractor Self- employed: Careplus Chiropractic Chiropractor Self - employed:Careplus Chiropractic OUTSTANDING BALANCE BEGINNING THIS PERIOD 800.00 (b) AMOUNT RECEIVED THIS PERIOD s 1000.00 700.00 SUBTOTALS $ Statement covers period 01/01/2015 from through (c) AMOUNT PAID OR FORGIVEN THIS PERIOD* ❑ PAID 06/30/2015 ) OUTSTANDING BALANCEAT CLOSE OF THIS PERIOD 0 800.00 ❑ FORGIVEN 0 s 0 12/31/14 s DATE DUE ❑ PAID '(e) INTEREST PAID THIS PERIOD 0 RATE SCHEDULER - PART 1 Page 5 I.D. NUMBER 1349155 (t) ORIGINAL AMOUNT OF LOAN of 10 (9) CUMULATIVE CONTRIBUTIONS TO DATE CALENDAR YEAR s 800.00 s 2500.00 PER ELECTION" 0 2/4/13 $ DATE INCURRED CALENDAR YEAR 0 1000.00 0 s 1000.00 2500.00 % ❑ FORGIVEN RATE PER ELECTION** 0 0 12/31/14 s 0 7/30/12 DATE DUE DATE INCURRED ❑ PAID ❑ FORGIVEN 0 0 700.00 0 12/31/14 DATE DUE 0 RATE s 700.00 CALENDAR YEAR s 2500.00 PER ELECTION"" 0 9/28/12 DATE INCURRED 0 $ 0 $ 2500.00 $ Schedule B Summary 1. Loans received this period (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) Enter the net here and on the Summary Page, Column A, Line 2. 0.00 0.00 NET $ 0.00 *Amounts forgiven or paid ** If required. by another party also must be reported on Schedule A. (May be a negative number) 0 (Enter (e) on Schedule E, Line 3) tContributor Codes IND— Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC— Small Contributor Committee FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866 /ASK -FPPC (8661275 -3772) Schedule B — Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Stewart Chen for Alameda City Council 2016 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Stewart Chen Alameda, CA 94501 t2 IND ❑ COM ❑ OTH ❑ PTY ❑ SCC t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Type or print in ink. Amounts may be rounded to whole dollars. IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF - EMPLOYED, ENTER NAME OF BUSINESS) Chiropractor Self- employed: Careplus Chiropractic (a) OUTSTANDING BALANCE BEGINNING THIS PERIOD 350.00 s AMOUNT RECEIVED THIS PERIOD s 5 0.00 Statement covers period 01/01/2015 from through (c) AMOUNT PAID OR FORGIVEN THIS PERIOD* ❑ PAID ❑ FORGIVEN 0 0 s ❑ PAID ❑ FORGIVEN s ❑ PAID ❑ FORGIVEN s 06/30/2015 OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD s s $ 350.00 12/31/14 DATE DUE DATE DUE DATE DUE $ $ (0) INTEREST PAID THIS PERIOD 0 RATE SCHEDULE B - PART 1 Page 6 of 10 I.D. NUMBER 1349155 (f) ORIGINAL AMOUNT OF LOAN 350.00 0.00 4/26/14 DATE INCURRED RATE RATE SUBTOTALS $ 0.00 $ 0.00 $ 350.00 $ 0.00 Schedule B Summary 1. Loans received this period $ (Total Column (b) plus unitemized loans of less than $100.) 2. Loans paid or forgiven this period (Total Column (c) plus loans under $100 paid or forgiven.) (Include loans paid by a third party that are also itemized on Schedule A.) 3. Net change this period. (Subtract Line 2 from Line 1.) Enter the net here and on the Summary Page, Column A, Line 2. Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. 0.00 0.00 NET $ 0.00 (May be a negative number) (Enter (e) on Schedule E, Line 3) $ DATE INCURRED DATE INCURRED (g) CUMULATIVE CONTRIBUTIONS TO DATE CALENDAR YEAR 350.00 PER ELECTION** s 2850.00 CALENDAR YEAR 5 PER ELECTION ** CALENDAR YEAR PER ELECTION** 1-Contributor Codes IND— Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee 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 INSTRUCTPONS ON REVERSE NAME OF FILER Stewart Chen for Alameda City Council 2016 - ~ - NAME OF CANDIDATE OFFICE, AND DISTRICT, OR MEASURE NUMBER OR LETTER AND JURISDICTION, OR COMMITTEE DATE 6/29/2015 Re-Elect Benny Lee for San Leandro City Council 2016 District 4FPPC|O#1348448 San Leandro, CA0457Q i2j Support 0 Oppose [] Support [] Oppose 0 Support 0 Oppose Type or print in ink. Amounts may be rounded to whole doUars. TYPE OF PAYMENT W6 Monetary Contribution []wonmomtary Contribution [] Independent Expenditure O Monetary Contribution • wonmonetary Contribution O Independent Expenditure []monetary Contribution [] Nonmonetary Contribution [] Independent Expenditure DESCRIPTION (IF REQUIRED) Statement covers period 01/01/2015 from through 06/30/2015 AMOUNT THIS PERIOD SCHEDULED 7 10 Page of uzwuwasm 1349155 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) 500.00 500.00 SUBTOTAL $ 500.00 Schedule 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) 500.00 500.00 0.00 500.00 FPPC Form 460 (January/05) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Stewart Chen for Alameda City Council 2016 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period 01/01/2015 from through 06/30/2015 CODES: If one of the following codes accurately describes the payment, you may enter the code. Othorwioe, describe the payment. oVP CNS on CVC FIL FND ND LEG LIT campaign campaign consultants contribution (explain nonmonetary)* civic donations candidate fihing/bailot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and maihinys NAME AND ADDRESS OF PAYEE (IF COMMITtEEALSO ENTER LO. NUMBER) City ofAlameda City Clerk Alameda, CA 94501 Alameda Sister City Association (ASCA) c/o Cynthia Bortta Alameda, CA 94501 MBR MTG OFC PET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polhing and survey research voomge, delivery and messenger services professional services (|nom, accounting) print ads Re-elect Benny Lee for City Council 2016 District 4 FPPC ID#1348446 San Leandro, CA 94579 CODE FIL CVC CTB mm RFD SAL TEL -FRC TRS TSF VOT WEB SCHEDULE E 8 10 Page of /.o.wowesn 1349155 radio airtime and production costs returned contributions campaign workers' salaries ,x or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (Internet, e-mail) OR DESCRIPTION OF PAYMENT Candidate's Baliot Statement * Payments that are contributions or independent expenditures must also be summarized on Schedule D. AMOUNT PAID 2186.82 500.00 500.00 SUBTOTALS 3186.82 Schedule E Summary 1. ttemized payments made this period. (lnclude alt Schedule E subtotals.) 2. Unitemizod payments made this period of under $1OO 3. Total interes paid this period on hoans. (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 $ � � 3186.82 0.00 0.00 3186.82 FPPC Form 460 (January/05) Schedule F Accrued Expenses (Unpaid Bills) SEE INSTRUCTIONS ON REVERSE NAME OF FILER Stewart Chen for Alameda City Council 2016 CODES: If one of the following codes accurately describes the CUP campaignparaphemalia/misc. MBR CNS campaign consultants MTG CTB contribution (explain nonmonetary)* OFC CVC civic donations PET FIL conoiuotonUno/bauot fees pH) END fundraising events POL IND independent expenditure supporting/opposing others (explain)* POS LEG legal defense PRO LIT campaign literature and mailings PRT NAME AND ADDRESS OF CREDITOR (IF COMMITFEE. ALSO ENTER ID, NUMBER) City of Alameda City Clerk Alameda, CA 94501 * Payments that are contribution or independent expenditures must also be summarized on Schedule D. Type or print in ink. Amounts may be rounded to whole dollars. payment, you may enter the code. member communications meetings and appearances office expenses petition circulating phone banks po(ling and survey research puamoe, delivery and messenger services professional services (|eoa|, accounting) print ads CODE OR DESCRIPTION OF PAYMENT Candidate's Statement (FIL) Statement covers period 01/01/2015 from through 06/30/2015 [themiuo, describe the payment. (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD 2000.00 SUBTOTALS $ 2000.00 $ RAD RFD SAL TEL nRC TRS TSF VOT WEB SCHEDULE F 9 10 Page of uzNUwBEa 1349155 radio airtime and production costs returned contributions campaign workers' salaries u/ or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (internet, e-mail) (b) AMOUNT INCURRED THIS PERIOD 2186.82 /»"�r»' (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) 2186.82 2186.82 $ 2186.82 $ Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under $100.) PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and on the Summary Page, Column A, Line 9.) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD 0.00 0.00 2186.82 2186.82 0.00 NET $ May be a negative number FPPC Form 460 (January/05) 'SchedWle I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF FILER Stewart Chen for Alameda City Council 2016 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER ID, NUMBER) Attach additional information on appropriafely Iabeled continuation sheets. Type or print in ink. Amounts may be rounded to whole dotlars. Statement covers period 01/01/2015 from through 06/30/ 2015 DESCRIPTION oFRECEIPT Schedule 1 Summary 1. Itemized increases to cash this period. � 2. Unitemized increases to cash of under $100 this period. $ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) � 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) TOTAL $ SCHEDULE 1 10 10 Page of I.D. NUMBER 1349155 AMOUNT OF INCREASE TO CASH SUBTOTAL * 8.00 0.00 1.22 0.00 1.22 FPPC Form 460 (January/05)