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Alameda Education Assication 450Recipient Committee Campaign Statement — Short Form SEE INSTRUCTIONS ON REVERSE For use by recipient committees that have not received a contribution or other receipt that must be itemized, have not received or made loans, and have no outstanding accrued expenses. 1. Type of Recipient Committee: D Ballot Measure Committee O Primarily Formed O Controlled O Sponsored Primarily Formed Candidate/ Officeholder Committee IMI■1•■•••■ 3. Committee Information Type or print in Ink. Statement covers period from January 1, 2015 te Stam Date of election if applica e: JUL 27 2015 (Month, Day, Year) CITY OF ALAMEDA through July 31, 2015 Gay CLERK'S OFFICE CAl_IFORNIA 450 FORM gl General Purpose Committee O Sponsored O Small Contributor Committee ID. NUMBER 1326421 COMMITTEE NAME ALAMEDA EDUCATION ASSOCIATION POLITICAL ACTION COMMITTEE OR AEA PAC STREET ADDRESS (NO P.O. BOX) CITY ALAMEDA STATE ZIP CODE AREA CODE/PHONE CA 94501 510-521-3034 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY OPTIONAL: FAX / E-MAIL ADDRESS aeactanea@sbc9lobal.net 4. Verification I have used all reasonable diligence in preparing and reviewing this s under penalty of perjury under the laws of the State of California that 7-62 0-15" STATE ZIP CODE AREA CODE/PHONE Executed on Executed on Executed on Executed on DATE DATE DATE DATE By By By By 2. Type of Statement: O Pre-election Statement • Semi-annual Statement O Termination Statement O Amendment (Explain) (Also check type of statement you are amending) Treasurer(s) NAME OF TREASURER Scott Mathieson MAILING ADDRESS CITY Alameda NAME OF ASSISTANT TREASURER, IF ANY Audrey Hyman MAILING ADDRESS CITY Alameda OPTIONAL: FAX / E-MAIL ADDRESS SHORT FORM age 1 of For Official Use Only 0 Quarterly Statement O Special Odd-year Report O Supplemental Pre-election Statement - Attach Form 495 STATE ZIP CODE CA 94501 STATE ZIP CODE CA 94502 AREA CODE/PHONE 510-523-5852 AREA CODE/PHONE 510-749-1308 MII1111■1■1 IF SIGNATUFK OF TREASURER OR ASSISTANT TREASURER SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT, OR RESPONSIBLE OFFICER OF SPONSOR SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT FPPC Form 450 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772) Recipient Committee Campaign Statement Summary Page NAME OF COMMITTEE Type or print in ink. Amounts may be rounded to whole dollars. from Statement covers period January 1, 2015 through July 31, 2015 CALIFORNIA SHORT FORM 450 FORM Page of I.D. NUMBER 1326421 Expenditures Made 1. Expenditures of $100 or more made this period 2. Expenditures under $100 made this period (Not itemized.) 3. SUBTOTAL EXPENDITURES MADE THIS PERIOD Add Lines 1 +2 $ 4. Nonmonetary Adjustment From Line 8 Below 5. Total expenditures made from previous statement Previous Summary Page, Line 6 $ (If this is the first statement for the calendar year, enter zero.) 6. TOTAL EXPENDITURES MADE TO DATE Add Lines 3 + 4 + 5 $ Contributions Received 7. Monetary contributions received this period 8. Non-monetary contributions received this period 9. Total contributions received from previous statement (If this is the first statement for the calendar year, enter zero.) 10. TOTAL CONTRIBUTIONS RECEIVED TO DATE Add Lines 7+ 8 + 9 $ Current Cash Statement 11. Beginning cash balance Previous Summary Page, Line 15 $ 12. Cash receipts this period Line 7 above 13. Miscellaneous increases to cash 14. Cash expenditures this period Line 3 above 15. ENDING CASH BALANCE THIS PERIOD Add Lines 11 + 12 + 13, then subtract Line 14 Previous Summary Page, Line 10 $ 500.00 96.80 596.80 0 596.80 75.00 2305.49 75.00 1783.69 FPPC Form 450 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Recipient Committee Campaign Statement — Short Form SEE INSTRUCTIONS ON REVERSE NAME OF COMMITTEE Type or print in ink. Amounts may be rounded to whole dollars. 5. Payments Made (If more space is needed, use additional copies of this page for continuation sheets.) DATE* 1/5/15 NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER ID. NUMBER) Terris, Barnes & Walters San Francisco, CA 94104 DESCRIPTION OF PAYMENT Postcards * Required only for payments which are contributions or independent expenditures. Statement covers period from January 1, 2015 through July 31, 2015 NAME OF CANDIDATE AND OFFICE OR NAME OF BALLOT MEASURE AND BALLOT NUMBER OR LETTER AND JURISDICTION SHORT FORM CALIFORNIA 450 FORM AMOUNT THIS PERIOD Page 3 of I.D. NUMBER 1326421 Karen Monroe 248 3rd Street, #724 $5-0606 Oakland, CA 94607 g Support 0 Oppose E] Contribution 0 Ind. Exp. O Support 0 Oppose O Contribution 0 Ind. Exp. O Support 0 Oppose O Contribution 0 Ind. Exp. SUBTOTAL 5-0 6, 001 CUMULATIVE AMOUNTS TO DATE* $ $ $ $ Calendar Year Other Calendar Year Other Calendar Year Other FPPC Form 450 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)