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Williams 460Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) 1110147 SEE INSTRUCTIONS ON REVERSE Statement covers period from 10/23/2016 through 12/31/2016 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee o State Candidate Election Committee o Recall (Also Complete Part 5) 0 General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 0 Primarily Formed Ballot Measure Committee o Controlled 0 Sponsored (Also Complete Pea 6) El Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I 3. Committee Information I.D. NUMBER 1384281 COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE) Jennifer Williams for 2016Alameda Unified School District Board STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE Alameda CA 94502 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE OPTIONAL: FAX / E-MAIL ADDRESS bassjenn@aol .com ZIP CODE AREA CODE/PHONE (415)269-0900 AREA CODE/PHONE Date Stamp. , • • Date of election if applicable: (Month, Day, Year) 11/08/2016 2. Type of Statement: 0 Preelection Statement O Semi-annual Statement 0 Termination Statement (Also file a Form 410 Termination) O Amendment (Explain below) Treasurer(s) NAME OF TREASURER Susan Reyes MAILING ADDRESS CITY Alameda NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY OPTIONAL: FAX / E-MAIL ADDRESS ssjreyes@comcast.net COVER PAGE CALIFORNIA 460 FORM 1 of 9 ,Page For Official Use Only • Quarterly Statement O Special Odd-Year Report • Supplemental Preelection Statement - Attach Form 495 STATE ZIP CODE AREA CODE/PHONE CA 94501 (510)882-4536 STATE ZIP CODE AREA CODE/PHONE 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 and correct. Executed on Executed on Executed on Executed on www.netfile.com 01/27/2017 Date 01/27/2017 Date Date Dale By By, By By Susan Reyes Signature of Controlling Officeholder, Candidate, State Measure Proponent Signature of Controlling Officeholder, Candidate, Stale Measure Proponent FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Recipient Committee Campaign Statement Cover Page — Part 2 01.116411 5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee NAME OF OFFICEHOLDER OR CANDIDATE NAME OF BALLOT MEASURE Jennifer Williams OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Alameda Unified School District Board Mb: City Of Alameda RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY STATE ZIP Alameda CA 94502 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? 0 YES 0 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 www.netfile.com CONTROLLED COMMITTEE? 0 YES LINO STREET ADDRESS (NO P.O. BOX) STATE ZIP CODE AREA CODE/PHONE BALLOT NO. OR LETTER JURISDICTION COVER PAGE - PART 2 CALIFORNIA A an FORM Page 2 of 9 0 SUPPORT 0 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 0 SUPPORT 0 OPPOSE 0 SUPPORT 0 OPPOSE O SUPPORT O OPPOSE 0 SUPPORT O OPPOSE FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVESE NAME OF FILER Amounts may be rounded to whole dollars. Jennifer Williams for 2016alameaa Unified School District Board Contributions Received 1. MnnetoryCnnthbufiona Schedule A, Linen 2. Loans Received Schedule u Line a 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines /+u 4. Nonmonetary Contributions Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 + 4 Expenditures Made 6. Payments Made T. Loans Made Schedule E, Line 4 Schedule H, Line 3 Add Line 6 + 7 Schedule F, Line 3 Schedule C, Line 3 8. SUBTOTAL CASH PAYMENTS 9. Accrued Expenses (Unpaid Bills) 10. Nonmonetary Adjustment 11. TOTALEXPENDITURES MADE Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Line ro 13. Cash Receipts Co!umn A, Line 3 above 14. Miscellaneous Increases to Cash Schedule 1, Line * 15. Cash Payments Column A, Line oabove 16. ENDING CASH BALANCE Add Lines /o~1o~/4, then subfracf Lino 15 If this is a termination statement, Line 16 must be zero. 007111■111 17. LOAN GUARANTEES RECEIVED Schedule 8, Pad 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse 19. Outstanding Debts Add Line o~ Line em Column aabove Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 1,060.00 0.00 1,060.00 s.o^o.2n 7,900.20 6,630.77 0.00 6,630.77 0.00 6,840.20 13,470.97 7,320.45 1,060.00 0.00 6,630.77 1,749.68 0 . 0» 0 00 0 00 � � � Statement covers period from through Column B CALENDAR YEAR TOTALTO DATE 24,289.00 0.00 24,289.00 10,898.35 35,187.35 22,539.32 0.00 22,539.32 0.00 m'voa.3s 33,437.67 To calculate Column B, add amounts in Column A to the corresponding amounts from Column B of your ast report. Some amounts in Column A may be negative figures that should be subtracted from prevous 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). 10/23/2016 12/31/2016 SUMMARY PAGE CALIFORNIA FORM Page 3 of I.D. NUMBER 9 1384281 '--~---'—~~~- - ----- ---- 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* (11 Subject (0 Voluntary Expendituro Limit) Date of Electio (mm/dd/yy) / / � � Total to Date *Amounts in lhis section may be different from amounts reported in Column B. rpm Form wm(Jan/201s) FPPC Advice (866/275-3772) Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jennifer Williams for 2016Alameda Unified School District Board DATE RECEIVED Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER /�mvuoen CODE * 10/23/201* Unity PACAlameda Labor Council (zo# 1294190) Oakland, CA 94621 10/e7/201* Mark white Alameda, CA 94501 10/31/2016 Richard Lyons Alameda, CA 94502 11/01/2016 Mark Hamilton Alameda, CA 94501 COM Omn PTY LJsco IND OCOM Uom PTY []sCo IND OCOM UmH OPTY LJnCo I§1 121 IND OCOM UmH OPTY LJaco []|wo OooM OmH OPTY LJscc Statement covers period from 10/23/2016 through 12/31/2016 IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER OF SELF-EMPLOY NAME OF BUSINESS) Nurse San Francisco General Hospital Attorney Wendell Rosen Public Educator San Leandro Unified School District SUBTOTAL $ Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include 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. Enter here and ori the Summary Page, Column A, Line 1.) TOTAL $ AMOUNT RECEIVED THIS PERIOD 450.00 100.00 250.00 210.00 1,010.00 1,010.00 SCHEDULE A Page 4 /zzwumaEn 1384281 mUMULmwroDATE CALENDAR YEAR (JAN. 1 - DEC. 31) of 9 PER ELECTION TO DATE (IF REQUIRED) 700.00 G2016 $700.00 100.00 G2016 $100.00 250.00 G2016 $250.00 310.00 G2016 $310.00 *Contributor Codes |mo—Individual COM — Recipient Committee (other than PTY or SCC) 50 oo OTH — Othe (e.g., busines entity) PTY — Political Party eoo— Small Contributor Committee 1,060.00 rppc Form wm(Jan/2no) pppc Advice: auwoo@, pc.mu.env(000/2r5-3rrz) www.fppc.ca.gov Schedule C Nonmonetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. Jennifer Williams for 2016Alameda Unified School District Board DATE RECEIVED FULL NAME, STREE ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMIUEE, ALSO ENTER ID, NUMBER) 11/01/2016 Alameda Education Association Political Action Committee pow 1326421/ Alameda, CA 94501 11/04/2016 Alameda Education Association Political Action Committee (zow 13264e1) Alameda, CA 94501 CONTRIBUTOR OCCUPATION AND EMPLOYER CODE * (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) IF AN INDIVIDUAL, ENTER DIND COM OOTH UPTY USCC []Iwo COM OOTH UPTY USco []Iwo OCOM U0H 11] PTY []SCo []|ND OCOM O0H OPTY sco Attach additional information on appropriately labeled continuation sheets. Statement covers period from 10/23/2016 through 12/31/2016 DESCRIPTION OF GOODS OR SERVICES CMP - misc Campaign Materials Misc. Campaign Materials (CMP) AMOUNT/ FAIR MARKET VALUE 3,047.20 3,793.00 SuoTulAL* 6,840.20 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (lnclude alt Schedule 0 subtotals.) � 2. Amount received this period — unitemized nonmonetary contributions of less than $100 � 3. Tot l nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) TOTAL $ 6,840.20 SCHEDULE C Page 5 LaNUMBER 1384281 CUMULATIVE TO DATE CALENDAR YEAR of 9 PER ELECTION TO DATE (IF REQUIRED) 9'511.33o2016 $9'511.33 9'511.33e2016 $9'511.33 *Contributor Codes IND — Individual com —Recipient Committee (other than PTY or SCC) 0.00 oT*— Other (e.g, business entity) PTY — Political Party nCC — amaUoontribvmrCommittee 6,840.20 FPPC Form 460 (Jan/2016) FPPC Advice: auwne@r pcuayvv(uoo/2rs-3rrz) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. Jennifer Williams for 2016Alameda Unified School District Board ~~ ----- - - ---- • Statement covers period from through 10/23/2016 12/31/2016 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. o� CNS CTB CVC FIL FND LEG LIT compoignnaranhemonomi,c. campaign consultants contribution (explain nonmonetary)* civic donations candidate fihing/bailot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign hiterature and mailings ~~ NAME AND ADDRESS OF PAYEE (IF COMMITFEE, ALSO ENTER ID. NUMBER) NationBuilder Los Angeles, CA 90071 Democracy Engine LLC Washington, DC 20009 Democracy Engine LLC Washington, DC 20009 MBR MTG OFC PET PHO POL poo PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research pvomnu, delivery and messenger services professional services (looa|, accounting) print ads CODE WEB OFC OFC RAD RFD SAL TEL TRS TSF VOT wsa SCHEDULE E CALIFORNIA FORM Page 6 Of 9 I.D. NUMBER 1384281 radio airtime and productton costs returned contributions campaign workers salaries t.x or cable airtime and production costs candidate travel, |nouino, 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 DESCRIPT!ON OF PAYMENT * Payments that are contributions or independent expenditures must also be summarized on Schedule D. •� AMOUNT PAID 29.00 5.30 4.87 SUBTOTAL $ 39.17 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) 2. Unitemized payments made this period of under $1 00 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 $ � � � www.netfile.com 6,594.29 36.48 0.00 6,630.77 FPPC Form wmVan/201q FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. Jennifer Williams for 2016Alameda Unified School District Board Statement covers period from 10/23/2016 through 12/31/2016 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, avP CNS CTB CVC FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate filing/ballot fees fundraising events independent expenditure supporting/opposing others (explain)' legal defense campaign literature and mailings NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Democracy Engine LLC Washington, DC 20009 Alliance Campaign Strategies Pleasanton, CA 94566 Autumn Press Berkeley, CA 94710 Office Depot Office Max Alameda, CA 94501 Democracy Engine LLC Washington, DC 20009 MBR MTG OFC PET PHO POL POS PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey research postage, delivery and messenger services professional services (legal, accounting) print ads RAD RFD SAL TEL TRC TRS TSF VOT VVEB SCHEDULE E (CONT.) CALIFORNIA 460 FORM Page 7 I.D. NUMBER 1389281 of 9 describe the payment. radio airtime and production costs returned contributions campaign workers' salaries t.v. 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) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID OFC CNS LIT OFC OFC * Payments that are contributions or independent expenditures must also be summarized on Schedule D. www.neffile.com SUBTOTAL $ 44.70 1,500.00 3,053.33 11.65 8.07 4,617.75 FPPC Form 460 (Jan/2016) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded to whole dollars. Jennifer Williams for 2016Alameda Unified School District Board CODES: If one of the following codes accurately describes the CNS CTB CVC FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate fihing/baliot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings • NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER ID. NUMBER) Office Office Max Alameda, CA 94501 Office Office Max Alameda, CA 94501 Democracy Engine LLC Washington, DC 20009 Susan u Alameda, CA 94501 Alliance Pleasanton, CA 94566 MBR MTG OFC FET PHO POL poa PRO PRT payment, you may ente the code. member communications meetings and appearances office expenses petition circulating phone banks polling and survey research pvstaoe, delivery and messenger services professional services (|uno|, accounting) print ads CODE OFC OFC OFC PRO CNS *Payments that are contributions or independent expenditures must also be summarized on Schedule D. Statement covers period from 10/23/2016 through 12/31/2016 SCHEDULE E (CONT.) CALIFORNIA A FORM Page 8 of 9 I.owuwasn 1384281 `-' Othomwioe, describe the payment. RAD radio airtime nu production cosx RFD returned contributions SAL campaign workers salaries TEL t.^ or cable airtime and production costs TRC candidate travel lodging, u meals TRS staff/spouse trav |. |vuomo, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration VVEB information technology costs (internet, e-mail) OR DESCRIPTION OF PAYMENT AMOUNT PAID 71.92 29.38 2.07 375.00 1,380.00 auoTolAL* 1,858.37 FPPC Form 460 (Jan/2016) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVEISE NAME OF FILER Amounts may be rounded to whole dollars. Jennifer Williams for 2016Alameda Unified School District Board Statement covers period from 10/23/2016 through 12/31/2016 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CiVP CNS CTB CVC FIL FND IND LEG LIT campaign paraphernalia/misc. campaign consultants contribution (explain nonmonetary)* civic donations candidate fihing/baliot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings • NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER ID. NUMBER) NationBuilder Los Angeles, CA 90071 CA Secretary of State saocameoto, CA 95814 MBR MTG OFC PET PHO POL pna PRO PRT member communications meetings and appearances office expenses petition circulating phone banks polling and survey res urco pnstano, delivery and messenger services professional services (|eoa|, accounting) print ads CODE WEB FIL * Payments that are contributions or independent expenditures must also be summarized on Schedule D. RAD RFD SAL TEL mo TRS TSF VOT WEB SCHEDULE E (CONT.) FORM 'VW AilF Page 9 of /.owuwosn 1384281 radio airtime and production costs returned contributions campaign workers' salaries tv. or cable airtime and production costs candidate travel, |ooninu, and meals staff/spouse travel, |vooino, and meals transfer between committees of the same candidate/sponsor voter re imranon information technology costs (internet, e-mail) OR DESCRIPTION OF PAYMENT SUBTOTAL $ AMOUNT PAID 29.00 50.00 79.00 FPPC Form 460 (Jan/2016) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) www,pp«.;».y^"