Tam 460Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
1191695
SEE INSTRUCTIONS ON REVERSE
1. Type of Recipient Committee: All Committees
Officeholder, Candidate Controlled Committee
0 State Candidate Election Committee
O Recall
(Also Complete Part 5)
0 General Purpose Committee
O Sponsored
0 Small Contributor Committee
0 Political Party/Central Committee
3. Committee Information
Statement covers period
from 01/01/2017
through
06/30/2017
Date of election if applicable:
(Month, Day, Year)
11/08/2016
g I CAW I a
Complete Parts 1, 2, 3, and 4.
O Primarily Formed Ballot Measure
Committee
0 Controlled
0 Sponsored
(Also Complete Pan 6)
• Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
11.D. NUMBER
1387962
COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE)
Tam for Council 2016
STREET ADDRESS (NO P.O. BOX)
CITY
STATE
Alameda CA
ZIP CODE
94501
MAILING ADDRESS (IF DIFFERENT) NO, AND STREET OR P.O. BOX
CITY
STATE
OPTIONAL: FAX / E-MAIL ADDRESS
WIS10111■■
M■1
AREA CODE/PHONE
(510)590-9536
ZIP CODE AREA CODE/PHONE
2. Type of Statement:
Preelection Statement
Semi-annual Statement
II
CA, ,IFC 1NIA
COVER PAGE
JUL 27 201
Page of 7
CITY OF ALAM DA For Official Use Only
CITY CLERK'S 0 FICE
O Termination Statement
(Also file a Form 410 Termination)
0 Amendment (Explain be)ow)
Treasurer(s)
O Quarterly Statement
O Special Odd-Year Report
0 Supplemental Preelection
Statement - Attach Form 495
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
IMIIK■1111
STATE ZIP CODE
CA 94501
STATE ZIP CODE
1110111■Willa
AREA CODE/PHONE
(510)882-9536
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.neffile.com
07/29/2017
07/29/2017
Date
Date
Date
By
By
By
By
Susan Reyes
/
Date
Responsible Officer of Sponsor
Signature of Controlling Officeholder, Candidate, State Measure Proponent
Signature of Controlling Officeholder, Candidate, State 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
5. Officeholder or Candidate Controlled Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Lena Tarn
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 ❑ NO
STREETADDRESS (NO P.O. BOX)
STATE ZIP CODE AREA CODE /PHONE
I.D. NUMBER
NAME OF TREASURER CONTROLLED COMMITTEE?
❑ YES ❑ NO
COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX)
CITY
www.neffile.com
STATE ZIP CODE AREA CODE /PHONE
6. Primarily Formed Ballot Measure Committee
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER
JURISDICTION
COVER PAGE - PART 2
CALIFORNIA
FORM
Page
2
460
of
7
❑ 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
❑ SUPPORT
❑ OPPOSE
❑ SUPPORT
❑ OPPOSE
❑ SUPPORT
❑ OPPOSE
❑ SUPPORT
❑ 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 REVERSE
NAME OF FILER
Tarn for Council 2016
Contributions Received
1. Monetary Contributions
2. Loans Received
3. SUBTOTAL CASH CONTRIBUTIONS
4. Nonmonetary Contributions
5. TOTAL CONTRIBUTIONS RECEIVED
Amounts may be rounded
to whole dollars.
Schedule A, Line 3 $
Schedule B, Line 3
Add Lines 1 + 2 $
Schedule C, Line 3
Add Lines 3 + 4 $
Expenditures Made
6. Payments Made Schedule E, Line 4 $
7. Loans Made 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 $
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.
17. LOAN GUARANTEES RECEIVED Schedule B, 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 $
www.neffile.com
Column A
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
0.00
0.00
0.00
0.00
0.00
6,091.98
0.00
6,091.98
0.00
0.00
6,091.98
8,284.12
0.00
0.00
6,091.48
2,192.64
Statement covers period
from
through
01/01/2017
SUMMARY PAGE
CALIFORNIA Ag A
FORM -Irww
06/30/2017 Page 3
I.D. NUMBER
1387962
of
7
Column B Calendar Year Summary for Candidates
CALENDAR YEAR
TOTAL TO DATE Running in Both the State Primary and
General Elections
0.00
867.00
867.00
0.00
867.00
6,091.98
0.00
6,091.98
0.00
0.00
6,091.98
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
0.00 for this calendar year, only
carry over the amounts
from Lines 2, 7, and 9 (if
any).
0.00
867.00
20. Contributions
Received
1/1 through 6/30 7/1 to Date
$ $
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 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866(275-3772)
www.fppc.ca.gov
Schedule B — Part 1
Loans Received
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Tam for Council 2016
FULL NAME, STREET ADDRESS AND ZIP CODE
OF LENDER
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
Lena Tam
Alameda, CA 94501
1- 0 IND 0 COM 0 OTH PTY D SCC
to IND 0 COM OTH 0 PTY 0 SCC
tO IND 0 COM 0 OTH PTY 0 SCC
Amounts may be rounded
to whole dollars.
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
Manager
EBMUD
OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
867.00
SUBTOTALS $
Statement covers period
from
through
(b) (c)
AMOUNT AMOUNT PAID
RECEIVED THIS OR FORGIVEN
PERIOD THIS PERIOD*
0.00
0.00 $
0 PAID
0.00
jJ FORGIVEN
0.00
0 PAID
FORGIVEN
PAID
fl FORGIVEN
$
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 $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.)
Enter the net here and on the Summary Page, Column A, Line 2.
*Amounts forgiven or paid by another party also must be reported on Schedule A.
** If required.
www.netfile.com
o . oo$
01/01/2017
06/30/2017
(d)
OUTSTANDING
BALANCE AT
CLOSE OF THIS
PERIOD
867.00
12/31/2018
DATE DUE
DATE DUE
DATE DUE
867.00$
0.00
0.00
NET $ 0.00
(May be a negative number)
(0)
INTEREST
PAID THIS
PERIOD
0
RATE
SCHEDULE B - PART 1
CALIFORNIA 460
FORM
Page 4
I.D. NUMBER
of 7
1387962
ORIGINAL CUMULATIVE
AMOUNT OF CONTRIBUTIONS
LOAN TO DATE
867.00
CALENDAR YEAR
0.00
PER ELECTION**
0.00 08/08/2016 s G2016 8E7 .00
DATE INCURRED
RATE
DATE INCURRED
RATE
DATE INCURRED
0.00
(Enter (e) on
Schedule E, Line 3)
CALENDAR YEAR
PER ELECTION **
CALENDAR YEAR
PER ELECTION**
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 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Schedule D
Summary of Expenditures
Supporting/Opposing Other
Candidates, Measures and Committees
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Tam for Council 201*
DATE NAME OF CANDIDATE OFFICE, AND DISTRICT, OR
MEASURE NUMSER OR LETTER AND JURISDICTION,
onoowwITss
03/04/2017 Re Elect Benny Lee For City Council 2016
District 4
Support 0 Oppose
06/29/2017 John Chiang for Governor 2018
0 Support [] Oppose
0 Support 0 Oppose
Amounts may be rounded
to whole dollars.
TYPE OF PAYMENT
Monetary
• Nonmonetary
Contribution
O Independent
Expenditure
Monetary
Contribution
Nonmonetary
Contribution
LJ Independent
Expenditure
O Monetary
Contribution
• Nonmonetary
Contribution
• Independent
Expenditure
DESCRIPTION
Statement covers period
from
01/01/2017
SCHEDULE D
CALIFORNIA A
FORM
through 06/30/e017 Page 5 of 7
uzNUMBER
1387962
CUMULATIVE PER ELECTION
AMOUNT THIS CALENDAR YEAR TO DATE
PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED)
300.00
300.00 02016 S300.00
2,500.00 2'500.00s2016 $2,500.00
SUBTOTAL $ 2.800.00
Schedule D Summary
1. Contributions and independent expenditures made this period of $100 or more. (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 pehod. (Add Lines 1 and 2. Do not enter on the Summary Page.) TOTAL $
pppc Form wm(Jamu 16)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
Schedule E
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Amounts may be rounded
to whole dollars.
Statement covers period
from
through
01/01/2017
06/30/2017
Tam for Council 2016
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
CNS
CTB
CVC
FIL
FND
IND
LEG
LIT
campaign paraphernalia/misc
campaign cons |tants
contribution (explain nonmonetary)*
civic donations
candidate filing/baliot fees
fundraising events
indeperident expenditure supporting/opposing others (explain)*
legal defense
campaign Iiterature and mailings
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ^moEwTEn/uwm^BEm
Angel Island Immigration
San Francisco, CA 94103
MBR
MTG
OFC
FET
nHO
POL
pos
PRO
PRT
member communications
meetings and appearances
office expenses
petition circulating
phone banks
polling and survey research
pnxtaoo, delivery and messenger services
professional services (|eoa|, accounting)
print ads
Re Elect Benny Lee For City Council 2016 District 4 (ID# 1348446)
San Leandro, CA e4573
City of Alameda
Alameda, CA 94501
CODE
CVC
CTB
FIL
RAD
RFD
SAL
TEL
TRC
TRS
TSF
VOT
WEB
SCHEDULE E
6 Page r o
/o.wumaEn
1387962
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, |nuoinn, and meals
transfer between committees of the same candidate/sponsor
voter registration
information technology costs (internet, e-mail)
OR DESCRIPTION OF PAYMENT
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
AMOUNT PAID
250.00
300.00
1,914.98
SVBTOlAL* 2'464.98
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) �
2. Unitemized payments made this period ofunder$100 s
3. Total interes paid this period on Ioans. (Enter amount from Schedule a. Part 1. Column (n).) �
4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $
5,771.48
320.00
0.00
6,091.48
FPPC Form 460 (Jan/20 6)
pppo Toll-Free xe/nxnp:xaovSK-FppoNsnors-3rru
www.fppc.ca.gov
Schedule E
(Continuation Sheet)
Payments Made
SEE INSTRUCTIONS ON REVERSE
NAME OF FILER
Amounts may be rounded
to whole dollars.
Statement covers period
from
01/01/2017
through 06/30/2017
Tam for Council 2016
•
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
ClvP
CNS
CTB
CVC
FIL
FND
IND
LEG
UT
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
NAMEANDADDRESSOFPAYEE
(IF COMMITTEE, ALSO ENTER I.D, NUMBER)
Alameda County APA Democratic Caucus (ID4 1288862)
San Leandro, CA 94577
Chinese Railroad Workers
San Francisco, CA 94108
Daily Bowl
Newark, CA 94560
John Chiang for Governor 2018 (1D4 1385799)
Encino, CA 91436
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
CODE OR
MTG
CVC
CVC
CTB
* Payments that are contributions or independent expenditures must also be summarized on Schedule D.
www.netfile.com
RAD
RFD
SAL
TEL
TRC
TRS
TSF
VOT
WEB
SCHEDULE E (CONT.)
CALIFORNIA A an
FORM 1.111,0
Page 7 of
LD. NUMBER
1387962
7
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)
DESCRIPTION OF PAYMENT
SUBTOTAL $
------■
AMOUNT PAID
250.00
399.00
157.50
2,500.00
3,306.50
FPPC Form 460 (Jan/2016)
FPPC Toll-Free Help line: 866/ASK-FPPC (866/275-3772)
www.fppc.ca.gov