Tam 460Recipient Committee
Campaign Statement
Cover Page
(Government Code Sections 84200-84216.5)
1154814
SEE INSTRUCTIONS ON REVERSE
Statement covers period
from
07/01/2017
Date of election if applicable:
(Month, Day, Year)
Date Stamp
E
JAN 3 1 2018
CA! IFORNIA
FORM
through 12/31/2017 11/08/2016 CITY OF ALAMEDA
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
O Sponsored
o Small Contributor Committee
O Political Party/Central Committee
0 Primarily Formed Ballot Measure
Committee
0 Controlled
0 Sponsored
(Also Complete Part 6)
[1] Primarily Formed Candidate/
Officeholder Committee
(Also Complete Part 7)
3. Committee Information I.D. NUMBER
1387962
COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE)
Tam for Council 2016
STREET ADDRESS (NO P.O. BOX)
CITY STATE
ZIP CODE
Alameda CA 94501
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX
CITY STATE
OPTIONAL: FAX / E-MAIL ADDRESS
1■•
1•1■1111711.
AREA CODE/PHONE
(510)590-4536
ZIP CODE AREA CODE/PHONE
2. Type of Statement:
O Preelection Statement
O Semi-annual Statement
CITY CLERK'S OFF CE
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
1 of 5
For Official Use Only
0 Quarterly Statement
0 Special Odd-Year Report
11 Supplemental Preelection
Statement - Attach Form 495
STATE ZIP CODE
CA 99501
STATE ZIP CODE
AREA CODE/PHONE
(510) 882-4536
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
01/31/2017
Date
01/31/2017
Date
Date
Date
By
By
By
By
Susan Reyes
Lena Tam
. —
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)
Recipient Committee
Campaign Statement
Cover Page — Part 2
5. Officeholder or Candidate Controlled Committee 6. Primarily Formed Ballot Measure Committee
NAME OF OFFICEHOLDER OR CANDIDATE
Lena Tam
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 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 CONTROLLED COMMITTEE?
0 YES 0 NO
COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
NAME OF BALLOT MEASURE
BALLOT NO. OR LETTER
JURISDICTION
COVER PAGE- PART 2
CALIFORNIA Aan
FORM 'II' 1111, ‘11F
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
O OPPOSE
0 SUPPORT
O OPPOSE
O SUPPORT
O OPPOSE
0 SUPPORT
O OPPOSE
FPPC Form 460 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
Campaign Disclosure Statement
Summary Page
SEE NSTRUCTIONS ON REVERSE
NAME OF FILER
Tam for Council 2016
Contributions Received
1. Monetary Contributions Schedule A, Line 3
Z. Loans Received Schedule B, Line 3
3. SUBTOTAL CASH CONTRIBUTIONS Add Lines /~z
4. Nonmonetary Contributions Schedule C, Line 3
5. TOTAL CONTRIBUTIONS RECEIVED Add Lines x~*
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 * Line o
10. Nonmonetary Adjustment Schedule C, Line 3
11. TOTAL EXPENDITURES MADE Add Lines o~y~m
Current Cash Statement
12. Beginning Cash Balance
13. Cash Receipts
14. Miscellaneous Increases to Cash
15. Cash Payments
16. ENDING CASH BALANCE
Previous Summary Page, Line 16
Cofumn A, Line 3 above
Schedule 1, Line 4
Column A, Line 8 above
Add Lines 12 + 13 + 14, then subtract Line 15
If this is a termination statement, Line 16 must be zero.
•
17. LOAN GUARANTEES RECE!VED Schedule B, Part
Cash Equivalents and Outstanding Debts
18. Cash Equivalents See instructions on reverse
19. Outstanding Debts
Amounts may be rounded
to whole dollars.
Column A
TOTAL THIS PERIOD
(FROM ATTACHED SCHEDULES)
0.00
-867.00
-867.00
0.00
-867.00
1,325.64
0.00
1,325.64
0.00
0.00
1,325.64
z'z92.a4
-867.00
0.00
1,325.64
0.00
0.00
0.00
Add Line 2 + Line 9 in Column B above $
».»«
�
Statement covers period
from
through
Column B
CALENDAR YEAR
TOTALTO DATE
0.00
0.00
0.00
0.00
0.00
7,417.12
0.00
7.«17.zz
0.00
0.00
7,417.12
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 ths is
the first report being filed
for this calendar year, only
carry over the amounts
from Liries 2, 7, and 9 (if
any).
07/01/2017
12/31/2017
SUMMARY PAGE
CALIFORNIA 460
FORM
3 Page s '
ID. NUMBER
1zx7yaz
|- '---'------^ -----'
Calendar ¥ear Surnrnary 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*
(IT Subject m Voluntary Expenditure Limit)
Date of Electio
(mm/dd/yy)
/ /
Total to Date
*Amounts in this section may be differen from amounts
reported in Column B.
pppo Form wm(Jun/2m16)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
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 ID. NUMBER)
Lena Tam
Alameda, CA 94501
IND 0 COM D OTH D PTY LJ SCC
-11:1 IND 0 COM 0 OTH 11] PTY SCC
1-0 IND D COM D OTH PTY SCC
Amounts may be rounded
to whole dollars.
IF AN INDIVIDUAL, ENTER
OCCUPATION AND EMPLOYER
(IF SELF-EMPLOYED, ENTER
NAME OF BUSINESS)
Manager
El3MUD
(a)
OUTSTANDING
BALANCE
BEGINNING THIS
PERIOD
867.00
SUBTOTALS $
Statement covers period
from
through
07/01/2017
12/31/2017
(b) (c) (d)
OUTSTANDING
AMOUNT AMOUNT PAID BALANCE AT
RECEIVED THIS OR FORGIVEN. CLOSE OF THIS
PERIOD THIS PERIOD PERIOD
0$ PAID
867.00 0.00
0 FORGIVEN
0.00 0.00 12/31/2018
DATE DUE
PAID
$ $
FORGIVEN
DATE DUE
PAID
$ $
0 FORGIVEN
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 $100 paid or forgiven.)
(Include loans paid by a third party that are also itemized on Schedule A.)
3. Net change this period. (Subtract Line 2 from Line 1.)
Enter the net here and on the Summary Page, Column A, Line 2.
*Amounts forgiven or paid by another party also must be reported on Schedule A.
** If required.
867.00$
DATE DUE
0. oo$
0.00
867.00
NET $ -867.00
(May be a negative number)
(e)
INTEREST
PAID THIS
PERIOD
0
RATE
SCHEDULE B - PART 1
CALIFORNIA 460
FORM
Page 4
I.D. NUMBER
1387962
(f)
ORIGINAL
AMOUNT OF
LOAN
867.00
0.00 08/08/2016
DATE INCURRED
5
RATE
RATE
0.00
(Enter (e) on
Schedule E, Line 3)
of 5
(9)
CUMULATIVE
CONTRIBUTIONS
TO DATE
CALENDAR YEAR
$ —867.00
PER ELECTION**
CALENDAR YEAR
$
DATE INCURRED
DATE INCURRED
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)
' Schedule E
Payments Made
SEE NSTRUCTONS ON REVERSE
NAME OF FILER
Tam for Council 2016
Amounts may be rounded
to whole dollars.
Statement covers period
from
through
07/01/2017
12/31/2017
CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment.
GAP
CNS
CTB
CVC
FIL
FND
IND
LEG
LIT
campaign paraphernalia/misc.
campaign consultants
contribution (explain nonmonetary)*
civic donations
candidate finng8,aUc*fono
fundraising events
independent expenditure supporting/opposing others (explain)*
legal defense
campaign literature and mailings
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE. ALSO ENTER m.NUMBER)
Susan Reyes
Alameda, CA 94501
MBR
MTG
OFC
FET
PHO
POL
PoS
PRO
PRT
member communications
meetings and appearances
office expenses
petition circulating
phone banks
polling and survey research
pnuxase, delivery and messenger services
professional services (|eUo|, accounting)
print ads
CODE
PRO
RAD
RFD
SAL
TEL
TRC
TRS
TSF
VOT
WEB
SCHEDULE E
CALIFORNIA
FORM 460
Page sn of s
/.o.wumasm
1387962
radio airtime and production costs
returned contributions
campaign workers' salaries
t.^ or cable airtime and production costs
candidate travel, lodging, and meals
staff/spouse travel, |odsino, 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.
SUBTOTAL $
Schedule E Summary
1. Itemized payments made this period. (Include all Schedule E subtotals.) �
2. Unitemized paymerits made this period of uncier $1 00 �
3. Total interest paid this period on Ioans. (Enter amountfrom 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 $
AMOUNT PAID
300.00
300.00
300.00
^'nz5.m
0.00
/'s2u.6«
FPPC Form 460 (Jan/2016)
pppc Toll-Free *v|pxne:ao6/Aan-FpPC(oomzrs's7rz)