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Tam 460Recipient Committee Campaign Statement Cover page (Government Code Sections 84200-84216.5) Type or print in ink. Statement covers period from January 1, 2009 SEE INSTRUCTIONS ON REVERSE NAME OF TREASURER through July 1' 2009 I Type of Recipient Committee: All Committees —Complete Parts 1, 2, 3, and 4. Officeholder, Candidate Controlled Committee Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall Controlled (Also Complete Part 5) 0 Sponsored General Purpose Committee {Also Complete Part 6} 0 Sponsored Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party /Central Committee (also Complete Part 7) 3. Committee Information CITY STATE ZIP CODE AREA CODEIPI -{ONE I.D. NUMBER OPTIONAL: FAX 1 E -MAIL ADDRESS 1267157 Date of election if appli (Month, Day, Year) COVER PAGE 2. Type of .Sta.tement: Preelection Statement Quarterly Statement Semi annual Statement Special. Odd -Year Report E❑ Termination Statement Supplemental Preelection (Also file a Form 410 Termination) Statement -Attach Form 495 Amendment (Explain below) Treasurer(s) COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) NAME OF TREASURER Friends for Lena Tam Lena Tam MAILING ADDRESS 2816 Waterton Street STREET ADDRESS (NO P.Q. BOX) CITY STATE ZIP CODE AREA CODE/PHONE Alameda, CA 94501 CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY Alameda, CA 94501 MAILING ADDRESS (IF DIFFERENT) NUJ. AND STREET OR P.D. Box MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODEIPI -{ONE Alameda, CA 94501 OPTIONAL: FAX 1 E -MAIL ADDRESS OPTIONAL. FAX 1 E -MAIL ADDRESS 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 By Rafe €Treasureror Assistant Treasurer 07/10 Executed on e y Date Signature of CorRrallincjOfriceholder, Candidate, State Measure Proponent or Responsible Officer of Sponsor Executed on By Rafe Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Controlling dfficeholder, Candidate, State Measure Proponent FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (866/275 -3772) State of California 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) Alameda City Council RESIDENTIALIBUSINESS 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? YES ND COMMITTEE ADDRESS STREETADDRESS (NO P.Q. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? YES ND COMMITTEE ADDRESS STREETADDRESS (NO P.O. BOX) CALIFORNIA 4 60.. FORM Page 2 of 5 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE BALLOT NO. OR LETTER .JURISDICTION 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 Farmed Ca /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 SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD SUPPORT E] OPPOSE u nn�n �.u ��vEV Atta co ntinuation s heets if necessary FPPC Form 460 January /05) FPPC Tall -Free Helpline: 865/ASK -FPPC (8661276 -3772) State of California Type or pri. t In ink. COVER.PAGE -PART 2 Campai Disclosure Statement T or print in ink. Amounts ma be rounded Summar Pa to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER SUMMARY PAGE Statement covers.. period from Januar 1, 2009 through Jul 1 2009 Page 3 of 5 I.D. NUMBER 12671.67 ..Calendar Year Summ for..Cand.idates Running in Both the State Primar and General Elections 111 throu 6130 711 to Date 20. Contributions Received 21. Expenditures Made Expenditures Made Column A Column B Contributions Received 7. Loans Made Schedule H, Line 3 TOTALTHIS PERIOD CALENDAR YEAR 8. SUBTOTAL CASH PAYMENTS Add Lines 6 7 72.00 11076.21 (FROM ATTACHED SCHEDULES) TOTAL TO DATE 1. Monetar Contributions Schedule A, Line 3 0 1,148.21 72.00 2. Loans Received Schedule B, Line 3 12. Be Cash Balance Previous Summar Pa Line 16 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 2 0 1,148.21 4. Nonmonetar Contributions Schedule C, Line 3 from Column B of y our last 5. TOTAL CONTRIBUTIONS RECEIVED Add Lines 3 +4 0 11148.21 fi that should be I.D. NUMBER 12671.67 ..Calendar Year Summ for..Cand.idates Running in Both the State Primar and General Elections 111 throu 6130 711 to Date 20. Contributions Received 21. Expenditures Made Expenditures Made 6. Pa Made Schedule E, Line 4 72.00 11076.21 7. Loans Made Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS Add Lines 6 7 72.00 11076.21 9. Accrued Expenses (Unpaid Bills) Schedule F, Line 3 10. Nonmonetar Adjustment Schedule C, Line 3 11. TOTAL EXPENDITURES MADE Add Lines 8 9 10 72.00 1,076.21 Current Cash Statement 12. Be Cash Balance Previous Summar Pa Line 16 21267.21 To calculate Column B, add 13. Cash Receipts Column A, Line 3 above 0 amounts. in Column A to the correspondin amounts 14. Miscellaneous Increases to Cash Schedule 1, Line 4 from Column B of y our last 15. Cash Pa Column A, Line 8 above 72.00 report. Some amounts in Column A ma be ne 16. ENDING CASH BALANCE Add Lines 12 13 14, then subtract Line 15 2,339.21 fi that should be subtracted from previous If this is a termination statement, Line 16 must be zero. period amounts. If this is the first report bein filed 17. LOAN GUARANTEES RECEIVED Schedule B, Part 2 for this calendar y ear, onl carr over the amounts from Lines 2, 7, and 0 (if Cash E and Outstandin Debts an 18. Cash E See instructions on reverse 19. Outstandin Debts Add Line 2 Line 9 in Column B above 21339.21 Expenditure Limit Summar for State Candidates 22. Cumulative Expenditures Made* if Subject to Voluntar Expenditure Limit) Date of Election Total to Date (mm/dd/ *Am ou nts in this section ma be different from amounts reported in Column B. FPPC Form 460 Januar y /05) FPPC Toll-Free Helpline: 866/ASK-FPPC (8661275-3772) Schedule A Type or print in ink. SCHEDULE A Monetary Contributions Received Amounts may be rounded Statement covers C to whale dollars. period from January 1, 2009 46O throug July 1, 2009 Pa 4 o f 5 Page SEE INSTRUCTIONS ON REVERSE g 9 NAME OF FILER I.D. NUMBER 1267167 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR T ZIB CpNTRIBUTC7R IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER AMOUNT RECEIVED THIS CUMULATIVE TO DATE CALENDAR YEAR PER ELECTION To DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CIF SELF EMPLOYED, ENTER NAME PERIOD (JAN. 1 DEC. 31 (IF REQUIRED) OF BUSINESS) IND COM OTH PTY SCC IND ❑COM OTH PTY SCC IND Co M R CTH PTY SCC IND ❑CoM CTH PTY SCC IND COM OTH PTY SCC i3 4�• F 5�'� n L 1 SUBTOTAL Schedule A Summary *Contributor Codes 1. Amount received this period —itemized monetary contributions IND Indi (Include all Schedule A subtotals.) COM Recipient Committee (other than PTY or SCC) 2. Amount received this period unitemized Monetary contributions of less than $100 0 OTH other (e .g., business entity) PTY Political Party 3. Total monetary contributions received this period. SCC Small Contributor Committee 0 (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) TOTAL FPPC Form 460 (January105) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) Schedule E Payments blade SEE I ON REVERSE Type or print in ink. Amounts may be rounded to whole dollars. NAME OF FILER Statement covers period from January 1, 2009 through July 1, 2009 CODES: If one of the 'Following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULEE Page 5 of 6 I.D. NUMBER 1267167 CMP campaign paraphernalia /misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing /ballot fees PHO phone banks TRC candidate travel, lodging; and meals FND fundraising events POL polling and survey research TRS staff /spouse travel, lodging, and meals IND independent expenditure supporting /opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate /sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e--mail) Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) 2. Uniternized payments made this period of under $100 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part'!, 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 72.00 FPPC Form 460 (January/05) FPPC Toll -Free Helpline: 866/ASK-FPPC (8661275 -3772) Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL