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Henneberry 460Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-84216.5) 1028020 Type or print in ink. Statement covers period from 07/01/2014 SEE INSTRUCTIONS ON REVERSE through 09/30/2014 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. 111 Officeholder, Candidate Controlled Committee o State Candidate Election Committee o Recall (Also Complete Part 5) General Purpose Committee 0 Sponsored o Small Contributor Committee 0 Political Party/Central Committee El Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Part 6) fl Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I NUMBER I.D . 3. Committee Information 1367459 COMMITTEE NAME (OR CANDIDATES NAME IF NO COMMITTEE) Solana Henneberry for AUSD School Board 2014 STREET ADDRESS (NO P.O. BOX) CITY STATE Alameda ZIP CODE CA 94501 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE OPTIONAL: FAX / E-MAIL ADDRESS solanahenneberry@gmail .com 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. ZIP CODE AREA CODE/PHONE (510)381-8369 AREA CODE/PHONE Date of election if applicable: (Month, Day, Year) 11/04/2014 2. Type of Statement: Preelection Statement 0 Semi-annual Statement Termination Statement (Also file a Form 410 Termination) Amendment (Explain below) COVER PAGE 460 CITY OF ;:\LAMEDg°r Official Use Only CITY CLERK'S OFFICE amend contributions and expenses Treasurer(s) NAME OF TREASURER Benjamin Reyes MAILING ADDRESS CITY Alameda NAME OF ASSISTANT TREASURER, IF ANY Susan Reyes MAILING ADDRESS CITY Alameda OPTIONAL: FAX / E-MAIL ADDRESS btr2esq@gmail .com 0 Quarterly Statement El Special Odd-Year Report LI Supplemental Preelection Statement - Attach Form 495 STATE ZIP CODE CA 94501 STATE ZIP CODE CA 94501 AREA CODE/PHONE (510)759-3236 AREA CODE/PHONE (510)882-4536 Executed on Executed on Executed on Executed on www.netfile.com 10/14/2014 Date 10/07/2014 Date 10/14/2014 Date Date By By By By Solana Henneberry Signature of Treasurer or Assistant Treasurer Benjamin Reyes Signature of Controlling Officeholder, Candidate, State Measure Proponent or Responsible Officerof Sponsor Susan Reyes Signature of Controlling Officeholder, Candidate, State Measure Proponent Signature of Controlling Officeholder, 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 Solana Henneberry OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) Board of Education AUSD School Board Member: City of Alameda RESIDENTIAUBUSINESS ADDRESS (NO. AND STREET) CITY Type or print in ink. 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 NAME OF TREASURER COMMITTEE ADDRESS CITY www.netfile.com CONTROLLED COMMITTEE? ❑ YES ❑ NO STREET ADDRESS (NO P.O. BOX) STATE ZIP CODE AREA CODE /PHONE I.D. NUMBER CONTROLLED COMMITTEE? ❑ YES ❑ NO STREET ADDRESS (NO P.O. BOX) 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 A an FORM ❑ 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 (January /05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Solana Henneberry for AUSD School Board 2014 Contributions Received 1 Monetary Contributions 2. Loans Received 3. SUBTOTAL CASH CONTRIBUTIONS 4. Nonmonetary Contributions 5. TOTAL CONTRIBUTIONS RECEIVED 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 13. Cash Receipts Previous Summary Page, Line 16 Column A, Line 3 above 14. Miscellaneous Increases to Cash Schedule I, 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 Type or print in ink. Amounts may be rounded to whole dollars. $ $ $ $ $ Schedule B, Part 2 $ $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents 19. Outstanding Debts www.netfile.com See instructions on reverse Add Line 2 + Line 9 in Column B above Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 6,263.00 0.00 6,263.00 2,615.85 8,878.85 2,375.66 0.00 2,375.66 0.00 2,615.85 4,991.51 100.00 6,263.00 0.00 2,375.66 3,987.34 0.00 0.00 Statement covers period from through Column B CALENDAR YEAR TOTALTO DATE 6,363.00 0.00 6,363.00 2,615.85 8,978.85 2,375.66 0.00 2,375.66 0.00 2,615.85 4,991.51 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 for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). 07/01/2014 09/30/2014 SUMMARY PAGE CALIFORNIA 460 FORM Page 3 of to I.D. NUMBER 1367459 Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 7/1 to Date 20. Contributions Received $ 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. 0.00 FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Solana Henneberry for AUSD School Board 2014 DATE RECEIVED 08/15/2014 09/08/2014 Type or print in nk. Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * Maura Schulz Yountville, CA 94599 Stewart Chen Kathy Oakland, CA 94607 09/08/2014 Patrick Corder San Leandro, CA 94577 09/08/2014 Erin Dorff San Leandro, CA 94577 09/08/2014 Alameda, CA 94501 IND OCOM Umm UPTY LJecc mm OCOM Uom UPTY LJeCc IND OCOM UOm UPTY L]000 IND OCOM Uom UPTY LJnoo IND 0 COM [110TH UPTY LJoCo IF AN IND(V(DUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Rep Union Dental Local 343 City Council City of Alameda Firefighter Alameda FD Teacher SLUSD Consultant Self SUBTOTAL $ Schedule A Summary 1 Amount received this period — itemized monetary contributions. (lnclude alt 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 on the Summary Page, Column A, Line 1.) TOTAL $ www.netfile.com Statement covers period from 07/01/2014 through 09/30/2014 AMOUNT RECEIVED THIS PERIOD 300.00 150.00 100.00 100.00 100.00 750.00 s'uoo.vv 1,063.00 6,263.00 SCHEDULE A CALIFORNIA Alan Page 4 /oNUMBER 1367459 mUMmLATIvToDATE CALENDAR YEAR of 10 PER ELECTION TO DATE (IF REQUIRED) 300.00 G2014 $300.00 150.00 G2014 $150.00 100.00 G2014 $100.00 100.00 G2014 $100.00 100.00 G2014 $100.00 *Contributor Codes |wo-Individual com- Recipient Committee (other than PTY or SCC) oTH- Other (e.n, business entity) pTv - ponncu|ponty sco- Small Contributor Committee FPPC Form 460 (January/05 FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772 Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER Solana Henneberry for AUSD School Board 2014 DATE RECEIVED Type or print in ink. Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE * 09/08/2014 Kristine Waters 3 IND San Anselmo, CA 94960 OCOM OTH PTY SCC 09/08/2014 Christine Wiedler IND ['COM Alameda, CA 94502 OOTH PTY EISCC 09/08/2014 Michael Williams in1 IND ECOM Alameda, CA 94501 OTH PTY 1=I SCC 09/16/2014 Douglas Bloch Alameda, CA 94502 09/16/2014 Nancy Crowley San Francisco, CA 94132 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee www.netfile.com IND OCOM OTH Li PTY scc El IND OCOM fl OTH [11 PTY LI SCC IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Teacher Berkeley USD Teacher AUSD Firefighter Alameda FD Union Organizer Teamsters Joint Council 7 Director FX Crowley SUBTOTAL $ from Statement covers period 07/01/2014 through 09/30/2014 SCHEDULE A (CONT.) CALIFORNIA 460 FORM Page 5 I.D. NUMBER 1367459 AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PERIOD (JAN. 1 - DEC. 31) 200.00 100.00 100.00 250.00 100.00 750.00 of 10 PER ELECTION TO DATE (IF REQUIRED) 200.00 G2014 $200.00 100.00 G2014 100.00 G2014 250.00 G2014 100.00 G2014 $100.00 $100.00 $250.00 $100.00 FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER Solana Henneberry for AUSD School Board 2014 ROMIIMSP■11 Type or print in ink. Amounts may be rounded to whole dollars. DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) RECEIVED CODE * 09/16/2014 Weiling Huber El Sobrante, CA 94803 09/23/2014 Hieu Dang Martinez, CA 94533 09/23/2014 Sign And Display PAC Local 510 (ID# 841600) San Francisco, CA 94134 09/26/2014 Alameda Labor CouncilUnity PAC (ID# 1294190) Oakland, CA 94621 09/26/2014 Rob Bonta For Assembly 2014 (ID# 1353796) Sacramento, CA 95815 *Contributor Codes IND— Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee www.netfile.com E2I IND "'COM 11 OTH LI PTY SCC IND COM II OTH PTY EISCC 1] IND COM LI OTH PTY OSCC LIJ IND COM EII OTH PTV LI SCC 111 IND COM LI OTH PTY LI SCC IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) President Unite Here Local 2850 Dentist Union Dental - Martinez Statement covers period from through 07/01/2014 09/30/2014 SCHEDULE A (CONT.) CALIFORNIA A c,f1 FORM Page 6 LD. NUMBER 1367459 AMOUNT CUMULATIVE TO DATE RECEIVED THIS CALENDAR YEAR PERIOD (JAN. 1 - DEC. 31) 100.00 500.00 100.00 1,000.00 1,000.00 SUBTOTAL $ 2,700.001 of 10 PER ELECTION TO DATE (IF REQUIRED) 100.00 G2014 500.00 G2014 100.00 G2014 1,000.00 G2014 1,000.00 G2014 $100.00 $500.00 $100.00 $1,000.00 $1,000.00 FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER Solana Henneberry for AUSD School Board 2014 Type or print In Ink. Amounts may be rounded to whole dollars. DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) RECEIVED CODE * 09/30/2014 United Food & Commercial Workers Local 5 PAC/A11 Purpose Account (ID# 1294035) San Jose, CA 95113-2310 *Contributor Codes IND — Individual COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party SCC — Small Contributor Committee www.netfile.com 0 IND COM OTH Li PTY SCC 0 IND 0 COM LI OTH ▪ PTY LI SCC IND O COM LI OTH PTY SCC 0 IND 0 COM ▪ OTH PTY SCC 01ND LI COM LJ OTH PTY LI SCC Statement covers period from through 07/01/2014 09/30/2014 SCHEDULE A (CONT.) CALIFORNIA A an FORM 6"I'VW Page 7 I.D. NUMBER 1367459 of 10 IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLOYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQU(RED) OF BUSINESS) 1,000.00 SUBTOTAL $ 1,000.00 1,000.00 G2014 $1,000.00 FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule C Nonmonetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Solana Henneberry for aoao School Board 2014 DATE RECEIVED FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR (IF COMMITTEE, ALSO ENTER I.D. NUMBER) 09/12/2014 Alameda Education Association Political Action cnmn tte PAC 1326421 (ID# 1326421) Alameda, CA 94501 Type or print in ink. Amounts may be rounded to whole dollars. CONTRIBUTOR /rmvINDIVIDUAL, ENTER CODE occupmIowAND EMPLOYER — (IF ncuF-ewpm,ED.ENTER NAME OF BUSINESS) Ea COM O0H 111 PTY UaoC []|ND O COM O OTH UPTY OGCS []|ND O COM OOTH OPTY []SCC []|ND 000M OOTH O PTY []SCC Attach additiona information on appropriately labeled continu tion sheets. Statement covers perio 07/01/2014 from through 09/30/2014 DESCRIPTION OF GOODS OR SERVICES Campaigning AMOUNT/ FAIR MARKET VALUE 2,615.85 SUBTOTAL $ 2,615.85 Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (lnclude all Schedule C subtotals.) � 2. Amount received this period — unitemized nonmonetary contributions of less than $100 � 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) TOTAL $ www.netfile.com 2,615.85 0.00 2,615.85 SCHEDULE C CALIFORNIA A an FORM "rAiiimi Page 8 /.uwumasR 1367459 CUMULATIVE TO DATE CALENDAR YEAR of 10 PER ELECTION TO DATE (IF REQUIRED) 2'615.85s2014 $2,615.85 *Contributor Codes |wo—Individual COM — Recipient Committe (other than PTY or SCC or*— Other (o.o, business entity) PTY — Political Party ocC— Small Contributor Committee FPPC Form 460 (January/05) pppc Toll-Free *elpxne:aso/Aow'pppo(86*/2ro-3rru Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Solana Henneberry for AUSD School Board 2014 • CODES: If one of the following codes accurately describes GVF 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) Green Chile Kitchen San Francisco, CA 94115 Cedric Cheng Design Concord, CA 94520 Office Max Alameda, CA 94501 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period from through the payment, you may enter the code. Otherwise, d MBR MTG OFC FET 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 FND CMP OFC RAD RFD SAL TEL TRC ms TSF VOT WEB 07/01/2014 09/30/2014 SCHEDULE E CALIFORNIA t1.60 FORM Page 9 of 10 I.D. NUMBER 1367459 escribe 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) OR DESCRIPTION OF PAYMENT 1•1•■151•01 AMOUNT PAID Food for Fundraiser Event 119.44 255.00 111.87 SUBTOTALS 486.31 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) 2. Unitemized payments made this period of under $100 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 2,305.77 69.89 0.00 2,375.66 FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E (Continuation Sheet) Payments Made Type or print in ink. Amounts may be rounded to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Solana Henneberry for AUSD School Board 2014 CODES: If one of the following codes accurately describes the CMP CNS CTB CVC FIL END IND LEG LfT 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) Cedric Cheng Design Concord, CA 94520 Pacific Printing San Jose, CA 95112 Susan Reyes Alameda, CA 94501 MBR MTG OFC PET PHO POL POS PRO PRT payment, you may enter the code. 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 WEB CMP PRO * Payments that are contributions or independent expenditures must also be summarized on Schedule D. www.netfile.com Statement covers period from 07/01/2014 through 09/30/2014 SCHEDULE E (CONT.) CALIFORNIA 460 FORM Page 10 I.D. NUMBER 1367459 of 10 Otherwise, describe the payment. RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t.v. or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (Internet, e-mail) OR DESCRIPTION OF PAYMENT AMOUNT PAID 572.00 886.31 Accounting & Finance Services 361.15 SUBTOTAL $ 1,819.46 FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)