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Alameda Education Association 450Recipient Committee Campaign Statement — Short Form SEE INSTRUCTIONS ON REVERSE For use by recipient committees that have not received a contribution or other receipt that must be itemized, have not received or made loans, and have no outstanding accrued expenses. from Type or print in ink. Statement covers period JULY 1, 2015 through DEC. 31, 2015 Date of election if applicable: (Month, Day, Year) 1. Type of Recipient Committee: 0 Ballot Measure Committee O Primarily Formed O Controlled O Sponsored Primarily Formed Candidate/ Officeholder Committee 3. Committee Information COMMITTEE NAME ALAMEDA EDUCATION ASSOCIATION POLITICAL ACTION COMMITTEE OR AEA PAC gi General Purpose Committee o Sponsored O Small Contributor Committee F.D. NUMBER 1326421 STREET ADDRESS (NO P.O. BOX) CITY ALAMEDA STATE ZIP CODE CA 94501 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE OPTIONAL: FAX / E-MAIL ADDRESS 4. Verification I have used all reasonable diligence in preparing and reviewing this TREASURER SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT, OR RESPONSIBLE OFFICER OF SPONSOR SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT -1860=11 SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT FPPC Form 450 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC' -1275-3772) Recipient Committee Campaign Statement Summary Page Type or print in ink. Amounts may be rounded to whole dollars. NAME OF COMMITTEE CL(41/(Dil al(-144-6-ebC . 4 from Statement covers period JULY 1,2015 SHORT FORM CALIFORNIA 450 FORM DEC. 31, 2015 2 through Page I.D. NUMBER PA-C 1326421 of 3 Expenditures Made 1. Expenditures of $100 or more made this period 2. Expenditures under $100 made this period (Not itemized.) 3. SUBTOTAL EXPENDITURES MADE THIS PERIOD Add Lines 1 + 2 $ 4. Nonmonetary Adjustment From Line 8 Below 5. Total expenditures made from previous statement (If this is the first statement for the calendar year, enter zero.) Previous Summary Page, Line 6 $ 6. TOTAL EXPENDITURES MADE TO DATE Add Lines 3 + 4 + 5 $ 01111■11190110 Contributions Received 7. Monetary contributions received this period 8. Non-monetary contributions received this period 9. Total contributions received from previous statement Previous Summary Page, Line 10 $ (If this is the first statement for the calendar year, enter zero.) 10. TOTAL CONTRIBUTIONS RECEIVED TO DATE Add Lines 7 + 8 + 9 $ $50.00 $50.00 $596.80 $646.80 ..,._1111■1016011.41111■9 Current Cash Statement 11. Beginning cash balance Previous Summary Page, Line 15 $ 12. Cash receipts this period Line 7 above 13. Miscellaneous increases to cash 14. Cash expenditures this period Line 3 above 15. ENDING CASH BALANCE THIS PERIOD Add Lines 11 + 12 + 13, then subtract Line 14 $ _ 1783.69 $50.00 1,733.69 FPPC Form 450 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Recipient Committee Campaign Statement — Short Form SEE INSTRUCTIONS ON REVERSE NAME OF COMMITTEE -—e) a/Ma-CA(43%/i P6312(:eZEI (A/c Type or print in ink. Amounts may be rounded to whole dollars. 5. Payments Made Of more space is needed, use additional copies of this page for continuation sheets.) DATE* 11/30 NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) SECRETARY OF STATE SACRAMENTO, CA 95814 DESCRIPTION OF PAYMENT ANNUAL COMMITTEE FEE * Required only for payments which are contributions or independent expenditures. from Statement covers period JULY 1,2015 SHORT FORM CALIFORNIA 50 FORM DEC. 31, 2015 3 through Page _ of I.D. NUMBER /4-74 1326421 NAME OF CANDIDATE AND OFFICE OR NAME OF BALLOT MEASURE AND BALLOT NUMBER OR LETTER AND JURISDICTION O Support 0 Oppose O Contribution 0 Ind. Exp. El Support 0 Oppose O Contribution 0 Ind. Exp. O Support 0 Oppose O Contribution 0 Ind. Exp. AMOUNT THIS PERIOD $50.00 SUBTOTAL $ 50.00 3 CUMULATIVE AMOUNTS TO DATE* $ $ $ Calendar Year Other Calendar Year Other Calendar Year Other FPPC Form 450 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)