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Chen 460Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE from Statement covers period 7/01/2015 through 1. Type of Recipient Committee: All Commit- tees — Complete Parts 1, 2, 3, and 4. 12/31/2015 Officeholder, Candidate Controlled Committee O State Candidate Election Committee O Recall (Also Complete Part 5) EI General Purpose Committee O Sponsored O Small Contributor Committee O Political Party/Central Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMM(TTEE) Stewart Chen for Alameda City Council 2016 STREET ADDRESS (NO P.O. BOX) CITY Alameda Primarily Formed Ballot Measure Committee O Controlled O Sponsored (Also Complete Part 6) Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1349155 STATE ZIP CODE CA 94501 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY San Leandro OPTIONAL: FAX E-MAIL ADDRESS lindajperry@hotmail.com 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to 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 Stewart Chen OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City Council Member, City of Alameda RESIDENTIAUBUSINESS 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 NAME OF TREASURER COMMITTEE ADDRESS CITY 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 COVER PAGE - PART 2 CALIFORNIA An FORM 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 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 Stewart Chen for Alameda City Council 2016 Contributions Received 1. Monetary Contributions Schedule A, Line3 2. Loans Received Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS Add Lines 1 +2 4. Nonmonetary Contributions Schedule C, Line 3 5. TOTAL CONTRIBUTIONS RECEIVED 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 3above 14. Miscellaneous Increases to Cash Schedule t, 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 8 above $ Amounts may be rounded to whole dollars. Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 0.00 0.00 0.00 0.00 0.00 580.00 0.00 580.00 0.00 0.00 580.00 500.53 0.00 500.62 580.00 421.15 0.00 0.00 2850.00 $ $ Statement covers period 7/01/2015 from through Column B CALENDAR YEAR TOTAL TO DATE 0.00 2850.00 2850.00 0.00 2850.00 3766.82 0.00 3766.82 0.00 0.00 3766.82 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). 12/31/2015 SUMMARY PAGE Page 3 of 8 I.D. NUMBER 1349155 Calendar Year Summary 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* (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 A Monetary Contributions Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Stewart Chen for Alameda City Council 2016 DATE RECEIVED m� whole � a"n"� _ SCHEDULE ___ FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER m.NUMBER) CODE * None Statement covers period 7/01/2015 from through 12/31/2015 CALIFORNIA 460 FORM 4 Page of /.owuMosn 1349155 8 IFxw INDIVIDUAL, ENTER AMOUNT CUMULATIVE roDATE PER ELECTION OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE (IF SELF-EMPLQYED, ENTER NAME PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) OF BUSINESS) SUBTOTAL$ 0.00 Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all ScheduleAsubtotals.) � 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 $ *Contributor Codes IND - Individual 0.00 COM - Recipient Committee (other than PTY or SCC 0.00 OTH - Othe (e.g., busines entity) prr - Pn|iVoa|Paoy scC - amanounmu"tn,cummimee 0.00 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 Stewart Chen for Alameda City Council 2016 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Stewart Chen Alameda, CA 94501 t IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Stewart Chen Alameda, CA 94501 IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Stewart Chen Alameda, CA 94501 I:6 IND ❑ COM ❑ OTH ❑ PTY ❑ SCC Schedule B Summary Amounts may be rounded to whole dollars. IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF - EMPLOYED, ENTER NAME OF BUSINESS) Chiropractor Self- employed: Careplus Chiropractic Chiropractor Self- employed: Careplus Chiropractic Chiropractor Self- employed: Careplus Chiropractic (a) OUTSTANDING BALANCE BEGINNING THIS PERIOD AMOUNT RECEIVED THIS PERIOD s 800.00 $ 1000.00 700.00 s SUBTOTALS $ Statement covers period 7/01/2015 from through AMOUNT PAID OR FORGIVEN THIS PERIOD * 0 PAID 12/31/2015 (31 OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD 0 800.00 0 FORGIVEN 0 $ 0 12/31/14 DATE DUE 0 ❑ PAID $ 0 ❑ FORGIVEN ❑ PAID 1000.00 0 12/31/14 $ DATE DUE SCHEDULE B - PART 1 Page 5 I.D. NUMBER 1349155 INTEREST ORIGINAL PAID THIS AMOUNT OF PERIOD LOAN 0 i RATE cyo RATE of 8 (g) CUMULATIVE CONTRIBUTIONS TO DATE CALENDAR YEAR $ 800.00 2500.00 PER ELECTION*" 0 2/4/13 $ DATE INCURRED $ 0 $ 700.00 0 i ❑ FORGIVEN RATE 0 0 12/31/14 s 0 DATE DUE 0 $ 0 $ 2500.00 $ 0 (Enter (e) on Schedule E, Line 3) 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.) NET $ 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. n no n nn (May be a negative number) CALENDAR YEAR s 1000.00 s 2500.00 PER ELECTION ** 7/30/12 DATE INCURRED 700.00 CALENDAR YEAR $ 2500.00 PER ELECTION" 9/28/12 DATE INCURRED 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 B — Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Stewart Chen for Alameda City Council 2016 1110010111 FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER 1 D, NUMBER) Stewart Chen Alameda, CA 94501 Amounts may be rounded to whole doltars. IFAN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOY D, ENTER NAME OF BUSINESS) Chiropractor Self-employed: Careplus Chiropractic (a) OUTSTANDING BALANCE BEGINNING THIS PERIOD n (b) AMOUNT RECEIVED THIS PERIOD 350.00 s 0.00 SUBTOTALS $ s Statement covers period 7/01/2015 from through 12/31/2015 w (d) AMOUNT OUTSTANDING BALANCE AT OR FORGIVEN. CLOSE opTxm THIS PERIOD PERIOD O'mo 0 n 350.00 0 FORGIVEN � 0 PAID 0 12/31/14 DATE DUE 0 0 FORGIVEN � 0 PAID 0 0 0 FORGIVEN , � 0 0.00 $ 0.00 $ Schedule B Summary 1. Loans received this period � (Total Column (b) plus unitemized loans of less than $100j 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.) NET $ Enter the net here and on the Summary Page, Column A, Line 2. *Amounts forgiven or paid by another party a(so must be reported on ScheduleA, If required. DATE DUE DATE DUE 7e)-- INTEREST PAID THIS PERIOD O % RATE 0.00 RATE RATE 350.00 $ 0.00 nno n nn n nn (May be a negative number) (Enter (e) on Schedule E, Line 3) SCHEDULE B PART 1 CALIFORNIA FORM 6 Page I.D. NUMBER 1349155 of 8 0'--- (m' ORIGINAL CUMULATIVE AMOUNT OF CONTRIBUTIONS LOAN TO DATE CALENDAR YEAR 350.00 F 350.00 PER ELECTION** $ 2850.00 4/20/14 DATE INCURRED S DATE INCURRED s o CALENDAR YEAR PER ELECTION** DATE INCURRED CALENDAR YEAR PER ELECTION' tContributor Codes |wo — |rmwuval 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) rppc Advice: aumce@h`ncop.gov(nsa/2r5'3rrz) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Stewart Chen for Alameda City Council 2016 Amounts may be rounded to whole doflars. Statement covers period 7/01/2015 from through 12/31/2015 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP CNS CTB CVC FIL FND IN D LEG LIT campaign campaign consultants contribution (explain nonmonetary) civic donations candidate fiUng/ballot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings NAMEANDADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER ID. NUMBER) Family Bridges Oakland, CA 94608 Man MTG OFC PET PHO POL poa PRO PRT member communication 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 CVC * Payments that are contribution or independ nt exp nditures must also be summarized on Schedule D. RAD RFD SAL TEL TRC TRS TSF VOT WEB SCHEDULE E CALIFORNIA FORM 7 8 Page of ID. NUMBER 1349155 radio airtime and production costs returned contributions campaign workers' salaries tv. or cable airtime and production costs candidate travel, lodging, and meals staff/spouse travel, lodging, and meals transfer between committees of the sanie candidate/sponsor voter registration information technology costs (Internet, e-mail) OR DESCRIPTION OF PAYMENT Sponsorship 11/21 Event AMOUNT PAID 528.00 SUBTOTAL* 528.00 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.) � 2. Untemized 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 $ 528.00 52.00 0.00 580.00 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule I Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE NAME OF FILER Stewart Chen for Alameda City Council 2016 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER ID. NUMBER) Alameda Sister City Association (ASCA) 12/31/15 Alameda, CA Attach additional information onappropriately Iabeled continuation sheets. Amounts may be rounded to whole dollars. Statement covers perio 7/01/2015 from through 12/31/2015 DESCRIPTION OF RECEIPT Voided Check --not cashed/stale dated Schedule 1 Summary 1. Itemized increases to cash this period. � 2. Unitemized increases to cash of under $100 this period. � 3. Total of all interest received this period on loans made to others. (Schedule H. Column (e).) s 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.) TOTAL $ SCHEDULE I CALIFORNIA 460 FORM 8 Page of ID. NUMBER 1349155 8 AMOUNT OF INCREASE TO CASH 500.00 SUBTOTAL $ 500.00 500.00 0.62 0.00 500.62 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov