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Chen 460Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE from Statement covers period 01/01/2016 through 06/30/2016 COVER PAGE Date of election if applica (Month, Day, Year) ^ ------ ` ~ `--- — � ------~~~��~-- --- 1. Type of Recipient Committee: All Committees - Complete Parts 1.2, 3, and 4. 2. Officeholder, Candidate Controlled Committee O State Candidate Election Committee O Recall (Also Complete Part 5) O General Purpose Committee O Sponsored O Small Contributor Committee O Political Party/Central Committee 0 Primarily Formed Ballot Measure Committee O Controlled O Sponsored (Also Complete Part 6) [] Prirnarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) 3. Committee Information COMMITrEE NAME (OR CANDIDATE'S NAME IF NO C0MMIEE) Stewart Chen forAlameda City Council 2016 STREET ADDRESS (NO puBOX) CITY Alameda ----- uzwuMosn 1349155 STATE ZIP CODE CA 94501 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR RO. BOX CITY STATE ZIP CODE San Leandro CA 94578 OPTIONAL: FAX / E-MAIL ADDRESS |indajperry@hotmniicom 4. Verification ^ns^000E/p*ows (510)465-7982 AREA CODE/PHONE (510)258-7787 11/08/2016 Type of Statement: [] Preelection Statement O Semi-annual Statement O Termination Statement (Also ole a Form 410 Termination) O Amendment (Explain below) Treasurer(s) NAME OF TREASURER Linda Perry MAILING ADDRESS 1 of 8 For Official Use Only [] Quarterly Statement El Special Odd-Year Report CITY STATE ZIP CODE San Leandro CA 94578 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY UPTIONAL: FAX / E-MAIL ADDRESS STATE ZIP CODE AREA CODE/PHONE (510)258-7787 AREA CODE/PHONE 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. | certify under penalty of perjury under Ihe laws of the State of Californ that the foreg Sgnature 01 Controtling Otficeholder. Candidate, State Measure Proponent or Responsibte Officer mSponsor Signature m Controlling Officeholder, Canddate, State Measure Proponent Signature m 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 6. Primarily Formed Ballot Measure 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 CONTROLLED COMMITTEE? COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER LJ YES n NO NAME OF TREASURER CONTROLLED COMMITTEE? COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY ll■■■■ 1411■1611■ Li YES [1] NO STATE ZIP CODE AREA CODE/PHONE NAME OF BALLOT MEASURE BALLOT NO. OR LETTER JURISDICTION COVER PAGE - PART 2 El SUPPORT LI 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 LJ SUPPORT LI OPPOSE Li SUPPORT LI OPPOSE LI El LI SUPPORT OPPOSE SUPPORT LI 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, Line 3 $ Loans Received Schedule 8, Line 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 $ IMM Current Cash Statement _. Beginning Cash Balance Previous Summary Page, Line 16 $ 13. Cash Receipts 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. Amounts may be rounded to whole dollars. Column A TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 17. LOAN GUARANTEES RECEIVED Schedule 8, Part 2 $ Cash Equivalents and Outstanding Debts 18. Cash Equivalents See instructions on reverse $ 19. Outstanding Debts Add Line 2 + Line 9 in Column B above $ 0.00 (2850.00) 0.00 0.00 0.00 421.66 0.00 421.66 0.00 0.00 421.66 421.15 0.00 0.51 421.66 0.00 $ Statement covers period 01/01/2016 from through Column B CALENDAR YEAR TOTAL TO DATE 0.00 0.00 0.00 0.00 0.00 421.66 0.00 421.66 0.00 0.00 421.66 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 0.00 filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if any). ammelels: 0.00 0.00 06/30/2016 SUMMARY PAGE CALIFORNIA 460 FORM 3 8 Page of I.D. NUMBER 1349155 _■■•1 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. 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 Amounts may be rounded to whole dollars. FULL NAME STREET AIJDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE, ALSO ENTER ID. NUMBER) CODE * None IF^m INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) SUBTOTAL $ Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all Schedule Aeubmta|s.) � 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, Lirie 1.) TOTAL $ Statement covers period 01/01/2016 from through 06/30/2016 AMOUNT RECEIVED THIS PERIOD 0.00 SCHEDULE A 4 Page I.owoMnER 1349155 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC, 31) of 8 PER ELECTION TO DATE (IF REQUIRED) *Contributor Codes |wo — |nuwumm 0.00 COM — Recipient Committee (other than PTY or SCC) 0.00 oT*— Other (o.g, business entity) PTv — poUhna|Pany soo — am"ncomnuvmroomm/moo 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 REVRSE NAME OF FILER Stewart Chen forAlameda City Councii 2016 FULL NAME, STREETADDRESSAND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER ID. NUMBER) ( StowartChen Alameda, CA 94501 Stewart Chen Alameda, CA 94501 Stewart Chen Alameda, CA 94501 y~"-- mm 0 com 0 OTH pr' 0 auu Amounts may be rounded to whole dollars. IFAN 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 800.00 1000.00 lw -� AMOUNT RECEIVED THIS PERIOD 700.00 s SUBTOTALS $ Statement covers period 01/01/2016 from through (c) AMOUNT PAID OR FORGIVEN THIS PERIOD * 0 PAID 417 n .SG 0 FORGIVEN 0 $ 382.34 0 PAID 0 0 FORGIVEN 06/30/2016 OUTSTANDING BALANCE AT CLOSE OF TH)S PERIOD 0.00 12/31/14 DATE DUE 0 PAID O 0 FORGIVEN 0 700 00 0 $ 2500.00 $ Schedule B Summary 1. Loans received this period � (Total Column (b) plus unitemized Ioans of Iess than $100.) 2. Loans paid or forgiven this perio � (Total Column (c) plus Ioans under $1 00 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 1J NET $ Enter the net here and on the Summary Page, Column A, Line 2. *Amounts by another party also must be reported on Schedule A. ** If required. DATE DUE 0.00 12/31/14 DATE DUE a INTEREST PAID THIS PERIOD 0 m RATE m RATE SCHEDULE B - PART 1 5 Page la NUMBER 1349155 ORIGINAL AMOUNT OF LOAN of 8 -- b[ CUMULATIVE CONTRIBUTIONS TO DATE CALENDAR YEAR $ 800.00 $ 2500.00 PER ELECTION" 0 2/4/13 � DATE INCURRED 1000.00 CALENDAR YEAR s 2500.00 PER ELECTION** 0 7/30/12 s DATE INCURRED CALENDAR YEAR 700.00 " 2500.00 PER ELECTION** 0 9/28/12 o DATE INCURRED 0.00 $ O n nn -(2850O0) (May be a negative number) (Enter (e) on Schedule E, Line 3) tContributor Codes IND — Individual Com — nompiemCommineo (other than PTY or SCC) OTH — Other (e.g., business entity) prr — pvmmu/panv soc — amuxconmvum,cvmmmoe 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 INSTRUCflONS 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 0 COM 0 OTH 0 PTY OSCC Omo 0 COM 0 OTH 0 PTY OSCC 'O IND 0 COM 0 OTH 0 PTY 0 SCC Amounts may be rounded to whole dollars. IFmw INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Chiropractor Self-employed: Careplus Chiropractic OUTSTANDING AMOUNT BALANCE RECEIVED THIS BEGINNING THIS PERIOD PERIOD 350.00 SUBTOTALS $ 0.00 Statement covers period 01/01/2016 from through */' -- AMOUNT PAID OR FORGIVEN THIS PERIOD * 0 PAID 06/30/2016 OUTSTANDING BALANCE AT CLOSE OF TH(S PERIOD SCHEDULE B - PART 1 6 Page of /.uwuMosn 8 --'---0 —PER — 1349155 (May be a negative number) (e) INTEREST ORIGINAL CUMULATIVE PAID AMOUNT OF CONTRIBUTIONS PERIOD LOAN TO DATE CALENDAR YEAR O m RATE FORGIVEN o ELECTION" 350.00 12/31/14 0.00 4/20/14 s 2850.00 DATE DUE DATE INCURRED 0 PAID FORGIVEN 0 0 PAID 0 FORGIVEN 0 0 0 0.00 $ 350.00 $ 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 Ioans under$100 paid orforgiven.) (Include loans paid by a third party that are also itemized on ScheduleA.) 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. � RATE DATE DUE DATE DUE DATE INCURRED DATE INCURRED 0.00 $ 0.00 ono n no 0 0n (Enter (e) on Schedule E, Line 3) CALENDAR YEAR $ PER ELECTION** � CALENDAR YEAR PER ELECTION" tContributor Codes |wo — |nuwmmg COM — Recipient Committee (other than PTY or SCC) oT*— Other (e.n, business entity) PTY — Political Party soc — amancum,muto,ovmmmoo FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Payments Made SEE INSTRUCTONS ON REVERSE NAME OF FILER Stewart Chen forAlameda City CouncU 2016 Amounts may be rounded to whole dollars. Statement covers period 01/01/2016 from SCHEDULE E through 06/30/2016 puye 7 of 8 �oNUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. [thomian, describe the payment. CMP CNS CTB CVC FIL FND |wo LEG LIT campaign campaign consultants contribution (explain nonmonetary)* civic donations candidate filing/bailot fees fundraising events independent expenditure supporting/opposing others (explain)* legal defense campaign literature and mailings NAMEANDADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER ID, NUMBER) Stewart Chen Alameda, CA 94501 men MTG OFC PET PHO POL pno 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 * Payrnents that are contributions or independent expenditures res must also be summarized on Schedule D. RAD RFD SAL TEL TRC TRS TSF VOT WEB 1349155 radio airtime and production costs returned contribution 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 same candidate/sponsor voter registration information technology costs (internet, e-mail) OR DESCRIPTION OF PAYMENT Loan Repayment AMOUNT PAID 417.66 SUBTOTAL * 417.68 Schedule E Summary 1. ltemized payments made this period. (Include alt 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 (o).) � 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.) TOTAL $ 417.66 4.00 0.00 421.66 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 forAlameda City CouncU 2016 DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE Amounts may be rounded to whole dollars. Statement covers period 01/01/2016 from through 06/30/2016 DESCRIPTION OF ��MwnTs�^mnc�c ID. NUMBER) -^`~~ '^~'~ RECEIPT INCREASE TO CASH Page of 8 I.D. NUMBER 1349155 8 AMOUNT OF Attach addition information on appropriately labeled continuation sheets. Schedule 1 Summary 1. Itemized increases to cash this period. � 2. Unitemized increases to cash of urider $100 this period. � 3. Total of all interest received this period on loans made to others. (Schedule H. Column (n)] � 4. Total miscellaneous increases to cash this period. (Add Lines 1.2. and 3. Enter here and onthe Summary Page, Line 14.) TOTAL $ SUBTOTAL $ 0.00 0.00 0.51 0.00 0.51 FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772)