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Cambra 460Recipient Committee Campaign Statement Cover Page (Government Code Sections 84200-842165) SEE INSTRUCTIONS ON REVERSE Type or print in ink. Statement covers period 10/1/12 from through 10/20/12 Date of election if applica (Month, Day, Year) 11/6/12 OCT2 5 , mix CAL r ORM )1.7 COVER PAGE 11111111 CITY OF ALAMEDA TY CLERKS OFFCE . 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 Pall 5) 0 General Puipose Committee O Sponsored 0 Small Contributor Committee O Political Party/Central Committee 0 Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Pall 6) El Primarily Formed Candidate/ Officeholder Committee (Also Complere Part 7) 3. Committee Information 1349146 LD, NUMBER C,OMMIEIFF NAME (OR CANDIDATES NAME IF NO COMMITTEE) Jeff Cambra for City Council 2012 STREET ADDRESS (NO P.O. BOX) crrY Alameda STATE CA ZIP CODE 94501 (510) 220-1040 ARLA CODE/PHONE MAO ING ADDRESS (IF DIFFERENT) NO. AND STREET OR PO BOX CITY STATE ZIP CODE San Leandro CA 94578 OPTIONAL_ FAX / E-MAIL ADDRESS lindajperry@hotmail.com ARLA CODE/PHONE (510) 258-7787 4. Verification I have used all reasonable diligence in preparing and reviewing this statement and to the best of my knowledge the info under penalty of perjury under the laws of the State of California that the foregoing is 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 Type or print in ink. 7111111111■14..... 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Jeff Cambra OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) City of Alameda City Council Member 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? 0 YES El NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? LI YES 0 NO COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY 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 460 FORM 0 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 0 SUPPORT 0 OPPOSE Li SUPPORT [I] OPPOSE El SUPPORT LI OPPOSE LI SUPPORT 0 OPPOSE FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772) State of California Campaign Disclosure Statement Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jeff Cambra for City Council 2012 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period 10/1/12 from through 10/20/12 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 Column A TOTAL THIS PERIOD (FROMATTACHED SCHEDULES) 2192.00 5000.00 7192.00 0 7192.00 $ $ Column B CALENDAR YEAR TOTAL TO DATE Expenditures Made 6. Payments Made 7. Loans Made 8. SUBTOTAL CASH PAYMENTS 9. Accrued Expenses (Unpaid Bills) 10. Nonmonetary Adjustment 11. TOTAL EXPENDITURES MADE Schedule E, Line 4 Schedule M, Line 3 Add Lines 6 + 7 Schedule F, Line 3 Schedule C, Line 3 Add Lines 8 + 9 + 10 3704.83 0 3704.83 0 0 3704.83 8460.00 10000.00 18460.00 0 18460.00 11276.98 0 11276.98 0 0 11276.98 Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Line 16 13. Cash Receipts Column A, Line 3 above 14. Miscellaneous Increases to Cash Schedule 1, 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 B above 3695.85 7192.00 0 3704.83 7183.02 0 0 10, 000.00 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). SUMMARY PAGE CALIFORNIA FORM 460 Page 3 of I.D. NUMBER 1349146 8 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 (January/05) FPPC Toll -Free Helpline: 866 /ASK -FPPC (866/275 -3772) Schedule A Monetary Contributions Received SEE NSTRUCTIONS ON REVERSE NAME OF FILER Jeff Cambra for City Council 2012 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period 10/1/12 from through 10/20/12 10/8/12 10/11/12 10/14/12 10/14/12 FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR CONTRIBUTOR (IF COMMITTEE ALSO ENTER ID. NUMBER) CODE * Murphy Alameda, CA 94501 Wellguard Insurance Solutions Inc. Alameda, CA 94501 Joseph J. Erns Alameda, CA 94501 Susan Holt Alameda, CAU45O1 Janice Gatewoo Alameda, CA 94501 62:1wm UC0N Omm UPTY LJooc []|wo OcoM oTH []PTY ||soc |wo OooM []oTH OPTY []occ VI|wo OooM [lnTH []PTY []scc EfINo OCOM Retired Uom N/A UPTY []aco IF AN INDIVIDUAL, ENTER OCCUPATION (IF SELF-EMPLOYED, ENTER NAM OF BUSINESS) Retired N/A Real Estate Self: Ernst Development Partners/SMR Retired N/A SUBTOTAL $ Schedule A Summary 1. Amount received this period — itemized monetary contributions. (Include all 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 $ AMOUNT RECEIVED THIS PERIOD 100.00 100.00 150.00 100.00 100.00 550.00 1250.00 942.00 2192.00 SCHEDULE A CALIFORNIA FORM 60� CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) 100.00 100.00 150.00 100.00 100.00 of 8 PER ELECTION TO DATE (IF REQUIRED) "Contributor Codes IND — Individua COM — Recipient Committee (other than PTY or SCC) OTH — Other (e.g., business entity) pTv —po|mno|pany SCC — Small Contributor Committee FPPC Form 460 (January/05) pppo Toll-Free nelpmm:unsouaK-FpPcNas/2rs-37rq Schedule A (Continuation Sheet) Monetary Contributions Received NAME OF FILER Jeff Cambra for City Council 2012 DATE RECEIVED 10/14/12 10/14/12 10/14/12 Type oi 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 * Stanton Schonberg Alameda, CA 94502 Diane Filipowicz Pacheco, CA 94553 Brenda Gast Alameda, CA 94501 *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 IND El COM OTH Clorox PTY SCC IND El COM OTH LI PTY OSCC IND COM El OTH • PTY [1 SCC IND ['COM OTH • PTY El SCC [J IND El COM LI OTH PTY ESCC IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Finance Director Sales Retired Retired N/A from Statement covers period 10/1/12 through 111•1■110111101111101701110111111 SUBTOTAL $ AMOUNT RECEIVED THIS PERIOD 10/20/12 500,00 100.00 100.00 300.00 SCHEDULE A (CONT.) CALIFORNIA 460 FORM 5 Page of I.D. NUMBER 1349146 CUMULATIVE TO DATE CALENDAR YEAR (JAN. 1 - DEC. 31) 500,00 100.00 100.00 1.11111.111 8 PER ELECTION TO DATE (IF REQUIRED) FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule B— Part 1 Loans Received SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jeff Cannbra for City Council 2012 Type or print in ink. Amounts may be rounded to whole dollars. FULL NAME, STREET ADDRESS AND ZIP CODE OF LENDER (IF COMMITTEE, ALSO ENTER ID, NUMBER) Jeff Cambra Alameda, CA 94501 SCC Jeff Cambra Alameda, CA 94501 IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) Special Events Producer/Attorney Self-employed: Festival Productions Special Events Producer/Attorney Self-employed: Festival Productions OUTSTANDING BALANCE BEGINNING THIS PERIOD (b) AMOUNT RECEIVED THIS PERIOD Statement covers period 10/1/12 OUTSTANDING from through (c) (d) AMOUNT PAID OR FORGIVEN THIS PERIOD* 0 PAID BALANCEAT CLOSE OF THIS PERIOD 10/20/12 0 5000.00 • FORGIVEN 0 5000.00 0 5000.00 PAID 1/1/13 DATE DUE 0 . 5000.00 O OmRGIvEN » SUBTOTALS $ 5000.00 $ • PAID O FORGIVEN Schedule B Summary 1. Loans received this period � (Total Column (b) plus unitemized Ioans of Iess than $1 00.) 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 Schedule A.) 1/1/13 DATE DUE DATE DUE (e) INTEREST PAID THIS PERIOD 0 � RATE 8m RATE SCHEDULE o' PART 1 CALIFORNIA 466 FORM 6 Page I.D. NUMBER 1349146 m ORIGINAL. AMOUNT OF LOAN of 8 (g) CUMULATIVE CONTRIBUTIONS TO DATE CALENDAR YEAR v5000.00 $ 10000.00 PER ELECTION** 0 1&1U2 DATE INCURRED 5000.00 /mn 0 /.�r - ..^~^ , CALENDAR YEAR DATE INCURRED CALENDAR YEAR 10000.00 PER ELECTION** DATE INCURRED PER ELECTION** 0 $ 10000.00 $ 5000.00 O 5000.00 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. wAmounts forg(ven or paid by another party also must be reported on Schedule A. If required. (May be a negative number) 0 Schedule E, Line 3) tContributor Codes IND — Individua oom —nrwviencommittem (other than PTY or SCC) OTH — Other (e.g., business entity) PTY — Political Party scc —Small Contributor Committee FPPC Form 460 (January/05) ppPc Toll-Free nulp|me:x000Amm-FpPn(nuoors-3r/2) Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jeff Cambra for City Council 2012 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period 10/1/12 from through 10/20/12 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CUP CNS CTB CVC m FND LEG LIT campaignpamphmnalia/mmc. 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 ID. NUMBER) Election Diges G2012FPPC|D#1345303 clo Larry Levine & Associates Sherman Oaks, CA 91423 Californians Vote Green FPPC|D#1323i71 c/o Dakota Communications Los Angeles, CA 90064 California Latino Voters' Guide Los Angeles, CA 90041 MBR MTG OFC FET nHO POL POS PRO pm member communications meetings and appearances office expenses petition circulating phone banks polling and survey research nvmtaoo, delivery and messenger services professional services <|oeo|, accounting) print ads mm RFD SAL TEL TRC TRS TSF VOT WEB ao*souLsE CALIFORNIA FORM 7 8 Page of I.D. NUMBER 1349146 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, mwnino, and meals transfer between committees of the same candidate/sponsor voter registration information technology costs (internet, e-mail) cODE OR DESCRIPTION OF PAYMEN1 Slate Card Mailer Slate Card Mailer Slate Card Mailer * Payments that are contributions or independent expenditures must also be summarized on Schedule D. AMOUNT PAID 800.00 966.35 250.00 euBnrnAL$ 2016.25 Schedule E Summary 1. ltemized payments made this period. (lnclude all Schedule E subtotals.) 2. Unhemizod payments made this period of under $1UO 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column (e).) � 4. Total payments madethis period. (Add Lines 1.2. and 3. Enter here and on the Summary Page, Column A. Line 8j TOTAL $ s � 3680.96 23.87 0 3704.83 FPPC Form 460 (Ja uarym5) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) Schedule E (Continuation Sheet) Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Jeff Cambra for City Council 2012 Type or print in ink. Amounts may be rounded to whole dollars. Statement covers period 10/1/12 10/20/12 from through SCHEDULE E (CONT.) CALIFORNIA 460 FORM 8 Page of I.D. NUMBER 1349146 8 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. OP campaign paraphernalia/misc. CNS campaign consultants CTB contribution (explain nonmonetary)* CVC civic donations FIL candidate filing/ballot fees FND fundraising events N) independent expenditure supporting/opposing others (explain)* LEG legal defense LIT campaign literature and mailings MBR MTG OFC PET 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 RAD RFD SAL TEL TRC TRS TSF VOT VVEB radio airtime and production costs returned contributions campaign workers' salaries Iv. 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) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER ID, NUMBER) Autumn Press Berkeley, CA 94710 Alameda Sun Alameda, CA 94501 CODE LIT PRT * Payments that are contributions or independent expenditures must also be summarized on Schedule D. OR DESCRIPTION OF PAYMENT Campaign Literature Campaign Ad AMOUNT PAID 1495.11 169.50 SUBTOTAL $ 1664.61 FPPC Form 460 (January/05) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772)