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Ballena Village 461Major Donor and Independent Expenditure Committee Campaign Statement (Government Code sections o*zn0-o4z1u n) SEE INSTRUCTIONS ON REVERSE 1. Name and Address of Filer NAME OF FILER Ballena village from Type or print in ink. Statement covers period Date of election if applicable: (Month, Day, Year) uonz/,no through 06/30/2017 RESIDENTIAL OR MAILING ADDRESS (NO AND STREET) CITY 06/05/2018 3. Summary (Amounts may be rounded to whole dollars.) 1 Expenditures and contributions (including loans) of $100 or more made this period. (Part 5.) $ 2. Unitemized expenditures and STATE ZIP CODE contributions (including loans) under $100 made this period � 3. Total expenditures and contributions made this period. (Add Lines 1 + 2.) SUBTOTAL $ 4. Total expenditures arid contributions made from prior statement. (Enter amount from Line 5 of Iast statement filed. If this is the first statement for the calendar year, enter zero.) � 5. Total expenditures and contributions (including loans) made since January 1 of the current calendar year. (Add Lines 3 + 4,) TOTAL $ INDEPENDENT EXPENDITURE JUL g 1 2017 CITY OF ALAMED CITY CLERK'S OFF/ E Page 1 2 For Official Use Only Walnut Creek, CA *596 RESPONSIBLE OFFICER mns^coosmmr/m�p�ows (nmeriuomo,monaninmwoua; ���0i ' � 7\' ��, 2�D _�4c�9— __.^.-��_-^_ x. ��-�_-_-__-__~' 2. Naturg and Interests of Filer (complete each applicable emmn) • A FILER WHO SAN INDIVIDUAL MUST LIST THE NAME, ADDRESS, AND BUSINESS INTERESTS - OF EMPLOYER OR. IF SELF-EMPLOYED, THE NAME, ADDRESS, AND NATURE OF THE BUSINESS NAME OF EMPLOYER/BUSINESS BUSINESS INTERESTS ADDRESS OF EMPLOYER/BUSINESS A FILER THAT ISA BUSINESS ENTITY MUST OESCRIBE THE BUSINESS ACTIVITY /w WHICH /r/o ENGAGED Apartment Building A FILER THAT SAN ASSOCIATION MUST PROVIDE A SPECIFIC DESCRIPTION OF ITS INTERESTS El A FILER THAT IS NOT AN INDIVIDUAL, BUSINESS ENTITY, OR ASSOCIATION MUST DESCRIBE THE COMMON ECONOMIC INTEREST OF THE GROUP OR ENTITY LIii Amendment (Explain): ^`---------~ 4. Verification | have used all reasonable diligence in preparing this statement. | have reviewed the statement and to the best of my knowledge the information contained herein is true and complete. | certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 35,672.00 0.00 35,672.00 35,672.00 Executed on "�J��| 7/ �' /' / »� � - By DAM / MIR ! ^.� ^���� �^,`�,r '. � m���-` ' =~� ~ _^ SIGNATURE OF INDIVIDUAL DONOR OR RESPONSIBLE OFFICER IF OTHER THAN AN INDIVIDUAL FPPC Form 461 (March/2011) Major Donor and Independent Expenditure Committee Campaign Statement SEE INSTRUCTIONS ON REVERSE NAME OF FILER Ballena Village Type or print in ink. Amounts may be rounded to whole dollars. Ifi■■■■0111MMI MAJOR DONOR Statement covers period from 01/01/2017 06/30/2017 through AND INDEPENDENT EXPENDITURE COMMITTEE STATEMENT 5. Contributions (Including Loans, Forgiveness of Loans, and Loan Guarantees) and Expenditures Made (If more space is needed, use additional copies of this page for continuation sheets.) DATE 06/07/2017 NAME, STREET ADDRESS, CITY. STATE AND ZIP CODE OF PAYEE OF COMMITTEE, ALSO ENTER I 0 NUMBER) amedans in Charge - A Coal i t ion of Rent al Property Owners , Haimeownex s, Businesses and Tenant's for Fair and Af f ririable Housing (I:139 /3 .3E TYPE OF PAYMENT Oakland, CA 94618 Monetary Contribution 0 Loan O Non-Monetary Contribution O Independent Expenditure ElMonetary Contribution O Loan El Non-Monetary Contribution 0 Independent Expenditure El Monetary Contribution O Loan O Non-Monetary Contribution El Independent Expenditure El Monetary Contribution O Loan O Non-Monetary Contribution El Independent Expenditure DESCRIPTION OF PAYMENT (IF OTHER THAN MONETARY CONTRIBUTION OR LOAN) CANDIDATE AND OFFICE, MEASURE AND JURISDICTION, OR COMMITTEE Ordinance Amending Municipal Code Concerning Rent Increases And Stabilization, Eviction Limitations And Relocation Assistance &IVSEnindledaTETA E Support J Oppose r] Support El Oppose Support Oppose Support LIi Oppose SUBTOTAL $ AMOUNT THIS PERIOD CUMULATIVE AMOUNT RELATED TO THIS CANDIDATE, MEASURE, OR COMMITTEE 35,672.00 35,672.00 35,672.4 FPPC Form 461 (March/2011) FPPC Toll-Free Helpline: 8661ASK-FPPC (866/275-3772)