HomeMy WebLinkAboutForm 410 - Eli Hill for San Rafael City Council D2 2022; Termination (state)Statement of Organization
Recipient Committee
Statement Type ❑ Initial ❑ Amendment
Q Not yet qualified
or
Q Date qualification threshold met Date qualification threshold met
/ /
M-M.T.7 M 7UMM. `. as MIr l.D. Number
in the RE office of the ecr Lary of
f the State of California
® Termination — See Part 5 AUG 04 2023
Date of termination
6 / 30 / 23
NAME OFWF COMMITTEE NAME OF TREASURER
Eli Hill for San Rafael D2 2022 Eli Hill
STREET ADDRESS (NO P.O. BOX)
STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE
San Rafael CA 94901
CITY STATE ZIP CODE AREA CODE/PHONE NAME OF ASSISTANT TREASURER, IF ANY
San Rafael CA 94901
FULL MAILING ADDRESS (IF DIFFERENT) STREET ADDRESS (NO P.O. BOX)
E-MAIL ADDRESS (REQUIRED)/FAX (OPTIONAL) CITY STATE ZIP CODE AREA CODE/PHONE
Marin
JURISDICTION WHERE COMMITTEE IS ACTIVE
City of San Rafael
Attach additional information on appropriately labeled continuation sheets.
NAME OF PRINCIPAL OFFICER(S)
STREET ADDRESS (NO P.O. BOX)
CITY
STATE ZIP CODE
AREA CODE/PHONE
I have used all reasonable diligence in preparing this statement and to the best of my knowledge the information contained herein is true and complete. I certity under
penalty of perjury under the laws of the State of California that the
OR STATE MEASURE PROPONENT
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT -
Executed on By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, OR STATE MEASURE PROPONENT -
FPPC Form 410 (August/2018)
FPPC Advice: advicetgIfiaric.ca.eov (866/275-3772)
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Statement of Organization CALIFORNIA
Recipient Committee FORM
INSTRUCTIONS ON REVERSE
Page 2
COMMITTEE NAME I.D. NUMBER
Eli Hill for San Rafael City Council D2 1439056
All committees must list the financial institution where the campaign bank account is located.
NAME OF FINANCIAL INSTITUTION AREA CODE/PHONE BANK ACCOUNT NUMBER
Mechanics Bank 415-460-6080
ADDRESS CITY STATE ZIP CODE
904 4th Street San Rafael CA 94901
• List the name of each controlling officeholder, candidate, or state measure proponent. If candidate or officeholder controlled,
also list the elective office sought or held, and district number, if any, and the year of the election.
• List the political party with which each officeholder or candidate is affiliated or check "nonpartisan." Stating "No party preference" is acceptable
• If this committee acts jointly with another controlled committee, list the name and identification number of the other controlled committee.
ELECTIVE OFFICE SOUGHT OR HELD YEAR OF PARTY
NAME OF CANDIDATE/OFFICEHOLDER/STATE MEASURE PROPONENT (INCLUDE DISTRICT NUMBER IF APPLICABLE) ELECTION CHECK ONE
Eli Hill for San Rafael City Council D2 2022
San Rafael City Council
2022
Nonpartisan
Partisan
(list political party below)
Of
Nonpartisan
Partisan
(list political party below)
Primarily Formed Committee Primarily formed to support or oppose specific candidates or measures in a single election. List below:
CANDIDATE(S) NAME OR MEASURE(S) FULL TITLE (INCLUDE BALLOT NO. OR LETTER) CANDIDATE(S) OFFICE SOUGHT OR HELD OR MEASURE(S) JURISDICTION
IF A RECALL, STATE "RECALL" IN FRONT OF THE OFFICEHOLDER'S NAME. (INCLUDE DISTRICT NO., CITY OR COUNTY, AS APPLICABLE) CHECK ONE
SUPPORT OPPOSE
SUPPORT OPPOSE
FPPC Form 410 (August/2018)
FPPC Advice: advict@fp c.ca. ovr (866/275-3772)
www.fppc.ca.gov