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Home My WebLink AboutForm 460 - Eli Hill for San Rafael City Council D2; 06-30-23 (09-02-25 Amendment)COVER PAGE Recipient Csaoimgmittee SEE INSTRUCTIONS ON REVERSE Statement covers period from 1/1/23 through 6/30/23 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. ® Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure ® State Candidate Election Committee Committee ❑ Recall ❑ Controlled (Also Complete Pad 5) ❑ Sponsored (Also Complete Part 6) ❑ General Purpose Committee Sponsored ❑ Primarily Formed Candidate/ Small Contributor Committee Officeholder Committee ❑I Political Party/Central Committee (Also Complete Part7) LD.NUMBER 3. Committee Information AArf lIA AO :OMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMIT Eli Hill for San Rafael City Council D2 2022 STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE San Rafael CA 94901 W1AIL!NG ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS 14 Date of election (Month, D, 2. Type of Statement: of Page ( '� ,� For Official Use Only ❑ Preelection Statement ❑ Quarterly Statement Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) a� Amendment (Explain below) Revisions to Schedules A + E + F, correcting cash basis for undeposited checks issued and service refunds Treasurer(s) NAME OF TREASURER Eli Hill MAILINGADDRESS CITY STATE ZIP CODE AREACODE/PHONE San Rafael CA 94901 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX/E-MAIL ADDRESS 4. Verification 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. I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on - By Date or Responsible Officer of Sponsor Executed on BY Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on BY Date 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 zwer Page m Part 2 5. Off Beholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Ell Hill OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) San Rafael City Council District 2 RESIDENTIAL/BUSINESS ADDRESS (NO.AND STREET) CITY STATE ZIP San Rafael CA 94901 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 I.D. NUMBER NAME OF TREASURER I CONTROLLED COMMITTEE? ii ❑ YES ❑ NO. STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS S (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 r-4 Page Z- of i 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 Lisrnames of officeholder(s) or candidate(s) for which this committee is primarily formed. NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE NAME OF OFFICEHOLDER OR CANDIDATE OFFICE SOUGHT OR HELD ❑ SUPPORT ❑ OPPOSE Attach continuation sheets if necessary FPPC Form 460 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov C-qm 3ator" Disclosure Statement Amounts may be rounded Un SEF INSTRUCTIONS ON REVERSE NAME OF FILER Column A Contributions Received TOTAL THIS PERIOD (FROM ATTACHED SCHEDULES) 1 Monetary Contributions................................................... Schedule A, Line 3 $ 0 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 $ 0 Expenditures !bade 6. Payments Made................................................................ Schedule E, Line 4 $ $2591.48 7. Leans Made....................................................................... Schedule H, Line 3 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ $2591.48 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F, Line 3 $5972.59 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 11. TOTAL EXPENDITURES MADE. ................................... Add Lines 8+9+4,0 $ 8456.07 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ $10,161.07 13. Cash Receipts........................................................... Column A, Line 3 above 0 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 $1234.11 15. Cash Payments......................................................... Column A, Line 8 above $2591.48 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ $8,803.70 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 $ through Column B CALENDAR YEAR TOTAL TO DATE $ $ $ $ io calculate Column B, add amounts in Column Ato 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 Page 5 of 7 I.D. NUMBER 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 $ 0 $ 21. Expenditures 8456.07 Made $ $ Expenditure Limit Summary for State Candidates 22. Cumulative Expenditures Made* (If Subject to Voluntary Expenditure Limit) Date of Election Total to Date (mm/dd/yy) 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 d. 4 Amounts may be rounded SCHEDULE A to lol!3m .:. ifP —..... ... ..., Page �— of .1 SEE INSTRUCTIONS ON REVERSE through NAME OF FILER I.D. NUMBER FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME OF BUSINESS) PERIOD (JAN. 1 — DEC. 31) (IF REQUIRED) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC SUBTOTAL$ Schedule A Summary 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 $ `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 FPPC Form 460 (1an/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Sf'hedl. a A (Onf1fi!?t;at!®n Sheet) Amounts may be rovridi?d SCHEDULE " ' 'CONT.) i i 7 through Page of NAME OF FILER I.D. NUMBER i FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION DATE CONTRIBUTOR CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE (IF SELF-EMPLOYED, ENTER NAME) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ❑ IND I ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑IND COM ❑ OTH ❑ PTY ❑ SCC ❑ IND '❑ COM i ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH PTY ❑ SCC ❑ IND ❑ COM ❑ OTH PTY SCC SUBTOTAL$ '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 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B PART 1 Pa Amounts may be rounded --. v , , a - y d" �:_... a- �w 42 through Page --- of ) SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER FULL NAME, TREETAL'DRESSAND ZIP CODE IF AN INDIVIDUAL, ENTER OUTSTANDING AMOUNT AMOUNT PAID OUTSTANDING INTEREST ORIGINAL CUMULATIVE E OF LENDER OCCUPATION AND EMPLOYER BALANCE RECEIVED THIS OR FORGIVEN BALANCE AT PAID THIS AMOUNT OF ONTRIBUTIONS COMMITTEOFL ENTER I.D. NUMBER) (IF SELF-EMPLOYED, ENTER BEGINNING THIS PERIOD THIS PERIOD. CLOSE OF THIS PERIOD LOAN TO DATE (IF NAME OF BUSINESS) PERIOD PERIOD ❑ PAID CALENDAR YEAR ❑ FORGIVEN RATE PER ELECTION DATE DUE DATE INCURRED El WC ❑ COM ❑ OTH ❑PTY ❑SCC Ej PAID CALENDAR YEAR $ $ 1. $ $ ❑ FORGIVEN PER ELECTION** RATE $ DATE DUE DATE INCURRED T❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC $ — ❑ PAID CALENDAR YEAR $ $ % $ $ ❑ FORGIVEN PER ELECTION- � I RATEi $ $ $ $ $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC i SUBTOTALS $ $ $ $ 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 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.)..................................... Enter the net here and on the Summary Page, Column A, Line 2. .................... $ .................................. $ ..................... NET $ (May be a negative number) 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 *Amounts forgiven or paid by another party also must be reported on Schedule A. ** If required. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 2 _ m q..,oan 5wa� µ..QC: through Page —_ of SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER LOAN AMOUNT GUARANTEED CUMULATIVE BALANCE OUTSTANDING CONTRIBUTOR CODE* (IF SELF-EMPLOYED, ENTER THIS PERIOD TO DATE TO DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) LENDER CALENDAR YEAR ❑ IND ❑ COM g ❑ OTH DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑ SCC g LENDER CALENDAR YEAR ❑ IND ❑COM $ ❑ OTH I DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑SCC I g CALENDAR YEAR LENDER ❑ IND ❑ COM g ❑ OTH PER ELECTION DATE (IF REQUIRED) ❑ PTY ❑ SCC $ LENDER CALENDAR YEAR ❑ IND ❑ COM g ❑ OTH PER ELECTION ❑ PTY DATE (IF REQUIRED) ❑ SCC g Enter on SUBTOTAL $ Summary Pag(, -- Line 17 only. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (966/275-3772) www.fppc.ca.gov ScheduleAmounts may be rounded mom, SCHEDULE C. 2 I A_ SEE INSTRUCTIONS ON REVERSEthrough — gage of VAME OF FILER ------ I.D. NUMBER DATE I FULL NAME, STREET ADDRESS AND IF AN INDIVIDUAL, ENTER CONTRIBUTOR OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ FAIR MARKET CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE* ; (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES VALUE CALENDAR YEAR (JAN 1 - DEC 31) I (IF REQUIRED) NAME OF BUSINESS) ❑!N ❑ CODA ❑ OTH ❑ PTY ❑ SCC ❑ IND f ❑ coM i ❑ OTH PTY ❑ SCC ❑ IND i I ❑ COM ii ❑ OTH I I i ❑ PTY ! ❑ SCC I- l ❑IND I ❑ COM I ❑ OTH ❑ PTY 17 SCC Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule C Summary 1. Amount received this period — itemized nonmonetary contributions. (Include all Schedule C subtotals.)......................................................................................................................$ 2. Amount received this period — unitemized nonmonetary contributions of less than $100..................................$ 3. Total nonmonetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Lines 4 and 10.) .....................TOTAL $ *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 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule D 50 d�siaa;dates, � eat ie, res and Committees — through 9f Page o SEE !NSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE PER ELECTION T DAE ( MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT (IF REQUIRED) PERIOD CALENDAR YEAR TO DATE OR COMMITTEE (JAN. 1 -DEC. 31) (IF REQUIRED) ❑ Monetary Contribution ❑ Nonmonetary Contribution ` ❑ Independent — ❑ Support ❑ Oppose Expenditure E] Monetary I Contribution { I ❑ Nonmonetary Contribution I ❑ independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution I ❑ Nonmonetary � Contribution I ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ Schedule D Summary 1. Itemized contributions and independent expenditures made this period. (Include all Schedule D subtotals.)....................................................... $ 2. Unitemized contributions and independent expenditures made this period of under$100.................................................................................... $ 3. Total contributions and independent expenditures made this period. (Add Lines 1 and 2. Do not enter on the Summary Page.) .......... TOTAL.. $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule Wa�.. A.r7aFsunts may br^ from SC>-- D _t_ C (CON i.) canciwates, imeasures and Uommittees i -through Page 1 h of C 7 NAME OF FILER I.D. NUMBER NAME OF CANDIDATE, OFFICE, AND DISTRICT, OR DESCRIPTION AMOUNT THIS CUMULATIVE TO DATE PER ELECTION DATE MEASURE NUMBER OR LETTER AND JURISDICTION, TYPE OF PAYMENT (IF REQUIRED) PERIOD CALENDAR YEAR TO DATE OR COMMITTEE (JAN. 1 -DEC. 31) (IF REQUIRED) ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent Support ❑ Oppose Expenditure I ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure SUBTOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded towt o; ;� dt7.01 P.=. Statement covers period through SCHEDULE E Page ) � of � / CODES: if one of the follo4ring codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/mist. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)" OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)` POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.C. NUMBER) Damon Connolly for Assembly 2024. FPPC !D# 1458544 CTB I 501c3 contribution 250 4200 Park Blvd., #128, Oakland, CA 94602 Marin, Community Clinic CTB I campaign contribution I 100 3260 Kerner Boulevard, San Rafael, CA Wix.com WEB Website hosting fees 246 500 Terry A Francois Blvd, San Francisco * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 596 Schedule E Summary 1. Itemized payments made this period. (Include all Schedule E subtotals.)............................................................................................................. $ 2591.48 2. Unitemized payments made this period of under$100.......................................................................................................................................... $ 0 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).)............................................................................. $ 0 4. Total payments made this period. Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6. TOTAL $ 2591.48 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E SCHEDULE E (CONY.) �' p9'�^ *y Amounts may be rounded >e Y. ^:54 eC? .4SS 1 R.a;�. State rent covers pe riCor. through _ ) z Page of SEE INSTRUCTIONS ON REVERSE —— NAME OF FILER I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CIV,P campaign paraphernalia/misc. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF PAYEE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Peerly Inc. WEB Direct voter texting program $1645.48 2232 De!I Range Blvd, Cheyenne, WY 82009 Dyana Delfin Polk CNS Campaign consulting fees $150 Berkeley, CA 94709 I Alexander McCoy CNS Campaign consulting fees $200 Berkeley, CA 94703 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1995.48 FPPC Form 460 (Jan 2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule F L SEE INSTRUCTIONS ON REVERSE NAME OF FILER Amounts may be rounded CODES: .. O rc; OI One 110.. ,Wir.y codes accura:e"Y describes ibes m pay-ment, you may enae^_ the code Civ.P campaign paraphernalia/misc. P: BR member communications CNS campaign consultants MTG meetings and appearances CTB contribution (explain nonmonetary)' OFC office expenses CVC civic donations PET petition circulating F!L candidate filing/ballot fees PHO phone banks FND fundraising events POL polling and survey research IND independent expenditure supporting/opposing others (explain)' POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) LIT campaign literature and mailings PRT print ads through SCHEDULE Page of-� I.D. NUMBER Ot1he,wise, describe The, payment. RAD radio airtime and production costs RFD returned contributions SAL campaign workers' salaries TEL t .v or cable airtime and production costs TRC candidate travel, lodging, and meals TRS staff/spouse travel, lodging, and meals TSF transfer between committees of the same candidate/sponsor VOT voter registration WEB information technology costs (internet, e-mail) NAME AND ADDRESS OF CREDITOR I (IF COMMITTEE: ALSO ENTER I.D. NUMBER) - CODE OR DESCRIPTION OF PAYMENT (a) OUTSTANDING � BALANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD Dyana Delfin Polk CNS f 0 $3372.59 i $150 i $3222 59 Berkeley, CA 94709 l Paden McNiff WEB I 0 I $2750 ! 0 $2750 Mill Walley, CA 94941 I 7-Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTALS $ $ Schedule F Summary 1. Total accrued expenses incurred this period. (Include all Schedule F, Column (b) subtotals for accrued expenses of $100 or more, plus total unitemized accrued expenses under $100.) ............................................INCURRED TOTALS $ 2. Total accrued expenses paid this period. (Include all Schedule F, Column (c) subtotals for payments on accrued expenses of $100 or more, plus total unitemized payments on accrued expenses under$100.).................................. PAID TOTALS $ 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and onthe Summary Page, Column A, Line 9.)............................................................................................................................................. ........................... NET $ $ 6112.59 150 5972.59 May be a negative number FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Amounts may be rrunded As NAME OF FILER through ODES: i` �f the rc .�..�lnru codes accurately describes the pay en-111, you may enter the code. Otherwise, describe the payment SCHEDULE F (CONT.) Page Y L-1 of I.D. NUMBER CM.P campaign paraphernalia/mist. MBR member communications R.AD radio airtime and production costs CNS campaign consu':tants MTG meetings and appearances RFD returned contributions CTS contribution (explain nonmonetary)' OFC office expenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filina/ballot fees PHO phone banks T RC candidate travel, lodging, and meals FND fundraising everts POL polling and survey research TRS TSF staff/spouse travel, lodging, and meals transfer between committees of the same candidate/sponsor IND independent expenditure supporting/opposing others (explain)` POS postage, delivery and messenger services LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF CREDITOR I (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCR!PTION OF PAYMENT (a) OUTSTANDING BALANCE BEGINNING OF THIS PERIOD (b) AMOUNT INCURRED THIS PERIOD I (c) AMOUNT PAID THIS PERIOD (ALSO REPORT ON E) (d) OUTSTANDING BALANCE AT CLOSE OF THIS PERIOD i i I SUBTOTALS$ $ $ $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule G SCHEDULE G .. S 7"�lade by an ;agent ®r Independent Amounts may be rounded Statement covers period w77- � through_ '3 --- i Page t� of t I SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER NAME OFAGENT OR I.'IDEPENDENT CONTRACTOR CODES: if one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/mist. MBR member communications RAD radio airtime and production costs CNS campaign consultants MTG meetings and appearances RFD returned contributions CTB contribution (explain nonmonetary)* OFC office excenses SAL campaign workers' salaries CVC civic donations PET petition circulating TEL t.v. or cable airtime and production costs FIL candidate filing/ballot fees PHO phone banks TRC candidate travel, lodging, and meals FND fundraising events POL polling and survey research TRS staff/spouse travel, lodging, and meals IND independent expenditure supporting/opposing others (explain)* POS postage, delivery and messenger services TSF transfer between committees of the same candidate/sponsor LEG legal defense PRO professional services (legal, accounting) VOT voter registration LIT campaign literature and mailings PRT print ads WEB information technology costs (internet, e-mail) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Attach additional information on appropriately labeled continuation sheets. TOTAL* $ * Do not transfer to any other schedule or to the Summary Page. This total may not equal the amount paid to the agent or FPPC Form 460 (Jan/2016)) independent contractor as reported on Schedule E. FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov E ther o 1 � SEE INSTRUCTIONS ON REVERSE through Page of NA%'.E OF FILER. I.D. NUMBER I IF AN !,NDIVICUAL, ENTER (a) FUL, NAME STREET ADDRESS, AND ZIP CODE I I OUTSTANDING I I OUTSTANDING OCCUPATION AND EMPLOYER AMOUNT IREPAYMENT OR ORIGINAL CUMULATIVE OF RECIPIENT i _ I. BALANCE BALANCE A? !NTERES? I AMOUNT OF LOANS 'IF COMMITTEE, ALSO ENTER L'J. NUMBER,) I !' °"F-EWP OYEC. ENTER I LOANED THIS FORGIVENESS NAME OF BUSINESS) IBE3F RI PERIOD �i THIS PERIOD* CLOSE OF THIS RECEIVED PFRIOD LOAN I TO DATE i 111 E] PAID CALENDAR YEAR i$ _ $ -ti $ j ' I RATE !i! i; ❑ FORGIVEN I I PER ELECTiON' --- �— I DATE DUE DATE INCURRED I I ! ❑ PAID I I { CALENDAR YEAR $ I V ! RATE a/ ❑ FORGIVEN I PER ELECTION** I I I i DATE DUE I DATE INCURRED "Loans that are contributions to another candidate or committee must I also be summarized on Schedule D. Loans forgiver must also be reported on Schedule E. SUBTOTALS$ $ I $ (toter (e) on - Schedule I, Line 3) Schedule H Summary 1. Loans made this period....................................................................................................................................................$ (Total Column (b) plus unitemized loans of less than $100.) —If Required 2. Payments received on loans............................................................................................................................................$ (Total Column (c) plus unitemized payments of less than $100.) 3. Net change this period. (Subtract Line 2 from Line 1.1) ........................................................................................... NET $ (Enter the net here and on the Summary Page, Column A, Line 7.) (May be a negative number) FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule ! Amounts may be rounded SCHEDULE I jI through Page -LT of �L_ SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER DATE j FL NAME AND ADDRESS OF SOURCE T FULL AMOUNT OF DESCRIPTION OF RECEIPT INCREASE TO CASH RECEIVED (iF COMMITTEE, ALSO ENTER I.D. NUti BFR) 5/24/23 1 Peerly Inc. Refund for overcharging 1234.11 i I 2232 Dell Range Blvd, Cheyenne, WY 82009 i I f i i Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ 1234.11 c e u e I Summary 1. Itemized increases to cash this period . ........................................................................................................................... $ 1234.11 2. Unitemized increases to cash of under $100 this period................................................................................................. $ 0 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).) ..............................$ 0 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the 1234.11 Summary Page, Line 14.)............................................................................................................................. TOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov