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Home My WebLink AboutForm 460 - Eli Hill for San Rafael City Council D2; 12-31-23 (09-02-25 Special Odd-Year Report)COVER PAGE Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 7/1 /23 through 12/31/23 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 ❑ Political Party/Central Committee (Also Complete Part l) I.D. NUMBER 3. Committee Information CANDIDATE'S Eli Hill for San Rafael City Council D2 2022 STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREACODE/PHONE San Rafael CA 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREACODE/PHONE OPTIONAL: FAX/E-MAILADDRESS 4 Date of election if ' lire le: �'' — (Month, Day, ear) Page I— of For Official Use Only CI CLERK'S OFFICE 2. Type of Statement: ❑ Preelection Statement ❑ Quarterly Statement ® Semi-annual Statement ® Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) Schedule E: Cash payments for contribution checks deposited and expenses accrued in previous period Treasurer(s) NAME OF TREASURER �- Eli Hill MAILING ADDRESS CITY STATE ZIP CODE AREACODE/PHONE San Rafael 94901 NAME OF ASSISTANT TREASURER, IF ANY MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/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 certify under penalty of perjury under the laws of the State of California that the foregoing is true and Proponent 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 Recipient Committee Campaign Statement Cover Page — Part 2 5. Officeholder or Candidate Controlled Committee NAME OF OFFICEHOLDER OR CANDIDATE Eli Hill OFFICE SOUGHT OR HELD (INCLUDE LOCATION AND DISTRICT NUMBER IF APPLICABLE) San Rafael City Council District 2 RESIDENTIAL/BUSINESSADDRESS (NO.ANDSTREET) 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.D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADD 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 STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page z- of i 7 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 List names of offlceho/der(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 Campaign Disclosure Statement Amounts may f rounded to whole dollars. Summary Page cFF IAICTRI ICTlr1NR C)N RF\/FRgP NAME OF FILER Contributions Received 1. Monetary Contributions................................................... Schedule A, Line 3 $ 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 $ Statement covers period from through Column A Column B TOTAL THIS PERIOD CALENDAR YEAR (FROM ATTACHED SCHEDULES) TOTAL TO DATE Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 7091.04 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 ......................... ........... AddLines8+s+10 $ 7091.04 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ $8,803.70 13. Cash Receipts........................................................... Column A, Line 3 above 0 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 15. Cash Payments......................................................... Column A, Line 8 above 7091.04 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 1712.66 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 $ $ To 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 ; of 17 I.D. NUMBER Calendar Year Summary for Candidates Running in Both the State Primary and General Elections 1/1 through 6/30 711 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 Total to Date (mm/dd/yy) IJ $ 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 CrhimAl lip A Amounts may be rounded SCHEDULE A to whole dollars. Monetary Contributions Received Statement covers period • ' . � � from • ' l through Page of SEE INSTRUCTIONS ON REVERSE 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 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 $ *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 A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period CALIFORNIA from .1 FORM Page of j through _— I.D. NUMBER NAME OF FILER FULL NAME, STREETADDRESS 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 "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 SUBTOTAL $ i j FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 1 Hmounrs may tie. rumiucu Schedule B — Part 1 to whole dollars. Statement covers period CALIFORNIA Loans Received from FORM through Page of 1-7 SEE INSTRUCTIONS ON REVERSE I.D. NUMBER NAME OF FILER FULL NAME, STREETADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER a OUTSTANDING BALANCE AMOUNT RECEIVED THIS � AMOUNT PAID OR FORGIVEN OUTSTANDING BALANCE AT e INTEREST PAID THIS ORIGINAL AMOUNT OF 9 CUMULATIVE CONTRIBUTIONS OF LENDER (IF SELF-EMPLOYED, ENTER BEGINNING THIS PERIOD THIS PERIOD. CLOSE OF THIS PERIOD LOAN TO DATE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) PERIOD PERIOD CALENDAR YEAR ❑ PAID $ $ % $ $ RATE ❑ FORGIVEN PER ELECTION $ $ $ $ $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ PAID CALENDAR YEAR ❑ FORGIVEN PER ELECTION" RATE g $ $ DATE DUE DATE INCURRED t❑ IND ❑ COM ❑ OTH ❑ PTY El SCC $ $ ❑ PAID CALENDAR YEAR $ $ % $ $ ❑ FORGIVEN RATE PER ELECTION" DATE DUE DATE INCURRED t ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC 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. 'Amounts forgiven or paid by another party also must be reported on Schedule A. " If required. .......................................... $ .......................................... $ NET $ (May be a negative number) (Enter (e) on Schedule E, Line 3) 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 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE B - PART 2 Schedule B — Part 2 Amounts may De rounaea to whole dollars. statement covers period • - 460 Loan Guarantors • ' from 7 ' 7 SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER LOAN AMOUNT GUARANTEED CUMULATIVE BALANCE OUTSTANDING CONTRIBUTOR r 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 $ ❑ OTH DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑ SCC g LENDER CALENDAR YEAR ❑ IND ❑ COM $ ❑ OTH DATE PER ELECTION ❑ PTY (IF REQUIRED) ❑ SCC g CALENDAR YEAR LENDER ❑ IND ❑ COM $ ❑ OTH PER ELECTION ❑ PTY DATE (IF REQUIRED) ❑ SCC $ LENDER CALENDAR YEAR ❑ IND ❑ COM $ ❑ OTH PER ELECTION ❑ PTY DATE (IF REQUIRED) ❑ SCC $ Enter on SUBTOTAL $ Summary Page, Line 17 only. FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc,ca.gov Schedule C Amounts may be rounded SCHEDULE C Nonmonetary Contributions Received LV WHOW uuualS. Statement covers period • . , from .1 • ? 7 SEE INSTRUCTIONS ON REVERSE through Page of VAME OF FILER I.D. NUMBER DATE FULL NAME, STREETADDRESS AND CONTRIBUTOR IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER DESCRIPTION OF AMOUNT/ CUMULATIVE TO DATE PER ELECTION TO DATE RECEIVED ZIP CODE OF CONTRIBUTOR * CODE (IF SELF-EMPLOYED, ENTER GOODS OR SERVICES FAIR MARKET VALUE CALENDAR YEAR (IF REQUIRED) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) (JAN 1 - DEC 31) ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ SCC ❑ IND ❑ COM ❑ OTH ❑ PTY ❑ 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 SCHEDULED Summary of Expenditures Amounts may be rounded statement covers period . FO townoiedotiars. • Supporting/Opposing Other . - Candidates, Measures and Committees from Li i 7 through Page of SEE INSTRUCTIONS ON REVERSE 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 ❑ Monetary Contribution ❑ Nonmonetary Contribution ❑ 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 D (Continuation Sheet) Amounts may be rounded SCHEDULE D (CONT.) Summary of Expenditures to whole dollars. Statement covers period CALIFORNIA , ' Supporting/Opposing Other • FORM from Candidates, Measures and Committees � 1 through Page! of 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) m Monetary 8/8/23 Kate Colin for San Rafael Mayor 2024, Contribution 500 FPPC# 1457593 P.O. Box 150817, San Rafael, CA 94915 ❑ Nonmonetary Contribution ❑ Independent m Support ❑ Oppose Expenditure m Monetary 8/7/23 Colbert for Supervisor 2024, FPPC# Contribution 500 1461276 ❑ Nonmonetary 26 Belle Ave, San Anselmo, CA 94960 Contribution ❑ Independent ❑ Support ❑ Oppose Expenditure ❑ 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 Payments Made SEE INSTRUCTIONS ON REVERSE Amounts may be rounded to whole dollars. Statement covers period from through SCHEDULE E Page 1 ! of ! CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP 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 CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID (IF COMMITTEE, ALSO ENTER I.D. NUMBER) Dyana Delfin Polk CNS Campaign consultant fee 3222.59 Berkeley, CA 94709 Paden McNiff CNS Campaign consultant fee 2750 Mill Valley, CA 94941 Colbert for Supervisor 2024, FPPC# 1461276 CTB I Campaign contribution 500 26 Belle Ave, San Anselmo, CA 94960 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 6472.59 Schedule E Summary 1. Itemized payments made this period. (Include all 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(e).)............................................... 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.).......... 6972.59 118.45 .......................... $ ............. TOTAL $ 7091.04 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E Amounts may be rounded (Continuation Sheet) to whole dollars. Payments Made SEE INSTRUCTIONS ON REVERSE OF FILER Statement covers period from through SCHEDULE E (CONT.) Page i Z. of 't 7 I.D. NUMBER CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member communications RAID 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 campaiqn 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 Kate Colin for San Rafael Mayor 2024, FPPC# 1457593 P.O. Box 150817, San Rafael, CA 94915 CTB Campaign Contribution 500 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 500 FPPC Form 460 (Jan 2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule F Amounts may be rounded Accrued Expenses (Unpaid Bills) to whole dollars. SFF INRTRI ICTinw; nN RFVFRSF NAME OF FILER Statement covers period from through SCHEDULE F Page 15 of !-7 I.D. NUMBER 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 RAID 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 FIND 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) (a) ( (c) (d) NAME AND ADDRESS OF CREDITOR CODE OR OUTSTANDING AMOUNT NCURRED IN AMOUNT PAID OUTSTANDING (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF PAYMENT BALANCE BEGINNING THIS PERIOD THIS PERIOD BALANCE AT CLOSE OF THIS PERIOD (ALSO REPORT ON E) OF THIS PERIOD Dyana Delfin Polk CNS 3229.59 0 3229.59 0 Berkeley, CA 94709 Paden McNiff WEB 2750 0 2750 0 Mill Valley, CA 94941 * Payments that are contributions or independent expenditures must also be SUBTOTALS $ $ $ $ summarized on Schedule D. Schedule F Summary 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.) ........ 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.)..................... INCURRED TOTALS $ U PAID TOTALS $ 5979.59 3. Net change this period. (Subtract Line 2 from Line 1. Enter the difference here and-5979.59 onthe Summary Page, Column A, Line 9.)................................................................................................................................................................................... NET $ May be a negative number FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov SCHEDULE F (CONT.) Schedule F Amounts may be rounded (Continuation Sheet) to whole dollars. Statement covers periodCALIF • ' • ' . Accrued Expenses (Unpaid Bills) from • through Page 1 H of 17 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. CMP campaign paraphernalia/misc. MBR member communications RAID 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) * Payments that are contributions or independent expenditures must also be summarized on Schedule D. NAME AND ADDRESS OF CREDITOR (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 SUBTOTALS $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule G SCHEDULE G Payments Made by an Agent or Independent Amounts may be rounded Statement covers periodCALIFORNIA 460 Contractor (on Behalf of This Committee) to whole dollars. from FORM through Page of 17 SEE INSTRUCTIONS ON REVERSE NAME OF FILER I.D. NUMBER NAME OF AGENT OR INDEPENDENT CONTRACTOR CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. CMP campaign paraphernalia/misc. MBR member communications RAID 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) * 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 independent contractor as reported on Schedule E. FPPC Form 460 (Jan) FPPC Advice: advice@fppc.ca.gov (866/275-37725-3772) www.fppc.ca.gov SCHEDULE H Schedule H Amounts may be rounded Statement covers period CALIFORNIA to whole dollars. • Loans Made to Others* from FORM 1 l SEE INSTRUCTIONS ON REVERSE through Page of NAME OF FILER I.D. NUMBER FULL NAME, STREETADDRESS AND ZIP CODE IF AN INDIVIDUAL, ENTER OCCUPATION AND EMPLOYER (a) OUTSTANDING (b) AMOUNT c REPAYMENT OR OUTSTANDING e (f) ORIGINAL 9 CUMULATIVE OF RECIPIENT (IF SELF-EMPLOYED, ENTER BALANCE BEGINNING THIS LOAN LOANED THIS FORGIVENESS BALANCEAT OF THIS INTEREST RECEIVED AMOUNT OF LOANS (IF COMMITTEE, ALSO ENTER I.D. NUMBER) NAME OF BUSINESS) EEPinnPERIOD THIS PERIOD' �RIODCLOSE LOAN TO DATE ❑ PAID CALENDAR YEAR RATE ❑ FORGIVEN PER ELECTION* $ $ $ $ $ DATE DUE DATE INCURRED ❑ PAID CALENDAR YEAR RATE ❑ FORGIVEN PER ELECTION* DATE DUE DATE INCURRED *Loans that are contributions to another candidate or committee must also be summarized on Schedule D. Loans forgiven must also be reported on Schedule E. SUBTOTALS $ $ $ $ (Enter (e) on Schedule I, Line 3) Schedule H Summary 1. Loans made this period.................................................................... (Total Column (b) plus unitemized loans of less than $100.) 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.) ..................... (Enter the net here and on the Summary Page, Column A, Line 7.) ................................................................................ $ ................................................................................$ ....................................................................... NET $ **If Required (May be a negative number) FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Sr•harli fla 1 A..,,. -+� », ., do ..,— d-1 SCHEDULE 1 to whole dollars. Miscellaneous Increases to Cash SEE INSTRUCTIONS ON REVERSE Statement covers period from through CALIFORNIA 4601 .- Page 1 7 of / NAME OF FILER I.D. NUMBER DATE RECEIVED FULL NAME AND ADDRESS OF SOURCE (IF COMMITTEE, ALSO ENTER I.D. NUMBER) DESCRIPTION OF RECEIPT AMOUNT OF INCREASE TO CASH Attach additional information on appropriately labeled continuation sheets. SUBTOTAL $ Schedule ummary 1. Itemized increases to cash this period.......................................................................................................... .................. $ 2. Unitemized increases to cash of under $100 this period................................................................................................. $ 3. Total of all interest received this period on loans made to others. (Schedule H, Column (e).)................................ I ...... $ 4. Total miscellaneous increases to cash this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Line 14.)............................................................................................................................. TOTAL $ FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov