HomeMy WebLinkAboutForm 450 - Eli Hill for San Rafael City Council D2; 06-30-25SHORT FORM
Recipient Committee
Campaign Statement — Short Form
SEE INSTRUCTIONS ON REVERSE
For use by recipient committees that have not received a
contribution or other receipt that must be itemized, have not
received or made loans, and have no outstanding accrued
expenses.
Statement covers period
from 1/1/25
through 6/30/25
1. Type of Recipient Committee:
❑ Ballot Measure Committee ❑ General Purpose Committee
❑ Primarily Formed ❑ Sponsored
❑ Controlled ❑ Small Contributor Committee
❑ Sponsored
V] Primarily Formed Candidate/
Officeholder Committee
3. Committee information
Eli Hill for San Rafael City Council D2 2022
I.D. NUMBER
1439046
STREET ADDRESS NO P.O. BOX)
CITY STATE ZIP CODE AREA CODE/PHONE
San Rafael CA 94901
MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.C. BOX
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX! E-MAILADDRESS
Date of election if a piioble:
(Month, Dayl `a
+� a r nraras f5r,
2. Type of Statement:
❑ Pre -election Statement
® Semi-annual Statement
❑ Termination Statement
CALIFORNIA
FORM 4
IDE
Page j of '3
For Official Use Only
❑ Quarterly Statement
❑ Special Odd -year Report
❑ Amendment (Explain)
(Also check type of statement you are amending)
Treasurer(s)
NAME OF TREASURER
Eli Hill
MAILING ADDRESS
9
STATE ZIP CODE AREA CODE/PHONE
San Rafael CA 94901 415-
OF ASSISTANT TREASURER, IF ANY
MAILING ADDRESS
CITY STATE ZIP CODE AREA CODE/PHONE
OPTIONAL: FAX / E-MAILADDRESS
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 is true and complete. I certify
under penalty of perjury unc)er the laws of the State of California that the foregoing is tru"
Executed on Z C� By
DATE SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT, OR RESPONSIBLE OFFICER OF SPONSOR
Executed on
DATE
Executed on
DATE
By
By
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
SIGNATURE OF CONTROLLING OFFICEHOLDER, CANDIDATE, STATE MEASURE PROPONENT
FPPC Form 450 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Recipient Committee
p
Amounts may be rounded
Statement covers period
SHORT FORM
Campaign Statement
to whole dollars.
1/1/25
� ,
'
Summary Page
from
..
6/30/25
through
Page Z of
NAME OF COMMITTEE
I.D.
NUMBER
Eli Hill for San Rafael City Council D2 2022
Expenditures Made
1. Expenditures of $100 or more made this period......................................................................................................................................
$
0
2. Expenditures under $100 made this period (Not itemized.).....................................................................................................................
108
3. SUBTOTAL EXPENDITURES MADE THIS PERIOD..........................................................................................................
Add Lines 1 + 2
$
108
4. Nonmonetary Adjustment...........................................................................................................................................
From Line 8 Below
5. Total expenditures made from previous statement...............................................................................
Previous Summary Page, Line 6
$
0
(if this is the first statement for the calendar year, enter zero.)
6. TOTAL EXPENDITURES MADE TO DATE..................................................................................................................
Add Lines 3 + 4 + 5
$
108
Contributions Received
7. Monetary contributions received this period.............................................................................................................................................
$
0
8. Non -monetary contributions received this period.. ...................................................................................................................................
9. Total contributions received from previous statement.........................................................................
Previous Summary Page, Line 10
$
(If this is the first statement for the calendar year, enter zero.)
10.TOTAL CONTRIBUTIONS RECEIVED TO DATE.........................................................................................................
Add Lines 7 + 8 + 9
$
0
Current Cash Statement
11. Beginning cash balance......................................................................................................................Previous
Summary Page, Line 15
$
1229.01
12. Cash receipts this period......................................................................................................................................................
Line 7 above
0
13. Miscellaneous increases to cash.............................................................................................................................................................
$
0
14.Cash expenditures this period..............................................................................................................................................Line
3 above
108
15. ENDING CASH BALANCE THIS PERIOD........................................................................Add
Lines 11 + 12 + 13, then subtract Line 14 $
1121.01
FPPC Form 450 (Jan/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov
Recipient Committee Amounts may be rounded
Campaign Statement — Short Form to whole dollars.
SEE INSTRUCTIONS ON REVERSE
NAME OF COMMITTEE
5. Payments Marie (If more space is needed, use additional copies of this page for continuation sheets.)
Statement covers
from
through
SHORT FORM
Page J of l
.D. NUMBER
NAME OF CANDIDATE AND OFFICE OR
DATE*
NAME AND ADDRESS OF PAYEE
(IF COMMITTEE, ALSO ENTER I.D. NUMBER)
DESCRIPTION OF PAYMENT
NAME OF BALLOT MEASURE AND
BALLOT NUMBER OR LETTER
AND JURISDICTION
AMOUNT
THIS PERIOD
CUMULATIVE
AMOUNTS TO DATE*
Calendar Year
I
$
I
Other
j
$
❑ Support ❑ Oppose
❑ Contribution ❑ Ind. Exp.
Calendar Year
Other
(
i
$
❑ Support ❑ Oppose
❑ Contribution ❑ Ind. Exp.
Calendar Year
Other
❑ Support ❑ Oppose
❑ Contribution ❑ Ind. Exp..
SUBTOTAL $
* Required only for payments which are contributions or independent expenditures.
FPPC Form 450 (1an/2016)
FPPC Advice: advice@fppc.ca.gov (866/275-3772)
www.fppc.ca.gov