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HomeMy WebLinkAboutForm 450 - Eli Hill for San Rafael City Council D2; 06-30-24 (Amendment)SHORTFORM Recipient Committee Des mp FA Campaign Statement — Short Form - SEE INSTRUCTIONS ON REVERSE Statement covers period D (' r Date of election if ble: r , 2 5 2 2`J Page of For use b recipient committees that have not received a 1/1/24 y p from (Month, Day, ear For Official Use Only contribution or other receipt that must be itemized, have not jj received or made loans, and have no outstanding accrued 6/30/24 ��YS 4i� expenses. through 1. Type of Recipient Committee: 2. Type of Statement: ❑ Ballot Measure Committee ❑ General Purpose Committee ❑ Pre -election Statement ❑ Quarterly Statement ❑ Primarily Formed ❑ Sponsored ® Semi-annual Statement ❑ Special Odd -year Report ❑ Controlled ❑ Small Contributor Committee ❑ Termination Statement ❑ Sponsored ® Primarily Formed Candidate/ ® Amendment (Explain) Officeholder Committee (Also check type of statement you are amending) 3. Committee Information I.D. NUMBER Treasurer(s) 1439046 COMMITTEE NAME NAME OF TREASURER Eli Hill Eli Hill for San Rafael City Council D2 2022 MAILINGADDRESS 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 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAILADDRESS OPTIONAL: FAX / E-MAILADDRESS 4. Verification have used all reasonable diligence in preparing and reviewing this statement and to the best of my 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 periodILD. SHORT FORM Campaign Statement to whole dollars. � . 1 Summary Page from � through of NAME OF COMMITTEE BER Expenditures Made 1. Expenditures of $100 or more made this period...................................................................................................................................... $ 250 2. Expenditures under $100 made this period Not itemized. 96 3. SUBTOTAL EXPENDITURES MADE THIS PERIOD.......................................................................................................... Add Lines 1 + 2 $ 346 4. Nonmonetary Adjustment........................................................................................................................................... From Line 8 Below 5. Total expenditures made from previous statement............................................................................... Previous Summary Page, Line 6 $ 346 (If this is the first statement for the calendar year, enter zero.) 6. TOTAL EXPENDITURES MADE TO DATE..... ...................................................................................................... Add Lines 3 + 4 + 5 $ 346 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 $ $1,712.66 12.Cash receipts this period......................................................................................................................................................Line 7 above 0 13. Miscellaneous increases to cash............................................................................................................................................................. $ 14.Cash expenditures this period ................................................... ........................................................................................... Line 3 above 346 15. ENDING CASH BALANCE THIS PERIOD........................................................................Add Lines 11 + 12 + 13, then subtract Line 14 $ 1366.66 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 Eli Hill for San Rafael City Council D2 2022 5. Payments Matte (if more space is needed, use additional copies of this page for continuation sheets.) Statement covers period from 1/1/24 6/30/24 through SHORTFORM Page of 3 I.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 AMOUNT THIS PERIOD CUMULATIVE AMOUNTS TO DATE' AND JURISDICTION Calendar Year Damon Connolly, State Assemt $ 250 6/14/24 Damon Connolly for Assembly FPPC ID# 1441 Campaign contribution p $250 Other © m Support ❑ Oppose $ ❑ Contribution ❑ Ind. Exp. Calendar Year $ Other ❑ 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 (Jan/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov