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HomeMy WebLinkAboutForm 460 - Eli Hill for San Rafael City Council D2; 06-30-22Recipient Committee S m COVER PAGE Campaign Statement �' • 1 Cover Page Mn SEE INSTRUCTIONS ON REVERSE Statement covers period from 1/1/22 through 6/30/22 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4. 0 Officeholder, Candidate Controlled Committee * State Candidate Election Committee O Recall (Also Complete Part 5) ❑ General Purpose Committee O Sponsored O Small Contributor Committee O Political Party/Central Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMM Eli Hill for San Rafael City Council D2 STREET ADDRESS (NO P.O. BOX) CITY ❑ Primarily Formed Ballot Measure Committee O Controlled O Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER 1439056 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-MAIL ADDRESS Date of election if appli1 J U I 20022 (Month, Day, Year)flli 11 11/8/22 2. Type of Statement: ❑ Preelection Statement ® Semi-annual Statement ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) 1 of 9 For Official Use Only ❑ Quarterly Statement ❑ Special Odd -Year Report Treasurer(s) NAME OF TREASURER Eli Hill MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE San Rafael, CA 94901 NAME OF ASSISTANT TREASURER, IF ANY Dyana Delfin Polk MAILING ADDRESS STATE ZIP CODE AREA CODE/PHONE Berkeley CA 94709 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 % 2 S t / Z U'LZ By Date Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure 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) 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/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 behaif of your candidacy. COMMITTEE NAME I.D. NUMBER NAME OF TREASURER� CONTROLLED COMMITTEE? ❑ YES ❑ NO COMMITTEE ADDRESS 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 COMM iTTEE ADDRESS STREET ADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 6. Primarily Formed Ballot Measure Committee NAME OF BALLOT MEASURE Of 9 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 N0. IF ANY 7. Primarily Formed Candidate/Officeholder Committee Listnamesof 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 (1an/2016) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Campaign Disclosure Statement Amounts may be rounded to whole dollars. Summary Page SEE INSTRUCTIONS ON REVERSE NAME OF FILER Eli Hill SUMMARY PAGE Statement covers peri from 1/1%22 through 6/30/22 Page 3 of 9 Contributions Received Column A TOTAL THIS PERIOD Column B CALENDARYEAR 6. Payments Made................................................................ (FROM ATTACHED SCHEDULES) TOTAL TO DATE 1. Monetary Contributions................................................... Schedule A, Line 3 $ 4615 $ 4615 2. Loans Received................................................................ Schedule B, Line 3 0 8. SUBTOTAL CASH PAYMENTS ....................................... 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ 4615 $ 4615 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 0 0 5. TOTAL CONTRIBUTIONS RECEIVED ........................ ........ Add Lines 3+4 $ 4615 $ 4615 Expenditures Made 6. Payments Made................................................................ Schedule E, Line 4 $ 2368.95 $ 2368.95 7. Loans Made....................................................................... Schedule H, Line 3 0 0 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 2118.95 $ 2118.95 9. Accrued Expenses (Unpaid Bills Schedule F, Line 3 0 0 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0 0 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 $ 2118.95 $ 2118.95 Current Cash Statement 12. Beginning Cash Balance ............................ Previous Summary Page, Line 16 $ 10,872.37 To calculate Column B, 13. Cash Receipts ........................................................... Column A, Line 3 above 4615 add amounts in Column 0 Ato the corresponding 14. Miscellaneous Increases to Cash .................................. Schedule 1, Line 4 amounts from Column B 15. Cash Payments......................................................... Column A, Line 8 above 2368.95 of your last report. Some amounts in Column A may 16. ENDING CASH BALANCE ..................Add Lines 12 + 13 + 14, then subtract Line 15 $ 13,118.42 be negative figures that should be subtracted from If this is a termination statement, Line 16 must be zero. previous period amounts. If this is the first report being 17. LOAN GUARANTEES RECEIVED ...................... Schedule 8, Part 2 $ filed for this calendar year, only carry over the amounts from Lines 2, 7, and 9 (if Cash Equivalents and Outstanding Debts any). 18. Cash Equivalents ................................................ See instructions on reverse $ 0 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column 8 above $ V I.D. NUMBER 1439056 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 $ $ — 21. Expenditures Made $ $ Expenditure Limit Summary for State I 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)1 FPPC Advice: advice@fppc.ca.gov (866/275-3772) Schedule A Amounts may be rounded SCHEDULE A Monetary Contributions Received w W"Ole u011ara. Statement covers period CALIFORNIA , from 1/1/22FORM, INSTRUCTIONS through 6/30/22 Page 4 of 9 SEE ON REVERSE NAME OF FILER I.D. NUMBER Eli Hill 1439056 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF [FAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR CONTRIBUTOR OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE * (IF SELF-EMPLOYED, ENTER NAME (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 2-19-22 Stephen Mizroch 0 IND Unemployed 500 500 ❑ COM ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 2-25-22 Linda Lieberman Z IND Unemployed 250 250 ❑ COM ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 2-27-22 Damon Connolly Z IND Supervisor, Marin County 250 250 ❑ coM ❑ OTH San Rafael, CA 94903 ❑ PTY ❑ ScC 3-20-22 Phyllis Lam i7J IND Self- employed, Small 100 100 ❑ CoM ❑ OTH Business Owner San Jose, CA 95125 ❑ PTY ❑ SCC 3-22-22 Mary Liz DeJong Z IND Unemployed 100 100 ❑ COM ❑ OTH San Francisco, CA 94112 ❑ PTY ❑ ScC SUBTOTAL $ 1200 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 $100 .. 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.). 4250 ..............$ 365 *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 TOTAL $ 4615 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) Schedule A (Continuation ,Sh.e@t) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers Period • . from 1/1/22 • - Page 5 of 9 through 6/30/22 NAME OF FILER I.D. NUMBER Eli Hill 1439056 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) 3-22-22 Jeremiah Zins Z IND Grocery Manager, Trader 100 100 ❑ CCM ❑ OTH Joe's San Rafael, CA 94903 ❑ PTY ❑ SCC 3-22-22 Kim Chang ® iND Freelance Consultant too 100 0 OTH i NY, New York 10128 ❑ PTY ❑ ScC 3-24-22 Ryne Scott ❑d IND Consultant, Slalom 100 100 ❑ COM San Pablo, CA 94806 ❑ OTH ❑ PTY ❑ SCC 4-9-22 Miles Lasater I Z IND Investor, Self -Employed 100 100 ❑ COM El OTH New Haven, CT 6511 ❑ PTY ❑ SCC 6-25-22 George Machun IND Unemployed 100 100 El COM ❑ OTH San Rafael, CA 94901 ❑ PTY I ❑ SCC SUBTOTAL $ 500 *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 Schedule A Amounts may be rounded SCHEDULE A "' WIlVic ""IId"' Monetary Contributions Received Statement covers period CALIFORNIA , 60 from 1/1/22 - SEE INSTRUCTIONS ON REVERSE through 6/30/22 Page 6 of 9 NAME OF FILER I.D. NUMBER Eli Hill 1439056 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 0 IND 6-29-22 Marguerite Roemer El COM Unemployed 200 200 ❑ OTH San Mateo, CA 94402 ❑ PTY ❑ SCC Z IND 6-29-22 Eduardo Blount ❑ COM Open Door Legal, Attorney 100 100 ❑ OTH San Francisco, CA 94122 ❑ PTY ❑ SCC Z IND 6-29-22 Otto Randolph ❑ coM Unemployed 100 100 ❑ OTH El Segundo, CA 90245 ❑ PTY ❑ scC V IND 6-29-22 Elbert Hill ❑ COM Expert Witness, Bicycle 200 200 ❑ OTH Commuter Services San Francisco, CA 94127 ❑ PTY ❑ SCC 7 IND 6-30-22 Catherine Colin ❑ COM Mayor, City of San Rafael 100 100 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC SUBTOTAL $ 700 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 $100 ...........................$ 4250 365 3. Total monetary contributions received this period. 4615 (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) Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE A (CONT.) Monetary Contributions Received to whole dollars. Statement covers period . • from 1/1/22 • - Page 7 of 9 through 6/30/22 NAME OF FILER I.D. NUMBER Eli Hill 1439056 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVED THIS CALENDAR YEAR TO DATE RECEIVED CODE (IF SELF-EMPLOYED, ENTER NAME) (IF COMMITTEE, ALSO ENTER I.D. NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) ❑ IND 1-8-22 Northern California Regional Council V COM ID# 972104 500 500 ❑ OTH Oakland, CA 94621 ❑ PTY ❑ SCC ® IND 4-6-22 Dean Bjornson El COM Unemployed 250 250 ❑ OTH Squiem, WA 96382 ❑ PTY ❑ SCC Z IND 4-8-22 Da oberto Ar ueta g g ❑ coM Admissions Counselor, 100 100 ❑ OTH SFSU San Francisco, CA 94131 ❑ PTY ❑ SCC ❑ IND 5-23-22 Resource Conservation PAC El COM N/A 500 500 ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC ❑ IND 6-8-22 Damon Connolly for Assembly 2022 ® COM N/A 500 500 FPPC ID# 1441976. ❑ OTH ❑ PTY SCC SUBTOTAL $ 1850 '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 Schedule E Payments Made SEE INSTRUCTIONS ON REVERSE NAME OF FILER Eli Hill Amounts may be rounded to whole dollars. Statement covers period from 1/1/22 through 6/30/22 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. SCHEDULE ORM;ALIF&MAIA Page 8 of 9 I.D. NUMBER 1439056 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 (IF COMMITTEE, ALSO ENTER I.D. NUMBER) CODE OR DESCRIPTION OF PAYMENT AMOUNT PAID Dyana Delfin Polk CNS Campaign consulting fees 1381.25 Berkeley, CA 94709 Rhett Jones Jr. Photography CMP Photos 450 Oakland, CA Secretary of State FIL Fees 200 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 2031.25 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.) ......................... 2281.25 87.7 ............... $ 0 .. TOTAL $ 2368.25 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 NAME OF FILER Eli Hill Statement covers period 1/1/22 from through 6/30/22 SCHEDULE E (CONT.) Page 9 of 9 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 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 Damon Connolly for Assembly 2022 FPPC ID# 1441976. CTB Contribution to Damon Connolly for Assembly campaign 250 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 250 FPPC Advice: advice@fppc.ca.gov (866/275-3772)