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Home My WebLink AboutForm 460 - Eli Hill for San Rafael City Council D2; 09-29-22Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 7/1/22 through 9/24/22 1. Type of Recipient Committee: All Committees - Complete Parts 1, 2, 3, and 4. Q Officeholder, Candidate Controlled Committee 0 State Candidate Election Committee 0 Recall (Also Complete Part 5) ❑ General Purpose Committee 0 Sponsored 0 Small Contributor Committee 0 Political Party/Central Committee 3. Committee Information COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMM Eli Hill for San Rafael City Council D2 2022 STREET ADDRESS (NO P.O. BOX) CITY ❑ Primarily Formed Ballot Measure Committee 0 Controlled 0 Sponsored (Also Complete Part 6) ❑ Primarily Formed Candidate/ Officeholder Committee (Also Complete Part 7) I.D. NUMBER A ft\ I �A I :LOIS] 9] �i1:1 �_��Zi] 91 =rl ;I:[@] i! 1 :1 San Rafael Ca 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY Y S IAT E ZIP CODE AREA CODE/HHONE OPTIONAL: FAX/ E-MAIL ADDRESS COVER PAGE IDDate of election if apps �j �7 �7nr� ge 1 of 7(Month, Day, YeaS E P L 9 2022 91 For Official Use Only 11'8'22 _ CLERK'S OFFICE 2. Type of Statement: m Preelection Statement C Quarterly Statement ❑ Semi-annual Statement ❑ Special Odd -Year Report ❑ Termination Statement (Also file a Form 410 Termination) ❑ Amendment (Explain below) 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 CITY 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 und'}er the laws of the State of California that the foregoing is true and correct. ��' Executed on — � V q / �� By 1Date 7 Proponent or Resconsible otTicer o1 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) .... ....f. .. .- -... 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 behalf 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 COMMITTEE ADDRESS STREET ADDRESS (NO P.O. BOX) COVER PAGE - PART 2 Page 2 of 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 Listnames 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 I' I l J IMI C LIr VVUC MPCCM VVUC/rrIVIVC 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 Summary Page Amounts may be rounded to whole dollars. Statement covers period from 7/1/22 SUMMARY PAGE Expenditures Made 6. Payments Made .................... ...... Schedule E, Line 4 $ 1975.4 9/24/22 Page 3 of SEE INSTRUCTIONS ON REVERSE 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 1975.4 through Schedule l , Line 3 0 NAME OF FILER Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 I.D. NUMBER Eli Hill 1439046 Contributions Received Column A TOTAL THIS Column B Calendar Year Summary for Candidates PERIOD (FROM ATTACHED SCHEDULES) CALENDARYEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 $ 3100 $ 7,715 0 0 1/1 through 6130 7/1 to Date 2. Loans Received................................................................ Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 $ 3100 $ 7,715 20. Contributions Received $ 4615 $ 3100 4. Nonmonetary Contributions ............................................ Schedule C, Line 3 0 0 21. Expenditures 4364.35 1975.4 3100 5. TOTAL CONTRIBUTIONS RECEIVED...............................Add Lines 3+4 $ 7,715 $ Made $ $ Expenditures Made 6. Payments Made .................... ...... Schedule E, Line 4 $ 1975.4 7. Loans Made....................................................................... Schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS ....................................... Add Lines 6+7 $ 1975.4 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule l , Line 3 0 10. Nonmonetary Adjustment......................................................... Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE....................................Add Lines 8+9+10 $ 1975.4 Current Cash Statement 12. Beginning Cash Balance Previous Summary Page, Line 16 $ 13,118,42 13. Cash Receipts.................................... ........................ Column A, Line 3 above 3100 14. Miscellaneous Increases to Cash .. Schedule /, Line 4 0 15. Cash Payments ..... Column A, Line 8 above 1975.4 16. ENDING CASH BALANCE Add Lines 12 + 13 + 14, then subtract Line 15 $ 14,243.02 If this is a termination statement, Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED ................................ Schedule B, Pane $ 0 Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse $ 0 19. Outstanding Debts............. ...........:..... Add Line 2 + Line 9 in Column B above $ 0 $ 4,364.35 0 $ 4,364.35 0 0 $ 4364.35 To calculate Column B, add amounts in Column A to 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). ` 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 Amounts may be rounded SCHEDULE A to whole aohars. Monetary Contributions Received Statement covers period from 7/1/22 • ' through Page 4 of SEE INSTRUCTIONS ON REVERSE .9/24/22 NAME OF FILER I.D. NUMBER Eli Hill 1439046 FULL NAME, STREETADDRESS AND ZIP CODE OF [FAN 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) 7/1/22 Michael Chin IND Retired 100 100 ❑ COM ❑ OTH San Francisco, CA 94122 ❑ PTY ❑ SCC 7/1/22 Paul Edmonson m IND Self-employed, Attorney 500 500 ❑ COM ❑ OTH Yakima, WA 98907 ❑ PTY ❑ SCC 7/1/22 Pamela Kawashima m IND Unemployed 200 200 ❑ COM ❑ OTH San Jose, CA 95129 ❑ PTY ❑ SCC 7/5/22 Annette Speed m IND SF State, Admin 100 100 ❑ COM ❑ OTH Coordinator South San Francisco, CA 94080 ❑ PTY ❑ SCC 7/10/22 Michael Foley m IND Retired 200 200 ❑ COM ❑ OTH San Francisco, CA 94127 ❑ PTY ❑ SCC SUBTOTAL $ 1,100 Schedule A Summary 1. Amount received this period — itemized monetary contributions. 2950 (Include all Schedule A subtotals.).........................................................................................................$ 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 150 3. Total monetary contributions received this period. 3100 (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 7/1/22 . - • 1 through 9/24/22 Page of 7 NAME OF FILER I.D. NUMBER Eli Hill DATE FULL NAME, STREETADDRESS AND ZIP CODE OF CONTRIBUTOR [FAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION CONTRIBUTOR * OCCUPATION AND EMPLOYER RECEIVEDTHIS 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) 7/12/22 Rodger Birt ® IND Unemployed 100 150 ❑ CoM ❑ OTH Oakland, CA 94610 ❑ PTY ❑ SCC 7/17/22 Jesse Sanford ® IND Mode, Staff Engineer 100 100 ❑ COM ❑ OTH San Francisco, CA 94114 ❑ PTY _ Michael Alexin ❑ SCC 7/30/22 RI IND Unemployed 100 100 ❑ COM ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 7/30/22 Philip Weismehl R1 IND Unemployed 100 100 ❑ COM ❑ OTH Alamo, CA 94507 ❑ PTY ❑ scc 8/4/22 Bill Wong Z IND Unemployed 200 200 ❑ coM ❑ OTH San Francisco, CA 94109 ❑ PTY SCC SUBTOTAL $ 600 "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 .7/1/22 through 9/24/22 CODES: If one of the following codes accurately describes the payment, you may enter the code. Otherwise, describe the payment. HEDULE Page (0 of -7 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) DonorBox DBA Rebel Idealist Inc Alexandria, VA 22314 Maribeth Bushey for San Rafael City Council 2022 FPPC IN 1452093 San Rafael, CA 94901 City of San Rafael San Rafael, CA 94901 CODE OR DESCRIPTION OF PAYMENT CMP Processing fees for DonorBox CTB I Political Contribution FIL Candidate statement fees * Payments that are contributions or independent expenditures must also be summarized on Schedule D. Schedule E Summary AMOUNT PAID 100.4 250 225 SUBTOTAL $ 575.5 1. Itemized payments made this period. (Include all Schedule E subtotals.).................................................................................................. 2. Unitemized payments made this period of under $100............................................................................................................................... 3. Total interest paid this period on loans. (Enter amount from Schedule B, Part 1, Column(e).).................................................................. 4. Total payments made this period. (Add Lines 1, 2, and 3. Enter here and on the Summary Page, Column A, Line 6.). 1975.4 TOTAL$ 1975.4 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov Schedule E (Continuation Sheet) Payments Made Amounts may be rounded to whole dollars. SCHEDULE E (CONT.) Statement covers period from • , ' Contribution SEE INSTRUCTIONS ON REVERSE San Rafael, CA 94901 Dyana Delfin Polk CNS Consulting fees 900 Berkelev. CA 94709 * Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 1400 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772)