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HomeMy WebLinkAboutForm 460 - Eli Hill for San Rafael City Council D2; 10-27-22Recipient Committee Campaign Statement Cover Page SEE INSTRUCTIONS ON REVERSE Statement covers period from 9/25/22 through 10/22/22 1. Type of Recipient Committee: All Committees — Complete Parts 1, 2, 3, and 4, Officeholder, Candidate Controlled Committee ❑ Primarily Formed Ballot Measure 0 State Candidate Election Committee Committee 0 Recall 0 Controlled (Also Complete Part 5) 0 Sponsored (Also Complete Part 6) ❑ General Purpose Committee 0 Sponsored ❑ Primarily Formed Candidate/ 0 Small Contributor Committee Officeholder Committee 0 Political Party/Central Committee (Also Complete Part 7) 3. Committee Information I I.D. NUMBER COMMITTEE NAME (OR CANDIDATE'S NAME IF NO COMMITTEE) Eli Hill for San Rafael City Council D2 2022 STREETADDRESS (NO P.O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE San Rafael CA 94901 MAILING ADDRESS (IF DIFFERENT) NO. AND STREET OR P.O. BOX CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAIL ADDRESS Date of election if ale. P CT 2 7 2022 (Month, Day, Y ) COVER PAGE JA FORM Page 1 of 6 For Official Use Only 11'8'22it C1 JCLERWSOFELE� 2. Type of Statement: Preelection Statement ❑ Quarterly Statement I— 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 MAILING ADDRESS CITY STATE ZIP CODE AREA CODE/PHONE OPTIONAL: FAX / E-MAILADDRESS 4. Verification 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 correct. Executed on to 7 Z 7,�ti gy 1111 Date or Responsible Officer of Sponsor Executed on By Date Signature of Controlling Officeholder, Candidate, State Measure Proponent Executed on By Date Signature of Oontrolling Officeholder, Candidate, State Measure Proponent FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) ......... r___ __ __.. 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 IFAPPLICABLE) San Rafael City Council District 2 RES IDENTIALIBUSINESSADDRESS (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 ADDRESS STREETADDRESS (NO P -O. BOX) CITY STATE ZIP CODE AREA CODE/PHONE COMMITTEE NAME I -D. NUMBER NAME OF TREASURER CONTROLLED COMMITTEE? ❑ YES ❑ NO CITY STATE ZIP CODE AREA CODE/PHONE COVER PAGE - PART 2 Page 2 of 6 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 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 be rounded to whole dollars. Summary Rage Statement covers period from 9/25/22 SUMMARY PAGE Expenditures Made 6. PaymentsMade,: .............................................................. through 10/22/22 Page 3 of 6 SEE INSTRUCTIONS ON REVERSE 0 8. SUBTOTAL CASH PAYMENTS........... ................ . AddLines6+7 $ .426.36 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 NAME OF FILER 10. Nonmonetary Adjustment ....................................................... Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE...................................Add I.D. NUMBER Eli Hill 1439046 Contributions Received Column A TOTAL THIS PERIOD Column B Calendar Year Summary for Candidates (FROM ATTACHED SCHEDULES) CALENDAR YEAR TOTAL TO DATE Running in Both the State Primary and General Elections 1. Monetary Contributions................................................... Schedule A, Line 3 $ 5850 $ 13,565 0 0 1/1 through 6/30 7l1 to Date 2. Loans Received..._. ............................................... ........... Schedule B, Line 3 3. SUBTOTAL CASH CONTRIBUTIONS .............................. Add Lines 1 +2 5850 $ 13,565 $ 20 Received Contributions $ 4615 $ 8950 4. Nonmonetary Contributions ............................................ schedule C, Line 3 0 0 21. Expenditures 4364.35 4790.71 Made 5. 1 OTAL CONTRIBUTIONS RECEIVED................................Add Lines 3+4 $ 5850 $ 13,565 $_ _ _ . $.. Expenditures Made 6. PaymentsMade,: .............................................................. Schedule E, Line 4 $ 426.36 7. Loans Made....................................................................... Schedule H, Line 3 0 8. SUBTOTAL CASH PAYMENTS........... ................ . AddLines6+7 $ .426.36 9. Accrued Expenses (Unpaid Bills) .......................................... Schedule F Line 3 0 10. Nonmonetary Adjustment ....................................................... Schedule C, Line 3 0 11. TOTAL EXPENDITURES MADE...................................Add Lines 8+9+10 $ 426.36 Current Cash Statement 12. Beginning Cash Balance ........................... Previous Summary Page, Line 16 $ 14,243.02 13. Cash Receipts ... column A, Line 3 above 5850 14. Miscellaneous Increases to Cash ....... Schedule 1, Line 4 20,093.02 15. Cash Payments column A, Line 8 above 426.36 16. ENDING CASH BALANCE .................Add Lines 12 + 13 + 14, then subtract Line 15 $ 19,666.66 If this is a termination statement Line 16 must be zero. 17. LOAN GUARANTEES RECEIVED. .... ....................... ... Schedule B, Part 2 $ 0 I Cash Equivalents and Outstanding Debts 18. Cash Equivalents ................................................ See instructions on reverse 19. Outstanding Debts .............................. Add Line 2 + Line 9 in Column B above $ 0 $ 0 $ 6766.11 0 $ 6766.11 0 0 $ 6766.11 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` (it 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 Monetary Contributions Received to whole dollars. from 9/25122 SEE INSTRUCTIONS ON REVERSE through 10/22/22 NAME OF FILER Eli Hill SCHEDULE A Page 4 of 6 I D, NUMBER 1439046 DATE FULL NAME, STREETADDRESS AND ZIP CODE OF IFAN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR CONTRIBUTOR CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED. ENTER NAME RECEIVED THIS CALENDAR YEAR TO DATE (IF COMMITTEE, ALSO ENTER I D NUMBER) OF BUSINESS] PERIOD (JAN. 1 - DEC, 31) (1F REQUIRED) 10/12/22 SRCC Candidates PAC iD Pending ❑ IND 2450 2450 Joanne Webster ®COM ❑ OTH San Rafael, CA 94901 p PTY pscC 10/15/22 Marin Professional Firefighters ❑ IND 1500 1500 ID# 930791 ® COM ❑ OTH Sacramento CA 94814 ❑ PTY ❑ SCC 10/13122 International Brotherhood of Electrical Workers Local ❑ IND 500 500 m COM 551 PAC ID# 1277746 ❑ OTH Sacramento, CA 95814 ❑ PTY ❑ SCC 10113/22 SE1U 1021 PAC ID# 1296948 ❑ IND 500 500 ® COM ❑ OTH Sacramento, CA 94901 ❑ PTY ❑SCC 10/13/22 Stephen Mizroch MD Z I Retired 300 300 DrCOM `❑ OTH San Rafael, CA 94901 ❑ PTY SCS SUBTOTAL $ 5250 Schedule A Summary 1. Amount received this period — itemized monetary contributions, 5850 (Include all Schedule A subtotals.) ........ _ ....... ............... ....................:....:............................................... $ 2. Amount received this period — unitemized monetary contributions of less than $100 ...........................$ 0 3. Total monetary contributions received this period. (Add Lines 1 and 2. Enter here and on the Summary Page, Column A, Line 1.) ...................TOTAL $ 5850 "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 46D (Jan/2016)) FPPC Advice: advice@fppc.ca,gov (866/275-3772) Schedule A (Continuation Sheet) Amounts may be rounded SCHEDULE (CONT.) monetary L;ontributionS Keceived to wnoie sonars. Statement covers period from 9/25/22 ■ a i through 10/22/22 Page 5 of 6 NAME OF FILER 1. D. NUMBER Eli Hill 1439046 DATE FULL NAME, STREET ADDRESS AND ZIP CODE OF CONTRIBUTOR IF AN INDIVIDUAL, ENTER AMOUNT CUMULATIVE TO DATE PER ELECTION RECEIVED CONTRIBUTOR * CODE OCCUPATION AND EMPLOYER (IF SELF-EMPLOYED, ENTER NAME) RECEIVED THIS CALENDAR YEAR TO DATE (IF COMMITTEE, ALSO ENTER I D NUMBER) OF BUSINESS) PERIOD (JAN. 1 - DEC. 31) (IF REQUIRED) 10/5/22 William Carney m IND Unemployed 100 100 El COM ❑ OTH San Rafael, CA 94901 ❑ PTY ❑ SCC 10/19/22 Susan Sidel m IND Self, Psychotherapist 100 100 ❑ COM ❑ OTH San Francisco, CA 94127 ❑ PTY ❑ SCC 10/19/22 Annette Speed ® IND Unemployed 100 100 ❑ COM ❑ OTH South San Francisco, CA 94080 ❑ PTY ❑ SCC 10/19/22 Mary Liz Dejong ® IND Unemployed 100 100 ❑ COM ❑ OTH San Francisco, CA 94122 ❑ PTY ❑ SCC 10/20/22 Phyllis Lam 0 IND Self Employed/Retailer 200 200 ❑ COM ❑ OTH San Jose, CA 95125 ❑ PTY SCG 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 Amounts may to rounded Payments Made to whole dollars. SEE INSTRUCTIONS ON REVERSE NAME OF FILER Eli Hill SCHEDULE E Staterrient•coiiers period CALIFORNIA 1 from 9/25/22 • through 10/22/22 Page 6 of 6 I.Q. NUMBER 1439043 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 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 surrey 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) Political Data Inc LIT Voter registration data for political mailer 181.55 Norwalk, CA 90650 Campaign PO Box Mailboxes Services Plus OFC 226.31 San Rafael, CA 94901 Donorbox IND Fundraising fees 18.5 Alexandria, VA 22314 Payments that are contributions or independent expenditures must also be summarized on Schedule D. SUBTOTAL $ 426.36 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.). $ 426.36 $ 0 ....................................... $ 0 TOTAL $ 426.36 FPPC Form 460 (Jan/2016)) FPPC Advice: advice@fppc.ca.gov (866/275-3772) www.fppc.ca.gov