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