CAMPAIGN FINANCE REPORT STATE OF WISCONSIN

Transcription

1 CAMPAIGN FINANCE REPORT STATE OF WISCONSIN Is this report an Amendment? YES NO X COMMITTEE IDENTIFICATION Name of Committee Address 929 O'Sheridan Street OFFICE USE ONLY City, State, ZIP Madison, WI WSEB # ID Please check if address is different than previously reported NAME OF REPORT Jan 2010 Continuing Pre-election Spring Fall Special (Please circle) July 2010 Continuing Pre-election Spring Fall Special SUMMARY OF RECEIPTS AND DISBURSEMENTS Column A Column B Audited Totals 1. RECEIPTS This Period YTD Office Use Only A. Contributions including Loans from Individuals $2, B. Contributions from Committees (Transfers-In) $ C. Other Income and Commercial Loans TOTAL RECEIPTS (Add totals from 1A, 1B, and 1C) $ 3, DISBURSEMENTS A. Gross Expenditures $ $ B. Contributions to Committees (Transfers-Out) $ TOTAL DISBURSEMENTS (Add totals from 2A and 2B) $ $ CASH SUMMARY $ 1, Cash Balance at Beginning of Report Total Receipts $ 3, Subtotal $ 4, Total Disbursements $ CASH BALANCE AT END OF REPORT $ 3, INCURRED OBLIGATIONS (at close of period) LOANS (at close of period) I certify that I have examined this report and to the best of my knowledge and belief it is true, correct and complete. Type or Print Name of Candidate or Treasurer Signature of Candidate or Treasurer Date Kyle Richmond Daytime Phone NOTE: The information on this form is required by ss , 11.20, Wisconsin. Stats. Failure to provide this information may subject you to the penalties os 11.60, 11.62, Wisconsin. Stas.

2 Contributions Including Loans from Individuals IN-KIND CONDUIT DATE LAST FIRST Address City State Zip EMPLOYER OCCUPATION AMOUNT YTD 11/16/2009 Passman Marj 3118 Todd Dr Madison WI Retired $ $ /17/2009 Chawla Yogesh 324 Russell St Madison WI $25.00 $ Elka Lane 11/17/2009 Rowe William #2 Madison WI $25.00 $ /20/2009 Bormann Virginia 1905 County RoSun Prairie WI $50.00 $ /20/2009 Silveira Arlene 5760 Barbara g Dr Fitchburg WI $25.00 $ /22/2009 Hogan Matt #1 Madison WI $25.00 $ /22/2009 Richmond Meredith 106 Main St g Ground IN Advisor Purdue University $ $ /23/2009 Bohlman Brian Dr Madison WI Physician Self Employed $ $ /23/2009 Richards Mondest 710 Spruce St Madison WI Retired $ $ Academy for Educational Development- Washington DC $ $ /23/2009 Richmond Brian 7410 Carroll Ave y Takoma Park MD Collaboration Specialist 11/23/2009 Richmond Niecie Ave Muncie in Retired $ $ /23/2009 Winston Johnny Lane Madison WI $25.00 $ /25/2009 Anglim Mary Washington 945 S. Gammon Madison WI $40.00 $ /28/2009 Mc Cants Darryl Rd 2753 Jacquelyn Madison WI $50.00 $ /29/2009 Casey Brian Dr 2622 Arboretum Fitchburg WI $65.00 $ /29/2010 Egger Julie Lane Madison WI $40.00 $ /30/2010 Bergren Dennis 1040 Spaight St Madison WI $50.00 $ /2/2009 Crandall Aaron 1110 Fish Hatchery Rd #3 Madison WI $10.00 $ /2/2009 DeChant Tom 629 South ShoreMadison WI Retired $ $ /2/2009 DeFelice Dave 6302 Dominion Dr Madison WI $25.00 $ /2/2009 Dooley Larry 1119 Emerald S Madison WI $50.00 $ /2/2009 Emery Carolyn 2601 Balden St Madison WI $15.00 $ /2/2009 Gervais Claire 3918 Paunack AMadison WI $25.00 $ /2/2009 Guilfoyle Sheila 3914 Rockwell DMadison WI $25.00 $ /2/2009 Hantke Bill 2635 Arboretum Madison WI $25.00 $ /2/2009 Harris Arnold 3427 County RoMount Hore WI $50.00 $ /2/2009 Hasbrouck Phyllis 3113 View RoadMadison WI $25.00 $ /2/2009 Hendrick John 1315 Spaight St Madison WI $50.00 $ /2/2009 Jackson Stanley 810 Emerson St Madison WI $30.00 $ /2/2009 Keys Bill 2 N Rock Road Madison WI $50.00 $ /2/2009 Kozlovsky Thomas No Address on check $25.00 $ /2/2009 Lockhart Bob 633 Cedar St Madison WI $25.00 $ /2/2009 McAllister Leslie 100 Lakewood GMadison WI $25.00 $ /2/2009 Perrotte Ann 617 W Olin AvenMadison WI $30.00 $ /2/2009 Pertzborn Rich 1825 Oakview DStoughton WI $25.00 $ /2/2009 Rider John 1008 Colby Stre Madison WI $25.00 $25.00

3 IN-KIND CONDUIT DATE LAST FIRST Address City State Zip EMPLOYER OCCUPATION AMOUNT YTD 12/2/2009 Schmidt Bonnie 813 Emerson St Madison WI $30.00 $ /2/2009 Stoebig Thomas 4309 Hegg Ave Madison WI $50.00 $ /2/2009 Tipler Gary 807 Jenifer St Madison WI $35.00 $ /2/2009 Voichick Sarah 3922 Plymouth CMadison WI $50.00 $ /2/2009 Weidel Sarah 1237 E Dayton SMadison WI $35.00 $ /2/2009 Levin Jeremy 1715 Hoyt St Madison WI $10.00 $ /2/2009 Barnes Chris 1126 Alrita Ct #3Madison WI $40.00 $ /2/2009 Cash Unitemized $ $ /3/2009 Carrig David 645 Skyview PlaMadison WI $20.00 $ Arboretum 12/4/2009 Elkind Steven Dr Madison WI $20.00 $ White Oak 12/4/2009 Martinson Tom Trail Oregon WI $ $ /4/2009 Mills Rick 3017 Artesian Lane Madison WI $ $ /6/2009 Emerson Anneliese 5137 Whitcomb Dr Madison WI $ $ /6/2009 Moran Elaine 1313 Gilson St Madison WI $ $ /7/2009 Gasiorowicz Mari 722 Wedgewood Way Madison WI $ $ /9/2009 Panepinto Joan St. Madison WI $ $ /10/2009 Elder Joann 1112 Grant St Madison WI $ $ /11/2009 Olch Bradley PO Box 1057 Park City UT Consultant Park City Foundation LLC $ $ /11/2009 Palmer Connie 1533 Comanche Glen Madison WI $ $ /12/2010 Robinson Juscha 2929 Union St Madison WI $ $ Marshall 12/15/2009 Wisniewski Sharyn Parkway p g Madison WI $ $ /6/2009 Farley Eugene Rose Rd Verona WI $ $ /17/2009 Holec Donald 3113 Ashford Lane Madison WI $ $ /19/2009 Glass Nick 709 South Shore Dr Madison WI $ $ /20/2009 Blanchard Brian 6722 Colony Dr Madison WI $ $ /22/2009 Zelazny Sherri 112 W. Lakeside St Madison WI $ $ $2, $ 2,915.00

4 SCHEDULE 1-B Contributions from Committees IN- KIND DATE LAST FIRST ADDRESS CITY ST ZIP AMOUNT YTD 4/3/2009 Friends of Jay Allen 2881 Commerce Park Dr Fitchburg WI $ $ Check for contribution not cashed 12/2/2009 Friends of Kathleen Falk PO Box 8832 Madison WI $ $ /2/2009 Friends of Brett Hulsey 110 Merrill Crest Dr Madison WI $ $ 30.00

5 SCHEDULE 1-C Other Income and Commercial Loans DATE LAST FIRST ADDRESS CITY ST ZIP Employer

6 12/2/ /2/ /2/ /2/2009

7 Occupation AMOUNT YTD

8

9 SCHEDULE 2-A Gross Expenditures DATE NAME ADDRESS CITY ST ZIP PURPOSE AMOUNT Check # Fee for transferring from 10/24/2009 Summit Credit Union 2424 Rimrock Rd Madison WI Park Bank $5.00 Bank charge 11/15/2009 Kinko's Fed Ex 7805 Mineral Point Rd Madison WI Printing $15.96 Debit card 11/16/2009 Walgreen's 7810 Mineral Point Rd Madison WI Envelopes & Postage $55.52 Debit card 11/17/2009 Post Office 733 Struck St Madison WI Postage $9.30 Debit card 11/22/2009 Kinko's Fed Ex 654 W. Washington Madison WI Printing $95.42 Debit card 11/22/2009 Staple's 6580 Monona Dr Monona WI Envelopes & Labels $25.40 Debit card 11/23/2009 Walgreen's 606 S. Whitney Way Madison WI Postage $ Debit card 12/2/2009 Taj Indian Restaurant 1256 S. Parks St Madison WI Fundraiser $ Debit card 12/21/2009 Judy Robinson 921 S. Brooks St. #8 Madison WI Thank you notes, supplies $20.00 Cash $755.30

10 SCHEDULE 2-B Contributions to Committees DATE NAME ADDRESS CITY ST ZIP PURPOSE AMOUNT Check #

11 SCHEDULE 3-A Incurred Obligations Excluding Loans DATE NAME ADDRESS CITY ST ZIP PURPOSE Outstanding Balance Beg of Period New Obligations This Period Payment This Period Outstanding Bal Close of Period

12 SCHEDULE 3-B Loans: Individual, Committee or Commercial DATE NAME ADDRESS CITY ST ZIP Outstanding Balance Beg of Period Cumulative Payments This Period Outstanding Balance End of Period Guaruntor (if any) Name and Address

13 SCHEDULE 3-C Estimated Value of In-Kind Contributions Received DATE NAME ADDRESS CITY ST ZIP Place of Business Individ or Comm Description of Contribution Estimated Amount Estimated YTD SCHEDULE 3-D Estimated Value of In-Kind Contributions Given DATE NAME ADDRESS CITY ST ZIP Place of Business Individ or Comm Description of Contribution Estimated Amount Estimated YTD SCHEDULE 3-E Contributions Returned to Contributor DATE OF ORIGINAL CONTRIB NAME ADDRESS CITY ST ZIP Amount Returned SCHEDULE 3-F Contributions Donated to Charity or Common School Fund DATE NAME ADDRESS CITY ST ZIP Reason Amount