State of West Virginia Campaign Financial Statement
(Long Form) in Relation to the 2012 Election Year

Candidate or Committee Name EPIC West Virginia PharmPAC		Candidate or Committee's Treasurer Mark Williams
Political Party (for candidates)		Treasurer's Mailing Address (Street, Route, or P.O. Box) Route 50, HC 61 Box 301 hokie.eer@gmail.com
Office Sought (for Candidates)	District/Division	City, State, Zip Code Capon Bridge, WV 26711	Daytime Phone # 304-856-2901

Election Cycle Reporting Period (check one):

Primary - First Report
Due Mar 31-Apr 06, 2012Mar 31-Apr 06, 2012

Pre-primary Report
Due Apr 23-Apr 27, 2012Apr 23-Apr 27, 2012

Post-primary Report
Due May 21-Jun 19, 2012May 21-Jun 19, 2012

General - First Report
Due Sep 24-Sep 28, 2012Sep 24-Sep 28, 2012

Pre-general Report
Due Oct 22-Oct 26, 2012Oct 22-Oct 26, 2012

Post-general Report
Due Nov 19-Dec 19, 2012Nov 19-Dec 19, 2012

Check if Applicable:

Amended Report
You must also check box of appropriate reporting period

Final Report
Zero balance required.
PAC must also file Form F-6 Dissolution

Non-Election Cycle Reporting Period:

Annual Report 2012 Calendar Year
Due last Saturday in March or within 6 days thereafter

Report Totals

Fill in totals at the completion of the report.

RECEIPTS OF FUNDS:	Totals for this Period
Contributions	$580.00
Monetary Contributions from all Fund-Raising Events	+$0.00
Receipt of a Transfer of Excess Funds	+$0.00
Total Monetary Contributions:	=$580.00
In-Kind Contributions	+$0.00
Total Contributions:	=$580.00

Other Income	$0.00
Loans Received	+$0.00
Total Other Income:	=$0.00

OUTSTANDING LOANS & DEBTS:
Unpaid Bills	$0.00
Outstanding Loans	+$0.00
Total Debts:	=$0.00

TOTAL CONTRIBUTIONS ELECTION YEAR-TO-DATE (Add total contributions from all reports)
$4,060.00

CASH BALANCE SUMMARY
Beginning Balance (ending balance from previous report)		$25,306.10
Total Monetary Contributions		+$580.00
Total Other Income		+$0.00
Subtotal:	a.	=$25,886.10

Total Expenditures Paid		$19,200.00
Total Disbursements of Excess Funds		+$0.00
Repayment of Loans		+$0.00
Subtotal:	b.	=$19,200.00

Ending Balance: (Subtotal a. - Subtotal b.) *Cannot be negative balance		=$6,686.10

TOTAL EXPENDITURES ELECTION YEAR-TO-DATE (Add total expenditures from all reports)
$19,200.00

Contributions
$250.00 or LESS

DATE	CONTRIBUTOR'S FULL NAME OR COMMITTEE'S NAME	AMOUNT
4/25/2012	Judy’s Drug Store	$20.00
4/25/2012	Reed’s Drug Store	$20.00
4/25/2012	Reed’s Pharmacy	$20.00
4/25/2012	Sav-A-Lot Pharmacy of Fort Ashby	$20.00
4/25/2012	Reed’s Pharmacy #2	$20.00
4/25/2012	Crab Orchard Pharmacy	$20.00
4/25/2012	American Pharmacy USA	$20.00
4/25/2012	Goodykoontz Drug Store	$20.00
4/25/2012	Flat Iron Drug Store	$20.00
4/25/2012	Fritz’s Pharmacy	$20.00
4/25/2012	Bluewell’s Family Pharmacy	$20.00
4/25/2012	Black Diamond PHarmacy	$20.00
4/25/2012	Clinic Pharmacy	$20.00
4/25/2012	Poca Valu-Rite	$20.00
4/25/2012	Health Aid Pharmacy	$20.00
4/25/2012	Cross Lanes Family Pharmacy	$20.00
4/25/2012	Med-A-Save Pharmacy	$20.00
4/25/2012	Nicholas Pharmacy	$20.00
4/25/2012	McDowell Pharmacy	$20.00
4/25/2012	Reed’s Drug Store LLC	$20.00
4/25/2012	Reed’s Pharmacy #4	$20.00
4/25/2012	Citizens Drug Store	$20.00
4/25/2012	Charlie’s Pharmacy of Mullens	$20.00
4/25/2012	Gregg’s Pharmacy	$20.00
4/25/2012	Judy’s Drug Store #2	$20.00
4/25/2012	Pill Box Pharmacy	$20.00
4/25/2012	Craigsville Hometown Pharmacy	$20.00
4/25/2012	Fritz’s Pharmacy II	$20.00
4/25/2012	Shepherdstown Pharmacy	$20.00
	Subtotal of contributions of $250.00 or less	$580.00

Contributions
More than $250.00

DATE	CONTRIBUTOR'S FULL NAME OR COMMITTEE'S NAME	AMOUNT
	Subtotal of all contributions of more than $250.00 Subtotal of all contributions of $250 or less Total Contributions:	$0.00 $580.00 $580.00

Other Income: Interest, Refunds, Miscellaneous Receipts

Date	Source of Income	Type of Receipt	Amount
		Total Other Income:	$0.00

In-Kind Contributions

Date	Name and Contributor Information	Description of Contribution	Value
		Total In-Kind Contributions:	$0

Loans

West Virginia Code: §3-8-5f. Loans to candidates, organizations or persons for election purposes.

"Every candidate, financial agent, person or association of persons or organization advocating or opposing the nomination or election of any candidate or the passage or defeat of any issue or item to be voted upon may not receive any money or any other thing of value toward election expenses except from the candidate, his or her spouse or a lending institution. All loans shall be evidenced by a written agreement executed by the lender, whether the candidate, his or her spouse, or the lending institution. Such agreement shall state the date and amount of the loan, the terms, including interest and repayment schedule, and a description of the collateral, if any, and the full names and addresses of all parties to the agreement. A copy of the agreement shall be filed with the financial statement next required after the loan is executed."

The loan agreement must include all items asked for in the statute. (See above.) The loan agreement does not have to follow a certain format; generally, if all the required information is listed, any format is acceptable. Candidates or political committees that take out a loan for the campaign through a bank or other commercial lending institution must include a copy of the loan agreement executed with that bank or institution. Candidates should not take out loans which are partially for personal use and partially for the campaign. It is almost impossible to keep reporting straight in this case. Any money a candidate contributes to his or her campaign committee with the hope of repayment must be treated as a loan and reported in this section. When a candidate determines that no further repayment can be expected, the loan can be reported as repaid in this section by entering the amount left to repay in the repayments column and reporting the same amount as a contribution from the candidate on Page 2. These loans must be executed in writing. Caution: Candidates may not carry outstanding loans from one campaign to the next. Each campaign is separate. Funds from a current campaign cannot be used to repay a loan from a previous campaign.

How To Report Loans

Each loan for your campaign should be listed on a separate line. (Each time you loan money to the campaign or get a loan, it is considered to be a separate loan.) Include the following information ont he form below.
1. loans(s) from prior reporting periods and the balance of each loan (Col A.) If a payment was made on the loan, list that in Col. C. Any loan that was repaid in previous reporting periods does not need to be listed.
2. new loans, the amount (Col. B), any repayments (Col. C), and the balance (Col. D.)
Attach a copy of the loan agreement for each loan received during the reporting period.

Loans (Continued)

Bank Loans: List name & address or financial institution Candidate or Candidate's Spouse Loans: List name, residence and mailing address of person(s) making or cosigning loan	Column A Balance of previous loan at end of period	Column B Amount of new loan received during period		Column C Repayments during period		Column D Balance outstanding at end of period
	Amount	Date	Amount	Date	Amount	Amount
		Loans Received		Repayment of Loans		Outstanding Loans
Totals:		$0.00		$0.00		$0.00

Itemized Expenditures

Date	Name of Person or Vendor And Address	Purpose	Amount
4/27/2012	Andes for House 15 Deer Valley Drive Hurricane, WV 25526	Campaign Contribution	$300.00
4/27/2012	Friends of Randy Swartzmiller 218 Heartwood Drive Chester, WV 26034	Campaign Contribution	$200.00
4/27/2012	Ryan Ferns for House 27 Jenna Way Wheeling, WV 26003	Campaign Contribution	$200.00
4/27/2012	Mike Ferro for House 2 Ninth Street McMechen, WV 26040	Campaign Contribution	$200.00
4/27/2012	Anna Border for House 39 Highland Meadows Drive Davisville, WV 26142	Campaign Contribution	$300.00
4/27/2012	Craig for House 2012 (Kevin J) 34 Chestnut Drive Huntington, WV 25705	Campaign Contribution	$400.00
4/27/2012	Jim Morgan for House P.O. Box 117 Huntington, WV 25706	Campaign Contribution	$400.00
4/27/2012	Carol Miller for House 1316 12th Street Huntington, WV 25701	Campaign Contribution	$300.00
4/27/2012	Rick Thompson for House 4625 Route 152 Lavalette, WV 25535	Campaign Contribution	$500.00
4/27/2012	Committee to Re-Elect Harry Keith White P.O. Box 1985 Gilbert, WV 25621	Campaign Contribution	$500.00
4/27/2012	Ted Tomblin for House P.O. Box 191 Logan, WV 25601	Campaign Contribution	$300.00
4/27/2012	Linda Goode Phillips for House P.O. Box 505 Pineville, WV 24874	Campaign Contribution	$300.00
4/27/2012	Joe Ellington for House 613 Pigeon Roost Trail Princeton, WV 24740	Campaign Contribution	$300.00
4/27/2012	John Shott for House 422 Oakhurst Ave. Bluefield, WV 24701	Campaign Contribution	$300.00
4/27/2012	Linda Summer for House 155 Oak Run Road Beckley, WV 25801	Campaign Contribution	$300.00
4/27/2012	Perry for House (Dave) 330 East Martin Ave. Oak Hill, WV 25901	Campaign Contribution	$300.00
4/27/2012	Committee to Elect Brent Boggs 145 Holly Gray Drive Sutton, WV 26601	Campaign Contribution	$300.00
4/27/2012	Bobbie Hatfield for House 3 Wilbur Drive South Charleston, WV 25303	Campaign Contribution	$500.00
4/27/2012	Committee to Elect Chris Morris 619 Churchill Drive Charleston, WV 25314	Campaign Contribution	$300.00
4/27/2012	Skaff for House (Doug) 3 Joplin Place South Charleston, WV 25303	Campaign Contribution	$300.00
4/27/2012	Committee to Elect Eric Nelson P.O. Box 186 Charleston, WV 25314	Campaign Contribution	$300.00
4/27/2012	Bob Johns for House Committee 216 Brooke St., Suite 200 Charleston, WV 25314	Campaign Contribution	$300.00
4/27/2012	Tim Armstead for House 20 Pine Cone Drive Elkview, WV 26241	Campaign Contribution	$300.00
4/27/2012	Hartman for House (Bill) P.O. Box 243 Elkins, WV 26241	Campaign Contribution	$500.00
4/27/2012	Joe Talbott for House 148 Webster Ave. Webster Springs, WV 26288	Campaign Contribution	$300.00
4/27/2012	Sam Cann for House 21 Maple Lake Road Bridgeport, WV 26288	Campaign Contribution	$300.00
4/27/2012	Richard Iaquinta for House 139 Vermont Ave Clarksburg, WV 26301	Campaign Contribution	$300.00
4/27/2012	Committee to Elect Tim Miley c/o The Miley Legal Group 230 W Pike St, Suite 205 Clarksburg, WV 26301	Campaign Contribution	$500.00
4/27/2012	Friends to Re-Elect Mike Caputo RR 1, Box 155 Riversville, WV 26588	Campaign Contribution	$400.00
4/27/2012	Pasdon for House (Amanda) P.O. Box 106 Morgantown, WV 26507	Campaign Contribution	$300.00
4/27/2012	Barill for the House (Tony) 18 W. 5th Street Westover, WV 26501	Campaign Contribution	$200.00
4/27/2012	Gary Howell for House P.O. Box 39 Keyser, WV 26726	Campaign Contribution	$200.00
4/27/2012	Ruth Rowan for House HC 60, Box 113-A Points, WV 25437	Campaign Contribution	$300.00
4/27/2012	Cowles for House 2612 Martinsburg Road Berkeley Springs, WV 25411	Campaign Contribution	$500.00
4/27/2012	Householder for House (Eric) 212 Snooks Lane Martinsburg, WV 25405	Campaign Contribution	$300.00
4/27/2012	Tiffany Lawrence 652 Sawgrass Drive Charles Town, WV 25414	Campaign Contribution	$300.00
4/27/2012	Committee to Elect Earl Ray Tomblin P.O. Box 11530 Charleston, WV 25339	Campaign Contribution	$500.00
4/27/2012	Re-Elect Jack Yost for Senate 1413 Pleasant Ave. Wellsburg, WV 26070	Campaign Contribution	$300.00
4/27/2012	Kessler for Senate (Jeffrey) 607 Wheeling Ave Glen Dale, WV 26038	Campaign Contribution	$500.00
4/27/2012	Committee to Elect Mitch Carmichael 101 Court St. Ripley, WV 25271	Campaign Contribution	$500.00
4/27/2012	Mark Wills for State Senate 218 Hale Ave. Princeton, WV 24740	Campaign Contribution	$300.00
4/27/2012	Kirkendoll for Senate (Art) P.O. Box 1227 Chapmanville, WV 25508	Campaign Contribution	$300.00
4/27/2012	Friends of Joshua Martin P.O. Box 513 Poca, WV 25159	Campaign Contribution	$300.00
4/27/2012	Browning 2012 (Richard) P.O. Box 158 Oceana, WV 24870	Campaign Contribution	$500.00
4/27/2012	Clark Barnes for Senate Route 2, Box 12-C Beverly, WV 26253	Campaign Contribution	$300.00
4/27/2012	Committee to Elect Doug Facemire 774 Shannon Road Bridgeport, WV 26330	Campaign Contribution	$400.00
4/27/2012	Committee to Re-Elect Roman Prezioso 1806 Dogwood Drive Fairmont, WV 26554	Campaign Contribution	$500.00
4/27/2012	Bob Williams for State Senate Committee P.O. Box 562 Grafton, WV 26354	Campaign Contribution	$300.00
4/27/2012	Elect Snyder Committee (Herb) P.O. Box 400 Shenandoah Junction, WV 25442	Campaign Contribution	$400.00
4/27/2012	Don Perdue for House 635 White’s Creek Road Prichard, WV 25555	Campaign Contribution	$500.00
4/27/2012	Staggers for House (Margaret Anne) 36 Barrington Hill Road Fayetteville, WV 25840	Campaign Contribution	$300.00
4/27/2012	Mark Hunt for House 406 Capitol Street, Suite 1009 Charleston, WV 25301	Campaign Contribution	$500.00
4/27/2012	Sharon Spenser for Delegate 412 Midland Ave. Belle, WV 25015	Campaign Contribution	$300.00
4/27/2012	Walters for House (Ron) P.O. Box 3665 Charleston, WV 25336	Campaign Contribution	$300.00
4/27/2012	Cliff Moore for House P.O. Box 67 Thorpe, WV 24888	Campaign Contribution	$400.00
		Total Expenditures:	$19,200.00

Receipt of a Transfer of Excess Funds

Date	Candidate Committee Name and Year	Amount
	Total Receipts of Transfer of Excess Funds:	$0.00

Disbursement of Excess Funds

Date	Name of candidate committee and election year disbursing excess funds	Purpose of Disbursement	Amount
		Total Disbursement of Excess Funds:	$0

Unpaid Bills

Date	Group or Firm Affiliation	Purpose	Amount
		Total Unpaid Bills:	$0.00

Office Use Only
Filed With West Virginia Secretary of State
Thursday, May 31, 2012 10:08:43 AM

State of West Virginia Campaign Financial Statement (Long Form) in Relation to the 2012 Election Year