State of West Virginia Campaign Financial Statement
(Long Form) in Relation to the 2011 Election Year

Candidate or Committee Name
Mid-Ohio Valley - West Virginia Carpenters PAC
Candidate or Committee's Treasurer
Joseph M. Elliott
Political Party (for candidates)
Treasurer's Mailing Address (Street, Route, or P.O. Box)
376 Maple Lane 
Office Sought (for Candidates)
City, State, Zip Code
Williamstown, WV 26187
Daytime Phone #

Election Cycle Reporting Period (check one):

Primary - First Report
Due Mar 26-Apr 01, 2011
Pre-primary Report
Due Apr 29-May 03, 2011
Post-primary Report
Due May 27-Jun 28, 2011
General - First Report
Due Aug 22-Aug 26, 2011
Pre-general Report
Due Sep 19-Sep 23, 2011
Post-general Report
Due Oct 17-Nov 15, 2011

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 2011 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  $900.85
Monetary Contributions from all Fund-Raising Events +$0.00
Receipt of a Transfer of Excess Funds +$0.00
Total Monetary Contributions: =$900.85
In-Kind Contributions +$0.00
Total Contributions: =$900.85
Other Income  $0.00
Loans Received +$0.00
Total Other Income: =$0.00
Unpaid Bills  $0.00
Outstanding Loans +$0.00
Total Debts: =$0.00
(Add total contributions from all reports)
Beginning Balance
(ending balance from previous report)
Total Monetary Contributions +$900.85
Total Other Income +$0.00
Subtotal: a. =$2,900.66
Total Expenditures Paid  $500.00
Total Disbursements of Excess Funds +$0.00
Repayment of Loans +$0.00
Subtotal: b. =$500.00
Ending Balance:
(Subtotal a. - Subtotal b.)

*Cannot be negative balance
(Add total expenditures from all reports)

$250.00 or LESS

 Subtotal of contributions of $250.00 or less 

More than $250.00

5/31/2011 Full Name:  Carpenters Local #899
Address:  Resident
458 Cedar Grove Road
Parkersburg, WV 26187

Contributor's Job: (individual contributor only) 
Where Contributor Works: (individual contributor only) 
Affiliation: (political committee only) 
6/29/2011 Full Name:  Carpenters Local #899
Address:  Resident
458 Cedar Grove Road
Parkersburg, WV 26104

Contributor's Job: (individual contributor only) 
Where Contributor Works: (individual contributor only) 
Affiliation: (political committee only) 
7/29/2011 Full Name:  Carpenters Local #899
Address:  Resident
458 Cedar Grove Road
Parkersburg, WV 26104

Contributor's Job: (individual contributor only) 
Where Contributor Works: (individual contributor only) 
Affiliation: (political committee only) 
 Subtotal of all contributions of more than $250.00
Subtotal of all contributions of $250 or less
Total Contributions:

Other Income: Interest, Refunds, Miscellaneous Receipts

DateSource of IncomeType of ReceiptAmount
  Total Other Income: $0.00

In-Kind Contributions

DateName and Contributor InformationDescription of ContributionValue
  Total In-Kind Contributions: $0


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

  1. 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.)
  2. 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

DateName of Person or Vendor And AddressPurposeAmount
8/16/2011 Comm. to elect Earl Ray Tomlin 2011
P.O.Box 11530
Charleston, WV 25339
Campaign contribution$500.00
  Total Expenditures: $500.00

Receipt of a Transfer of Excess Funds

DateCandidate Committee Name and YearAmount
 Total Receipts of Transfer of Excess Funds: $0.00

Disbursement of Excess Funds

DateName of candidate committee and election year disbursing excess fundsPurpose of DisbursementAmount
  Total Disbursement of Excess Funds: $0

Unpaid Bills

DateGroup or Firm AffiliationPurposeAmount
  Total Unpaid Bills: $0.00

Office Use Only
Filed With West Virginia Secretary of State
Wednesday, April 25, 2012 11:09:15 AM