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

Candidate or Committee Name
Cliffs WV PAC
Candidate or Committee's Treasurer
Juliet A. Terry
Political Party (for candidates)
Treasurer's Mailing Address (Street, Route, or P.O. Box)
900 Lee Street East, Suite 1227 
Office Sought (for Candidates)
City, State, Zip Code
Charleston, WV 25301
Daytime Phone #

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 2013 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  $3,520.00
Monetary Contributions from all Fund-Raising Events +$0.00
Receipt of a Transfer of Excess Funds +$0.00
Total Monetary Contributions: =$3,520.00
In-Kind Contributions +$0.00
Total Contributions: =$3,520.00
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 +$3,520.00
Total Other Income +$0.00
Subtotal: a. =$5,511.01
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

11/30/2012Larry Blevins$15.00
11/30/2012Patrick Bloom$5.00
11/30/2012Donald Burgess$10.00
11/30/2012Dana Byrne$25.00
11/30/2012Joseph Carrabba$50.00
11/30/2012Bradley Ciampanella$10.00
11/30/2012Lynne Degand$7.50
11/30/2012Susanne Dickerson$10.00
11/30/2012Gregory Duffey$10.00
11/30/2012James D. Graham$10.00
11/30/2012James Kennedy$20.00
11/30/2012James Kosowski$10.00
11/30/2012Howard McClure$5.00
11/30/2012Stormy McCoy$10.00
11/30/2012Dwight Meadows$10.00
11/30/2012Kenneth Morgan$20.00
11/30/2012Mark Nelson$25.00
11/30/2012Dallas Prater$12.50
11/30/2012Dana Queen$20.00
11/30/2012Kimberly Regan$10.00
11/30/2012Kenneth Simmons$5.00
11/30/2012Juliet A. Terry$10.00
11/30/2012William Thornton$15.00
11/30/2012David Toler$10.00
11/30/2012Randall Topping$10.00
11/30/2012David Trader$10.00
12/15/2012Larry Blevins$15.00
12/15/2012Patrick Bloom$5.00
12/15/2012Donald Burgess$10.00
12/15/2012Dana Byrne$25.00
12/15/2012Joseph Carrabba$50.00
12/15/2012Bradley Ciampanella$10.00
12/15/2012Lynne Degand$7.50
12/15/2012Susanne Dickerson$10.00
12/15/2012Gregory Duffey$10.00
12/15/2012James D. Graham$10.00
12/15/2012James Kennedy$20.00
12/15/2012James Kosowski$10.00
12/15/2012Howard McClure$5.00
12/15/2012Stormy McCoy$10.00
12/15/2012Dwight Meadows$10.00
12/15/2012Kenneth Morgan$20.00
12/15/2012Mark Nelson$25.00
12/15/2012Dallas Prater$12.50
12/15/2012Dana Queen$20.00
12/15/2012Kimberly Regan$10.00
12/15/2012Kenneth Simmons$5.00
12/15/2012Juliet A. Terry$10.00
12/15/2012William Thornton$15.00
12/15/2012David Toler$10.00
12/15/2012Randall Topping$10.00
12/15/2012David Trader$10.00
12/31/2012Larry Blevins$15.00
12/31/2012Patrick Bloom$5.00
12/31/2012Donald Burgess$10.00
12/31/2012Dana Byrne$25.00
12/31/2012Joseph Carrabba$50.00
12/31/2012Bradley Ciampanella$10.00
12/31/2012Lynne Degand$7.50
12/31/2012Susanne Dickerson$10.00
12/31/2012Gregory Duffey$10.00
12/31/2012James D. Graham$10.00
12/31/2012James Kennedy$20.00
12/31/2012James Kosowski$10.00
12/31/2012Howard McClure$5.00
12/31/2012Stormy McCoy$10.00
12/31/2012Dwight Meadows$10.00
12/31/2012Kenneth Morgan$20.00
12/31/2012Mark Nelson$25.00
12/31/2012Dallas Prater$12.50
12/31/2012Dana Queen$20.00
12/31/2012Kimberly Regan$10.00
12/31/2012Kenneth Simmons$5.00
12/31/2012Juliet A. Terry$10.00
12/31/2012William Thornton$15.00
12/31/2012David Toler$10.00
12/31/2012Randall Topping$10.00
12/31/2012David Trader$10.00
1/15/2013Wayne Barry$10.00
1/31/2013Wayne Barry$10.00
2/15/2013Wayne Barry$10.00
2/28/2013Wayne Barry$10.00
3/15/2013Wayne Barry$10.00
3/29/2013Wayne Barry$10.00
1/15/2013Larry Blevins$15.00
1/31/2013Larry Blevins$15.00
2/15/2013Larry Blevins$15.00
2/28/2013Larry Blevins$15.00
3/15/2013Larry Blevins$15.00
3/29/2013Larry Blevins$15.00
1/15/2013Patrick Bloom$5.00
1/31/2013Patrick Bloom$5.00
2/15/2013Patrick Bloom$5.00
2/28/2013Patrick Bloom$5.00
3/15/2013Patrick Bloom$5.00
3/29/2013Patrick Bloom$5.00
1/15/2013Donald Burgess$10.00
1/31/2013Donald Burgess$10.00
2/15/2013Donald Burgess$10.00
2/28/2013Donald Burgess$10.00
3/15/2013Donald Burgess$10.00
3/29/2013Donald Burgess$10.00
1/15/2013Dana Byrne$25.00
1/31/2013Dana Byrne$25.00
2/15/2013Dana Byrne$25.00
2/28/2013Dana Byrne$25.00
3/15/2013Dana Byrne$25.00
3/29/2013Dana Byrne$25.00
1/15/2013Joseph Carrabba$50.00
1/31/2013Joseph Carrabba$50.00
2/15/2013Joseph Carrabba$50.00
2/28/2013Joseph Carrabba$50.00
3/15/2013Joseph Carrabba$50.00
3/29/2013Joseph Carrabba$50.00
1/15/2013Bradley Ciampanella$10.00
1/31/2013Bradley Ciampanella$10.00
2/15/2013Bradley Ciampanella$10.00
2/28/2013Bradley Ciampanella$10.00
3/15/2013Bradley Ciampanella$10.00
3/29/2013Bradley Ciampanella$10.00
1/15/2013Lynne Degand$7.50
1/31/2013Lynne Degand$7.50
2/15/2013Lynne Degand$7.50
2/28/2013Lynne Degand$7.50
3/15/2013Lynne Degand$7.50
3/29/2013Lynne Degand$7.50
1/15/2013Susanne Dickerson$10.00
1/31/2013Susanne Dickerson$10.00
2/15/2013Susanne Dickerson$10.00
2/28/2013Susanne Dickerson$10.00
3/15/2013Susanne Dickerson$10.00
3/29/2013Susanne Dickerson$10.00
1/15/2013Gregory Duffey$10.00
1/31/2013Gregory Duffey$10.00
2/15/2013Gregory Duffey$10.00
2/28/2013Gregory Duffey$10.00
3/15/2013Gregory Duffey$10.00
3/29/2013Gregory Duffey$10.00
1/15/2013Robert Fischer$10.00
1/31/2013Robert Fischer$10.00
2/15/2013Robert Fischer$10.00
2/28/2013Robert Fischer$10.00
3/15/2013Robert Fischer$10.00
3/29/2013Robert Fischer$10.00
1/15/2013James D. Graham$10.00
1/31/2013James D. Graham$10.00
2/15/2013James D. Graham$10.00
2/28/2013James D. Graham$10.00
3/15/2013James D. Graham$10.00
3/29/2013James D. Graham$10.00
1/15/2013James Kennedy$20.00
1/31/2013James Kennedy$20.00
2/15/2013James Kennedy$20.00
2/28/2013James Kennedy$20.00
3/15/2013James Kennedy$20.00
3/29/2013James Kennedy$20.00
1/15/2013James Kosowski$10.00
1/31/2013James Kosowski$10.00
2/15/2013James Kosowski$10.00
2/28/2013James Kosowski$10.00
3/15/2013James Kosowski$10.00
3/29/2013James Kosowski$10.00
1/15/2013Melissa Lehky$5.00
1/31/2013Melissa Lehky$5.00
2/15/2013Melissa Lehky$5.00
2/28/2013Melissa Lehky$5.00
3/15/2013Melissa Lehky$5.00
3/29/2013Melissa Lehky$5.00
1/15/2013Marc Mallett$10.00
1/31/2013Marc Mallett$10.00
2/15/2013Marc Mallett$10.00
2/28/2013Marc Mallett$10.00
3/15/2013Marc Mallett$10.00
3/29/2013Marc Mallett$10.00
1/15/2013Howard McClure$5.00
1/31/2013Howard McClure$5.00
2/15/2013Howard McClure$5.00
2/28/2013Howard McClure$5.00
1/15/2013Stormy McCoy$10.00
1/31/2013Stormy McCoy$10.00
2/15/2013Stormy McCoy$10.00
2/28/2013Stormy McCoy$10.00
3/15/2013Stormy McCoy$10.00
3/29/2013Stormy McCoy$10.00
1/15/2013Dwight Meadows$10.00
1/31/2013Dwight Meadows$10.00
2/15/2013Dwight Meadows$10.00
2/28/2013Dwight Meadows$10.00
3/15/2013Dwight Meadows$10.00
3/29/2013Dwight Meadows$10.00
1/15/2013Kenneth Morgan$20.00
1/31/2013Kenneth Morgan$20.00
2/15/2013Kenneth Morgan$20.00
2/28/2013Kenneth Morgan$20.00
3/15/2013Kenneth Morgan$20.00
3/29/2013Kenneth Morgan$20.00
1/15/2013Mark Nelson$25.00
1/31/2013Mark Nelson$25.00
2/15/2013Mark Nelson$25.00
2/28/2013Mark Nelson$25.00
3/15/2013Mark Nelson$25.00
3/29/2013Mark Nelson$25.00
1/15/2013Dallas Prater$12.50
1/31/2013Dallas Prater$12.50
2/15/2013Dallas Prater$12.50
2/28/2013Dallas Prater$12.50
1/15/2013Dana Queen$20.00
1/31/2013Dana Queen$20.00
2/15/2013Dana Queen$20.00
2/28/2013Dana Queen$20.00
3/15/2013Dana Queen$20.00
3/29/2013Dana Queen$20.00
1/15/2013Kimberly Regan$10.00
1/31/2013Kimberly Regan$10.00
2/28/2013Kimberly Regan$10.00
3/15/2013Kimberly Regan$10.00
3/29/2013Kimberly Regan$10.00
1/15/2013Clifford Smith$25.00
1/31/2013Clifford Smith$25.00
2/15/2013Clifford Smith$25.00
2/28/2013Clifford Smith$25.00
3/15/2013Clifford Smith$25.00
3/29/2013Clifford Smith$25.00
1/15/2013Juliet A. Terry$10.00
1/31/2013Juliet A. Terry$10.00
2/15/2013Juliet A. Terry$10.00
2/28/2013Juliet A. Terry$10.00
3/15/2013Juliet A. Terry$10.00
3/29/2013Juliet A. Terry$10.00
1/15/2013William Thornton$15.00
1/31/2013William Thornton$15.00
2/15/2013William Thornton$15.00
2/28/2013William Thornton$15.00
3/15/2013William Thornton$15.00
3/29/2013William Thornton$15.00
1/15/2013John Tish$5.00
1/31/2013John Tish$5.00
2/15/2013John Tish$5.00
2/28/2013John Tish$5.00
3/15/2013John Tish$5.00
3/29/2013John Tish$5.00
1/15/2013David Toler$10.00
1/31/2013David Toler$10.00
2/15/2013David Toler$10.00
2/28/2013David Toler$10.00
3/15/2013David Toler$10.00
3/29/2013David Toler$10.00
1/15/2013Randall Topping$10.00
1/31/2013Randall Topping$10.00
2/15/2013Randall Topping$10.00
2/28/2013Randall Topping$10.00
3/15/2013Randall Topping$10.00
3/29/2013Randall Topping$10.00
1/15/2013David Trader$10.00
1/31/2013David Trader$10.00
2/15/2013David Trader$10.00
2/28/2013David Trader$10.00
3/15/2013David Trader$10.00
3/29/2013David Trader$10.00
2/15/2013Kimberly Regan$10.00
 Subtotal of contributions of $250.00 or less$3,520.00

More than $250.00

 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
12/4/2012 Morrisey for Attorney General
PO Box 820
Charles Town, WV 25414
Attorney General Patrick Morrisey$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
Thursday, May 2, 2013 11:44:30 AM