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

Candidate or Committee Name
Berkeley Co. Democratic Executive Committee
Candidate or Committee's Treasurer
E. Rosalie Bernick
Political Party (for candidates)
Treasurer's Mailing Address (Street, Route, or P.O. Box)
287 Crispin Lane 
Office Sought (for Candidates)
City, State, Zip Code
Falling Waters, WV 25419
Daytime Phone #
(304) 274-9310

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  $0.00
Monetary Contributions from all Fund-Raising Events +$8,525.00
Receipt of a Transfer of Excess Funds +$0.00
Total Monetary Contributions: =$8,525.00
In-Kind Contributions +$0.00
Total Contributions: =$8,525.00
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 +$8,525.00
Total Other Income +$0.00
Subtotal: a. =$13,275.47
Total Expenditures Paid  $4,465.70
Total Disbursements of Excess Funds +$0.00
Repayment of Loans +$0.00
Subtotal: b. =$4,465.70
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

 Subtotal of all contributions of more than $250.00
Subtotal of all contributions of $250 or less
Total Contributions:

Fund-Raising Events

All monetary contributions received at a fundraiser must be reported in the Event Summary below.
If contributor's name and amount are not listed, the contribution must be turned over to the West Virginia General Revenue Fund. The only exception to this rule may apply to political party executive committees. (WV Code 3-8-5a).

St Patricks Day Elimination Dinner Event Summary

Date of Event: 3/16/2012 Total Monetary Contributions:  $8,525.00
Type of Event: Elimination Dinner Total Expenditures: -$4,054.23
Name of Place Held: Comfort Inn Martinsburg NET RECEIPTS: =$4,470.77
Address of Place Held: 1872 Edwin Miller Blvd
Martinsburg, WV 25404
Total In-Kind Contributions Related to the Fundraiser  $0.00

$250 or Less

3/16/2012Marva Barron$35.00
3/16/2012Tish Chafin$45.00
3/16/2012CJ Majestro$35.00
3/16/2012Crystal Copeland$35.00
3/16/2012Shirley Fry$35.00
3/16/2012Betsy Giggenbach$40.00
3/16/2012Gilda Kauffman$35.00
3/16/2012Michael Kauffman$35.00
3/16/2012Sherman Lambert$35.00
3/16/2012Hendra Lambert$35.00
3/16/2012Debbie Lupis$35.00
3/16/2012Shelly Perkins$50.00
3/16/2012Jeremy Perkins$35.00
3/16/2012Cecil Perkins$35.00
3/16/2012Richard Rector$35.00
3/16/2012Shelli Roberts$35.00
3/16/2012Mike Roberts$35.00
3/16/2012Paul Rossario$35.00
3/16/2012Katrina Rossario$35.00
3/16/2012Mike Secuss$35.00
3/16/2012Ed Shepherd$35.00
3/16/2012Milly Shepherd$35.00
3/16/2012Judy Shoemaker$35.00
3/16/2012Shelva Sine$35.00
3/16/2012Lucy Smith$35.00
3/16/2012Mike Smith$35.00
3/16/2012Shelly Stull$35.00
3/16/2012Lee Stull$35.00
3/16/2012Amelia Ashman$70.00
3/16/2012Matt Barney$70.00
3/16/2012Robert Barrat$70.00
3/16/2012Jason Barrett$70.00
3/16/2012Denny Barron$70.00
3/16/2012Rosalie Bernick$105.00
3/16/2012Belinda Biafore$70.00
3/16/2012Ed Boober$105.00
3/16/2012Terry Britt$200.00
3/16/2012Dugald Brown$70.00
3/16/2012Dale Buck$35.00
3/16/2012Bill Butler$105.00
3/16/2012Dave Camelletti$35.00
3/16/2012Mary Sue Catlett$70.00
3/16/2012Ken Collinson$70.00
3/16/2012Committee to elect Terry Walker$35.00
3/16/2012Joe Cordell$35.00
3/16/2012Mike Cox$70.00
3/16/2012Kim Crockett$70.00
3/16/2012Stacy Dugan$70.00
3/16/2012John Fink$70.00
3/16/2012Gerry Fitzgerald$35.00
3/16/2012Suzie Fosaaen$35.00
3/16/2012Hannah Geffert$70.00
3/16/2012Dave Greenberg$70.00
3/16/2012Steve Groh$70.00
3/16/2012Dave Hammer$70.00
3/16/2012Helen Harris$70.00
3/16/2012Dauna Hawkins$35.00
3/16/2012Frank Hill$35.00
3/16/2012Cynthia Hill$70.00
3/16/2012Jim Humphrey$70.00
3/16/2012Kevin Jackson$140.00
3/16/2012Sally Jackson$70.00
3/16/2012Todd Johnson$35.00
3/16/2012Tina Jones$70.00
3/16/2012Andrea Kackley$245.00
3/16/2012Jill Korn$70.00
3/16/2012Betty Kreinik$35.00
3/16/2012Larry Lam$70.00
3/16/2012Kenny LeMaster$70.00
3/16/2012Kris Loken$35.00
3/16/2012Mike Lorensen$70.00
3/16/2012Maria Lorensen$70.00
3/16/2012Judy Malone$35.00
3/16/2012Donn Marshall$70.00
3/16/2012Ken Mattson$70.00
3/16/2012Elaine Mauck$35.00
3/16/2012Russell McClatchy$70.00
3/16/2012Darrell McGraw$105.00
3/16/2012Charles Mease$70.00
3/16/2012Sandy Miller$25.00
3/16/2012Danny Miller$70.00
3/16/2012Robert Mills$70.00
3/16/2012Mike Moore$35.00
3/16/2012Charles O’Roke$70.00
3/16/2012Domenic Palmer$70.00
3/16/2012Max Parkinson$70.00
3/16/2012Butch Pennington$70.00
3/16/2012John Perdue$70.00
3/16/2012Connie Perry$35.00
3/16/2012Laura Rattenni$70.00
3/16/2012David Robinson$70.00
3/16/2012H. John Rogers$35.00
3/16/2012Jim Rowe$70.00
3/16/2012Kim Sencindiver$35.00
3/16/2012John Sherman$70.00
3/16/2012Virginia Sine$35.00
3/16/2012Stephen Skinner$70.00
3/16/2012Myrtle Snow$35.00
3/16/2012Herb Snyder$35.00
3/16/2012Danny Staggers$35.00
3/16/2012Ricardo Stith$70.00
3/16/2012Karen Sumner$70.00
3/16/2012Robert Taylor$70.00
3/16/2012John Taylor$70.00
3/16/2012Paul Taylor$70.00
3/16/2012Rick Wachtel$35.00
3/16/2012Joy Walls$70.00
3/16/2012Jim Whitacre$70.00
3/16/2012William Yearout$140.00
 Subtotal of event contributions of less than $250.00 $6,450.00

More than $250

3/16/2012 Full Name:  Jill Burkhart
Address:  Resident
711 Cushwa Road
Martinsburg, WV 25403

Contributor's Job: (individual contributor only)  Teacher
Where Contributor Works: (individual contributor only)  Hood College
Affiliation: (political committee only) 
3/16/2012 Full Name:  Proceeds from 50/50, drawing, tip jar, auction
Address:  Resident
Martinsburg, WV 25401

Contributor's Job: (individual contributor only)  Various contributors
Where Contributor Works: (individual contributor only)  n/a
Affiliation: (political committee only)  n/a
 Event contributions of $250 or more: 
Event contributions of less than $250: 
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
2/7/2012 Niles Bernick
287 Crispin Lane
Falling Waters, WV 25419
Reimbursement for website charge$66.67
3/16/2012 Stephen Skinner
PO Box 487
Charles Town, WV 25414
Elimination Award$50.00
3/16/2012 Scott Korn
100 Dali Ct
Martinsburg, WV 25401
Elimination Award$50.00
3/16/2012 Ruth Peyton
371 Stayman
Falling Waters, WV 25419
Elimination Award$50.00
3/16/2012 Shelva Sine
394 Winebrenner Rd
Martinsburg, WV 25404
Elimination Award$50.00
3/16/2012 Terry Britt
PO Box 1800
Martinsburg, WV 25402
Elimination Award$50.00
3/16/2012 Jim Whitacre
3829 Winchester Ave
Martinsburg , WV 25405
Elimination Award$50.00
3/16/2012 Elaine Mauck
263 Nameless Way
Martinsburg, WV 25404
Elimination Award$200.00
3/16/2012 Danny Miller
166 Fishook Ln
Hedgesville, WV 25427
Elimination Award$200.00
3/16/2012 Paul Taylor
134 W Burke Street
Martinsburg, WV 25401
Elimination Award$200.00
3/16/2012 Larry Puccio
Charleston, WV 12345
Elimination Award$200.00
3/16/2012 William Norris
2255 Nadenbousch Lane
Inwood, WV 25428
DJ Services$100.00
3/26/2012 The Journal
PO Box 807
Martinsburg, WV 25402
Advertising: Convention Legal Notice$319.80
3/27/2012 Berkeley County Clerk
100 W. King St
Martinsburg, WV 25401
Redistricting Map - Magisterial Districts$25.00
3/15/2012 Comfort Inn
1872 Edwin Miller Blvd
Martinsburg, WV 25404
Rental of facility$250.00
3/16/2012 Cecil Perkins
711 Cushwa Road
Martinsburg, WV 25403
Elimination Award$200.00
3/16/2012 Savoy Catering
1655 Anthony Highway
Waynesboro, PA 17268
Catering Services$2,404.23
  Total Expenditures: $4,465.70

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
Saturday, March 31, 2012 11:21:48 AM