State of West Virginia Campaign Financial Statement
(Long Form) in Relation to the 2010 Election Year

Candidate or Committee Name
Greenbrier Co. Republican Club
Candidate or Committee's Treasurer
Michael S. Rose
Political Party (for candidates)
Treasurer's Mailing Address (Street, Route, or P.O. Box)
PO Box 1300 
Office Sought (for Candidates)
City, State, Zip Code
Lewisburg, WV 24901
Daytime Phone #
(304) 497-4319

Election Cycle Reporting Period (check one):

Primary - First Report
Due Mar 27-Apr 02, 2010
Pre-primary Report
Due Apr 26-Apr 30, 2010
Post-primary Report
Due May 24-Jun 23, 2010
General - First Report
Due Sep 20-Sep 24, 2010
Pre-general Report
Due Oct 18-Oct 22, 2010
Post-general Report
Due Nov 15-Dec 15, 2010

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 2010 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  $3,274.00
Monetary Contributions from all Fund-Raising Events +$0.00
Receipt of a Transfer of Excess Funds +$0.00
Total Monetary Contributions: =$3,274.00
In-Kind Contributions +$0.00
Total Contributions: =$3,274.00
Other Income  $713.73
Loans Received +$0.00
Total Other Income: =$713.73
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 +$3,274.00
Total Other Income +$713.73
Subtotal: a. =$7,426.04
Total Expenditures Paid  $2,252.08
Total Disbursements of Excess Funds +$0.00
Repayment of Loans +$0.00
Subtotal: b. =$2,252.08
Ending Balance:
(Subtotal a. - Subtotal b.)

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

$250.00 or LESS

7/2/2009Genette Hill$200.00
7/2/2009Marianne Brewster$30.00
8/10/2009Gloria Fouche$30.00
8/10/2009Don Dick$20.00
8/10/2009Theresa Thompson$50.00
8/10/2009David W. Hambrick$50.00
8/10/2009Margaret Schmidt$20.00
8/10/2009Mr. &. Mrs. Selwyn Vanderpool$50.00
8/10/2009Jim Childers$25.00
8/10/2009John Gwinn$30.00
8/10/2009Mr. &. Mrs. Cleveland K. Benedict$100.00
8/10/2009Mr. & Mrs. Harold Hanson$50.00
8/10/2009Mr. & Mrs. Alonzo Brown$30.00
8/10/2009James Roberts$20.00
8/10/2009Bill Simmons$30.00
8/10/2009Mr. & Mrs. Ronald B. Snyder$30.00
8/10/2009Gary Waple$30.00
8/10/2009Mr. & Mrs. Lowell Rose$30.00
8/10/2009Mr. & Mrs. Welton D. Shipe$30.00
8/10/2009Jesse Guills, Jr.$20.00
8/10/2009Mr. & Mrs. Rick Romeo$30.00
8/10/2009Cassandra Perkins$20.00
8/10/2009Frank Tuckwiller$176.00
8/10/2009Mr. & Mrs. Mel Dobbins$30.00
8/10/2009Mr. & Mrs. Russell Siegel$30.00
8/10/2009Louis Querec$6.00
8/10/2009Michael McClung$6.00
8/10/2009Jim Childers$6.00
10/1/2009Frank Collins$30.00
10/1/2009Douglas E. McKinney$60.00
10/1/2009Tim Stanley$12.00
10/1/2009Louis Querec$24.00
10/1/2009Craig Stapp$12.00
12/3/2009Mr. & Mrs. Kurt Emmerling$30.00
1/4/2010John Wyatt$20.00
1/4/2010Mr. & Mrs. Louis Querec$30.00
1/4/2010Denny & Ray Canterbury$30.00
1/4/2010Steve Dunford$20.00
1/15/2010Frank Tuckwiller$12.00
1/15/2010Clare Bredell$30.00
1/15/2010Mr. & Mrs. Douglas E. McKinney$75.00
1/15/2010Mr. & Mrs. Michael McClung$30.00
1/15/2010Mr. & Mrs. Thomas L. Isaac$30.00
2/8/2010Mr. & Mrs. Lowell Rose$30.00
2/8/2010Rosanne Shupe$20.00
2/8/2010Mr. & Mrs. Charles Elmore$30.00
2/8/2010Mr. & Mrs. William Horne$30.00
2/8/2010Mr. & Mrs. Larry Heffner$30.00
2/8/2010Janet Neathawk$60.00
2/8/2010John Barnes$20.00
2/8/2010Joan Ahern$20.00
2/8/2010Mr. & Mrs. Russell Siegel$30.00
2/8/2010Mr. & Mrs. Sam Hudson$30.00
2/18/2010Chris Meldrum$20.00
2/18/2010Mr. & Mrs. Douglas E. McKinney$30.00
2/18/2010Virginia Warren$20.00
2/18/2010Bill Wallace$20.00
2/18/2010David Hambrick$50.00
2/18/2010Charles Brackman$20.00
3/1/2010Jim Childers$60.00
3/1/2010Mr. & Mrs. Frank Tuckwiller$30.00
3/1/2010Theresa Thompson$50.00
3/1/2010Cleveland Benedict$50.00
3/3/2010Cassandra Perkins$20.00
3/3/2010Sue Spicer$20.00
3/3/2010Rose Dobbins$30.00
3/6/2010Steve Dunford$40.00
3/6/2010Gaye Keech$30.00
3/6/2010William Higgenbotham$20.00
3/6/2010Debra Bowman$30.00
3/6/2010Shirley Gail Ratliff$20.00
3/16/2010Mr. & Mrs. Ronald B. Snyder$30.00
3/16/2010Mr. & Mrs. Roger Cerasoli$30.00
3/20/2010Eleanor Herkness$130.00
 Subtotal of contributions of $250.00 or less$2,674.00

More than $250.00

1/15/2010 Full Name:  Eleanor Herkness
Address:  Resident
POBox 511
Lewisburg, WV 24901

Contributor's Job: (individual contributor only)  Retired
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:

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).

West Virginia State Fair 2009 Event Summary

Date of Event: 8/14/2009 Total Monetary Contributions:  $0.00
Type of Event: Booth Total Expenditures: -$412.50
Name of Place Held: State Fairgrounds NET RECEIPTS: =($412.50)
Address of Place Held: 891 Maplewood Avenue
Fairlea, WV 24902
Total In-Kind Contributions Related to the Fundraiser  $0.00

$250 or Less

 Subtotal of event contributions of less than $250.00 $0.00

More than $250

 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
12/31/2009City National Bankchecking acct interest$2.23
8/22/2009Booth at 2009 WV State FairSale of t-shirts, baseball caps, pin-on buttons, etc.$711.50
  Total Other Income: $713.73

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
6/5/2009 City National Bank
PO Box 7077
Cross Lanes, WV 25356
Bank chargebacks and fee$70.00
9/2/2009 William Horne
106 N. Lee Street
Lewisburg, WV 24901
Flag pole reimbursement balance$161.00
9/3/2009 Frank Tuckwiller
2245 Blue Sulphur Pike
Rt 2, Box 322
Lewisburg, WV 24901
Reimbursement for purchase of items offered for sale$200.00
10/5/2009 Tate Hudson
PO Box 847
Lewisburg, WV 24901
Reimbursement for postage$40.92
2/8/2010 Claire V. Querec
Rt 1, Box 129
Ronceverte, WV 24970
Reimbursement for postage and office supplies$128.66
2/17/2010 Postmaster - Lewisburg
200 E. Washington Street
Lewisburg, WV 24901
Post office box renewal for one year$44.00
3/6/2010 State Fair of West Virginia
891 Maplewood Avenue
Fairlea, WV 24902
Booth rental (+ insurance) at 2010 State Fair of West Virginia$595.00
3/15/2010 WVGOP, Inc.
PO Box 271
Charleston, WV 25330
WVGOP Unity Picnic program ad$100.00
8/6/2009 William Horne
106 N. Lee Street
Lewisburg, WV 24901
partial reimbursement for flag & pole donated to library$700.00
6/16/2009 State Fair of West Virginia
891 Maplewood Avenue
Fairlea, WV 24902
Balance on booth rental$212.50
  Total Expenditures: $2,252.08

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, April 1, 2010 5:07:48 PM