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

Candidate or Committee Name
DAN D. SIZEMORE
Candidate or Committee's Treasurer
DAN DEVLIN SIZEMORE
Political Party (for candidates)
Democrat
Treasurer's Mailing Address (Street, Route, or P.O. Box)
4253 PROCIOUS MAYSEL ROAD  
Office Sought (for Candidates)
House of Delegates
District/Division
33
City, State, Zip Code
MAYSEL, WV 25133
Daytime Phone #
3045877578

Election Cycle Reporting Period (check one):

    
Primary - First Report
Due Mar 31-Apr 06, 2012Mar 31-Apr 06, 2012
 X 
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  $2,075.00
Monetary Contributions from all Fund-Raising Events +$0.00
Receipt of a Transfer of Excess Funds +$0.00
Total Monetary Contributions: =$2,075.00
In-Kind Contributions +$0.00
Total Contributions: =$2,075.00
 
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)
$7,300.00
 
CASH BALANCE SUMMARY
Beginning Balance
(ending balance from previous report)
 $2,528.99
Total Monetary Contributions +$2,075.00
Total Other Income +$0.00
Subtotal: a. =$4,603.99
 
Total Expenditures Paid  $3,118.88
Total Disbursements of Excess Funds +$0.00
Repayment of Loans +$0.00
Subtotal: b. =$3,118.88
 
Ending Balance:
(Subtotal a. - Subtotal b.)

*Cannot be negative balance
=$1,485.11
 
TOTAL EXPENDITURES ELECTION YEAR-TO-DATE
(Add total expenditures from all reports)
$5,814.89

Contributions
$250.00 or LESS

DATECONTRIBUTOR'S FULL NAME OR COMMITTEE'S NAMEAMOUNT
4/7/2012J and K State Legislature PAC$200.00
4/12/2012West Virginians for Coal$250.00
4/12/2012Robert and Dianna Slodowitz$100.00
4/17/2012Alan Exline$25.00
 Subtotal of contributions of $250.00 or less$575.00
 

Contributions
More than $250.00

DATECONTRIBUTOR'S FULL NAME OR COMMITTEE'S NAMEAMOUNT
4/3/2012 Full Name:  FirstEnergy PAC
Address:  Resident
7 Greenbrier Street
Suite 100
Charleston, WV 25311

Contributor's Job: (individual contributor only)  multicandidate committee
Where Contributor Works: (individual contributor only)  FirstEnergy
Affiliation: (political committee only) 
$500.00
4/6/2012 Full Name:  WV Chamber of Commerce
Address:  Resident
PO BOX 2789
Charleston, WV 25330

Contributor's Job: (individual contributor only)  PAC
Where Contributor Works: (individual contributor only)  WV Chamber of Commerce
Affiliation: (political committee only)  endorsement
$1,000.00
 Subtotal of all contributions of more than $250.00
Subtotal of all contributions of $250 or less
Total Contributions:
$1,500.00
$575.00
$2,075.00


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

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

  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
1. Dan Sizemore
4253 Procious Maysel Road
Maysel, WV 25133
$0.00 $0.00
Loans Received Repayment of Loans Outstanding Loans
Totals: $0.00 $0.00 $0.00

Itemized Expenditures

DateName of Person or Vendor And AddressPurposeAmount
4/3/2012 Clay County Special Olympics
PO Box 245
Clay, WV 25043
advertisement$25.00
4/3/2012 Wallback Lake Youth Fishing Derby
PO Box 125
Maysel, WV 25133
Advertising$25.00
4/3/2012 Signature Signs
Elk River Road
Procious , WV 25164
signs$106.00
4/3/2012 Frog Pond Printery
PO Box
Maysel, WV 25133
signs$485.48
4/7/2012 Go-Mart 65
rt 4&16
clay, WV 25043
Fuel$50.00
4/9/2012 clay free press
main street
clay, WV 25043
newspaper ad$228.00
4/9/2012 wvrc radio
106 radio street
spencer, WV 25276
radio ad$306.50
4/9/2012 calhoun chronicle
main
grantsville, WV 26147
newspaper ad$144.00
4/9/2012 glenville democrat
po box 458
glenville, WV 26351
newspaper ad$214.50
4/10/2012 go-mart
main street
gassaway, WV 25555
fuel$50.00
4/12/2012 Best Western Glenville
61 Development Drive
Glenville, WV 26351
Hotel room$197.28
4/12/2012 WV Democratic Party
Greenbrier Street
Charleston, WV 25302
vote builder$100.00
4/16/2012 Kroger
Lee Street
Charleston, WV 25304
food for selection meeting at Dem ex meeting$19.33
4/17/2012 Bullards Exxon
rt 4
Maysel, WV 25133
Fuel $54.00
4/17/2012 Frog Pond Printery
PO BOX 135
Maysel, WV 25133
signs and pens$564.98
4/9/2012 Wal-Mart
shopping plaza
Spencer, WV 25556
computer supplies$315.88
4/19/2012 CCHS Athletic Boosters
1 Panther Drive
Clay, WV 25043
advertising$100.00
4/21/2012 The Calhoun Chronicle
PO Box 2200
Grantsville, WV 26147
newspaper ad$72.00
4/13/2012 Clay Farm Bureau
12 main street
Clay, WV 25043
sign posts$60.93
  Total Expenditures: $3,118.88

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
Monday, April 23, 2012 5:46:32 AM