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

Candidate or Committee Name
Candidate or Committee's Treasurer
Political Party (for candidates)
Treasurer's Mailing Address (Street, Route, or P.O. Box)
Office Sought (for Candidates)
House of Delegates
City, State, Zip Code
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 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  $215.00
Monetary Contributions from all Fund-Raising Events +$1,715.00
Receipt of a Transfer of Excess Funds +$0.00
Total Monetary Contributions: =$1,930.00
In-Kind Contributions +$0.00
Total Contributions: =$1,930.00
Other Income  $0.00
Loans Received +$0.00
Total Other Income: =$0.00
Unpaid Bills  $0.00
Outstanding Loans +$2,238.44
Total Debts: =$2,238.44
(Add total contributions from all reports)
Beginning Balance
(ending balance from previous report)
Total Monetary Contributions +$1,930.00
Total Other Income +$0.00
Subtotal: a. =$3,558.03
Total Expenditures Paid  $848.23
Total Disbursements of Excess Funds +$0.00
Repayment of Loans +$0.00
Subtotal: b. =$848.23
Ending Balance:
(Subtotal a. - Subtotal b.)

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

$250.00 or LESS

5/5/2012Beverly Mull$5.00
5/5/2012Wayne Turk$5.00
5/5/2012Doris Turk$5.00
5/5/2012Nancy Parsons$25.00
5/5/2012William Parsons$25.00
5/5/2012Kathleen McNinch$25.00
5/5/2012Ellen Jane McNinch$25.00
5/5/2012Donald A. Haskins$100.00
 Subtotal of contributions of $250.00 or less$215.00

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).

Evans for House Meet the Candidate Breakfast Event Summary

Date of Event: 5/5/2012 Total Monetary Contributions:  $1,715.00
Type of Event: Breakfast with the Candidate Total Expenditures: -$350.00
Name of Place Held: Moundsville Guest House Restaurant NET RECEIPTS: =$1,365.00
Address of Place Held: 1400 Lafayette Avenue
Moundsville, WV 26041
Total In-Kind Contributions Related to the Fundraiser  $0.00

$250 or Less

5/5/2012Alice Buzzard$15.00
5/5/2012Donald K. Mason$30.00
5/5/2012Robin Quigley$15.00
5/5/2012Bob Baird$15.00
5/5/2012Barb Baird$15.00
5/5/2012Fred Bane$15.00
5/5/2012Evelyn Bane$15.00
5/5/2012Pam Faulkner$15.00
5/5/2012Barry Koch$15.00
5/5/2012Bob Koch$25.00
5/5/2012Brian L. Schambach$30.00
5/5/2012Wayne Turk$15.00
5/5/2012Doris Turk$15.00
5/5/2012Greg Galentine$15.00
5/5/2012Mark Mathews$15.00
5/5/2012Zeke McElwee$25.00
5/5/2012Sally McElwee$25.00
5/5/2012Charles Miller$100.00
5/5/2012Steve Robinson$15.00
5/5/2012Joyce Robinson$15.00
5/5/2012Helen Doman$15.00
5/5/2012Joan Gardner$15.00
5/5/2012Morgan Goode$15.00
5/5/2012Billie Gorby$15.00
5/5/2012J. R. Gorby$15.00
5/5/2012Vickie Jenree$15.00
5/5/2012Ila Mae McConaughey$15.00
5/5/2012David McConaughey$15.00
5/5/2012Retta Wayne$15.00
5/5/2012Jim Rogers$30.00
5/5/2012Christy Rogers$30.00
5/5/2012Sue Briggs$15.00
5/5/2012Jack Briggs$15.00
5/5/2012Nancy Parsons$15.00
5/5/2012Bill Parsons$15.00
5/5/2012Betty Whipkey$15.00
5/5/2012Terry Whipkey$15.00
5/5/2012Bruce Whipkey$15.00
5/5/2012Tom Briggs$15.00
5/5/2012Brenda Briggs$90.00
5/5/2012Walt Donellan$15.00
5/5/2012Laura Donellan$15.00
5/5/2012Ruth Murphy$15.00
5/5/2012Howard Coffield$50.00
5/5/2012Karen Coffield$50.00
5/5/2012Emily Payne$15.00
5/5/2012Brenda Purdy$15.00
5/5/2012Terry Blake$15.00
5/5/2012Linda Noon$15.00
5/5/2012Carole Wood$15.00
5/5/2012Elizabeth Purdy$15.00
5/5/2012Kate McNinch$15.00
5/5/2012Jane McNinch$15.00
5/5/2012Cassie Clark$15.00
5/5/2012Ralph Clark$15.00
5/5/2012Jessica Boyd$15.00
5/5/2012Bill Harris$30.00
5/5/2012Fred Bruner$20.00
5/5/2012Mike Dunn$15.00
5/5/2012Kandy Dunn$15.00
5/5/2012Bob Mull$15.00
5/5/2012Beverly Mull$15.00
5/5/2012Samuel Kosanovic$50.00
5/5/2012Judith Kosanovic$50.00
5/5/2012Peg Cantu$30.00
5/5/2012Stan Steward$30.00
5/5/2012Jim Thomas$15.00
5/5/2012Debbie Thomas$15.00
5/5/2012Joan LeMasters$15.00
5/5/2012Wayne Lemasters$15.00
5/5/2012Don Haskins$15.00
5/5/2012Jody Haskins$15.00
5/5/2012Bob Miller, Jr. $15.00
5/5/2012Bob Miller, Sr.$15.00
5/5/2012Renee Dorsey$15.00
5/5/2012Kevin Dorsey$15.00
5/5/2012Virginia Martin$15.00
5/5/2012Velia McCloskey$15.00
5/5/2012Chuck Okel, Jr.$15.00
5/5/2012Bill Porter$15.00
5/5/2012Gail Porter$15.00
5/5/2012DeAnne Ferraro$15.00
5/5/2012Greg White$15.00
5/5/2012Dave Evans$15.00
5/5/2012Celeste Evans$15.00
 Subtotal of event contributions of less than $250.00 $1,715.00

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
  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
1. David A. Evans, Candidate
15 Pleasants Drive
Cameron, WV 26033
$238.44 $238.44
2. David A. Evans, Candidate
15 Pleasants Drive
Cameron, WV 26033
$2,000.00 $2,000.00
Loans Received Repayment of Loans Outstanding Loans
Totals: $0.00 $0.00 $2,238.44

Itemized Expenditures

DateName of Person or Vendor And AddressPurposeAmount
5/2/2012 Hometown Hardware
52 Waynesburg Avenue
Cameron, WV 26033
Campaign Sign making supplies$47.73
5/5/2012 Guest House Restaurant
1400 Lafayette Avenue
Moundsville, WV 26041
Fundraiser breakfast costs$350.00
5/5/2012 Rich & Shirley’s Quick Print
92-16th Street
Wheeling, WV 26003
campaign ad brochure printing$450.50
  Total Expenditures: $848.23

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
Friday, May 25, 2012 10:55:33 PM