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)
State Treasurer
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  $9,605.00
Monetary Contributions from all Fund-Raising Events +$1,300.00
Receipt of a Transfer of Excess Funds +$0.00
Total Monetary Contributions: =$10,905.00
In-Kind Contributions +$0.00
Total Contributions: =$10,905.00
Other Income  $0.00
Loans Received +$0.00
Total Other Income: =$0.00
Unpaid Bills  $0.00
Outstanding Loans +$50,000.00
Total Debts: =$50,000.00
(Add total contributions from all reports)
Beginning Balance
(ending balance from previous report)
Total Monetary Contributions +$10,905.00
Total Other Income +$0.00
Subtotal: a. =$74,086.30
Total Expenditures Paid  $16,100.20
Total Disbursements of Excess Funds +$0.00
Repayment of Loans +$0.00
Subtotal: b. =$16,100.20
Ending Balance:
(Subtotal a. - Subtotal b.)

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

$250.00 or LESS

9/25/2012R Austin Wallace$100.00
9/28/2012Mike Hall$5.00
9/28/2012Michael Shawler$25.00
10/4/2012Arch PAC$250.00
10/4/2012Pleasants Co Republican Executive Comm$125.00
10/11/2012Jack Fellure$50.00
10/11/2012Jeannie Fellure$50.00
10/11/2012James Linsenmeyer$100.00
10/15/2012Robin Hayhurst$250.00
10/15/2012Beulah Hayhurst$250.00
10/15/2012Ronald Hayhurst$250.00
10/15/2012Russell Davisson$50.00
10/15/2012Chad Barry$50.00
10/15/2012Raleigh Co Exec Comm$50.00
10/20/2012Frederick Ottoson$25.00
10/20/2012Thea Hart$250.00
10/20/2012Carol Martin$100.00
10/20/2012L K Grimm$25.00
10/20/2012Repub Exec Comm Jefferson Co$100.00
 Subtotal of contributions of $250.00 or less$2,105.00

More than $250.00

9/28/2012 Full Name:  Eric Tarr
Address:  Resident
530 Spanoaks Dr
Milton, WV 25541

Contributor's Job: (individual contributor only)  Business Owner
Where Contributor Works: (individual contributor only)  Generations Physical Therapy
Affiliation: (political committee only) 
9/28/2012 Full Name:  Friends for Facemyer
Address:  Resident
Rt 1 Box 142
Ripley, WV 25271

Contributor's Job: (individual contributor only)  Campaign COmmittee
Where Contributor Works: (individual contributor only)  None
Affiliation: (political committee only)  Karen Facemyer
9/28/2012 Full Name:  Calvin Sutphin
Address:  Resident
134 Mayapple Trail
Lewisburg, WV 24901

Contributor's Job: (individual contributor only)  Investor
Where Contributor Works: (individual contributor only) 
Affiliation: (political committee only) 
10/1/2012 Full Name:  William Snyder
Address:  Resident
P O Box 950
Hurricane, WV 25526

Contributor's Job: (individual contributor only)  Senior Consultant
Where Contributor Works: (individual contributor only)  Benefit Assistance Corp
Affiliation: (political committee only) 
10/11/2012 Full Name:  WV Oil Marketers
Address:  Resident
2506 Kanawha Blvd E
Charleston, WV 25311

Contributor's Job: (individual contributor only)  Political Action Committee
Where Contributor Works: (individual contributor only)  WV Oil Marketers and Grocers Assoc
Affiliation: (political committee only)  WV Oil Marketers and Grocers Assoc
10/11/2012 Full Name:  Pepsico Concerned Citizens Fund
Address:  Resident
700 Anderson Hill Road
Purchase, NY 10577

Contributor's Job: (individual contributor only)  PAC
Where Contributor Works: (individual contributor only)  Pepsico Inc
Affiliation: (political committee only)  Pepsico Inc
10/15/2012 Full Name:  John Wade
Address:  Resident
340 Snowcrest Lane
Pt Pleasant, WV 25550

Contributor's Job: (individual contributor only)  Physician
Where Contributor Works: (individual contributor only)  Self
Affiliation: (political committee only) 
10/15/2012 Full Name:  AEP PAC
Address:  Resident
1 Riverside Complex
Columbus, OH 43215

Contributor's Job: (individual contributor only)  PAC
Where Contributor Works: (individual contributor only)  AEP
Affiliation: (political committee only)  AEP
10/20/2012 Full Name:  Richard Abraham
Address:  Resident
149 Golf Meadows
Chapmanville, WV 25508

Contributor's Job: (individual contributor only)  Coal miner
Where Contributor Works: (individual contributor only)  Rio Group
Affiliation: (political committee only) 
10/20/2012 Full Name:  Dale Nibert
Address:  Resident
26155 Huntington Road
Apple Grove, WV 25502

Contributor's Job: (individual contributor only)  Farmer
Where Contributor Works: (individual contributor only)  Self
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).

Huntington EVent Event Summary

Date of Event: 10/16/2012 Total Monetary Contributions:  $1,300.00
Type of Event: Fundraiser Total Expenditures: -$0.00
Name of Place Held: Frederick Hotel NET RECEIPTS: =$1,300.00
Address of Place Held: 4th and 10th
Huntington, WV 25701
Total In-Kind Contributions Related to the Fundraiser  $0.00

$250 or Less

10/16/2012Mukesh Shah$250.00
10/16/2012Kelli Sobonya$25.00
10/16/2012Thomas Craig$100.00
10/16/2012John Morris$25.00
10/16/2012Ray Duncan$100.00
 Subtotal of event contributions of less than $250.00 $500.00

More than $250

10/16/2012 Full Name:  Matt Miller
Address:  Resident
1316 12th St
Huntington, WV 25701

Contributor's Job: (individual contributor only)  Auto Dealer
Where Contributor Works: (individual contributor only)  Dutch Miller Chevrolet
Affiliation: (political committee only) 
10/16/2012 Full Name:  John Lafear
Address:  Resident
2020 Wiltshire Blvd
Huntington, WV 25701

Contributor's Job: (individual contributor only)  Accountant
Where Contributor Works: (individual contributor only)  Hayflich and Steinberg
Affiliation: (political committee only) 
 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. Mike Hall
76 Crystal Springs
Winfield, WV 25213
$50,000.00 $50,000.00
Loans Received Repayment of Loans Outstanding Loans
Totals: $0.00 $0.00 $50,000.00

Itemized Expenditures

DateName of Person or Vendor And AddressPurposeAmount
9/28/2012 Chase Bank
Great Teays Blvd
Scott Depot, WV 25560
Bank Fee$23.84
9/30/2012 State of West Virginia
Capitol Complex
Charleston, WV 25301
Refund of unknown contribution of 5/29/2012$9.55
10/4/2012 Mike Hall
12 Stonegate
Hurricane, WV 25526
Campaign Signs$1,272.00
10/4/2012 Mike Hall
12 Stonegate
Hurricane, WV 25526
Reimburse for hotel room$92.58
10/4/2012 West Virginia Bankers Assn
120 Washington St East
Charleston, WV 25301
Convention registration$675.00
10/5/2012 Mike Hall
12 Stonegate
Hurricane, WV 25526
Reimbursement of travel expense$110.87
10/8/2012 Stephen Reed
27 Eldon Drive
Charles Town, WV 25414
10/11/2012 Capital Communications Group
601 Sixth Ave
St Albans, WV 25177
10/15/2012 Charleston Newspapers
1001 Va St East
Charleston, WV 25301
10/15/2012 Huntington Herald Dispatch
1001 Fifth Ave
Huntington, WV 25701
10/15/2012 Martisnburg Journal
273 W King St
Martinsburg, WV 25410
10/18/2012 Capital Communications Group
601 Sixth Ave
St Albans, WV 25177
10/20/2012 Chase Bank
Great Teays Blvd
Scott Depot, WV 25143
Bank Fee$57.34
  Total Expenditures: $16,100.20

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, October 25, 2012 7:40:12 AM