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

Candidate or Committee Name
J&K State Legislative PAC (Jackson and Kelly)
Candidate or Committee's Treasurer
Louis S. Southworth II
Political Party (for candidates)
Treasurer's Mailing Address (Street, Route, or P.O. Box)
PO Box 553 
Office Sought (for Candidates)
District/Division
City, State, Zip Code
Charleston, WV 25322
Daytime Phone #
(304) 340-1231

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  $0.00
Monetary Contributions from all Fund-Raising Events +$0.00
Receipt of a Transfer of Excess Funds +$0.00
Total Monetary Contributions: =$0.00
In-Kind Contributions +$0.00
Total Contributions: =$0.00
 
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)
$9,600.00
 
CASH BALANCE SUMMARY
Beginning Balance
(ending balance from previous report)
 $15,072.99
Total Monetary Contributions +$0.00
Total Other Income +$0.00
Subtotal: a. =$15,072.99
 
Total Expenditures Paid  $11,400.00
Total Disbursements of Excess Funds +$0.00
Repayment of Loans +$0.00
Subtotal: b. =$11,400.00
 
Ending Balance:
(Subtotal a. - Subtotal b.)

*Cannot be negative balance
=$3,672.99
 
TOTAL EXPENDITURES ELECTION YEAR-TO-DATE
(Add total expenditures from all reports)
$20,350.00

Contributions
$250.00 or LESS

DATECONTRIBUTOR'S FULL NAME OR COMMITTEE'S NAMEAMOUNT
 Subtotal of contributions of $250.00 or less 
 

Contributions
More than $250.00

DATECONTRIBUTOR'S FULL NAME OR COMMITTEE'S NAMEAMOUNT
 Subtotal of all contributions of more than $250.00
Subtotal of all contributions of $250 or less
Total Contributions:
$0.00
$0.00
$0.00


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
Loans Received Repayment of Loans Outstanding Loans
Totals: $0.00 $0.00 $0.00

Itemized Expenditures

DateName of Person or Vendor And AddressPurposeAmount
4/4/2012 Committee to Elect Tom Azinger
1310 7th Street
Vienna, WV 26105
Contribution$200.00
4/4/2012 Committee to Elect Carol Miller
1316 12th Street
Huntington, WV 25701
Contribution$200.00
4/4/2012 Committee to Elect Dan D. Sizemore
4253 Procious Maysel Road
Maysel, WV 25133
Contribution$200.00
4/4/2012 Committee to Elect Kevin Scott Poe
3016 Fairmont Road
Morgantown, WV 26501
Contribution$200.00
4/4/2012 Committee to Elect John P. Woods
5 Bayberry Terrace
Morgantown, WV 26508
Contribution$200.00
4/9/2012 Committee to Elect Craig P. Blair
47 Wasser Drive
Martinsburg, WV 25403
Contribution$500.00
4/4/2012 Committee to Elect Randy Swartzmiller
216 Heartwood Drive
Chester, WV 26034
Contribution$200.00
4/4/2012 Committee to Elect John H. Shott
422 Oakhurst Avenue
Bluefield, WV 24701
Contribution$200.00
4/4/2012 Committee to Elect Fred Giggenbach
P.O. Box 2403
Charleston, WV 25329
Contribution$200.00
4/4/2012 Committee to Elect Bob Johns
6 Timberline Place
Charleston, WV 25311
Contribution$200.00
4/9/2012 Committee to Elect Pat McGeehan
616 Florida Avenue
Apt #5
Chester, WV 26034
Contribution$500.00
4/4/2012 Committee to Elect David Sidiropolis
506 Marshall Street
McMechen, WV 26040
Contribution$200.00
4/4/2012 Committee to Elect Kevin J. Craig
34 Chestnut Drive
Huntington, WV 25705
Contribution$500.00
4/4/2012 Committee to Elect Jim Morgan
P.O. Box 117
Huntington, WV 25706
Contribution$500.00
4/4/2012 Committee to Elect Bill Wooton
210 Main Street
Beckley, WV 25801
Contribution$200.00
4/4/2012 Committee to Elect John B. McCuskey
P.O. Box 11359
Charleston, WV 25339
Contribution$200.00
4/4/2012 Committee to Elect Eric Nelson
P.O. Box 186
Charleston, WV 26321
Contribution$250.00
4/4/2012 Committee to Elect Sharon Spencer
412 Midland Avenue
Belle, WV 25015
Contribution$100.00
4/4/2012 Committee to Elect Tim Miley
23 Valley View Road
Bridgeport, WV 26330
Contribution$500.00
4/4/2012 Committee to Elect Troy Andes
15 Deer Valley Drive
Hurricane, WV 25526
Contribution$500.00
4/4/2012 Committee to Elect John Pino
300 Oyler Avenue
Oak Hill, WV 25901
Contribution$200.00
4/4/2012 Committee to Elect Brent Boggs
151 Park Street
Gassaway, WV 26624
Contribution$500.00
4/4/2012 Committee to Elect Denise L. Campbell
Rt 1 Box 330-36
Elkins, WV 26241
Contribution$200.00
4/4/2012 Committee to Elect Bill Hartman
P.O. Box 243
Elkins, WV 26241
Contribution$250.00
4/4/2012 Committee to Elect Samuel J. "Sam" Cann
21 Maple Lake Road
Bridgeport, WV 26330
Contribution$200.00
4/9/2012 Committee to Elect Jeff Asbury
416 Dunbar Street
Summersville, WV 26651
Contribution$250.00
4/16/2012 Committee to Elect Joshua Nelson
3712 Lick Cr Rd
Danville, WV 25053
Contribution$250.00
4/4/2012 Committee to Elect Mike Ferro
32 9th Street
McMechen, WV 26040
Contribution$200.00
4/4/2012 Committee to Elect Teddy "Ted" Tomblin
P.O. Box 191
Logan, WV 25601
Contribution$200.00
4/4/2012 Committee to Elect Clif Moore
P.O. Box 67
Thorpe, WV 24888
Contribution$200.00
4/4/2012 Committee to Elect Jeff Tansill
1037 West Main Street
Grafton, WV 26354
Contribution$200.00
4/4/2012 Committee to Elect Cindy Frich
1248 Bakers Ridge Road
Morgantown, WV 26505
Contribution$200.00
4/9/2012 Committee to Elect Mitch B. Carmichael
2 Colonial Drive
Ripley, WV 25271
Contribution$500.00
4/9/2012 Committee to Elect Bill Cole
404 Oakhurst Avenue
Bluefield, WV 24701
Contribution$500.00
4/9/2012 Committee to Elect Chris Walters
P.O. Box 1131
Poca, WV 25159
Contribution$500.00
4/4/2012 Committee to Elect Doug Reynolds
219 Briercliff Drive
Huntington, WV 25704
Contribution$200.00
4/4/2012 Committee to Elect Kelli Sobonya
P.O. Box 367
Barboursville, WV 25504
Contribution$200.00
4/4/2012 Committee to Elect Dave Perry
330 E. Martin Avenue
Oak Hill, WV 25901
Contribution$200.00
4/4/2012 Committee to Elect Amanda Pasdon
P.O. Box 106
Morgantown, WV 26507
Contribution$500.00
4/4/2012 Committee to Elect Tiffany Lawrence
652 Sawgrass Drive
Charles Town, WV 25414
Contribution$200.00
  Total Expenditures: $11,400.00

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 26, 2012 10:52:27 AM