campaign finance report state of wisconsin gab-2 · 2012. 7. 19. · waupaca, wi 54981 self...

2A. Gross Expenditures

2B. Contributions to Committees (Transfers-Out)

TOTAL DISBURSEMENTS (Add totals from 2A and 2B)

2. DISBURSEMENTS

$7,202.91 $7,202.91

$0.00 $0.00

$7,202.91 $7,202.91

Street Address: P.O. Box 227

City, State and Zip: Waupaca, WI 54981

Filing Period Name: July Continuing 2012

Name of Committee/Corporation:

Petersen- Republican for 40th Assembly

CAMPAIGN FINANCE REPORT STATE OF WISCONSIN

GAB-2COMMITTEE IDENTIFICATION

1. RECEIPTS

1A. Contributions (Including Loans) from Individuals

1B. Contributions from Committees (Transfers-In)

1C. Other Income and Commercial Loans

TOTAL RECEIPTS (Add totals from 1A, 1B and 1C)

Column A This Period

Column B Calendar Year-To-Date

$16,085.00 $16,085.00

$5,500.00 $5,500.00

$0.00 $0.00

$21,585.00 $21,585.00

SUMMARY OF RECEIPTS AND DISBURSEMENTS

GAB ID: 0104400

OFFICE USE ONLY

CASH SUMMARY

Cash Balance Beginning of Report

Total Receipts

Subtotal

Total Disbursements

CASH BALANCE END OF REPORT

INCURRED OBLIGATIONS

(Balance at the Close of This Period-3A)

LOANS (Balance at the Close of This Period-3B)

$10,452.56

$21,585.00

$32,037.56

$7,202.91

$0.00

$2,000.00

$24,834.65*

*

I certify that I have examined this report and to the best of my knowledge and belief it is true, correct and complete.

Type or Print Name of Candidate or Treasurer: Signature of Candidate or Treasurer Date:

Daytime Phone:Petersen, Michelle Marie

NOTE: The information on this form is required by ss.11.06, 11.20, Wis. Stats. Failure to provide the information may subject you to thepenalties of ss.11.60, 11.61, Wis. Stats.

GAB-2 (Rev. 12/03) This form is prescribed by the Government Accountability Board, P.O. Box 7984, Madison, WI 53707-7984, 608-266-8005.

*Cash Balance as reported by committee

SCHEDULE 1-A RECEIPTS Contributions From Individuals

Complete Committee Name: Petersen- Republican for 40th Assembly

04/18/2012 Connelly, William N3686 Romberg Rd, Caroliine, WI 54928

Dentist Self Employed

270 N. Main St, Clintonville, WI 54929

$50.00 $50.00

04/27/2012 Koutnik, Darren N243 Eastowne Ln, Appleton, WI 54915

Principal Architect Thrivent Financial For Lutherans

4321 N. Ballard Rd, Appleton, WI 54919

$50.00 $50.00

04/18/2012 Peglow, Jennifer E1285 Radley Rd, Waupaca, WI 54981


1501 Plover St, Stevens Point, WI 54481

$100.00 $100.00

04/18/2012 Mackin, Dennis N2202 Whispering Pines Rd, Waupaca, WI 54981


701 Riverside Dr, Waupaca, WI 54981

$50.00 $50.00

Comment(s): Kevin Petersen, STATE HOUSE 40th WI

06/28/2012 Pamperin, Tom 135 Pine Ridge Court, Marion, WI 54950

President and CEO

Premier Community Bank- Marion

230 Mavis Road, PO Box 496, Marion, WI 54950

$250.00 $400.00

04/27/2012 Meister, Andrew 121 E. Water St, Appleton, WI 54911

Sr. Equity Research Analyst

Thrivent Financial For Lutherans


$50.00 $50.00

04/27/2012 Vandehey, Mary 534 Windmill Dr, Kimberly, WI 54136

Direct Member Growth Strategy



$50.00 $50.00

04/18/2012 Stoll, Steven 1525 Rue Reynard St, Menasha, WI 54952


151 E. Forest Ave, Neenah, WI 54956

$100.00 $100.00

04/18/2012 Haldeman, Lance 710 Eddington Dr, Sun Prairie, WI 53590

Agency Sales American Family Insurance Group

302 N. Walbridge Ave, Madison, WI 53714

$25.00 $75.00

04/18/2012 Garceau, Jerry 530 E. 2nd St, Fond Du Lac, WI 54935

Agent American Family Insurance Group

P.O. Box 590, Waupun, WI 53963

$25.00 $50.00

04/18/2012 Birschbach, Lyle 5 Eastbrook Ln, Fond Du Lac, WI 54935


384 N. Main St Suite 3, Fond Du Lac, WI 54935

$75.00 $125.00

04/18/2012 Bacus, Lisa 4915 Champions Run, Middleton, WI 53562

Exec V.P. American Family Insurance Group

600 American Pkwy, Madison, WI 53777

$25.00 $25.00

04/18/2012 Brusletten, Gregory

315 Valley St, Amery, WI 54001


531 Keller Ave S., Amery, WI 54001

$25.00 $50.00

Conduit Contribution

Date Full Name Address Occupation Employer Name

Employer Address

Amount YTD

03/26/2012 Shambeau, Stephanie

714 Woodland Circle, Waupaca, WI 54981

Homemaker $250.00 $500.00

04/14/2012 Sonntag, Thomas E1216 Rural Rd, Waupaca, WI 54981

$100.00 $100.00

04/06/2012 Petersen, Karen E1496 Grandview Rd P.O. Box 245, Waupaca, WI 54981

Homemaker $250.00 $500.00

04/06/2012 Petersen, Jeffrey E1496 Grandview Rd P.O. Box 245, Waupaca, WI 54981

Self Employed Petersen Investing

106 W. Union St, Waupaca, WI 54981

$250.00 $500.00

04/12/2012 Sturm, Leisa 157 Euclid Ave, Manawa, WI 54949

Flight Attendant United Airlines

77 W. Wacker Dr., Chicago, IL 60601

$250.00 $250.00

04/14/2012 Engebretson, Mike E1986 Larson Rd, Waupaca, WI 54981

Self Employed Engebretson Plumbing LLC

E1986 Larson Rd, Waupaca, WI 54981

$250.00 $500.00

04/14/2012 Unglaub, Fred N419 Cty Rd W, Fremont, WI 54940

$50.00 $50.00

04/14/2012 Engebretson, Amy E1986 Larson Rd, Waupaca, WI 54981

Finance First National Bank

111 Jefferson St, Waupaca, WI 54981

$250.00 $500.00

03/23/2012 Schmitt, Vicki 7399 Cty Rd A, Almond, WI 54909

Retired $250.00 $500.00

03/26/2012 Shambeau, Thomas

N2614 Norris Lane, Waupaca, WI 54981

Retired $250.00 $500.00

03/23/2012 Schmitt, James 7399 Cty Rd A, Almond, WI 54909

Retired $250.00 $500.00

03/26/2012 Krause, Chester 290 E. Iola St, Iola, WI 54945

Owner Krause Auto Collection LLC

160 N. Chet Krause Dr. P.O. Box 252, Iola, WI 54945

$500.00 $500.00

03/24/2012 Mishler, Clifford N2253 Butternut Rd, Waupaca, WI 54981

Retired $500.00 $500.00

Monetary

04/18/2012 Kopp, Steven 86 Golf Parkway, Madison, WI 53704


2101 N. Sherman Ave, Madison, WI 53704

$25.00 $50.00

04/18/2012 Jacob, David 14645 Marcella Ln, Brookfield, WI 53005


13620 W. Capitol Dr., Brookfield, WI 53005

$50.00 $50.00

04/27/2012 Pope, Jennifer 1920 North Outagamie St, Appleton, WI 54914

Member Field Interactions



$50.00 $50.00

04/18/2012 Nick, James 4501 Burger Ln, Wausau, WI 54403


P.O. Box 2106, Wausau, WI 54402

$25.00 $50.00

Sub Total $1,025.00

Conduit Contribution

05/09/2012 Noble, Ken N2506 Melody Ln, Waupaca, WI 54981

$100.00 $100.00

04/10/2012 Biddison, Jeanne N1993 Anklam Rd P.O. Box 112, Weyauwega, WI 54983

Owner Transportation Insurance Services

100 E. Main St P.O. Box 740, Weyauwega, WI 54983

$250.00 $250.00

04/10/2012 Biddison, James N1993 Anklam Rd P.O. Box 112, Weyauwega, WI 54983

Owner Transportation Insurance Services

100 E. Main St P.O. Box 740, Weyauwega, WI 54983

$250.00 $500.00

04/24/2012 Overby, Archie 1014 Berlin St, Waupaca, WI 54981

President First National Bank


$500.00 $500.00

04/10/2012 Johnson, Richard E1061 Whispering Pines Rd, Waupaca, WI 54981

Attorney Richard G. Johnson Attorney & Counsel at Law


$500.00 $500.00

04/14/2012 Hardel, Brad N6417 Cty G, Scandinavia, WI 54977

$25.00 $25.00

05/09/2012 Abraham, Michael 409 S. River Rd, Fremont, WI 54940

$100.00 $100.00

04/03/2012 Groholski, Kenneth

N6385 Pin Oak St, Manawa, WI 54949

$50.00 $100.00

04/14/2012 Maas, William N1053 Chalet Dr, Waupaca, WI 54981

Retired $125.00 $250.00

04/27/2012 Blanchard, Richard

230 Countryside Ct Unit A, Waupaca, WI 54981

$50.00 $50.00

04/10/2012 Lytle, Douglas N8901 Froland Rd, Iola, WI 54945

$25.00 $65.00

04/10/2012 Spoerl, Robert E900 Tammy Trail, Waupaca, WI 54981

Executive General Beer, Inc

5201 Coye Dr., Stevens Point, WI 54481

$250.00 $500.00

05/09/2012 Yaeger, Christine N6963 Berkans Dr, Fremont, WI 54940

$100.00 $100.00

04/10/2012 Fox, Jodi N2803 Locksley Lane, Waupaca, WI 54981

Homemaker $250.00 $250.00

04/10/2012 Bellin, Giles N2871 Otter Dr, Waupaca, WI 54981

$25.00 $25.00

04/10/2012 Vergauwen, Fran 711 Evans St, Waupaca, WI 54981

$100.00 $100.00

04/20/2012 Sengstock, Jeanne

E6098 Tri Cty Rd, Weyauwega, WI 54983

$100.00 $100.00

04/10/2012 Sperger, Michael E9136 Crain Rd, New London, WI 54961

$10.00 $10.00

Monetary

05/22/2012 Justmann, Charles E1288 Frontage Rd, Waupaca, WI 54981

$50.00 $50.00

04/20/2012 Nelson, Michaelean

E7802 Neitzke Rd, Clintonville, WI 54929

$10.00 $10.00

05/30/2012 Conroy, Robert N4753 State Rd 22 / 110, Manawa, WI 54949

$100.00 $100.00

05/14/2012 Korth, Douglas 125 E. Main St P.O. Box 56, Embarrass, WI 54933

Owner Korth's Badger Tap

133 E. Main St, Embarrass, WI 54933

$200.00 $200.00

05/14/2012 Deeg, Daniel N2505 Bean City Road, New London, WI 54961

Owner Bean City Bar & Grill

N2505 Bean City Road, New London, WI 54961

$200.00 $200.00

04/20/2012 Shambeau, Steve N2687 Brown Lane, Waupaca, WI 54981

Attorney Hansen & Shambeau S.C.

204 S. Main St, Waupaca, WI 54981

$100.00 $150.00

04/24/2012 Fudge, Shari E8188 Seefeld Rd, New London, WI 54961

$25.00 $55.00

04/06/2012 Johnston, James 150 Shadow Lake Dr, Waupaca, WI 54981

$25.00 $75.00

04/05/2012 Kirk, Barbara 334 Granite St, Waupaca, WI 54981

$10.00 $10.00

04/05/2012 Carroll, Thomas N297 Cty Rd E, Waupaca, WI 54981

$25.00 $25.00

05/14/2012 Sprenger, Robert P.O. Box 312, Marion, WI 54950

Owner Bubba's 121 N. Main St, Marion, WI 54950

$200.00 $200.00

04/06/2012 Dorow, Rose N2180 Cty Hwy K, Waupaca, WI 54981

$50.00 $100.00

04/06/2012 Winch, Judith N2185 Butternut Rd, Waupaca, WI 54981

$50.00 $50.00

04/04/2012 Barden, Arlin #6 Shadow Woods Lane, Waupaca, WI 54981

Retired $50.00 $150.00

04/04/2012 Fontecchio, Wayne

N3529 Knight Rd, New London, WI 54961

$50.00 $50.00

04/06/2012 Waid, James 232 Prairie View Ct, Waupaca, WI 54981

$50.00 $50.00

04/06/2012 Kneisler, Donald E3797 Cty Rd EE, Waupaca, WI 54981

$25.00 $50.00

04/05/2012 Larson, James N2991 White Pine Lane, Waupaca, WI 54981

$50.00 $50.00

04/06/2012 Murphy, Gerald N2576 Norris Lane, Waupaca, WI 54981

$25.00 $25.00

Monetary

04/19/2012 Spindt, Eric 788 Hillock Ct, Waupaca, WI 54981

$100.00 $100.00

04/16/2012 Cordio, John N96 W7323 Coventry St, Cedarburg, WI 53012

$100.00 $100.00

04/18/2012 Hartsough, Julie P.O. Box 288, Pittsville, WI 54466

$100.00 $100.00

04/18/2012 Blum, Greg E1684 Nelson Rd, Iola, WI 54945

Executive Central Wisconsin Electric Cooperative

10401 Lystul Rd, Rosholt, WI 54473

$250.00 $500.00

04/18/2012 Rasmussen, Scott 615 N. Mill St, Weyauwega, WI 54983

$100.00 $100.00

04/18/2012 Quimby, Jerald N8870 Nelson Rd, Iola, WI 54945

Retired $150.00 $250.00

04/24/2012 Boario, Mary Ellen 326 S. Washington St, Waupaca, WI 54981

$50.00 $50.00

04/20/2012 Zepplin, Mark E1221 Mertl Lane, Waupaca, WI 54981

$100.00 $100.00

04/18/2012 Thoe, Gary N2644 Pleasant Park Lane, Waupaca, WI 54981

$100.00 $100.00

04/20/2012 Kislewski, Jackie N1949 Ernst Rd, Waupaca, WI 54981

$20.00 $45.00

04/20/2012 Trinrud, Dale E1596 Haase Rd, Waupaca, WI 54981

$50.00 $50.00

04/30/2012 VanKampen, Lorraine

E7724 Ostrander Rd, New London, WI 54961

Owner McDonalds 1135 N. Shawno St, New London, WI 54961

$250.00 $250.00

04/16/2012 Luft, Rick 8639 Bison Rd, Larsen, WI 54947

$100.00 $100.00

04/18/2012 Loberg, Charles E8649 Dey Rd, New London, WI 54961

$50.00 $50.00

04/18/2012 Tenant, Michael 3379 Constance Rd, Waupaca, WI 54981

Owner I&I Printing Centers, Inc.

113 N. Main St, Waupaca, WI 54981

$50.00 $150.00

04/18/2012 Buetow, Janet E2362 Rocky Hill Lane, Waupaca, WI 54981

Retired $300.00 $350.00

04/18/2012 Elgin, Jeff 6257 Mallory Lane, Eden Prairie, MN 55346

CEO Capistar Franchise

7500 Flying Cloud Drive Suite 600, Eden Prairie, MN 55344

$500.00 $500.00

04/18/2012 Lungwitz, Valentine

N2171 Cty Rd E, Redgranite, WI 54970

$50.00 $50.00

Monetary

04/16/2012 Mertz-Kiesow, Ethyl Mae

N1869 Cty Rd K, Waupaca, WI 54981

$50.00 $90.00

04/05/2012 Kiesgen, Clarella N3239 Silver Lake Dr, Waupaca, WI 54981

$25.00 $25.00

04/06/2012 Buetow, Janet E2362 Rocky Hill Lane, Waupaca, WI 54981

$50.00 $50.00

04/09/2012 Kienert, Maxine 691 Leighton Dr, Waupaca, WI 54981

Retired $100.00 $150.00

04/06/2012 Peterson, Alvera 524 Larson St, Waupaca, WI 54981

$50.00 $90.00

04/06/2012 Volkman, Donald N3569 Woodfield Ct, Waupaca, WI 54981

$100.00 $100.00

04/06/2012 Pelletier, Larrine E8188 Seefeld Rd, New London, WI 54961

$25.00 $50.00

04/09/2012 Morgan, Beverly 104 E. Sumner St P.O. Box 566, Weyauwega, WI 54983

Retired $125.00 $250.00

04/09/2012 Petersen, Todd 857 Sunridge Dr., Waupaca, WI 54981

Business Manager Neuville Motor's Inc

1407 Royalton St, Waupaca, WI 54981

$250.00 $500.00

04/09/2012 Petersen, Jillian 857 Sunridge Dr, Waupaca, WI 54981

Homemaker $250.00 $500.00

04/06/2012 Koeppen, Richard 107 Rohrer St, Clintonville, WI 54929

$50.00 $100.00

04/18/2012 Shearer, Frank N2122 Parfreyville Rd, Waupaca, WI 54981

$50.00 $90.00

04/16/2012 Marshall, Don N1201 Chalet Ct, Waupaca, WI 54981

$25.00 $25.00

04/09/2012 Timdal, Mary 140 Lafollette St, Iola, WI 54945

$50.00 $50.00

04/06/2012 Durfee, Ben E633 Berkshire Ln, Waupaca, WI 54981

$40.00 $90.00

04/06/2012 Faulks, Randall E5931 N. Shore Rd, Weyauwega, WI 54983

$100.00 $100.00

04/05/2012 Miller, Dennis N10489 Ness Rd, Iola, WI 54945

Retired $100.00 $140.00

04/09/2012 Sturm, Paul Jay P.O. Box 954, Manawa, WI 54949

Attorney Omholt & Forsythe S.C.

942 Depot St, Manawa, WI 54949

$250.00 $500.00

04/09/2012 Sturm, Pam P.O. Box 954, Manawa, WI 54949

Homemaker $250.00 $500.00

04/06/2012 Heberer, Bill E1391 Haase Rd, Waupaca, WI 54981

$25.00 $25.00

Monetary

04/18/2012 Dixon, Marilynn N2325 Whispering Pines Rd, Waupaca, WI 54981

Self-Employed Shaklee Distributor

N2325 Whispering Pines Rd, Waupaca, WI 54981

$125.00 $125.00

04/14/2012 Baehnman, James P.O. Box 177, Weyauwega, WI 54983

$50.00 $50.00

04/18/2012 Darr, Ruth 1042 Pendleton Rd, Neenah, WI 54956

$50.00 $100.00

04/05/2012 Reynolds, Rose N2539 Cleghorn Rd, Waupaca, WI 54981

$50.00 $50.00

04/14/2012 Squires, Karen E6498 Cty Rd N, Manawa, WI 54949

$50.00 $50.00

04/18/2012 Baumgartner, Louis

1004 Berlin St, Waupaca, WI 54981

$25.00 $45.00

04/05/2012 Godfrey, Thomas 950 Cty Hwy QQ, Waupaca, WI 54981

$50.00 $90.00

04/12/2012 Meighan, Pat N2320 Whispering Pines Rd, Waupaca, WI 54981

Owner Clear Water Harbor Restaurant & Bar

N2757 Cty Tk QQ, Waupaca, WI 54981

$250.00 $500.00

04/06/2012 Gauerke, Daniel N2711 Browne Lane, Waupaca, WI 54981

$50.00 $50.00

04/10/2012 Luft, Karlton 3966 Highland Shore Ln, Oshkosh, WI 54904

$50.00 $50.00

04/10/2012 Henning, Joanne E7192 Symco Rd, Bear Creek, WI 54922

$100.00 $100.00

04/10/2012 Thoe, Sylvia N3121 Shamrock Ln, Waupaca, WI 54981

$100.00 $100.00

04/12/2012 Hansen, Steve N1339 Speer Rd, Waupaca, WI 54981

$40.00 $90.00

04/11/2012 Gruer, Albert N2228 Cleghorn Rd, Waupaca, WI 54981

$40.00 $90.00

04/11/2012 Johnson, Lowell E4366 Hwy 10 & 49, Waupaca, WI 54981

Owner Johnson Auto Body

E4274 Harrington Rd, Waupaca, WI 54981

$200.00 $200.00

04/11/2012 Dearth, Kenny 208 E. Alfred St, Weyauwega, WI 54983

$25.00 $25.00

04/10/2012 Catlin, Tom W4511 Shagbark Ln, Waupaca, WI 54981

$50.00 $50.00

04/18/2012 Desens, James 304 W. Clark St, Waupaca, WI 54981

Retired $100.00 $200.00

Monetary

04/10/2012 Sorensen, Delores 222 Avon St, New London, WI 54961

$50.00 $50.00

04/10/2012 Snider, John 406 E. Lake St, Waupaca, WI 54981

$50.00 $50.00

04/10/2012 Peterson, Irene E5251 Hwy 54, Weyauwega, WI 54983

$25.00 $50.00

04/16/2012 Poehlman, Arne N4502 Baldwin Rd, Weyauwega, WI 54983

$25.00 $25.00

04/18/2012 Lyons, Karen N2348 Birchwood Dr, Waupaca, WI 54981

Homemaker $200.00 $200.00

04/10/2012 Rusch, Kent 217 W. Cook St, New London, WI 54961

Funeral Director Cline Hanson, Inc.

209 W. Cook St, New London, WI 54961

$125.00 $250.00

04/10/2012 Rusch, David 1910 Mayflower Ct, New London, WI 54961

Funeral Director Cline Hanson, Inc.

209 W. Cook St, New London, WI 54961

$125.00 $250.00

04/10/2012 Rogers, Judith N3208 W. Silver Lake Dr, Waupaca, WI 54981

Retired $250.00 $500.00

04/10/2012 Johnson, David E4246 Harrington Rd, Waupaca, WI 54981

$50.00 $50.00

04/14/2012 Oestreich, Wayne 175 Fairway Dr, Clintonville, WI 54929

$100.00 $100.00

04/12/2012 Rieser, Gretchen N7065 E. Pine Lake Lane, Waupaca, WI 54981

$40.00 $90.00

04/14/2012 Oestreich, Carol 175 Fairway Dr, Clintonville, WI 54929

$100.00 $100.00

04/10/2012 Donaldson, Jean N1591 East Rd, Waupaca, WI 54981

$25.00 $50.00

04/18/2012 Discher, Rick E1320 Cty Q, Scandinavia, WI 54977

$50.00 $50.00

04/12/2012 Boettcher, James E8985 Cut Off Rd, New London, WI 54961

$50.00 $50.00

04/12/2012 Halpin, Michael P.O. Box 162, Waupaca, WI 54981

V.P. Stewart Title Guarantee Company


$50.00 $300.00

04/14/2012 Halpin, Michael P.O. Box 162, Waupaca, WI 54981

V.P. Stewart Title Guarantee Company


$200.00 $500.00

04/14/2012 Boushley, Marian E5485 White Lake Rd, Weyauwega, WI 54983

$100.00 $100.00

04/12/2012 Rickel, Donna N1963 Cty Rd EE, Waupaca, WI 54981

$50.00 $90.00

Monetary

04/19/2012 Malone, Donna N2990 Highland Ln, Waupaca, WI 54981

$100.00 $100.00

Sub Total $15,060.00

Monetary

Non-Monetary (-): $0.00

Loan Forgiven (-): $0.00

Total $16,085.00

Total UnItemized Contributions $0.00

Total Anonymous Contributions $0.00

Grand Total $16,085.00

SCHEDULE 1-B RECEIPTS Contributions from Committees

(Transfers-In)


04/18/2012 Citizens for Joe Leean N2390 South Tammy Trail, Waupaca, WI 54981

$100.00 $100.00

04/18/2012 WALA PAC 1414 MacArthur Rd Suite 311, PO Box 7730, Madison, WI 53707-7730

$100.00 $100.00

04/27/2012 Dean Health System 1808 West Beltline Highway, Madison, WI 53713

$250.00 $250.00

04/18/2012 WI Insurance Alliance PAC 44 East Mifflin Street, Suite 901, Madison, WI 53703

$500.00 $500.00

06/15/2012 Citizens for Joe Leean N2390 South Tammy Trail, Waupaca, WI 54981

$150.00 $250.00

06/05/2012 FONEPAC 122 West Washington Avenue, Suite 1050, Madison, WI 53703

$200.00 $200.00

06/30/2012 WI Institute of CPA's PAC 235 N. Executive Drive #200, Brookfield, WI 53005

$400.00 $400.00

06/05/2012 HMS Holdings Corp. Political Action Committee

401 Park Ave. S, Fl 9, New York, NY 10016-8808

$200.00 $200.00

06/14/2012 Northwestern Mutual Life Political Action Committee

720 East Wisconsin Ave, Milwaukee, WI 53202

$500.00 $500.00

04/20/2012 WI Dental Assn PAC 10 East Doty Street, #509, Madison, WI 53703

$500.00 $500.00

03/09/2012 Cooperative Outreach for Objective Politics

1 South Pinckney Street, Suite 810, Madison, WI 53703-2869

$250.00 $250.00

02/28/2012 Steamfitters Local 601 PAC 3300 South 103rd Street, Milwaukee, WI 53227

$250.00 $250.00

05/24/2012 WH&LA PAC 1025 South Moorland Road, Suite 200, Brookfield, WI 53005

$100.00 $100.00

02/10/2012 Sprint Nextel Corporation PAC KSOPHN0304 - 3B311, 6450 Sprint Parkway, Overland Park, KS 66251

$250.00 $250.00

02/28/2012 Act Comm/Rural Electrification 1 South Pinckney Street, Suite 810, Madison, WI 53703-2869

$500.00 $500.00

04/20/2012 IFAPAC Wisconsin 22 N Carroll St, Ste 300, Madison, WI 53703

$250.00 $250.00

04/14/2012 Insuring WIsconsin PAC 725 John Nolen Drive, Madison, WI 53713

$500.00 $500.00

04/14/2012 RPAC - Wisconsin 4801 Forest Run Road, Suite 201, Madison, WI 53704

$500.00 $500.00

Sub Total $5,500.00

Monetary



Total $5,500.00

Date Full Name Address Amount YTD

SCHEDULE 1-C RECEIPTSOther Income and Commercial Loans


Total $0.00

Date Full Name Address Amount YTD

SCHEDULE 2-A DISBURSEMENTS Gross Expenditures

Complete Committee Name:

02/13/2012 Petersen, Kevin David N1433 Drivas Road, Waupaca, WI 54981

Reimbursement - Food

$40.00


Candidate Expenses - Travel

$113.49

01/21/2012 U.S. Postal Service 306 S. Main St, Waupaca, WI 54981

Postage $110.00

03/27/2012 U.S. Postal Service 306 S. Main St, Waupaca, WI 54981

Postage $675.00

04/03/2012 Petersen, Pat N1441 Drivas Road, Waupaca, WI 54981

Parade Expenses - Fees, candy

$21.00

01/20/2012 New London Area Chamber of Commerce

301 E. Beacon Ave, New London, WI 54961

Membership Dues - Community Org

$94.00

01/24/2012 Waupaca Area Chamber of Commerce


Membership Dues - Community Org

$220.00


Candidate Expenses - Travel

$159.59


Maelstrom Solutions

250 N. Sunny Slope Rd Suite 300, Brookfield, WI 53089

Media - Website Development

$1,350.00

06/29/2012 Waupaca Area Chamber of Commerce



$20.00

Monetary


$250.00


$250.00

Sub Total $500.00

Loan Payment

Date Full Name Address Vendor Name Vendor Address

Expense Purpose

Amount


06/14/2012 Comfort Suites Foxfire 199 Foxfire Drive, Waupaca, WI 54981

Staff - Lodging

$248.34

04/20/2012 I&I Printing Centers, Inc.

113 North Main St, Waupaca, WI 54981

Printing - Brochures

$1,029.15

05/31/2012 Waupaca BP Food Shop

1070 W. Fulton St, Waupaca, WI 54981

Staff - Gas $200.00

06/22/2012 Manawa Mid Western Rodeo Parade

P.O. Box 190, Manawa, WI 54949


$25.00

06/01/2012 Heinzen Printing 550 South Central Ave, Marshfield, WI 54449

Printing - Brochures

$707.91

05/11/2012 Office Outfitters P.O. Box 328, Waupaca, WI 54981

Office Supplies

$4.78

04/18/2012 New Directions Custom Embroidery & Engraving

115 N. Western Ave, Waupaca, WI 54981

Printing Misc. (buttons, bumper stickers, t-shirts)

$14.19

04/18/2012 Beer Barrel Liquor 1070 W. Fulton St, Waupaca, WI 54981

Fundraiser - Food & Beverage

$253.49

04/20/2012 Comfort Suites Foxfire 199 Foxfire Dr, Waupaca, WI 54981

Staff - Lodging

$165.56

04/18/2012 Rockman Catering 2807 Plover Springs Drive, Plover, WI 54467

Fundraiser - Food & Beverage

$1,051.41



Staff - Gas $100.00



Staff - Gas $100.00

Sub Total $6,702.91

Monetary

Total $7,202.91



SCHEDULE 2-B DISBURSEMENTS Contributions To Committees

(Transfers-Out)


Total $0.00

Registrant In-Kind Sub Total (-): $0.00


Grand Total $0.00

Date Full Name Address Vendor Name Vendor Address

Amount

ADDITIONAL DISCLOSUREIncurred Obligations Excluding Loans

SCHEDULE 3-A


Incurred Obligation Outstanding Amount:

Grand Total $0.00

Date Full Name Address Amount

$0.00


Grand Total $0.00

Date Full Name Amount Paid

ADDITIONAL DISCLOSURELoans

Individual, Committee or Commercial

SCHEDULE 3-B


Loans Outstanding Amount:


$2,500.00

Grand Total $0.00

Date Lender Name Address Loan Amount Loan Payment + Forgiven Amount

Outstanding Amount

campaign finance report state of wisconsin gab-2 · 2012. 7. 19. · waupaca, wi 54981 self...

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