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Republican Assembly Victory Fund
Name Office (if applicable) District (if applicable)
9500 W Flamingo Rd, Suite #203, Las Vegas, NV, 89147 7023348735
Mailing Address Telephone No.
 
E-Mail Address

 Select Appropriate Box(es)
CANDIDATE PAC POLITICAL PARTY INDEPENDENT EXPENDITURE
NONPROFIT CORP LEGAL DEFENSE FUND AMENDED
Annual Filing - Due January 15, 2012
Period: Jan 01, 2011 - Dec 31, 2011
Report #1 - Due May 22, 2012
Period: Jan 01, 2012 - May 18, 2012
Report #2 - Due June 08, 2012
Period: May 19, 2012 - Jun 07, 2012
Report #3 - Due October 16, 2012
Period: Jun 08, 2012 - Oct 12, 2012
Report #4 - Due November 02, 2012
Period: Oct 13, 2012 - Nov 01, 2012
Report #5 - Due January 15, 2013*
Period: Nov 02, 2012 - Dec 31, 2012
Annual Filing - Due January 15, 2013
Period: Jan 01, 2012 - Dec 31, 2012
FILED
May 21 2012
 
ROSS MILLER
SECRETARY OF STATE
FOR OFFICE USE ONLY
      * Report #5 suffices for the 2013 Annual Filing only if Report #'s 1, 2, 3 and 4 are previously filed
1. Total Monetary Contributions Received in Excess of $100
    (See page 1 of instruction sheet)
$ 6,000.00   $ 6,000.00
2. Total Monetary Contributions in the Form of Loans Guaranteed by a 3rd-Party in Excess of $100
    (See page 1 of instruction sheet)
$ 0.00   $0.00
3. Total Monetary Contributions in the Form of Loans that were Forgiven in Excess of $100
    (See page 2 of instruction sheet)
$ 0.00   $0.00
4. Total Amount of Written Commitments for Contributions in Excess of $100
    (See page 2 of instruction sheet)
$ 0.00   $0.00
5. Total Value of In Kind Contributions in Excess of $100
    (See page 2 of instruction sheet)
$ 0.00   $0.00
6. Total Value of Written Commitments for In Kind Contributions in Excess of $100
    (See page 2 of instruction sheet)
$ 0.00   $0.00
7. Total Amount of all Contributions of $100 or less
    (See page 2 of instruction sheet)
$ 0.00   $0.00
8. Total Amount of All Contributions (Add Lines 1 through 7)
    (See page 2 of instruction sheet)
$ 6,000.00   $6,000.00
 
9. Total Monetary Expenses Paid in Excess of $100
    (See page 2 of instruction sheet)
$ 3,000.00   $3,000.00
10. Total Value In Kind Expenses in Excess of $100
    (See page 3 of instruction sheet)
$ 0.00   $0.00
11. Total Amount of all Expenses of $100 or less
    (See page 3 of instruction sheet)
$ 0.00   $0.00
12. Total Amount of All Expenses (Add Lines 9 through 11)
    (See page 3 of instruction sheet)
$ 3,000.00   $3,000.00
 
MUST SELECT AT LEAST ONE:
 I Declare Under Penalty of Perjury That the Foregoing is True and Correct.
 I Declare Under an Oath to God that the Forgoing is True and Correct*
         * A declaration under an oath to God is subject to the same penalties as declaration under penalty of perjury



Justin Harrison 05/21/2012
Signature Date
 

 MONETARY
 CONTRIBUTIONS
Report Period   # 1
Republican Assembly Victory Fund
Name (print) Office (if applicable) District (if applicable)

MONETARY CONTRIBUTIONS

NAME AND ADDRESS OF PERSON, GROUP OR ORGANIZATION WHO MADE CONTRIBUTIONDATE OF
CONTRIBUTION
AMOUNT OF
CONTRIBUTION
CHECK HERE IF LOANNAME AND ADDRESS OF 3rd PARTY IF LOAN GUARANTEED BY 3rd PARTYNAME AND ADDRESS OF PERSON, GROUP OR ORGANIZATION WHO FORGAVE THE LOAN, IF DIFFERENT THAN CONTRIBUTOR
Farmers
2030 E. Flamingo Road #200
Las Vegas, NV 89119
04/13/2012$1,000.00   
Nevada Bankers Association
9081 W Sahara Ave Ste 230
LAS VEGAS, NV 89117
04/13/2012$2,000.00   
Farmers Insurance PAC
2030 E. Flamingo Road, Suite 200
LAS VEGAS, NV 89119
05/10/2012$2,000.00   
i3 Public Affairs, LLC
200 S Virginia Street Ste 825
RENO, NV 89501
05/10/2012$1,000.00   

 

 WRITTEN COMMITMENTS Report Period   # 1
Republican Assembly Victory Fund
Name (print) Office (if applicable) District (if applicable)

WRITTEN COMMITMENTS

NAME AND ADDRESS OF PERSON, GROUP OR ORGANIZATION WHO MADE THE COMMITMENTDATE OF
COMMITMENT
AMOUNT OF
COMMITMENT
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   

 

 IN KIND CONTRIBUTIONS Report Period   # 1
Republican Assembly Victory Fund
Name (print) Office (if applicable) District (if applicable)

IN KIND CONTRIBUTIONS






 

 WRITTEN COMMITMENTS FOR IN KIND
 CONTRIBUTIONS
Report Period   # 1
Republican Assembly Victory Fund
Name (print) Office (if applicable) District (if applicable)

WRITTEN COMMITMENTS FOR IN KIND CONTRIBUTIONS

NAME AND ADDRESS OF PERSON, GROUP OR ORGANIZATION WHO MADE THE IN KIND WRITTEN COMMITMENTDATE OF IN KIND
WRITTEN COMMITMENT
VALUE OF IN KIND
WRITTEN COMMITMENT
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   

 

 EXPENSE CATEGORIES Report Period   # 1
Republican Assembly Victory Fund
Name (print) Office (if applicable) District (if applicable)


Expense Categories (NRS 294A.365)


 CATEGORIES  CODE
 Office expenses A
 Expenses related to volunteers B
 Expenses related to travel C
 Expenses related to advertising D
 Expenses related to paid staff E
 Expenses related to consultants F
 Expenses related to polling G
 Expenses related to special events H
 Expenses related to legal defense fund I
Goods and services provided in kind for which money would  otherwise have been paid
J
Contributions made to: (i) another candidate; (ii) a nonprofit corporation that is registered or required to be registered pursuant to NRS 294A.225; (iii) a PAC that is registered or required to be registered pursuant to NRS 294A.230; or (iv) a Recall Committee that is registered or required to be registered pursuant to NRS 294A.250
K
 Other miscellaneous expenses L










NRS 294A.362 requires “In Kind” contributions and expenses to be reported separately.
 

 MONETARY EXPENSES Report Period   # 1
Republican Assembly Victory Fund
Name (print) Office (if applicable) District (if applicable)

MONETARY EXPENSES

 
 


 IN KIND EXPENSES Report Period   # 1
Republican Assembly Victory Fund
Name (print) Office (if applicable) District (if applicable)

IN KIND EXPENSES


Prescribed by Secretary of State
NRS 294A.120, 294A.125,
294A.140, 294A.150, 294A.160
294A.200, 294A.210, 294A.220, 294A.362