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Sunrise Healthcare System Good Government PAC Fund
Name Office (if applicable) District (if applicable)
3186 S Maryland Parkway, Las Vegas, NV, 89109 7027318000
Mailing Address Telephone No.
Steve.Killian@hcahealthcare.com
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
Oct 15 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)
$ 0.00   $ 0.00
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)
$ 0.00   $0.00
 
9. Total Monetary Expenses Paid in Excess of $100
    (See page 2 of instruction sheet)
$ 68,500.00   $102,250.00
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)
$ 68,500.00   $102,250.00
 
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



Steve Killian 10/15/2012
Signature Date
 

 MONETARY
 CONTRIBUTIONS
Report Period   # 3
Sunrise Healthcare System Good Government PAC 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
      
      
      
      
      
      
      
      
      
      
      
      
      
      
      

 

 WRITTEN COMMITMENTS Report Period   # 3
Sunrise Healthcare System Good Government PAC 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   # 3
Sunrise Healthcare System Good Government PAC Fund
Name (print) Office (if applicable) District (if applicable)

IN KIND CONTRIBUTIONS






 

 WRITTEN COMMITMENTS FOR IN KIND
 CONTRIBUTIONS
Report Period   # 3
Sunrise Healthcare System Good Government PAC 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   # 3
Sunrise Healthcare System Good Government PAC 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   # 3
Sunrise Healthcare System Good Government PAC Fund
Name (print) Office (if applicable) District (if applicable)

MONETARY EXPENSES

NAME AND ADDRESS OF PERSON, GROUP OR ORGANIZATION WHO RECEIVED THE PAYMENT FOR THE EXPENSECATEGORY
(NRS 294A.365)
DATE OF
EXPENSE
AMOUNT OF
EXPENSE
Marilyn Dondero Loop
3724 Emerald Bay Circle
Las Vegas, NV 89147
L06/20/2012$1,000.00
Paul Anderson
10000 W. Charleston Blvd 135
LAS VEGAS, NV 89135
L
L
L
06/20/2012
07/12/2012
09/12/2012
$500.00
$500.00
$500.00
Richard Carrillo
4819 Diza Court
Las Vegas, NV 89122
L06/20/2012$1,000.00
Harvey Munford
809 Sunny Place
Las Vegas, NV 89106
L06/20/2012$1,000.00
Lynn Stewart
2720 Cool Lilac Avenue
Henderson, NV 89052
L
L
06/20/2012
09/12/2012
$1,000.00
$500.00
Steve Sisolak
29 Burning Tree Ct
LAS VEGAS, NV 89113
L06/20/2012$2,000.00
Tom Collins
P.O. Box 249
LOGANDALE, NV 89021
L06/20/2012$2,500.00
Pat Hickey
1180 Forest St
Reno, NV 89509
L06/20/2012$1,000.00
Joe Hogan
2208 Plaza de la Candela
Las Vegas, NV 89102
L07/12/2012$500.00
James Ohrenschall
P.O. Box 97741
LAS VEGAS, NV 89193
L07/12/2012$1,000.00
David Parks
PO Box 71887
Las Vegas, NV 89170
L07/12/2012$500.00
Kelvin Atkinson
832 High Altitude Avenue
N Las Vegas, NV 89032
L07/12/2012$1,000.00
Tick Segerblom
700 S. 3rd Street
Las Vegas, NV 89101
L07/12/2012$1,000.00
Pete Goicoechea
P.O. Box 97
Eureka, NV 89316
L07/12/2012$1,000.00
Patricia Spearman
5575 Simmons Street
Suite 1-174
NORTH LAS VEGAS, NV 89031
L07/12/2012$1,500.00
Aaron Ford
P O Box 96003
LAS VEGAS, NV 89193
L07/12/2012$2,000.00
Larry Brown
6100 Elton Avenue 1000
LAS VEGAS, NV 89107
L07/12/2012$5,000.00
Peggy Pierce
5304 Gipsy Ave.
Las Vegas, NV 89107
L07/12/2012$1,000.00
Michelle Fiore
9085 W.Rosada Way
Las Vegas, NV 89149
L07/12/2012$500.00
Dina Neal
3217 Brautigan Ct.
Las Vegas, NV 89032
L07/12/2012$500.00
Maggie Carlton
5540 Cartwright Avenue
LAS VEGAS, NV 89110
L07/12/2012$500.00
Heidi Swank
546 Barbara Way
LAS VEGAS, NV 89104
L07/12/2012$750.00
Ira Hansen
68 Amigo Ct.
Sparks, NV 89441
L07/12/2012$1,000.00
John Ellison
438 S 5th Street
ELKO, NV 89801
L07/12/2012$1,000.00
James Oscarson
3340 S.Hwy 160 300
PAHRUMP, NV 89048
L07/12/2012$500.00
Tom Grady
43 Fairway Dr.
Yerington, NV 89447
L07/12/2012$1,000.00
Jason Frierson
P.O. Box 31623
LAS VEGAS, NV 89173
L07/12/2012$500.00
Ellen Spiegel
2764 N. Green Valley Pky #327
HENDERSON, NV 89014
L07/12/2012$500.00
David Bobzien
1605 Wesley Dr
Reno, NV 89503
L07/12/2012$500.00
Lucy Flores
420 N Nellis Blvd Ste A3-87
Las Vegas, NV 89110
L07/12/2012$500.00
IRENE BUSTAMANTE ADAMS
3800 REFLECTION WAY
LAS VEGAS, NV 89147
L07/12/2012$500.00
Sunrise Leadership PAC
1210 S.Valley View Blvd 114
LAS VEGAS, NV 89102
L08/31/2012$1,500.00
Leadership Business PAC
7225 Montecito Circle
LAS VEGAS, NV 89120
L08/31/2012$1,000.00
Senate Legacy PAC
770 Wildes Road
FALLON, NV 89406
L08/31/2012$2,000.00
JOE HARDY
P.O BOX 60306
Boulder City, NV 89006
L08/31/2012$1,000.00
RUBEN KIHUEN
P.O BOX 427
LAS VEGAS, NV 89125
L08/31/2012$500.00
Ben Kieckhefer
10045 Goler Wash Court
Reno, NV 89521
L08/31/2012$500.00
Greg Brower
4790 Caughlin Parkway 170
RENO, NV 89519
L08/31/2012$1,000.00
Joyce Woodhouse
246 Garfield Dr
Henderson, NV 89074
L08/31/2012$1,000.00
Steve Kirk
6100 Elton Ave., Suite 1000
LAS VEGAS, NV 89107
L08/31/2012$1,000.00
Mark Hutchison
10080 W Alta Dr 130
Las Vegas, NV 89145
L08/31/2012$1,000.00
Benny Yerushalmi
1930 Village Center Cir Ste #3-435
LAS VEGAS, NV 89134
L08/31/2012$1,000.00
Justin Jones
PO Box 371626
LAS VEGAS, NV 89137
L08/31/2012$1,000.00
Mari Nakashima St. Martin
9050 W Warm Springs Rd
Unit 2146
Las Vegas, NV 89148
L08/31/2012$1,000.00
Scott Hammond
8408 Gracious Pines Avenue
Las Vegas, NV 89143
L08/31/2012$1,000.00
Nevada State Democratic Party
1210 S. Valley View Road
Suite 114
Las Vegas, NV 89102
L08/31/2012$6,000.00
Andy Eisen
9850 S. Maryland Pkwy
STE A5-162
LAS VEGAS, NV 89183
L08/31/2012$1,000.00
Bob Coffin
1139 5th Place
Las Vegas, NV 89104
L08/31/2012$1,000.00
Assembly Democratic Caucus
2251 North Rampart Blvd. 341
Las Vegas, NV 89128
L09/12/2012$1,000.00
Republican Assembly Caucus
PO Box 401508
LAS VEGAS, NV 89140
L09/12/2012$1,500.00
Marcus Conklin
2251 North Rampart Blvd
Suite 305
Las Vegas, NV 89128
L09/12/2012$2,500.00
Marilyn Kirkpatrick
4747 Showdown Dr.
North Las Vegas, NV 89031
L09/12/2012$1,000.00
William Horne
2251 N. Rampart Blvd #357
Las Vegas, NV 89128
L09/12/2012$1,500.00
April Mastroluca
265 Copper Glow Court
Henderson, NV 89074
L09/12/2012$500.00
Maggie Carlton
5540 EAST CARTWRIGHT AVE
Las Vegas, NV 89110
L09/12/2012$500.00
Pete Livermore
4 Raglan Circle
Carson City, NV 89701
L09/12/2012$500.00
Paul Aizley
237 East Eldorado Lane
Las Vegas, NV 89123
L09/12/2012$250.00
ANDREW MARTIN
7345 S DURANGO DR. #B107-319
LAS VEGAS, NV 89113
L09/12/2012$500.00
James Healey
7800 S Rainbow Blvd 2015
las vegas, NV 89139
L09/12/2012$500.00
Jim Wheeler
P O Box 2135
MINDEN, NV 89423
L09/12/2012$500.00
Lawrence Weekly
6100 Elton Avenue, Ste 1000
LAS VEGAS, NV 89107
L09/12/2012$1,000.00
 
 


 IN KIND EXPENSES Report Period   # 3
Sunrise Healthcare System Good Government PAC 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