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Ben Kieckhefer State Senate, Washoe District 4  
Name Office (if applicable) District (if applicable)
10045 Goler Wash Ct., Reno, NV, 89521 (775) 223-9618
Mailing Address Telephone No.
Ben@BenForNevada.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
Jan 17 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)
$ 17,250.00   $ 17,250.00
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)
$ 1,032.00   $1,032.00
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)
$ 18,282.00   $18,282.00
 
9. Total Monetary Expenses Paid in Excess of $100
    (See page 2 of instruction sheet)
$ 24,075.45   $24,075.45
10. Total Value In Kind Expenses in Excess of $100
    (See page 3 of instruction sheet)
$ 516.00   $516.00
11. Total Amount of all Expenses of $100 or less
    (See page 3 of instruction sheet)
$ 1,501.91   $1,501.91
12. Total Amount of All Expenses (Add Lines 9 through 11)
    (See page 3 of instruction sheet)
$ 26,093.36   $26,093.36
 
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



Benjamin R. Kieckhefer 01/17/2012
Signature Date
 

 MONETARY
 CONTRIBUTIONS
Report Period   # An.
Ben Kieckhefer State Senate, Washoe District 4  
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
Wynn Las Vegas
3131 Las Vegas Blvd So.
Las Vegas, NV 89109
07/28/2011$2,000.00   
Pfizer Inc.
235 East 42nd Street
New York, NY 10017
10/06/2011$750.00   
CenturyTel, Inc.
P O Box 4065
Monroe, LA 71211
10/17/2011$2,000.00   
Barrick Goldstrike
136 East South Temple
Salt Lake City, UT 84111
10/28/2011$1,000.00   
LAW OFFICES OF KEITH L LEE
3400 KAUAI CT #204
RENO, NV 89509
11/14/2011$500.00   
PhRMA
950 F Street NW
Suite 300
WASHINGTON, DC 20004
11/14/2011$1,500.00   
R&R Partners Inc
900 S Pavillion Center Dr
Las Vegas, NV 89144
11/15/2011$2,000.00   
ORMAT Nevada, Inc.
6225 Neil Rd.
Reno, NV 89511
12/07/2011$1,000.00   
Amerigroup Corporation
4425 Corporation Lane
Virginia Beach, VA 23462
12/08/2011$1,000.00   
RAI Services Company
PO Box 464
WINSTON SALEM, NC 27102
12/15/2011$1,000.00   
Title Max
15 Bull Street
Suite 200
Savannah, GA 31401
12/23/2011$2,500.00   
Newmont USA Limited
6363 South Fidders Green Cir.
ENGLEWOOD, CO 80111
12/23/2011$2,000.00   

 

 WRITTEN COMMITMENTS Report Period   # An.
Ben Kieckhefer State Senate, Washoe District 4  
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   # An.
Ben Kieckhefer State Senate, Washoe District 4  
Name (print) Office (if applicable) District (if applicable)

IN KIND CONTRIBUTIONS






 

 WRITTEN COMMITMENTS FOR IN KIND
 CONTRIBUTIONS
Report Period   # An.
Ben Kieckhefer State Senate, Washoe District 4  
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   # An.
Ben Kieckhefer State Senate, Washoe District 4  
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   # An.
Ben Kieckhefer State Senate, Washoe District 4  
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
Autumn Productions
P. O. Box 371553
Las Vegas, NV 89137
F01/05/2011$10,691.80
United Postal Service
748 S. Meadows Pkwy.
Suite A9
RENO, NV 89521-4841
A01/11/2011$136.80
Roots HQ LLC
211 7th Avenue North, Suite LL-15
Nashville, TN 37219
F01/25/2011$625.47
The Coney Island Bar
2644 Prater Way
SPARKS, NV 89431
H02/09/2011$361.96
Danielle Cherry & Co.
345 Sondrio Way
Reno, NV 89521
F03/02/2011$800.00
American Legislative Exchange Council
1101 Vermont Ave., NW, 11th Floor
Washington, DC 20005
L
H
H
03/08/2011
11/09/2011
11/09/2011
$200.00
$325.00
$150.00
Reel PAC
701 N. Green Valley Parkway
Suite 401
Henderson, NV 89074
L04/25/2011$5,000.00
American Airlines
P.O. Box 619612
BEDFORD, TX 76021
C07/22/2011$453.80
Southwest
P.O. Box 36647 1CR
Dallas, TX 75235
C
C
C
C
C
C
C
C
C
C
08/15/2011
09/19/2011
10/11/2011
10/11/2011
10/13/2011
10/14/2011
10/17/2011
10/24/2011
10/24/2011
11/09/2011
$401.40
$305.40
$139.40
$267.10
$139.40
$136.44
$121.00
$123.00
$205.00
$232.10
Southwest Air
P.O. Box 36647
Dallas, TX 75235
C09/16/2011$289.40
Western Republican Leadership Conference
P.O. Box 401477
LAS VEGAS, NV 89140
H10/14/2011$136.44
New York-New York Hotel & Casino
3790 Las Vegas Blvd. South
LAS VEGAS, NV 89109
C10/19/2011$123.20
Dollar Rent A Car
7135 Gillespie St
Las Vegas, NV 89119
C
C
10/21/2011
12/08/2011
$140.54
$116.95
Hotel Frank
386 Geary Street
SAN FRANCISCO, CA 94102
C11/22/2011$223.55
Westin Kierland Resort
6902 E. Greenway Parkway
SCOTTSDALE, AZ 85254
C12/05/2011$1,230.30
Committee to Elect Jodi Stephens
P.O. Box 51315
Sparks, NV 89435
K12/30/2011$1,000.00
 
 


 IN KIND EXPENSES Report Period   # An.
Ben Kieckhefer State Senate, Washoe District 4  
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