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Irene Bustamante Adams State Assembly, District 42 42
Name Office (if applicable) District (if applicable)
3800 Reflection Way, Las Vegas, NV, 89147 702-542-3900
Mailing Address Telephone No.
ibustamanteadams@gmail.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 15 2013
 
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)
$ 6,350.00   $ 93,078.57
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   $3,079.07
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)
$ 100.00   $2,010.00
8. Total Amount of All Contributions (Add Lines 1 through 7)
    (See page 2 of instruction sheet)
$ 6,450.00   $98,167.64
 
9. Total Monetary Expenses Paid in Excess of $100
    (See page 2 of instruction sheet)
$ 9,643.80   $75,237.64
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)
$ 1,531.35   $9,167.37
12. Total Amount of All Expenses (Add Lines 9 through 11)
    (See page 3 of instruction sheet)
$ 11,175.15   $84,405.01
 
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



Irene Bustamante Adams 01/15/2013
Signature Date
 

 MONETARY
 CONTRIBUTIONS
Report Period   # 5
Irene Bustamante Adams State Assembly, District 42 42
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
Akers and Associates
5440 West Sahara Ave 205
LAS VEGAS, NV 89146
11/07/2012$250.00   
Nevada Veterinary Medical Association
PO Box 34420
Reno, NV 895344
11/07/2012$1,000.00   
PhRMA
950 F Street NW Ste 300
Washington, DC 20004
11/09/2012$1,000.00   
The Travelers Companies, Inc. PAC
One Tower Square
HARTFORD, CT 06183
11/26/2012$350.00   
Neveda Realtors PAC
760 Margrave Drive 200
RENO, NV 89502
12/10/2012$2,000.00   
CLARK COUNTY FIRE FIGHTERS LOCAL 1908
6200 W. CHARLESTON BLVD.
LAS VEGAS, NV 89146
12/11/2012$250.00   
Broadacres Open Air Marketplace
2222 Michelson Dr.
Suite 498
Irvine, CA 92612
12/16/2012$500.00   
Nevada Restaurant Services, Inc.
P.O. Box 93835
LAS VEGAS, NV 89193
12/16/2012$500.00   
Midland Credit Management Inc
8875 Aero Drive 200
SAN DIEGO, CA 92123
12/16/2012$500.00   

 

 WRITTEN COMMITMENTS Report Period   # 5
Irene Bustamante Adams State Assembly, District 42 42
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   # 5
Irene Bustamante Adams State Assembly, District 42 42
Name (print) Office (if applicable) District (if applicable)

IN KIND CONTRIBUTIONS






 

 WRITTEN COMMITMENTS FOR IN KIND
 CONTRIBUTIONS
Report Period   # 5
Irene Bustamante Adams State Assembly, District 42 42
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   # 5
Irene Bustamante Adams State Assembly, District 42 42
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   # 5
Irene Bustamante Adams State Assembly, District 42 42
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
Southwest Airlines
PO Box 36647-1CR
DALLAS, TX 75235
C
C
11/05/2012
12/17/2012
$317.60
$240.60
Trevor Perez
11845 Tevare Lane #2070
LAS VEGAS, NV 89138
E11/07/2012$135.00
Danny Oselbaugh
8780 W Hammer Lane
LAS VEGAS, NV 89149
E11/07/2012$210.00
Lyden Lee
568 Aspen Leaf Court
LAS VEGAS, NV 89135
E11/07/2012$225.00
Jay Knox
8201 Wildwood Glen
LAS VEGAS, NV 89149
E11/08/2012$150.00
Jon Berman
1340 Marina Del Rey Court
LAS VEGAS, NV 89107
E11/08/2012$300.00
Enterprise
Reno Tahoe International Airport
RENO, NV 89502
C11/08/2012$117.98
Tara Villalobos
7784 Buckwood Court
LAS VEGAS, NV 89149
E
E
11/09/2012
12/12/2012
$1,252.64
$949.80
Bridge Communications
50 Progress Circle Unit &A
Newington, CT 61110
D, F11/13/2012$912.50
Assembly Democratic Caucus
2251 North Rampart Blvd. #341
LAS VEGAS, NV 89128
E
K
11/14/2012
12/12/2012
$855.00
$1,500.00
Verizon Wireless
Online
LAS VEGAS, NV 89147
A
A
11/19/2012
12/18/2012
$142.86
$144.93
American Express
PO Box 0001
Los Angeles, CA 90096-0001
C, H, L11/30/2012$737.12
Nevada Hispanic Legislative Caucus
3800 Reflection Way
LAS VEGAS, NV 89147
K12/20/2012$1,000.00
Latinos en Accion
2160 W Charleston Blvd Ste M
LAS VEGAS, NV 89102
K12/21/2012$150.00
Sam's Club (various dates)
7175 Spring Mountain Road
LAS VEGAS, NV 89117
C12/31/2012$302.77
 
 


 IN KIND EXPENSES Report Period   # 5
Irene Bustamante Adams State Assembly, District 42 42
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