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AGCPAC
Name Office (if applicable) District (if applicable)
PO Box 10291, Reno, NV, 89510 7753296116
Mailing Address Telephone No.
melissad@nevadaagc.org
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 13 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)
$ 6,880.00   $ 6,880.00
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)
$ 6,880.00   $6,880.00
 
9. Total Monetary Expenses Paid in Excess of $100
    (See page 2 of instruction sheet)
$ 8,339.20   $8,339.20
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)
$ 8,339.20   $8,339.20
 
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



John D. Madole Jr. 01/13/2012
Signature Date
 

 MONETARY
 CONTRIBUTIONS
Report Period   # An.
AGCPAC
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
Western Nevada Supply
P.O. Box 1576
Sparks, NV 89432
06/15/2011$500.00   
West Coast Contractors
7785 White Fir Street
RENO, NV 89523
06/15/2011$1,530.00   
Stetson Beemer Insurance
690 E. Plumb Lane Ste 100
Reno, NV 89502
06/15/2011$540.00   
MOANA NURSERY
1100 W. MOANA LN
RENO, NV 89509
06/15/2011
07/14/2011
$135.00
$135.00
   
Frank Omboli
1255 Autumn Hills Drive
Reno, NV 89511
06/29/2011$135.00   
Quick Space
P.O. Box 7417
Reno, NV 89510
06/29/2011$135.00   
McDonald Carano Wilson
100 West Liberty Street
10th Floor
Reno, NV 89505
06/29/2011$540.00   
PAR Electrical Contractors
1465 W. 4th Street
Reno, NV 89503
07/06/2011$500.00   
Nevada Cement Company
P. O. Box 840
Fernley, NV 89408
07/06/2011$840.00   
Lindell's Painting
140 Inventors Place
Sparks, NV 89441
07/06/2011$540.00   
Reno Tahoe Construction
2050 Kleppe Lane
Sparks, NV 89431
08/01/2011$270.00   
SIERRA NEVADA CONSTRUCTION, INC
PO BOX 50760
SPARKS, NV 89435-0760
08/24/2011$1,080.00   

 

 WRITTEN COMMITMENTS Report Period   # An.
AGCPAC
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.
AGCPAC
Name (print) Office (if applicable) District (if applicable)

IN KIND CONTRIBUTIONS






 

 WRITTEN COMMITMENTS FOR IN KIND
 CONTRIBUTIONS
Report Period   # An.
AGCPAC
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.
AGCPAC
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.
AGCPAC
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
Voter Voice
P.O. Box 82130
Baton Rouge, LA 70884
A01/18/2011$1,500.00
Wells Fargo Insurance Services
6900 S. McCarran, Ste. #2050
Reno, NV 89509
A02/23/2011$251.01
Washoe County Golf Course
PO Box 2186
Reno, NV 89505
H
H
06/07/2011
06/15/2011
$150.00
$2,320.00
Odette's
P.O. Box 2186
RENO, NV 89505
H06/15/2011$702.10
North American Embrodery
435 Kietzke Lane
Reno, NV 89502
H
H
06/15/2011
06/27/2011
$807.94
$400.00
AMERICAN EXPRESS
BOX 0001
Los Angeles, CA 90096-0001
H
H
06/15/2011
07/15/2011
$180.00
$423.43
Patrick Turner
1024 Manor
RENO, NV 89509
A06/27/2011$392.72
Cathy Hartman
3350 W. Hidden Valley Dr.
RENO, NV 89502
H06/27/2011$212.00
REPUBLICAN ASSEMBLY CANCUS
P.O BOX 401508
LAS VEGAS, NV 89140
K09/14/2011$1,000.00
 
 


 IN KIND EXPENSES Report Period   # An.
AGCPAC
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