8/3/2019 February 2012 Finance Report -- Roman Larson for School Board

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Roman Larson for School Board Finance Report

Spring Pre-Primary

February 13, 2012

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CAMPAIGN FINANCE REPORT

LOCAL COMMITTEES OF WISCONSIN

Is This Report an Amendment: Yes No

Instructions for completing schedules are on the back of each schedule.

COMMITTEE IDENTIFICATIONName of Committee

Street Address OFFICE USE ONLY

City, State and Zip Code

Please check if address is different than previously reported, and complete the Campaign Registration Statement in the back of this form.

NAME OF REPORT

January Continuing _____ Pre-Primary _____ Spring Fall SpecialTerminationRepor

July Continuing _____ Pre-Election _____ Spring Fall Special also complete Schedule

SUMMARY OF RECEIPTS AND

DISBURSEMENTS

Column A

This Period

Column B

Calendar

1. RECEIPTS Year-To-Date

1A. Contributions (Including Loans) from Individuals $ $

1B. Contributions from Committees (Transfers-In) $ $

1C. Other Income and Commercial Loans $ $

TOTAL RECEIPTS(Add totals from 1A, 1B and 1C) $ $

2. DISBURSEMENTS

2A. Gross Expenditures $ $

2B. Contributions to Committees (Transfers-Out) $ $

TOTAL DISBURSEMENTS(Add totals from 2A and 2B) $ $

CASH SUMMARY

Cash Balance Beginning of Report $

Total Receipts $

Subtotal $

Total Disbursements $

CASH BALANCE END OF REPORT $INCURRED OBLIGATIONS(Balance at the Close of This Period-3A) $

LOANS (Balance at the Close of This Period-3B) $

I certify that I have examined this report and to the best of my knowledge and belief it is true, correct and complete.

Type or Print Name of Candidate or Treasurer Signature of Candidate or Treasurer Date:

Daytime Phone:

NOTE: The information on this form is required by ss.11.06, 11.20, Wis. Stats. Failure to provide the information may subject you to the penalties ofss.11.60, 11.61, Wis. Stats.

GAB-2L (Rev. 12/09) This form is prescribed by the Government Accountability Board. Completed forms must be filed with your local clerk.

s

Roman Larson for School Board

9119 West Bonniwell Road

2012

480.00 880.00

0.00 0.00

0.00 0.00

480.00 880.00

493.49 500.86

0.00 0.00

493.49 500.86

392.63

480.00

872.63

493.49

379.14

0.00

0.00

Roman Larson

Mequon, WI 53097

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SCHEDULE 1-A Page ____ of ____RECEIPTSContributions (Including Loans) From Individuals

Complete Committee Name

Instructions for completing schedules are on the back of each schedule.Date

02 / 13 / 2012

Full Name, Mailing Address and Zip Code Occupation, Name and Address of Principal PlaceOf Employment (if year-to-date total exceeds $100)

Amount CalendarYear-to-Date Total

Check if: In-Kind Loan Conduit Conduit Name:_______________________________

Date

01 / 18 / 2012

Full Name, Mailing Address and Zip Code Occupation, Name and Address of Principal Place CalendarYear-to-Date Total

Check if: In-Kind Loan Conduit Conduit Name:_______________________________

Date

01 / 01 / 2012

Full Name, Mailing Address and Zip Code Occupation, Name and Address of Principal PlaceOf Employment (if year-to-date total exceeds $100)

Amount CalendarYear-to-Date Total

Check if: In-Kind Loan Conduit Conduit Name:_______________________________

Date

/ /

Full Name, Mailing Address and Zip Code Occupation, Name and Address of Principal PlaceOf Employment (if year-to-date total exceeds $100)

Amount CalendarYear-to-Date Total

Check if: In-Kind Loan Conduit Conduit Name:_______________________________

Date

/ /

Full Name, Mailing Address and Zip Code Occupation, Name and Address of Principal PlaceOf Employment (if year-to-date total exceeds $100)

Amount CalendarYear-to-Date Total

Check if: In-Kind Loan Conduit Conduit Name:_______________________________

Date

/ /

Full Name, Mailing Address and Zip Code Occupation, Name and Address of Principal PlaceOf Employment (if year-to-date total exceeds $100)

Amount CalendarYear-to-Date Total

Check if: In-Kind Loan Conduit Conduit Name:_______________________________

Date

/ /

Full Name, Mailing Address and Zip Code Occupation, Name and Address of Principal PlaceOf Employment (if year-to-date total exceeds $100)

Amount CalendarYear-to-Date Total

Check if: In-Kind Loan Conduit Conduit Name:_______________________________Date

/ /

Full Name, Mailing Address and Zip Code Occupation, Name and Address of Principal PlaceOf Employment (if year-to-date total exceeds $100)

Amount CalendarYear-to-Date Total

Check if: In-Kind Loan Conduit Conduit Name:_______________________________

SUBTOTAL ITEMIZED CONTRIBUTIONS THIS PAGE $

TOTAL ITEMIZED CONTRIBUTIONS $

TOTAL UNITEMIZED CONTRIBUTIONS $20 OR LESS $

TOTAL CONTRIBUTIONS RECEIVED FROM INDIVIDUALS $

1 1

Roman Larson for School Board

480.00

480.00

0.00

480.00

Student

531 Lasuen Mall

PO Box 17559

Stanford, CA 94309

Senior Vice President

Bank Mutual

2600 N Mayfair Rd

Milwaukee, WI 53226

Roman Larson

9119 W Bonniwell Rd

Mequon, WI 53097

Gregory Larson

9119 W Bonniwell Rd

Mequon, WI 53097

$200.00$600.00

$250.00$250.00

Viraj Bindra

531 Lasuen Mall

PO Box 12713

Stanford, CA 94309

$30.00

$30.00

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SCHEDULE 2-ADISBURSEMENTSGross Expenditures

Page ___ of ___

Complete Committee Name

Instructions for completing schedules are on the back of each schedule.

Date

01 / 09 / 2012

Full Name, Mailing Address and Zip CodeOf Person or Business to Whom Payment is Made

Check if: In-Kind Offset

Specific Purpose of Expenditure Amount

Date

01 / 16 / 2012

Full Name, Mailing Address and Zip CodeOf Person or Business to Whom Payment is Made

Check if: In-Kind Offset

Specific Purpose of Expenditure Amount

Date

01 / 20 / 2012

Full Name, Mailing Address and Zip CodeOf Person or Business to Whom Payment is Made

Check if: In-Kind Offset

Specific Purpose of Expenditure Amount

Date

01 / 20 / 2012

Full Name, Mailing Address and Zip CodeOf Person or Business to Whom Payment is Made

Check if: In-Kind Offset

Specific Purpose of Expenditure Amount

Date

01 / 21 / 2012

Full Name, Mailing Address and Zip CodeOf Person or Business to Whom Payment is Made

Check if: In-Kind Offset

Specific Purpose of Expenditure Amount

Date

02 / 10 / 2012

Full Name, Mailing Address and Zip CodeOf Person or Business to Whom Payment is Made

Check if: In-Kind Offset

Specific Purpose of Expenditure Amount

Date

01 / 01/ 2012

Full Name, Mailing Address and Zip CodeOf Person or Business to Whom Payment is Made

Check if: In-Kind Offset

Specific Purpose of Expenditure Amount

Date

/ /

Full Name, Mailing Address and Zip CodeOf Person or Business to Whom Payment is Made

Check if: In-Kind Offset

Specific Purpose of Expenditure Amount

Date

/ /

Full Name, Mailing Address and Zip CodeOf Person or Business to Whom Payment is Made

Check if: In-Kind Offset

Specific Purpose of Expenditure Amount

SUBTOTAL ITEMIZED EXPENDITURES THIS PAGE $

TOTAL ITEMIZED EXPENDITURES $

TOTAL UNITEMIZED EXPENDITURES $20 OR LESS $

TOTAL EXPENDITURES $

Roman Larson for School Board

493.49

493.49

0.00

493.49

1 1

Alec Winograd

531 Lasuen Mall, PO Box 14379

Stanford, CA 94309

Website development and design for

campaign website $130.00

FedEx Corporation

942 South Shady Grove Road

Memphis, TN 38120

Delivery of campaign registration

materials to district clerk for filing

purposes$26.44

AirTran Airways

9955 AirTran Blvd

Orlando, FL 32827

Airplane tickets to return to Wisconsin

for campaigning $21.50

Frontier Airlines

7001 Tower Rd

Denver, CO 80249

Airplane tickets to return to Wisconsinfor campaigning

$120.60

United Airlines

PO Box 66100

Chicago, IL 60666

Airplane tickets to return to Wisconsin

for campaigning $139.10

Facebook

1601 S California Ave

Palo Alto, CA 94304

Advertising Roman Larson for School

Board on Facebook$25.85

Viraj Bindra

531 Lasuen Mall, PO Box 12713

Stanford, CA 94309

Logo refinement and design

$30.00