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IMPAC - Henderson Chamber of Commerce
Name Office (if applicable) District (if applicable)
590 South Boulder Hwy, Henderson, NV, 89015 (702) 565-8951
Mailing Address Telephone No.
 
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)
$ 2,000.00   $ 5,500.00
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)
$ 2,000.00   $5,500.00
 
9. Total Monetary Expenses Paid in Excess of $100
    (See page 2 of instruction sheet)
$ 10,750.00   $10,750.00
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)
$ 10,750.00   $10,750.00
 
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



Scott Muelrath 10/15/2012
Signature Date
 

 MONETARY
 CONTRIBUTIONS
Report Period   # 3
IMPAC - Henderson Chamber of Commerce
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
Debbie Tuttle
871 Coronado Center Drive Ste 100
HENDERSON, NV 89052
06/27/2012$500.00   
CenturyLink
6700 Via Austi Parkway
LAS VEGAS, NV 89119
07/31/2012$500.00   
David Chavez
2831 St. Rose Pkwy
Suite 200
HENDERSON, NV 89052
09/12/2012$500.00   
Charles Perry
2912 W. Oakey Blvd.
LAS VEGAS, NV 89102
09/12/2012$500.00   

 

 WRITTEN COMMITMENTS Report Period   # 3
IMPAC - Henderson Chamber of Commerce
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
IMPAC - Henderson Chamber of Commerce
Name (print) Office (if applicable) District (if applicable)

IN KIND CONTRIBUTIONS






 

 WRITTEN COMMITMENTS FOR IN KIND
 CONTRIBUTIONS
Report Period   # 3
IMPAC - Henderson Chamber of Commerce
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
IMPAC - Henderson Chamber of Commerce
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
IMPAC - Henderson Chamber of Commerce
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
Committee to Elect Steve Kirk
2018 Deer Spring Dr
HENDERSON, NV 89074
K09/26/2012$1,000.00
Committe to Elect David Parks
PO Box 71887
LAS VEGAS, NV 89170
K09/26/2012$1,000.00
Friends of Mari St. Martin
50 S Jones Blvd Ste 202
LAS VEGAS, NV 89107
K09/26/2012$1,000.00
Committee to Elect Pete Goicechea
PO Box 97
Eureka, NV 89316
K09/26/2012$1,000.00
Marilyn Kirkpatrick
4747 Showdown Drive
North Las Vegas, NV 89031
K09/26/2012$750.00
Committee to Elect James Ohrenschall
P.O. Box 97741
Las Vegas, NV 89193
K09/26/2012$750.00
Crescent Hardy fo Assembly Seat 20
PO Box 7396
BUNKERVILLE, NV 89007
K09/26/2012$750.00
Ellen Spiegel Campaign
2764 N. Greenvalley Pkwy. #327 #327
HENDERSON, NV 89014
K09/26/2012$750.00
Becky Harris for Nevada
3333 E Serene Ave Ste 150
HENDERSON, NV 89074
K09/26/2012$750.00
Committee to Elect Lynn Stewart
1025 Belle River Court
Henderson, NV 89052
K09/26/2012$750.00
Committee to elect Melissa Woodbury
9500 W. Flamingo Rd.
Suite 203
Las Vegas, NV 89147
K09/26/2012$750.00
Bob Irwin 2012
2950 E. Tropicana Ave
LAS VEGAS, NV 89121
K09/26/2012$750.00
Committee to Elect Regeski
2870 w. Pebble Road
LAS VEGAS, NV 89123
K09/26/2012$750.00
 
 


 IN KIND EXPENSES Report Period   # 3
IMPAC - Henderson Chamber of Commerce
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