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X NoYesIS THIS AN AMENDMENT?
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information
on this form. For assistance in completing this form, see instructions on the
reverse side.
(CFA-4)
Summary Sheet
6504
12
TOTAL PAGES IN ENTIRE CFA-4 REPORT
FILE NUMBERIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
CANDIDATE INFORMATION (For Candidate's Committee Only)
1. Full name of committee (as on Statement of Organization)
2. Acronym or abbreviated name, if any 3. Committee telephone number
4. Mailing address (address where all campaign finance correspondence is received
5. City, state, ZIP code 6. Party affiliation (if applicable)
7. Full name of candidate (include any nickname) 8. Party affiliation or if independent
9. Office sought (include district number, if any. Not required for exploratory committee. 10. County of residence
COMMITTEE INFORMATION
TYPE OF REPORT CONVENTION CANDIDATES ONLY
13. Cash on hand and investments at the beginning of this reporting period.
11.
14. Cash on hand and investments January 1, current year.
(Note: These amounts include in-kind contributions and loans, as well as cash contributions.)
15a. Itemized (use Schedule A)
15b. Unitemized
15c. Add lines 15a, and 15b in both columns
16. Add lines 13 and 15c in Column A and lines 14 and 15c in Column B
(Note: These amounts include in-kind expenditures and loan repayments.)
17a. Itemized (use Schedule B) (Public Question: use Schedule C)
17b. Unitemized
17c. Add lines 17a and 17b in both columns
18. Cash on hand and investments at close of this reporting period(subtract 17c from 16 in both columns) TOTAL
SUBTOTAL
SUBTOTAL
TOTAL
19. Debts OWED BY the committee (use Schedule D)
20. Debts OWED TO the committee (use Schedule E)
EXPENDITURES
CONTRIBUTIONS AND RECEIPTS
COLUMN A
This Period
COLUMN B
Year to Date
12. Check one:
12. Reporting period:
From: Through:
CERTIFICATION
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
Pre-Convention
Post-Convention
Check if this is a new name
Check if this is a new address
Bassler Campaign Committee
(812) 617-4269
Republican
Eric Bassler Republican
State Senator District: 39 Daviess
01/01/2014 04/11/2014
63,310.11 63,310.11
30,265.18 30,265.18
805.00 805.00
31,070.18 31,070.18
94,380.29 94,380.29
64,401.46 64,401.46
157.81 157.81
64,559.27 64,559.27
29,821.02 29,821.02
0.00
0.00
Treasurer 04/21/2014
04/21/2014
Signature Included
Signature Included
12 NE 7TH STREET
WASHINGTON IN 47501
PrePrimary
Filed: Online
4/21/14 11:15 am
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
6504
Page 1 of 3
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): -
Brenda Sobecki
1208 Bedford Road
Washington IN 47501
200.00 200.00 01/10/2014
Dave Osmon
1 Contribution: Direct
Contributor's Occupation (if required): -
Ed Swartzentruber
895 Mehring Way
Cincinnati OH 45203
250.00 250.00 01/10/2014
Dave Osmon
2 Contribution: Direct
Contributor's Occupation (if required): -
Barry F McDonnell
Drawer K
Michigan City IN 46360
250.00 250.00 01/10/2014
Dave Osmon
3 Contribution: Direct
Contributor's Occupation (if required): Homemaker -
Pamela G Williams
1062 E 200 N
Washington IN 47501
1,500.00 1,500.00 01/29/2014
Dave Osmon
4 Contribution: Direct
Contributor's Occupation (if required): -
Dana Dumezich
1107 Turnberry Dr
Schereville IN 46375
500.00 500.00 02/18/2014
Dave Osmon
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
2,700.00
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
6504
Page 2 of 3
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): Healthcare/Medical -
Thomas C Abrell
RR 2 Box 1567
Clay City IN 47427
1,000.00 1,000.00 03/05/2014
Dave Osmon
1 Contribution: Direct
Contributor's Occupation (if required): General Business -
Eric Harrah
211 E South St
Bloomfield IN 47424
1,000.00 1,000.00 03/14/2014
Dave Osmon
2 Contribution: Direct
Contributor's Occupation (if required): -
Troy D Stoll
10712 N Lumberyard Rd
Edwardsport IN 47528
350.00 350.00 03/24/2014
Dave Osmon
3 Contribution: Direct
Contributor's Occupation (if required): -
Richard Brown
366 N 1600 W
Linton IN 47441
250.00 250.00 03/24/2014
Dave Osmon
4 Contribution: Direct
Contributor's Occupation (if required): General Business -
David Lipps
217 N Easy St
Edmond OK 73012
1,000.00 1,000.00 04/01/2014
Dave Osmon
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
3,600.00
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
6504
Page 3 of 3
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): -
Joe Bassler
216 NE 9th St
Washington IN 47501
300.00 300.00 04/11/2014
Dave Osmon
1 Contribution: Direct
Contributor's Occupation (if required): Attorney/Legal -
Grant E Swartzentruber
1100 Wagner Dr
Washington IN 47501 Mileage to event
40.32 40.32 03/25/2014
Dave Osmon
2 Contribution: In-Kind
Contributor's Occupation (if required): Financial/Investment -
Eric Bassler
12 NE 7th St
Washington IN 47501 Mileage
5,600.00 5,600.00 04/11/2014
Dave Osmon
3 Contribution: In-Kind
Contributor's Occupation (if required): Attorney/Legal -
Grant E Swartzentruber
1100 Wagner Dr
Washington IN 47501
140.32 180.64 04/04/2014
Dave Osmon
4 Contribution: In-Kind
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) 12,380.64$
6,080.64
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
(CFA-4 SCHEDULE A-2)
CONTRIBUTIONS BY CORPORATIONS
Itemized Contributions and Other Receipts
Page 1 of 1
6504
FILE NUMBERINSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY CORPORATIONS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary
Sheet. All cumulative contributions from corporations OVER $100 per contributor, within a calendar year MUST
be itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan
proceeds and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income)
OVER $100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular
party committee).
Bloomfield Manufacturing
46 W Spring St
Bloomfield IN 47424
2,000.00 2,000.00 03/14/2014
Dave Osmon
1 Contribution: Direct
Graber Post Buildings Inc
7716 N CR900 E
Montgomery IN 47558 Lumber for yard signs
650.00 650.00 04/01/2014
Dave Osmon
2 Contribution: In-Kind
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) 2,650.00$
2,650.00
(CFA-4 SCHEDULE A-4)
CONTRIBUTIONS BY
POLITICAL ACTION COMMITTEESIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 1 of 2
6504
FILE NUMBER
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY POLITICAL ACTION COMMITTEES ON THIS SCHEDULE.
Please type or print legibly IN BLACK INK all information on this schedule. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document contributions and receipts
totaled on ITEM15a of the Summary Sheet. All cumulative contributions from political action committees
OVER $100 per contributor, within a calendar year MUST be itemized on this schedule ( over $200, if regular
party committee ). All transfers-in and in-kind contributions regardless of the amount from political action
committees MUST be itemized on this schedule. All cumulative receipts, (such as loan proceeds and repayments,
refunds, rebates, returns of deposit, proceeds from sales, interest or other income ) OVER $100 per contributor,
within a calendar year, MUST be itemized on this schedule (over $200 if regular party committee).
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Indiana Business for Responsive Government
115 W Washington
Indianapolis IN 46204
3,000.00 3,000.00 02/04/2014
Dave Osmon
1 Other Receipt: Misc
Indiana Business for Responsive Government
115 W Washington
Indianapolis IN 46204
1,000.00 4,000.00 03/24/2014
Dave Osmon
2 Other Receipt: Misc
Indiana Business for Responsive Government
115 W Washington
Indianapolis IN 46204 Susquehanna Polling and
Research
7,395.00 7,395.00 01/17/2014
Dave Osmon
3 Contribution: In-Kind
Indiana Business for Responsive Government
115 W Washington
Indianapolis IN 46204 Graphic design
85.00 3,085.00 02/25/2014
Dave Osmon
4 Contribution: In-Kind
Indiana Business for Responsive Government
115 W Washington
Indianapolis IN 46204 Website
170.00 3,255.00 03/03/2014
Dave Osmon
5 Contribution: In-Kind
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
11,650.00
(CFA-4 SCHEDULE A-4)
CONTRIBUTIONS BY
POLITICAL ACTION COMMITTEESIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 2 of 2
6504
FILE NUMBER
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY POLITICAL ACTION COMMITTEES ON THIS SCHEDULE.
Please type or print legibly IN BLACK INK all information on this schedule. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document contributions and receipts
totaled on ITEM15a of the Summary Sheet. All cumulative contributions from political action committees
OVER $100 per contributor, within a calendar year MUST be itemized on this schedule ( over $200, if regular
party committee ). All transfers-in and in-kind contributions regardless of the amount from political action
committees MUST be itemized on this schedule. All cumulative receipts, (such as loan proceeds and repayments,
refunds, rebates, returns of deposit, proceeds from sales, interest or other income ) OVER $100 per contributor,
within a calendar year, MUST be itemized on this schedule (over $200 if regular party committee).
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Indiana Business for Responsive Government
115 W Washington
Indianapolis IN 46204 Labels and lists
488.78 3,743.78 03/10/2014
Dave Osmon
1 Contribution: In-Kind
Indiana Business for Responsive Government
115 W Washington
Indianapolis IN 46204 Printing and advertising
91.66 4,091.66 04/07/2014
Dave Osmon
2 Contribution: In-Kind
Indiana Business for Responsive Government
115 W Washington
Indianapolis IN 46204 Research
3,004.10 7,095.76 04/08/2014
Dave Osmon
3 Contribution: In-Kind
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) 15,234.54$
3,584.54
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 1 of 5
6504
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose:
Code: Operations
Keller Interactive Media
5901 Sandalwood Drive
Carmel IN 46033
Media/Public Relations Direct 2,565.00 2,565.00 02/04/2014
1
Purpose:
Code: Advertising
Clay County Republicans
c/o Jodi Lohrman
Brazil IN 47834
Direct 125.00 125.00 02/07/2014
2
Purpose:
Code: Operations
Knox County Republican Party
PO Box 402
Vincennes IN 47591
Direct 200.00 200.00 02/10/2014
3
Purpose: Office expense
and travel reimbursement
Code: Operations
Eric Bassler
12 E 7th St
Washington IN 47501
Financial/Investment Direct 82.66 82.66 02/11/2014
4
Purpose:
Code: Operations
Grant E Swartzentruber
1100 Wagner Dr
Washington IN 47501
Direct 50.00 50.00 02/17/2014
5
Purpose:
Code: Operations
Grant E Swartzentruber
1100 Wagner Dr
Washington IN 47501
Direct 25.00 75.00 03/04/2014
6
Purpose:
Code: Advertising
Knox County Republican Party
PO Box 402
Vincennes IN 47591
Direct 200.00 400.00 03/04/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 3,247.66
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 2 of 5
6504
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose:
Code: Advertising
Indiana Business Forms and Labels
1648 E 675 S
Washington IN 47501
Retail Sales Direct 546.77 546.77 03/06/2014
1
Purpose:
Code: Advertising
Howey Politics Indiana
405 Massachusetts Ave
Indianapolis IN 46204
Direct 850.00 850.00 03/11/2014
2
Purpose:
Code: Advertising
Indiana Business Forms and Labels
1648 E 675 S
Washington IN 47501
Retail Sales Direct 775.02 1,321.79 03/15/2014
3
Purpose:
Code: Advertising
Limestone Strategies
12409 Brean Way
Fishers IN 46037
Media/Public Relations Direct 9,885.00 9,885.00 03/15/2014
4
Purpose:
Code: Advertising
DLC Media
800 W National Hwy
Washington IN 47501
Direct 370.00 370.00 03/20/2014
5
Purpose:
Code: Advertising
Steve Cassidy Photographer
PO Box 655
Beech Grove IN 46107-0655
Direct 850.00 850.00 03/24/2014
6
Purpose: Event expense
reimbursement and postage
Code: Operations
Eric Bassler
12 E 7th St
Washington IN 47501
Financial/Investment Direct 614.86 697.52 03/24/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 13,891.65
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 3 of 5
6504
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose:
Code: Advertising
DLC Media
800 W National Hwy
Washington IN 47501
Direct 370.00 740.00 03/26/2014
1
Purpose: Reimbursement
for campaign advertising
items
Code: Advertising
Julie Bassler
12 NE 7th St
Washington IN 47501
Homemaker Direct 1,182.35 1,182.35 02/26/2014
2
Purpose:
Code: Advertising
Limestone Strategies
12409 Brean Way
Fishers IN 46037
Media/Public Relations Direct 20,933.99 30,818.99 04/07/2014
3
Purpose:
Code: Advertising
Indiana Business Forms and Labels
1648 E 675 S
Washington IN 47501
Retail Sales Direct 6,841.58 8,163.37 04/07/2014
4
Purpose: Event expense
reimbursement
Code: Operations
Grant E Swartzentruber
1100 Wagner Dr
Washington IN 47501
Direct 34.95 109.95 04/10/2014
5
Purpose: Event expense
reimbursement
Code: Operations
Eric Bassler
12 E 7th St
Washington IN 47501
Financial/Investment Direct 234.10 931.62 04/10/2014
6
Purpose: Research
Code: Operations
Indiana Business for Responsive
Government
115 W Washington St
Indianapolis IN 46204
In-Kind 7,395.00 7,395.00 01/17/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 36,991.97
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 4 of 5
6504
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: Graphic Design
Code: Operations
Indiana Business for Responsive
Government
115 W Washington St
Indianapolis IN 46204
In-Kind 85.00 7,480.00 02/25/2014
1
Purpose: Website
Code: Operations
Indiana Business for Responsive
Government
115 W Washington St
Indianapolis IN 46204
In-Kind 170.00 7,650.00 03/03/2014
2
Purpose: Voter data
Code: Operations
Indiana Business for Responsive
Government
115 W Washington St
Indianapolis IN 46204
In-Kind 488.78 8,138.78 03/10/2014
3
Purpose: Mileage
Code: Operations
Grant E Swartzentruber
1100 Wagner Dr
Washington IN 47501
In-Kind 40.32 115.32 03/25/2014
4
Purpose: Campaign meals
and mileage
Code: Operations
Grant E Swartzentruber
1100 Wagner Dr
Washington IN 47501
In-Kind 140.32 255.64 04/04/2014
5
Purpose: Printing and
advertising
Code: Advertising
Indiana Business for Responsive
Government
115 W Washington St
Indianapolis IN 46204
In-Kind 91.66 8,230.44 04/07/2014
6
Purpose: Research
Code: Operations
Indiana Business for Responsive
Government
115 W Washington St
Indianapolis IN 46204
In-Kind 3,004.10 11,234.54 04/08/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 4,020.18
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 5 of 5
6504
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: Lumber for yard
signs
Code: Advertising
Graber Post Buildings Inc
7716 N CR 900 E
Montgomery IN 47558
Construction/Engineering In-Kind 650.00 650.00 04/01/2014
1
Purpose: Mileage
Code: Operations
Eric Bassler
12 E 7th St
Washington IN 47501
Financial/Investment In-Kind 5,600.00 6,531.62 04/11/2014
2
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$ 64,401.46
SUB TOTAL THIS PAGE OF SCHEDULE B 6,250.00
SUPPLEMENTAL "LARGE CONTRIBUTION"
REPORT BY A CANDIDATE'S COMMITTEE
($1,000 CONTRIBUTIONS OR MORE)
State Form 48492 (R3/11-05)
Indiana Election commission (IC 3-9-5-20)
FILE NUMBER
TOTAL PAGES IN ENTIRE CFA-11 REPORT
1
6504
(CFA-11)
INSTRUCTIONS: Only candidates receiving a "large contribution" are required
to file this report. Please type or print legibly IN BLACK INK all information on this
form. For assistance in completing this form, see instrucitons on the reverse side.
Check is this is a new name1. Full name of candidate (include any nickname) 2. Committee telephone number
3. Mailing address (address where all campaign finance correspondence is received
4. City, state, ZIP code 5. Party affiliation or if independent
6. Office sought (include district number, if any. Not required for exploratory committ 7. County of residence
COMMITTEE INFORMATION
8. Reporting period:
From: Through:
Check is this is a new address
For classification, enter INDV for individual; PAC for political action committee; CORP for corporation; LAB for labor
organization; NONE for all entries which are not one of the above categories.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT OF
CONTRIBUTION
DATE RECEIVED
RECEIVED BY
Eric Bassler
WASHINGTON IN 47501
District: 39
12 NE 7TH STREET
Republican
STATEWIDE
04/29/2014 04/29/2014
State Senator
Classification: Political Action C
Contributor's Occupation (if applicable)
Hoosiers for Economic Growth PAC
PO Box 2441
Indianapolis IN 46206
Other Receipt: Misc 10,000.00 04/29/2014
1.
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
CERTIFICATION
Signature Included
Signature Included
Treasurer 04/29/2014
04/29/2014
Filed: Online
4/29/2014 2:09:33PM
SUPPLEMENTAL "LARGE CONTRIBUTION"
REPORT BY A CANDIDATE'S COMMITTEE
($1,000 CONTRIBUTIONS OR MORE)
State Form 48492 (R3/11-05)
Indiana Election commission (IC 3-9-5-20)
FILE NUMBER
TOTAL PAGES IN ENTIRE CFA-11 REPORT
1
6504
(CFA-11)
INSTRUCTIONS: Only candidates receiving a "large contribution" are required
to file this report. Please type or print legibly IN BLACK INK all information on this
form. For assistance in completing this form, see instrucitons on the reverse side.
Check is this is a new name1. Full name of candidate (include any nickname) 2. Committee telephone number
3. Mailing address (address where all campaign finance correspondence is received
4. City, state, ZIP code 5. Party affiliation or if independent
6. Office sought (include district number, if any. Not required for exploratory committ 7. County of residence
COMMITTEE INFORMATION
8. Reporting period:
From: Through:
Check is this is a new address
For classification, enter INDV for individual; PAC for political action committee; CORP for corporation; LAB for labor
organization; NONE for all entries which are not one of the above categories.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT OF
CONTRIBUTION
DATE RECEIVED
RECEIVED BY
Eric Bassler
WASHINGTON IN 47501
District: 39
12 NE 7TH STREET
Republican
STATEWIDE
04/25/2014 04/25/2014
State Senator
Classification: Other Organiza
Contributor's Occupation (if applicable)
Michael L Baker D.O., LLC
1401 Memorial Ave
Washington IN 47501
Contribution: Direct 1,000.00 04/25/2014
1.
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
CERTIFICATION
Signature Included
Signature Included
Treasurer 04/26/2014
04/26/2014
Filed: Online
4/26/2014 10:05:37AM
SUPPLEMENTAL "LARGE CONTRIBUTION"
REPORT BY A CANDIDATE'S COMMITTEE
($1,000 CONTRIBUTIONS OR MORE)
State Form 48492 (R3/11-05)
Indiana Election commission (IC 3-9-5-20)
FILE NUMBER
TOTAL PAGES IN ENTIRE CFA-11 REPORT
1
6504
(CFA-11)
INSTRUCTIONS: Only candidates receiving a "large contribution" are required
to file this report. Please type or print legibly IN BLACK INK all information on this
form. For assistance in completing this form, see instrucitons on the reverse side.
Check is this is a new name1. Full name of candidate (include any nickname) 2. Committee telephone number
3. Mailing address (address where all campaign finance correspondence is received
4. City, state, ZIP code 5. Party affiliation or if independent
6. Office sought (include district number, if any. Not required for exploratory committ 7. County of residence
COMMITTEE INFORMATION
8. Reporting period:
From: Through:
Check is this is a new address
For classification, enter INDV for individual; PAC for political action committee; CORP for corporation; LAB for labor
organization; NONE for all entries which are not one of the above categories.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT OF
CONTRIBUTION
DATE RECEIVED
RECEIVED BY
Eric Bassler
WASHINGTON IN 47501
District: 39
12 NE 7TH STREET
Republican
STATEWIDE
04/24/2014 04/24/2014
State Senator
Classification: Individual
Contributor's Occupation (if applicable) Homemaker
Julie A Bassler
12 NE 7th St
Washington IN 47501
Contribution: Direct 10,000.00 04/24/2014
1.
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
CERTIFICATION
Signature Included
Signature Included
Treasurer 04/26/2014
04/26/2014
Filed: Online
4/26/2014 10:04:53AM
SUPPLEMENTAL "LARGE CONTRIBUTION"
REPORT BY A CANDIDATE'S COMMITTEE
($1,000 CONTRIBUTIONS OR MORE)
State Form 48492 (R3/11-05)
Indiana Election commission (IC 3-9-5-20)
FILE NUMBER
TOTAL PAGES IN ENTIRE CFA-11 REPORT
1
6504
(CFA-11)
INSTRUCTIONS: Only candidates receiving a "large contribution" are required
to file this report. Please type or print legibly IN BLACK INK all information on this
form. For assistance in completing this form, see instrucitons on the reverse side.
Check is this is a new name1. Full name of candidate (include any nickname) 2. Committee telephone number
3. Mailing address (address where all campaign finance correspondence is received
4. City, state, ZIP code 5. Party affiliation or if independent
6. Office sought (include district number, if any. Not required for exploratory committ 7. County of residence
COMMITTEE INFORMATION
8. Reporting period:
From: Through:
Check is this is a new address
For classification, enter INDV for individual; PAC for political action committee; CORP for corporation; LAB for labor
organization; NONE for all entries which are not one of the above categories.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT OF
CONTRIBUTION
DATE RECEIVED
RECEIVED BY
Eric Bassler
WASHINGTON IN 47501
District: 39
12 NE 7TH STREET
Republican
STATEWIDE
04/23/2014 04/23/2014
State Senator
Classification: Individual
Contributor's Occupation (if applicable)
Nathan W Gabhart
6590 S 1050 E
Loogootee IN 47553
Contribution: Direct 5,000.00 04/23/2014
1.
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
CERTIFICATION
Signature Included
Signature Included
Treasurer 04/23/2014
04/23/2014
Filed: Online
4/23/2014 8:33:19AM
SUPPLEMENTAL "LARGE CONTRIBUTION"
REPORT BY A CANDIDATE'S COMMITTEE
($1,000 CONTRIBUTIONS OR MORE)
State Form 48492 (R3/11-05)
Indiana Election commission (IC 3-9-5-20)
FILE NUMBER
TOTAL PAGES IN ENTIRE CFA-11 REPORT
1
6504
(CFA-11)
INSTRUCTIONS: Only candidates receiving a "large contribution" are required
to file this report. Please type or print legibly IN BLACK INK all information on this
form. For assistance in completing this form, see instrucitons on the reverse side.
Check is this is a new name1. Full name of candidate (include any nickname) 2. Committee telephone number
3. Mailing address (address where all campaign finance correspondence is received
4. City, state, ZIP code 5. Party affiliation or if independent
6. Office sought (include district number, if any. Not required for exploratory committ 7. County of residence
COMMITTEE INFORMATION
8. Reporting period:
From: Through:
Check is this is a new address
For classification, enter INDV for individual; PAC for political action committee; CORP for corporation; LAB for labor
organization; NONE for all entries which are not one of the above categories.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT OF
CONTRIBUTION
DATE RECEIVED
RECEIVED BY
Eric Bassler
WASHINGTON IN 47501
District: 39
12 NE 7TH STREET
Republican
STATEWIDE
04/22/2014 04/22/2014
State Senator
Classification: Individual
Contributor's Occupation (if applicable) Homemaker
Sharon K Staudt
882 W Roxbury Pkwy
Chestnut Hill MA 02467
Contribution: Direct 1,500.00 04/22/2014
1.
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
CERTIFICATION
Signature Included
Signature Included
Treasurer 04/22/2014
04/22/2014
Filed: Online
4/22/2014 10:52:13AM
SUPPLEMENTAL "LARGE CONTRIBUTION"
REPORT BY A CANDIDATE'S COMMITTEE
($1,000 CONTRIBUTIONS OR MORE)
State Form 48492 (R3/11-05)
Indiana Election commission (IC 3-9-5-20)
FILE NUMBER
TOTAL PAGES IN ENTIRE CFA-11 REPORT
1
6504
(CFA-11)
INSTRUCTIONS: Only candidates receiving a "large contribution" are required
to file this report. Please type or print legibly IN BLACK INK all information on this
form. For assistance in completing this form, see instrucitons on the reverse side.
Check is this is a new name1. Full name of candidate (include any nickname) 2. Committee telephone number
3. Mailing address (address where all campaign finance correspondence is received
4. City, state, ZIP code 5. Party affiliation or if independent
6. Office sought (include district number, if any. Not required for exploratory committ 7. County of residence
COMMITTEE INFORMATION
8. Reporting period:
From: Through:
Check is this is a new address
For classification, enter INDV for individual; PAC for political action committee; CORP for corporation; LAB for labor
organization; NONE for all entries which are not one of the above categories.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT OF
CONTRIBUTION
DATE RECEIVED
RECEIVED BY
Eric Bassler
WASHINGTON IN 47501
District: 39
12 NE 7TH STREET
Republican
STATEWIDE
04/14/2014 04/14/2014
State Senator
Classification: Individual
Contributor's Occupation (if applicable)
James Goghinska
424 Trace Way Dr.
Montgomery TX 77316
Contribution: Direct 2,000.00 04/14/2014
1.
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
CERTIFICATION
Signature Included
Signature Included
Treasurer 04/16/2014
04/16/2014
Filed: Paper
4/16/2014 4:08:00PM
X NoYesIS THIS AN AMENDMENT?
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information
on this form. For assistance in completing this form, see instructions on the
reverse side.
(CFA-4)
Summary Sheet
3843
37
TOTAL PAGES IN ENTIRE CFA-4 REPORT
FILE NUMBERIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
CANDIDATE INFORMATION (For Candidate's Committee Only)
1. Full name of committee (as on Statement of Organization)
2. Acronym or abbreviated name, if any 3. Committee telephone number
4. Mailing address (address where all campaign finance correspondence is received
5. City, state, ZIP code 6. Party affiliation (if applicable)
7. Full name of candidate (include any nickname) 8. Party affiliation or if independent
9. Office sought (include district number, if any. Not required for exploratory committee. 10. County of residence
COMMITTEE INFORMATION
TYPE OF REPORT CONVENTION CANDIDATES ONLY
13. Cash on hand and investments at the beginning of this reporting period.
11.
14. Cash on hand and investments January 1, current year.
(Note: These amounts include in-kind contributions and loans, as well as cash contributions.)
15a. Itemized (use Schedule A)
15b. Unitemized
15c. Add lines 15a, and 15b in both columns
16. Add lines 13 and 15c in Column A and lines 14 and 15c in Column B
(Note: These amounts include in-kind expenditures and loan repayments.)
17a. Itemized (use Schedule B) (Public Question: use Schedule C)
17b. Unitemized
17c. Add lines 17a and 17b in both columns
18. Cash on hand and investments at close of this reporting period(subtract 17c from 16 in both columns) TOTAL
SUBTOTAL
SUBTOTAL
TOTAL
19. Debts OWED BY the committee (use Schedule D)
20. Debts OWED TO the committee (use Schedule E)
EXPENDITURES
CONTRIBUTIONS AND RECEIPTS
COLUMN A
This Period
COLUMN B
Year to Date
12. Check one:
12. Reporting period:
From: Through:
CERTIFICATION
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
Pre-Convention
Post-Convention
Check if this is a new name
Check if this is a new address
COMMITTEE TO ELECT JOHN WATERMAN STATE SENATE
(812) 397-5536
Republican
JOHN M. WATERMAN Republican
State Senator District: 39 Sullivan
01/01/2014 04/11/2014
12,977.92 12,977.92
57,691.62 57,691.62
0.00 0.00
57,691.62 57,691.62
70,669.54 70,669.54
29,982.59 29,982.59
0.00 0.00
29,982.59 29,982.59
40,681.95 40,681.95
0.00
0.00
Treasurer 04/25/2014
04/25/2014
Signature Included
Signature Included
7452 N. CO. RD, 375 E.
SHELBURN IN 47879
PrePrimary
Filed: Paper
4/21/14 10:58 am
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
3843
Page 1 of 10
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): -
Robert Lusk Jr.
1302 E New York St.
Indianapolis IN 46202
100.00 100.00 04/10/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Contributor's Occupation (if required): -
Martha Jean Jackman
1299 N 850 W
Switz City IN 47465
100.00 100.00 04/10/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Contributor's Occupation (if required): -
Robert Neehey
809 W Main
Washington IN 47501
20.00 20.00 03/21/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Contributor's Occupation (if required): -
Bob Underwood
700 W Main
Washington IN 47501
20.00 20.00 03/21/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Contributor's Occupation (if required): -
Lawrence Alden
8800 Beamer Station Rd
Bowling Green IN 47833
100.00 100.00 03/21/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
340.00
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
3843
Page 2 of 10
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): -
Harry & Charlene Halstead
1850 Oak St.
Linton IN 47441
100.00 100.00 03/11/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Contributor's Occupation (if required): -
Edward Charbonneau
2503 Sherwood Dr.
Valparaiso IN 46385
500.00 500.00 04/08/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Contributor's Occupation (if required): -
Mark Ford
Holiday Drive West
indianapolis IN 46760
300.00 300.00 04/09/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Contributor's Occupation (if required): - attorney/Senator
David Long
7100 W. Jefferson
Ft. Wayne IN 46804
1,000.00 1,000.00 04/08/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Contributor's Occupation (if required): - Attorney/Senator
R.Michael Young
310 Columbine Cr
Indianapolis IN 46224
500.00 500.00 04/08/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
2,400.00
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
3843
Page 3 of 10
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): - Attorney/Senator
Randy Head
5003 Waterbury Ct
Logansport IN 46947
500.00 500.00 04/08/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Contributor's Occupation (if required): - VP IN Railroad
Jim Merritt
10327 Tarpon Dr
Indianapolis IN 46256
500.00 500.00 04/08/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Contributor's Occupation (if required): -
John W Wood III
PO Box 462
Farmersburg IN 47850
10.00 10.00 01/02/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Contributor's Occupation (if required): -
Carmen Harting
114 N Indiana St.
Edwardsport IN 47528
15.00 15.00 01/02/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Contributor's Occupation (if required): -
Charles Greene
PO Box 341
Crane IN 47522
34.50 34.50 01/02/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
1,059.50
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
3843
Page 4 of 10
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): -
Dallas & Carolyn Benham
4356 W. 300 S
Lyons IN 47443
20.00 20.00 01/02/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Contributor's Occupation (if required): -
James Sampson Vinca Wiccum
775 E S. Rd 48
Shelburn IN 47879
10.00 10.00 01/02/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Contributor's Occupation (if required): -
Mary Walker
303 SE 15th
Washington IN 47501
10.00 10.00 01/02/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Contributor's Occupation (if required): -
Karen Pigg
2206 N C. Rd. 50 E
Sullivan IN 47882
100.00 100.00 01/02/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Contributor's Occupation (if required): -
Jack & Winnifred Knust
338 S CR 200 W
Cory IN 47846
25.00 25.00 01/02/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
165.00
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
3843
Page 5 of 10
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): -
Charles McCullough
354 W. Frakes St.
Sullivan IN 47882
10.00 10.00 01/02/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Contributor's Occupation (if required): -
Yvonne Morrissey
PO Box 39
Hymera IN 47855
35.00 35.00 01/02/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Contributor's Occupation (if required): -
William & Rebecca Daymude
510 NE D St.
Linton IN 47441
34.50 34.50 01/02/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Contributor's Occupation (if required): -
Matthew Ubelhor
RR2, Box 116A
Bloomfield IN 47474
500.00 500.00 04/10/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Contributor's Occupation (if required): -
Warren & Sonja Hayes
3820 W. 250 W
Switz City IN 47465
100.00 100.00 04/10/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
679.50
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
3843
Page 6 of 10
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): -
Martha & Richard Vongilder
3190 W. Chowning
Shelburn IN 47879
250.00 250.00 04/10/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Contributor's Occupation (if required): -
Richard Bray
289 E Washington St.
Martinsville IN 46151
400.00 400.00 04/11/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Contributor's Occupation (if required): -
Jeffrey & Nancy Swedrain
122 W. Main St.
Worthington IN 47471
100.00 100.00 04/07/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Contributor's Occupation (if required): - gen. business
Mary Jane Graber
11320 E. 1475 N
Odon IN 47562
5,000.00 5,000.00 01/24/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Contributor's Occupation (if required): -
Bradley & Margaret Dickerson
14829 S. Co. Rd. 625 W
Jasonville IN 47438
200.00 200.00 03/22/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
5,950.00
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
3843
Page 7 of 10
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): -
Gerald/Patricia Raymann
604 Dewey Ave
Washington IN 47501
100.00 100.00 03/21/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Contributor's Occupation (if required): -
Darlene McCreary
6239 Harvey Branch Rd.
Oldenburg IN 47036
300.00 300.00 04/10/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Contributor's Occupation (if required): -
Leon Dixon
*Omitted on report* IN
1,000.00 1,000.00 03/24/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Contributor's Occupation (if required): -
Karen Pigg
2206 N C. Rd. 50 E
Sullivan IN 47882
50.00 150.00 02/03/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Contributor's Occupation (if required): -
Donald & Elaine Wile
12476 W. 200 N
Linton IN 47441
200.00 200.00 02/25/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
1,650.00
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
3843
Page 8 of 10
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): -
Lavon & Patsy Yoho
PO Box 54
Solsberry IN 47459
200.00 200.00 02/05/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Contributor's Occupation (if required): -
John K Everhart
5621 CR 500 N
Shelburn IN 47879
100.00 100.00 03/12/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Contributor's Occupation (if required): -
Michael Lewinski
10073 E. SR 56
Dubois IN 47527
25.00 25.00 03/22/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Contributor's Occupation (if required): -
Margie Tomes
9412 Hwy 66
Wadesville IN 47638
250.00 250.00 04/09/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Contributor's Occupation (if required): -
Bill Webster
*Omitted on report* IN
100.00 100.00 04/09/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
675.00
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
3843
Page 9 of 10
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): -
Forrest David & Janet Rowland
1227 Texas Pike
Spencer IN 47460
100.00 100.00 04/10/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Contributor's Occupation (if required): -
Mary & Anthony McKannon
PO Box 422
Haubstadt IN 47639
25.00 25.00 04/10/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Contributor's Occupation (if required): -
Berniece Tirmenstein
1636 E. Blackford
Evansville IN 47714
30.00 30.00 04/10/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Contributor's Occupation (if required): -
Ray & Linda Harvey
208 E. York St.
Rockville IN 47872
50.00 50.00 04/08/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Contributor's Occupation (if required): -
J & C Braker
1700 E. Blackford Ave
Evansville IN 47914
100.00 100.00 04/10/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
305.00
(CFA-4 SCHEDULE A-1)
CONTRIBUTIONS BY INDIVIDUALS
Itemized Contributions and OtherIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
FILE NUMBER
3843
Page 10 of 10
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY INDIVIDUALS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary Sheet.
All cumulative contributions from individuals OVER $100 per contributor, within a calendar year MUST be
itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan proceeds
and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income) OVER
$100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular party
committee). A contributor's occupation is required if an individual makes at least $1,000 in contributions during
the calendar year. Otherwise, this is optional.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Contributor's Occupation (if required): -
Dallas & Carolyn Benham
4356 W. 300 S
Lyons IN 47443
25.00 45.00 02/11/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Contributor's Occupation (if required): -
Jack & Winnifred Knust
338 S CR 200 W
Cory IN 47846
25.00 50.00 02/22/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Contributor's Occupation (if required): -
John W Wood III
PO Box 462
Farmersburg IN 47850
10.00 20.00 02/10/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Contributor's Occupation (if required): -
Warren & Sonja Hayes
3820 W. 250 W
Switz City IN 47465
50.00 150.00 03/22/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Contributor's Occupation (if required): -
Arthur & Nina Jo Moms
3447 Williams Rd
Gosport IN 47433
200.00 200.00 04/07/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) 13,534.00$
310.00
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
(CFA-4 SCHEDULE A-2)
CONTRIBUTIONS BY CORPORATIONS
Itemized Contributions and Other Receipts
Page 1 of 1
3843
FILE NUMBERINSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY CORPORATIONS ON THIS SCHEDULE. Please type or print legibly
IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on the reverse
side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary
Sheet. All cumulative contributions from corporations OVER $100 per contributor, within a calendar year MUST
be itemized on this schedule (over $200, if regular party committee). All cumulative receipts, (such as loan
proceeds and repayments, refunds, rebates, returns of deposit, proceeds from sales, interest or other income)
OVER $100 per contributor, within a calendar year, MUST be itemized on this schedule (over $200 if regular
party committee).
VanGilder Well Drilling Inc
3001 E. Springhill Dr.
Terre Haute IN 47802
250.00 250.00 04/10/2014
JOHN M.
WATERMAN
1 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) 250.00$
250.00
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
(CFA-4 SCHEDULE A-3)
CONTRIBUTIONS BY LABOR
ORGANIZATIONS
Page 1 of 1
3843
FILE NUMBER
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY LABOR ORGANIZATIONS ON THIS SCHEDULE. Please type or
print legibly IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions on
the reverse side. This schedule is used to document contributions and receipts totaled on ITEM15a of the
Summary Sheet. All cumulative contributions from labor organizations OVER $100 per contributor, within a
calendar year MUST be itemized on this schedule ( over $200, if regular party committee). All cumulative
receipts, (such as loan proceeds and repayments, refunds, rebates, returns of deposit, proceeds from sales,
interest or other income ) OVER $100 per contributor, within a calendar year, MUST be itemized on this schedule
(over $200 if regular party committee).
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
LABORERS INTERNATIONAL UNIONS OF NORTH
AMERICA LOCAL #204
401 POPLAR ST
TERRE HAUTE IN 47807
500.00 500.00 03/17/2014
JOHN M.
WATERMAN
1 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) 500.00$
500.00
(CFA-4 SCHEDULE A-4)
CONTRIBUTIONS BY
POLITICAL ACTION COMMITTEESIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 1 of 3
3843
FILE NUMBER
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY POLITICAL ACTION COMMITTEES ON THIS SCHEDULE.
Please type or print legibly IN BLACK INK all information on this schedule. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document contributions and receipts
totaled on ITEM15a of the Summary Sheet. All cumulative contributions from political action committees
OVER $100 per contributor, within a calendar year MUST be itemized on this schedule ( over $200, if regular
party committee ). All transfers-in and in-kind contributions regardless of the amount from political action
committees MUST be itemized on this schedule. All cumulative receipts, (such as loan proceeds and repayments,
refunds, rebates, returns of deposit, proceeds from sales, interest or other income ) OVER $100 per contributor,
within a calendar year, MUST be itemized on this schedule (over $200 if regular party committee).
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Indiana Energy Assoc
1600 One American Square
Indianapolis IN 46282
1,000.00 1,000.00 01/02/2014
JOHN M.
WATERMAN
1 Contribution: Direct
In Regional Council of Carpenters
2635 Madison Ave
Indianapolis IN 46225
2,500.00 2,500.00 03/21/2014
JOHN M.
WATERMAN
2 Contribution: Direct
INDIANA MANUFACTURERS POLITICAL ACTION
COMMITTEE, INC.
2400 ONE AMERICAN SQUARE, BOX 82012
INDIANAPOLIS IN 46282
500.00 500.00 04/10/2014
JOHN M.
WATERMAN
3 Contribution: Direct
BIPAC
150 West Market St Ste 812
Indy IN 46204
1,000.00 1,000.00 04/07/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Local 841 In PAC
PO Box 2157
Terre Haute IN 47802
2,000.00 2,000.00 04/07/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
7,000.00
(CFA-4 SCHEDULE A-4)
CONTRIBUTIONS BY
POLITICAL ACTION COMMITTEESIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 2 of 3
3843
FILE NUMBER
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY POLITICAL ACTION COMMITTEES ON THIS SCHEDULE.
Please type or print legibly IN BLACK INK all information on this schedule. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document contributions and receipts
totaled on ITEM15a of the Summary Sheet. All cumulative contributions from political action committees
OVER $100 per contributor, within a calendar year MUST be itemized on this schedule ( over $200, if regular
party committee ). All transfers-in and in-kind contributions regardless of the amount from political action
committees MUST be itemized on this schedule. All cumulative receipts, (such as loan proceeds and repayments,
refunds, rebates, returns of deposit, proceeds from sales, interest or other income ) OVER $100 per contributor,
within a calendar year, MUST be itemized on this schedule (over $200 if regular party committee).
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
SEIU Healthcare IN Pac
209 W. Jackson Blvd Ste. 200
Chicago IL 60606
500.00 500.00 01/02/2014
JOHN M.
WATERMAN
1 Contribution: Direct
IN Laborers Dist. Council PAC
425 S 4th St.
Terre Haute IN 47807
1,000.00 1,000.00 03/17/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Duke Energy Corpration PAC
550 SOUTH TYRON STREET, DEC37D
CHARLOTTE NC 28202
300.00 300.00 04/11/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Big Red PAC
101 West Ohio St, Ste. 2000
Indianapolis IN 46204
500.00 500.00 04/11/2014
JOHN M.
WATERMAN
4 Contribution: Direct
The Power PAC
ONE MONUMENT CIRCLE
INDIANAPOLIS IN 46204
300.00 300.00 04/11/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
2,600.00
(CFA-4 SCHEDULE A-4)
CONTRIBUTIONS BY
POLITICAL ACTION COMMITTEESIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 3 of 3
3843
FILE NUMBER
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY POLITICAL ACTION COMMITTEES ON THIS SCHEDULE.
Please type or print legibly IN BLACK INK all information on this schedule. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document contributions and receipts
totaled on ITEM15a of the Summary Sheet. All cumulative contributions from political action committees
OVER $100 per contributor, within a calendar year MUST be itemized on this schedule ( over $200, if regular
party committee ). All transfers-in and in-kind contributions regardless of the amount from political action
committees MUST be itemized on this schedule. All cumulative receipts, (such as loan proceeds and repayments,
refunds, rebates, returns of deposit, proceeds from sales, interest or other income ) OVER $100 per contributor,
within a calendar year, MUST be itemized on this schedule (over $200 if regular party committee).
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
AT & T Indiana PAC
240 N Meridian St, Rm 1824
Indianapolis IN 46204
500.00 500.00 04/11/2014
JOHN M.
WATERMAN
1 Contribution: Direct
BackPAC
200 S. MERIDIAN ST., STE. 410
INDIANAPOLIS IN 46225
300.00 300.00 04/11/2014
JOHN M.
WATERMAN
2 Contribution: Direct
LAW PAC OF INDIANA
150 W MARKET, SUITE 210
INDIANAPOLIS IN 46204
5,000.00 5,000.00 03/24/2014
JOHN M.
WATERMAN
3 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) 15,400.00$
5,800.00
(CFA-4 SCHEDULE A-5)
CONTRIBUTIONS BY
OTHER ORGANIZATIONSIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 1 of 5
3843
FILE NUMBER
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY ORGANIZATIONS OTHER THAN CORPORATIONS, LABOR
ORGANIZATIONS, POLITICAL ACTION COMMITTEES AND INDIVIDUALS ON THIS SCHEDULE. Please type or print
legibly IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions
on the reverse side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary
Sheet. All cumulative contributions from other entities OVER $100 per contributor, within a calendar year MUST
be itemized on this schedule (over $200, if regular party committee). All transfers-in and in-kind contributions
regardless of the amount from candidate's, legislative caucus, and regular party committees MUST be itemized
on this schedule. All cumulative receipts, (such as loan proceeds and repayments, refunds, rebates, returns
of deposit, proceeds from sales, interest or other income) OVER $100 per contributor, within a calendar year,
MUST be itemized on this schedule ( over $200 if regular party committee).
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Citizens for Knise
6704 County Rd. 31
Auburn IN 46706
500.00 500.00 04/08/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Taxpayers for Greg Walker
541 Terrace Lake Rd
Columbus IN 47201
1,000.00 1,000.00 04/08/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Steele for State Senate Comm.
PO Box 368
Bedford IN 47421
1,000.00 1,000.00 04/07/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Hoosiers for Holdman
2467 W. 100 N
Markle IN 46770
500.00 500.00 04/08/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Jean Leising for Senate
5268 Stockpile Rd
Oldenburg IN 47036
500.00 500.00 04/08/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
3,500.00
(CFA-4 SCHEDULE A-5)
CONTRIBUTIONS BY
OTHER ORGANIZATIONSIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 2 of 5
3843
FILE NUMBER
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY ORGANIZATIONS OTHER THAN CORPORATIONS, LABOR
ORGANIZATIONS, POLITICAL ACTION COMMITTEES AND INDIVIDUALS ON THIS SCHEDULE. Please type or print
legibly IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions
on the reverse side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary
Sheet. All cumulative contributions from other entities OVER $100 per contributor, within a calendar year MUST
be itemized on this schedule (over $200, if regular party committee). All transfers-in and in-kind contributions
regardless of the amount from candidate's, legislative caucus, and regular party committees MUST be itemized
on this schedule. All cumulative receipts, (such as loan proceeds and repayments, refunds, rebates, returns
of deposit, proceeds from sales, interest or other income) OVER $100 per contributor, within a calendar year,
MUST be itemized on this schedule ( over $200 if regular party committee).
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Committee to Elect Brent Waltz
PO Box 7274
Greenwood IN 46142
500.00 500.00 04/10/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Johnny Nugent Victory Team
920 Pribble Cir
Lawrenceburg IN 47025
500.00 500.00 04/10/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Committee to Elect Pete Miller
172 Clear Branch Dr.
Brownsburg IN 46112
500.00 500.00 04/11/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Friends of Jim Banks
238 S. Eagle Glen Trail
Columbia City IN 46725
500.00 500.00 04/11/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Joe Zakas for State Senate
10372 Wild Cherry Dr
Granger IN 46536
500.00 500.00 04/11/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
2,500.00
(CFA-4 SCHEDULE A-5)
CONTRIBUTIONS BY
OTHER ORGANIZATIONSIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 3 of 5
3843
FILE NUMBER
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY ORGANIZATIONS OTHER THAN CORPORATIONS, LABOR
ORGANIZATIONS, POLITICAL ACTION COMMITTEES AND INDIVIDUALS ON THIS SCHEDULE. Please type or print
legibly IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions
on the reverse side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary
Sheet. All cumulative contributions from other entities OVER $100 per contributor, within a calendar year MUST
be itemized on this schedule (over $200, if regular party committee). All transfers-in and in-kind contributions
regardless of the amount from candidate's, legislative caucus, and regular party committees MUST be itemized
on this schedule. All cumulative receipts, (such as loan proceeds and repayments, refunds, rebates, returns
of deposit, proceeds from sales, interest or other income) OVER $100 per contributor, within a calendar year,
MUST be itemized on this schedule ( over $200 if regular party committee).
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Sue Glick for Senate Comm
113 W. Spring St
LaGrange IN 46761
500.00 500.00 04/11/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Rodric D. Bray for State Sen
489 W. Jefferson St.
Martinsville IN 46157
500.00 500.00 04/11/2014
JOHN M.
WATERMAN
2 Contribution: Direct
Senate Majortiy Campaign Committee
47 S. Meridian St, 2nd Fl.
Indianapolis IN 46204
3,000.00 3,000.00 03/27/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Senate Majortiy Campaign Committee
47 S. Meridian St, 2nd Fl.
Indianapolis IN 46204 mail
3,450.00 6,450.00 03/21/2014
JOHN M.
WATERMAN
4 Contribution: In-Kind
Senate Majortiy Campaign Committee
47 S. Meridian St, 2nd Fl.
Indianapolis IN 46204 telephone research
2,543.20 8,993.20 03/27/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
9,993.20
(CFA-4 SCHEDULE A-5)
CONTRIBUTIONS BY
OTHER ORGANIZATIONSIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 4 of 5
3843
FILE NUMBER
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY ORGANIZATIONS OTHER THAN CORPORATIONS, LABOR
ORGANIZATIONS, POLITICAL ACTION COMMITTEES AND INDIVIDUALS ON THIS SCHEDULE. Please type or print
legibly IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions
on the reverse side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary
Sheet. All cumulative contributions from other entities OVER $100 per contributor, within a calendar year MUST
be itemized on this schedule (over $200, if regular party committee). All transfers-in and in-kind contributions
regardless of the amount from candidate's, legislative caucus, and regular party committees MUST be itemized
on this schedule. All cumulative receipts, (such as loan proceeds and repayments, refunds, rebates, returns
of deposit, proceeds from sales, interest or other income) OVER $100 per contributor, within a calendar year,
MUST be itemized on this schedule ( over $200 if regular party committee).
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
Senate Majortiy Campaign Committee
47 S. Meridian St, 2nd Fl.
Indianapolis IN 46204 mail
8,108.92 17,102.12 04/03/2014
JOHN M.
WATERMAN
1 Contribution: In-Kind
Senate Majortiy Campaign Committee
47 S. Meridian St, 2nd Fl.
Indianapolis IN 46204
500.00 17,602.12 04/11/2014
JOHN M.
WATERMAN
2 Contribution: In-Kind
Comm. to Elect Jim Tomes
9412 Hwy 66
Wadesville IN 46738
500.00 500.00 04/09/2014
JOHN M.
WATERMAN
3 Contribution: Direct
Pat Miller for State Senate
1041 Muessing Rd.
Indianapolis IN 46239
1,000.00 1,000.00 03/25/2014
JOHN M.
WATERMAN
4 Contribution: Direct
Blue Ribbon Morgan Puppies LLC
8478 N 1000 E
Odon IN 47562
500.00 500.00 03/15/2014
JOHN M.
WATERMAN
5 Contribution: Direct
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) $
10,608.92
(CFA-4 SCHEDULE A-5)
CONTRIBUTIONS BY
OTHER ORGANIZATIONSIndiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 5 of 5
3843
FILE NUMBER
INSTRUCTIONS: LIST ONLY CONTRIBUTIONS BY ORGANIZATIONS OTHER THAN CORPORATIONS, LABOR
ORGANIZATIONS, POLITICAL ACTION COMMITTEES AND INDIVIDUALS ON THIS SCHEDULE. Please type or print
legibly IN BLACK INK all information on this schedule. For assistance in completing this schedule, see instructions
on the reverse side. This schedule is used to document contributions and receipts totaled on ITEM15a of the Summary
Sheet. All cumulative contributions from other entities OVER $100 per contributor, within a calendar year MUST
be itemized on this schedule (over $200, if regular party committee). All transfers-in and in-kind contributions
regardless of the amount from candidate's, legislative caucus, and regular party committees MUST be itemized
on this schedule. All cumulative receipts, (such as loan proceeds and repayments, refunds, rebates, returns
of deposit, proceeds from sales, interest or other income) OVER $100 per contributor, within a calendar year,
MUST be itemized on this schedule ( over $200 if regular party committee).
CONTRIBUTOR'S FULL NAME AND FULL MAILING
ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
DATE RECEIVED
RECEIVED BY
IN Assoc of Beverage Retailers
200 S Meridian,. Ste. 350
Indianapolis IN 46225
500.00 500.00 04/11/2014
JOHN M.
WATERMAN
1 Contribution: Direct
Purdue CES Education Fund - Greene
4503 W. State Rd. 54
Bloomfield IN 47424 refund of deposit
100.00 100.00 04/10/2014
JOHN M.
WATERMAN
2 Other Receipt: Misc
$SUB TOTAL THIS PAGE OF SCHEDULE A
TOTAL OF ALL PAGES OF SCHEDULE A ON THE LAST PAGE ONLY
( Enter total on ITEM 15a of the Summary Sheet ) 27,202.12$
600.00
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 1 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: gas
Code: Operations
Jiffy Mart
782 West Wolf St
Sullivan IN 47882
- Conv. Mart Direct 38.35 38.35 01/02/2014
1
Purpose: gas
Code: Operations
Sunmart
722 N. Walnut St
Shelburn IN 47879
- convenient mart Direct 75.02 75.02 01/03/2014
2
Purpose: signs
Code: Advertising
Harcourt Industries Inc
77655 S 175 w
Milroy IN 46156
- Design Company Direct 1,645.77 1,645.77 01/07/2014
3
Purpose: gas
Code: Operations
Vans
506 Main St.
Clay City IN 47841
Direct 19.40 19.40 01/08/2014
4
Purpose: memorial fund
Code: Missing
Senate Memorial Fund
StateHouse
Indianapolis IN
- Fund Direct 100.00 100.00 01/08/2014
5
Purpose: parade supplies
Code: Advertising
SEARS
HONEY CREEK MALL
TERRE HAUTE IN 47802
- SHOPPING CENTER Direct 269.00 269.00 01/08/2014
6
Purpose: gas
Code: Operations
Fast Max
Sandborn IN
Direct 42.50 42.50 01/11/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 2,190.04
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 2 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 80.50 155.52 01/11/2014
1
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 45.00 200.52 01/15/2014
2
Purpose: gas
Code: Operations
Junction
6959 Hwy 41
Shelburn IN 47879
Direct 57.00 57.00 01/17/2014
3
Purpose: meals
Code: Operations
Stolls Country Inn
Hwy 41
Evansville IN 47725
Direct 22.47 22.47 01/20/2014
4
Purpose: t-shirts
Code: Advertising
Wal-Mart
Hwy 415
Sullivan IN 47882
Direct 225.77 225.77 01/20/2014
5
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 55.00 255.52 01/25/2014
6
Purpose:
Code: Operations
Dennis Morgan
Linton IN
Direct 300.00 300.00 01/26/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 785.74
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 3 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: door prizes
Code: Missing
Dry Ridge Blacksmith
*Omitted on report* IN
Direct 156.00 156.00 01/26/2014
1
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 90.60 346.12 01/26/2014
2
Purpose: flags door prizes
Code: Missing
Indiana State Senate
200 West Washington St.
Indianapolis IN 46204
- State Senate Direct 41.25 41.25 01/27/2014
3
Purpose: parade candy
Code: Operations
Walmart
41 S
Sullivan IN 47882
- Department store Direct 25.25 251.02 01/27/2014
4
Purpose: bldg rental
Code: Operations
Owen Co GOP
*Omitted on report* IN
Direct 145.00 145.00 01/29/2014
5
Purpose: door prizes
Code: Operations
Earl Boyd Sr.
Shoals IN
Direct 96.30 96.30 01/31/2014
6
Purpose: gas
Code: Operations
Hannah Waterman
St. Rd. 48
Shelburn IN 47879
Direct 20.00 20.00 01/31/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 574.40
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 4 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 32.45 378.57 02/01/2014
1
Purpose: gas
Code: Operations
Chuckles
Taylor Oil Co.
Bicknell IN 47512
Direct 25.00 25.00 02/01/2014
2
Purpose: gas
Code: Operations
Casey's
715 W Main St
Jasonville IN 47438
- general store Direct 70.84 70.84 02/01/2014
3
Purpose: gas
Code: Operations
Junction
6959 Hwy 41
Shelburn IN 47879
Direct 30.35 87.35 02/04/2014
4
Purpose: gas
Code: Operations
Vans
506 Main St.
Clay City IN 47841
Direct 15.00 34.40 02/07/2014
5
Purpose: gas
Code: Operations
Hoosiers Pete's
1035 E. Main
Jasonville IN 47438
Direct 28.30 28.30 02/07/2014
6
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 93.55 472.12 02/08/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 295.49
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 5 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: ink cartridge
Code: Operations
Cartridge Depot
Lafayette IN
Direct 95.23 95.23 02/10/2014
1
Purpose: gas
Code: Operations
Hoosiers Pete's
1035 E. Main
Jasonville IN 47438
Direct 33.65 89.45 02/10/2014
2
Purpose: gas
Code: Operations
Hoosiers Pete's
1035 E. Main
Jasonville IN 47438
Direct 27.50 89.45 02/12/2014
3
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 50.02 522.14 02/14/2014
4
Purpose: door prizes
Code: Advertising
Walmart
41 S
Sullivan IN 47882
- Department store Direct 188.32 439.34 02/11/2014
5
Purpose: gas
Code: Operations
Hoosiers Pete's
1035 E. Main
Jasonville IN 47438
Direct 30.00 119.45 02/15/2014
6
Purpose: supplies
Code: Advertising
Warren Waterman
Sullivan IN 47882
Direct 73.80 73.80 02/15/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 498.52
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 6 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 26.00 548.14 02/17/2014
1
Purpose: ad
Code: Advertising
Bloomfield Schools
Bloomfield IN
Direct 50.00 50.00 02/18/2014
2
Purpose: flags door prizes
Code: Missing
Indiana State Senate
200 West Washington St.
Indianapolis IN 46204
- State Senate Direct 26.45 67.70 02/20/2014
3
Purpose: gas
Code: Operations
Hoosiers Pete's
1035 E. Main
Jasonville IN 47438
Direct 29.75 149.20 02/21/2014
4
Purpose: campaign ad
Code: Advertising
Shopper Rust Publishing
PO Box 509
Greencastle IN 46135
Direct 324.45 324.45 02/20/2014
5
Purpose: gas
Code: Operations
Junction
6959 Hwy 41
Shelburn IN 47879
Direct 48.01 135.36 02/21/2014
6
Purpose: gas
Code: Operations
Hoosiers Pete's
1035 E. Main
Jasonville IN 47438
Direct 24.00 173.20 02/21/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 528.66
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 7 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: ad program
Code: Advertising
Friends of NRA
*Omitted on report* IN
Direct 150.00 150.00 02/21/2014
1
Purpose:
Code: Advertising
Clay County Republcans
*Omitted on report* IN
Direct 75.00 75.00 02/21/2014
2
Purpose: parade float
supplies
Code: Operations
SEARS
HONEY CREEK MALL
TERRE HAUTE IN 47802
- SHOPPING CENTER Direct 173.44 442.44 02/23/2014
3
Purpose: gas
Code: Operations
Casey's
715 W Main St
Jasonville IN 47438
- general store Direct 31.75 102.59 02/24/2014
4
Purpose: gas
Code: Operations
Country Porch
Hwy 54 E
Linton IN 47441
Direct 53.06 53.06 02/25/2014
5
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 127.75 675.89 02/28/2014
6
Purpose: gas
Code: Operations
Trey Waterman
Sullivan IN
Direct 40.00 40.00 02/13/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 651.00
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 8 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: gas
Code: Operations
Joshua Waterman
7352 CR 375 E
Shelburn IN
Direct 40.00 40.00 02/13/2014
1
Purpose: reimbursement for
sign stakes
Code: Operations
Cheryl Waterman
7452 CR 375 E
Shelburn IN
Direct 273.00 273.00 02/11/2014
2
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 64.00 739.89 02/18/2014
3
Purpose: gas
Code: Operations
Trey Waterman
Sullivan IN
Direct 100.00 140.00 02/22/2014
4
Purpose: storage for signs
Code: Operations
Mike Kimberling
Hymera IN 47855
Direct 490.00 490.00 02/28/2014
5
Purpose: donation for sign
Code: Contributions
Wild LIfe Designs
*Omitted on report* IN
Direct 135.00 135.00 03/01/2014
6
Purpose: gas
Code: Operations
Van's Service Center
506 Main St.
Clay City IN 47841
- service center Direct 49.75 84.15 03/03/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 1,151.75
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 9 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: flags
Code: Missing
ABC
PLAINFIELD IN
- NOVELTY STORE Direct 53.50 53.50 03/03/2014
1
Purpose: mail
Code: Missing
The Lukens Co
*Omitted on report* IN
Direct 7,418.80 7,418.80 03/07/2014
2
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 117.92 857.81 03/08/2014
3
Purpose: staff lunch
Code: Operations
The Lodge
Loogootee IN
Direct 38.52 38.52 03/08/2014
4
Purpose: ad Lincoln Day
Dinner
Code: Advertising
Martin Co. Republicans
*Omitted on report* IN
Direct 72.00 72.00 03/08/2014
5
Purpose: gas
Code: Operations
Junction
6959 Hwy 41
Shelburn IN 47879
Direct 60.25 195.61 03/10/2014
6
Purpose: gas
Code: Operations
Hoosiers Pete's
1035 E. Main
Jasonville IN 47438
Direct 48.00 221.20 03/12/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 7,808.99
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 10 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 70.00 927.81 03/14/2014
1
Purpose: supplies for signs
Code: Advertising
Staples
125 Dairs Ave
Terre Haute IN 47802
Direct 35.26 35.26 03/14/2014
2
Purpose: ad dinner
Code: Advertising
Knox Co. GOP
Bicknell IN
Direct 95.00 95.00 03/15/2014
3
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 61.40 989.21 03/16/2014
4
Purpose:
Code: Missing
Kent Hurt
Sandborn IN
Direct 300.00 300.00 03/18/2014
5
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 92.92 1,082.13 03/19/2014
6
Purpose: ties for yard signs
Code: Advertising
NAPA
138 W. Co. Rd. 300 N
Sullivan IN 47882
Direct 30.69 30.69 03/19/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 685.27
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 11 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 56.50 1,138.63 03/21/2014
1
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 58.60 1,197.23 03/22/2014
2
Purpose: supplies for signs
Code: Advertising
Lowes
4701 S. US Hwy 41
Terre Haute IN 47802
- Home improvement
warehouse
Direct 127.26 127.26 03/23/2014
3
Purpose: gas
Code: Operations
Hoosiers Pete's
1035 E. Main
Jasonville IN 47438
Direct 63.00 284.20 03/23/2014
4
Purpose: mail & palm cards
Code: Advertising
The Lukens Co
2800 Shirlington
Arlington VA 22206
Direct 3,750.00 3,750.00 03/24/2014
5
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 79.50 1,276.73 03/24/2014
6
Purpose: door prizes
Code: Advertising
ABC
PLAINFIELD IN
- NOVELTY STORE Direct 152.48 205.98 03/25/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 4,287.34
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 12 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: gas
Code: Operations
Vans
506 Main St.
Clay City IN 47841
Direct 30.00 114.15 03/27/2014
1
Purpose: gas
Code: Operations
Sunoco
722 N. Walnut
Shelburn IN 47879
- Service Station Direct 117.95 1,394.68 03/28/2014
2
Purpose: mail
Code: Advertising
The Lukens Co
2800 Shirlington
Arlington VA 22206
Direct 7,000.00 18,168.80 03/28/2014
3
Purpose: t-shirts
Code: Advertising
QTs Design Wear
St. Rd. 54
Bloomfield IN
Direct 225.00 225.00 03/28/2014
4
Purpose: ad fish fry
Code: Advertising
Duggar Lodge 721
Dugger IN
Direct 50.00 50.00 03/29/2014
5
Purpose: a fish fry
Code: Advertising
Lum C Veteran Memorial
Lyons IN
Direct 25.00 25.00 03/29/2014
6
Purpose: gas
Code: Operations
Fast Max
Sandborn IN
Direct 52.93 95.43 03/31/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 7,500.88
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 13 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: gas
Code: Operations
casey's
454 13th St NW
Linton IN 47441
Direct 60.00 60.00 04/02/2014
1
Purpose: rent/ 4-H bldg.
Code: Advertising
Purdue CFS ED Fund
Switz City IN
Direct 350.00 350.00 04/02/2014
2
Purpose: post signs
Code: Advertising
Grabre Farm Center
Odon IN
Direct 117.70 117.70 04/02/2014
3
Purpose: gas
Code: Operations
Hoosiers Pete's
1035 E. Main
Jasonville IN 47438
Direct 69.62 353.82 04/03/2014
4
Purpose: banner
Code: Missing
Here's your design
Washington IN 47501
Direct 231.12 231.12 04/04/2014
5
Purpose: gas
Code: Operations
chuckles
1830 S. St. Rd. 57
Washington IN 47501
Direct 58.00 83.00 04/04/2014
6
Purpose: t-shirts
Code: Advertising
Orschelm Farm
2135 Hwy 54 W
Linton IN 47441
Direct 19.26 19.26 04/05/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 905.70
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 14 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: fish fry
Code: Operations
Jasonville Firefighters
Jasonville IN
Direct 63.00 63.00 04/05/2014
1
Purpose: sign material
Code: Advertising
Lowes
4701 S. US Hwy 41
Terre Haute IN 47802
- Home improvement
warehouse
Direct 86.04 213.30 04/06/2014
2
Purpose: sign material
Code: Advertising
Menards
1380 E. Ft. Harrison Rd
Terre Haute IN 47805
Direct 46.27 46.27 04/06/2014
3
Purpose: gas
Code: Operations
chuckles
1435 A St. NE
Linton IN 47441
Direct 60.00 60.00 04/08/2014
4
Purpose: door prizes
Code: Fundraising
John Gettinger
Sullivan IN
Direct 90.00 90.00 04/09/2014
5
Purpose: meals for
fundraiser
Code: Fundraising
Greene Co. Shooting Sports
Linton IN
Direct 144.00 144.00 04/09/2014
6
Purpose: gas
Code: Operations
Caseys General Store
714 W Main St
Jasonville IN 47438
- Convenience Store Direct 63.67 226.26 04/09/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 552.98
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 15 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: festival ad
Code: Fundraising
Coal City Festival
Coal City IN
Direct 25.00 25.00 04/10/2014
1
Purpose: meals for staff
Code: Operations
Velmas Dinner
Shoals IN
Direct 45.34 45.34 04/11/2014
2
Purpose: gas
Code: Operations
Fast Max
103 W Highway 57
Elnora IN 47529
Direct 34.25 34.25 04/11/2014
3
Purpose: phone service
Code: Operations
AT & T Mobility
PO Box 6416
Carol Stream IL 60197
Direct 428.87 428.87 01/03/2014
4
Purpose: phone service
Code: Operations
AT & T Mobility
PO Box 6416
Carol Stream IL 60197
Direct 425.69 854.56 02/01/2014
5
Purpose: phone service
Code: Operations
AT & T Mobility
PO Box 6416
Carol Stream IL 60197
Direct 430.55 1,285.11 03/01/2014
6
Purpose: mail
Code: Advertising
Senate Majority Campaign Committee
47 S. Meridian Ste. 200
Indianapolis IN 46204
Direct 3,450.00 3,450.00 03/21/2014
7
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$
SUB TOTAL THIS PAGE OF SCHEDULE B 4,839.70
(CFA-4 SCHEDULE B)
Itemized Expenditures
Indiana Election commission (IC 3-9-5-14)
State Form 4606 (R13/11-05)
REPORT OF RECEIPTS AND EXPENDITURES
OF A POLITICAL COMMITTEE
Page 16 of 16
3843
FILE NUMBER
RECIPIENT'S NAME AND MAILING
ADDRESS
(street, number, city, state, ZIP code)
TYPE OF EXPENDITURE
and
PURPOSE (be specific)
COLUMN A
AMOUNT THIS
PERIOD
COLUMN B
CUMULATIVE
YEAR-TO-DATE
RECIPIENT'S OCCUPATION
OFFICE SOUGHT (if applicable)
DATE OF
EXPENDITURE
INSTRUCTIONS: Please type or print legibly IN BLACK INK all information on this form. For assistance in completing this
schedule, see instructions on the reverse side. This schedule is used to document expenditures totaled on ITEM
17a of the Summary Sheet. All cumulative expenses paid to individuals, businesses, labor organizations and
other entities OVER $100 per recipient, within a calendar year MUST be itemized on this schedule (over $200,
if regular party committee). All cumulative expenses, including in-kind, regardless of amount paid to political
committees (such as transfers-out from candidate, legislative caucus, political action, or regular party committees)
MUST be itemized on this schedule.
Purpose: telephone
research
Code: Advertising
Senate Majority Campaign Committee
47 S. Meridian Ste. 200
Indianapolis IN 46204
Direct 2,543.20 5,993.20 03/27/2014
1
Purpose: mail
Code: Advertising
Senate Majority Campaign Committee
47 S. Meridian Ste. 200
Indianapolis IN 46204
Direct 8,108.92 14,102.12 04/03/2014
2
Purpose: e-marketing
Code: Advertising
Senate Majority Campaign Committee
47 S. Meridian Ste. 200
Indianapolis IN 46204
Direct 500.00 14,602.12 04/01/2014
3
Purpose: donation for sign
Code: Contributions
Friends of Goose Pond
Linton IN
Direct 140.00 140.00 02/28/2014
4
$
TOTAL OF ALL PAGES OF SCHEDULE B ON THE LAST PAGE ONLY
(Enter total on ITEM 17a of the Summary Sheet)$ 44,548.58
SUB TOTAL THIS PAGE OF SCHEDULE B 11,292.12
SUPPLEMENTAL "LARGE CONTRIBUTION"
REPORT BY A CANDIDATE'S COMMITTEE
($1,000 CONTRIBUTIONS OR MORE)
State Form 48492 (R3/11-05)
Indiana Election commission (IC 3-9-5-20)
FILE NUMBER
TOTAL PAGES IN ENTIRE CFA-11 REPORT
1
3843
(CFA-11)
INSTRUCTIONS: Only candidates receiving a "large contribution" are required
to file this report. Please type or print legibly IN BLACK INK all information on this
form. For assistance in completing this form, see instrucitons on the reverse side.
Check is this is a new name1. Full name of candidate (include any nickname) 2. Committee telephone number
3. Mailing address (address where all campaign finance correspondence is received
4. City, state, ZIP code 5. Party affiliation or if independent
6. Office sought (include district number, if any. Not required for exploratory committ 7. County of residence
COMMITTEE INFORMATION
8. Reporting period:
From: Through:
Check is this is a new address
For classification, enter INDV for individual; PAC for political action committee; CORP for corporation; LAB for labor
organization; NONE for all entries which are not one of the above categories.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT OF
CONTRIBUTION
DATE RECEIVED
RECEIVED BY
JOHN M. WATERMAN
SHELBURN IN 47879
District: 39
7452 N. CO. RD, 375 E.
Republican
STATEWIDE
04/16/2014 04/16/2014
State Senator
Classification: Other Organiza
Contributor's Occupation (if applicable)
Hershman for Senate
6142 Maderia Lane
Buck Creek IN 47924
Contribution: Direct 2,000.00 04/16/2014
1.
Classification: Other Organiza
Contributor's Occupation (if applicable)
Elect Luke Kenley Committtee
PO Box 809
Noblesville IN 46061
Contribution: Direct 1,000.00 04/16/2014
2.
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
CERTIFICATION
Signature Included
Signature Included
Treasurer 04/17/2014
04/17/2014
Filed: Paper
4/17/2014 12:34:00PM
SUPPLEMENTAL "LARGE CONTRIBUTION"
REPORT BY A CANDIDATE'S COMMITTEE
($1,000 CONTRIBUTIONS OR MORE)
State Form 48492 (R3/11-05)
Indiana Election commission (IC 3-9-5-20)
FILE NUMBER
TOTAL PAGES IN ENTIRE CFA-11 REPORT
1
3843
(CFA-11)
INSTRUCTIONS: Only candidates receiving a "large contribution" are required
to file this report. Please type or print legibly IN BLACK INK all information on this
form. For assistance in completing this form, see instrucitons on the reverse side.
Check is this is a new name1. Full name of candidate (include any nickname) 2. Committee telephone number
3. Mailing address (address where all campaign finance correspondence is received
4. City, state, ZIP code 5. Party affiliation or if independent
6. Office sought (include district number, if any. Not required for exploratory committ 7. County of residence
COMMITTEE INFORMATION
8. Reporting period:
From: Through:
Check is this is a new address
For classification, enter INDV for individual; PAC for political action committee; CORP for corporation; LAB for labor
organization; NONE for all entries which are not one of the above categories.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT OF
CONTRIBUTION
DATE RECEIVED
RECEIVED BY
JOHN M. WATERMAN
SHELBURN IN 47879
District: 39
7452 N. CO. RD, 375 E.
Republican
STATEWIDE
04/24/2014 04/24/2014
State Senator
Classification: Other Organiza
Contributor's Occupation (if applicable)
Vision Concepts LLC
3737 Waldemere Rd.
Indianapolis IN 46241
Contribution: Direct 1,000.00 04/24/2014
1.
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
CERTIFICATION
Signature Included
Signature Included
Treasurer 04/25/2014
04/25/2014
Filed: Online
4/25/2014 4:49:48PM
SUPPLEMENTAL "LARGE CONTRIBUTION"
REPORT BY A CANDIDATE'S COMMITTEE
($1,000 CONTRIBUTIONS OR MORE)
State Form 48492 (R3/11-05)
Indiana Election commission (IC 3-9-5-20)
FILE NUMBER
TOTAL PAGES IN ENTIRE CFA-11 REPORT
1
3843
(CFA-11)
INSTRUCTIONS: Only candidates receiving a "large contribution" are required
to file this report. Please type or print legibly IN BLACK INK all information on this
form. For assistance in completing this form, see instrucitons on the reverse side.
Check is this is a new name1. Full name of candidate (include any nickname) 2. Committee telephone number
3. Mailing address (address where all campaign finance correspondence is received
4. City, state, ZIP code 5. Party affiliation or if independent
6. Office sought (include district number, if any. Not required for exploratory committ 7. County of residence
COMMITTEE INFORMATION
8. Reporting period:
From: Through:
Check is this is a new address
For classification, enter INDV for individual; PAC for political action committee; CORP for corporation; LAB for labor
organization; NONE for all entries which are not one of the above categories.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT OF
CONTRIBUTION
DATE RECEIVED
RECEIVED BY
JOHN M. WATERMAN
SHELBURN IN 47879
District: 39
7452 N. CO. RD, 375 E.
Republican
STATEWIDE
04/30/2014 04/30/2014
State Senator
Classification: Political Action C
Contributor's Occupation (if applicable)
Capital PAC of Indiana
5553 Rosslyn Ave.
Indianapolis IN 46220
Contribution: Direct 1,000.00 04/30/2014
1.
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
CERTIFICATION
Signature Included
Signature Included
Treasurer 04/30/2014
04/30/2014
Filed: Online
4/30/2014 10:09:38AM
SUPPLEMENTAL "LARGE CONTRIBUTION"
REPORT BY A CANDIDATE'S COMMITTEE
($1,000 CONTRIBUTIONS OR MORE)
State Form 48492 (R3/11-05)
Indiana Election commission (IC 3-9-5-20)
FILE NUMBER
TOTAL PAGES IN ENTIRE CFA-11 REPORT
1
3843
(CFA-11)
INSTRUCTIONS: Only candidates receiving a "large contribution" are required
to file this report. Please type or print legibly IN BLACK INK all information on this
form. For assistance in completing this form, see instrucitons on the reverse side.
Check is this is a new name1. Full name of candidate (include any nickname) 2. Committee telephone number
3. Mailing address (address where all campaign finance correspondence is received
4. City, state, ZIP code 5. Party affiliation or if independent
6. Office sought (include district number, if any. Not required for exploratory committ 7. County of residence
COMMITTEE INFORMATION
8. Reporting period:
From: Through:
Check is this is a new address
For classification, enter INDV for individual; PAC for political action committee; CORP for corporation; LAB for labor
organization; NONE for all entries which are not one of the above categories.
CONTRIBUTOR'S FULL NAME AND OCCUPATION
FULL MAILING ADDRESS
(street, number, city, state ZIP code)
TYPE OF CONTRIBUTION
OR OTHER RECEIPT
COLUMN A
AMOUNT OF
CONTRIBUTION
DATE RECEIVED
RECEIVED BY
JOHN M. WATERMAN
SHELBURN IN 47879
District: 39
7452 N. CO. RD, 375 E.
Republican
STATEWIDE
04/29/2014 04/29/2014
State Senator
Classification: Other Organiza
Contributor's Occupation (if applicable)
Senate Majortiy Campaign Committee
47 S. Meridian St, 2nd Fl.
Indianapolis IN 46204
Contribution: Direct 25,000.00 04/29/2014
1.
I CERTIFY THAT I HAVE EXAMINED THIS STATEMENT, TO THE BEST OF MY KNOWLEDGE AND BELIEF IT IS
TRUE, CORRECT AND COMPLETE.
Signature of Treasurer
Signature of Candidate (if applicable)
Title Date
Date
FOR OFFICE USE ONLY
WARNING: Any information contained in this report may not be copied for sale or used for any commercial purpose.
(IC 3-9-4-5) A person who knowingly files a fraudulent report commits a Class D Felony . (IC 3-14-1-13) A person who fails
to file a complete or accurate report as required by the Indiana Campaign Finance Law commits a Class B Misdemeanor
(IC 3-14-1-14) and may be subject to civil penalties (IC 3-9-4-16, 3-9-4-17, 3-9-4-18.)
CERTIFICATION
Signature Included
Signature Included
Treasurer 04/30/2014
04/30/2014
Filed: Online
4/30/2014 10:10:13AM