2A. Gross Expenditures 2B. Contributions to Committees (Transfers-Out) TOTAL DISBURSEMENTS (Add totals from 2A and 2B) 2. DISBURSEMENTS $773.28 $773.28 $0.00 $0.00 $773.28 $773.28 Street Address: 2390 East Ridge Terrace City, State and Zip: Green Bay, WI 54311 Filing Period Name: July Continuing 2012 Name of Committee/Corporation: Jacque for Assembly CAMPAIGN FINANCE REPORT STATE OF WISCONSIN GAB-2 COMMITTEE IDENTIFICATION 1. RECEIPTS 1A. Contributions (Including Loans) from Individuals 1B. Contributions from Committees (Transfers-In) 1C. Other Income and Commercial Loans TOTAL RECEIPTS (Add totals from 1A, 1B and 1C) Column A This Period Column B Calendar Year-To-Date $10,653.45 $10,653.45 $2,600.00 $2,600.00 $0.00 $0.00 $13,253.45 $13,253.45 SUMMARY OF RECEIPTS AND DISBURSEMENTS GAB ID: 0104808 OFFICE USE ONLY CASH SUMMARY Cash Balance Beginning of Report Total Receipts Subtotal Total Disbursements CASH BALANCE END OF REPORT INCURRED OBLIGATIONS (Balance at the Close of This Period-3A) LOANS (Balance at the Close of This Period-3B) $3,819.00 $13,253.45 $17,072.45 $773.28 $0.00 $0.00 $16,299.17 * * I certify that I have examined this report and to the best of my knowledge and belief it is true, correct and complete. Type or Print Name of Candidate or Treasurer: Signature of Candidate or Treasurer Date: Daytime Phone: Atwell, Robert B NOTE: The information on this form is required by ss.11.06, 11.20, Wis. Stats. Failure to provide the information may subject you to the penalties of ss.11.60, 11.61, Wis. Stats. GAB-2 (Rev. 12/03) This form is prescribed by the Government Accountability Board, P.O. Box 7984, Madison, WI 53707-7984, 608-266-8005. * Cash Balance as reported by committee
Transcript
2A. Gross Expenditures
2B. Contributions to Committees (Transfers-Out)
TOTAL DISBURSEMENTS (Add totals from 2A and 2B)
2. DISBURSEMENTS
$773.28 $773.28
$0.00 $0.00
$773.28 $773.28
Street Address: 2390 East Ridge Terrace
City, State and Zip: Green Bay, WI 54311
Filing Period Name: July Continuing 2012
Name of Committee/Corporation:
Jacque for Assembly
CAMPAIGN FINANCE REPORT STATE OF WISCONSIN
GAB-2COMMITTEE IDENTIFICATION
1. RECEIPTS
1A. Contributions (Including Loans) from Individuals
1B. Contributions from Committees (Transfers-In)
1C. Other Income and Commercial Loans
TOTAL RECEIPTS (Add totals from 1A, 1B and 1C)
Column A This Period
Column B Calendar Year-To-Date
$10,653.45 $10,653.45
$2,600.00 $2,600.00
$0.00 $0.00
$13,253.45 $13,253.45
SUMMARY OF RECEIPTS AND DISBURSEMENTS
GAB ID: 0104808
OFFICE USE ONLY
CASH SUMMARY
Cash Balance Beginning of Report
Total Receipts
Subtotal
Total Disbursements
CASH BALANCE END OF REPORT
INCURRED OBLIGATIONS
(Balance at the Close of This Period-3A)
LOANS (Balance at the Close of This Period-3B)
$3,819.00
$13,253.45
$17,072.45
$773.28
$0.00
$0.00
$16,299.17*
*
I certify that I have examined this report and to the best of my knowledge and belief it is true, correct and complete.
Type or Print Name of Candidate or Treasurer: Signature of Candidate or Treasurer Date:
Daytime Phone:Atwell, Robert B
NOTE: The information on this form is required by ss.11.06, 11.20, Wis. Stats. Failure to provide the information may subject you to thepenalties of ss.11.60, 11.61, Wis. Stats.
GAB-2 (Rev. 12/03) This form is prescribed by the Government Accountability Board, P.O. Box 7984, Madison, WI 53707-7984, 608-266-8005.
*Cash Balance as reported by committee
SCHEDULE 1-A RECEIPTS Contributions From Individuals
Complete Committee Name: Jacque for Assembly
06/12/2012 Frigo, Fran Chapman
1245 Outward Ave., De Pere, WI 54115
RETIRED $150.00 $250.00
06/12/2012 Atwell, Heather 3486 Solitude Rd., De Pere, WI 54115
STUDENT $250.00 $250.00
06/12/2012 Giese, Matt 5391 River Oaks Dr., De Pere, WI 54115
$25.00 $25.00
06/12/2012 Giese, Mary 5391 River Oaks Dr., De Pere, WI 54115
$25.00 $25.00
06/12/2012 Selk, Erv W4821 Dick Rd., Chilton, WI 53014
$100.00 $100.00
06/12/2012 Alt, James L. 430 Grant St., Apt. 108, De Pere, WI 54115
RETIRED $125.00 $125.00
06/12/2012 Alt, Audrey 430 Grant St., Apt. 108, De Pere, WI 54115
RETIRED $125.00 $125.00
06/12/2012 Koch, Dr. Paul D. 5374 Moonlite Dr., De Pere, WI 54115
RETIRED $100.00 $250.00
06/12/2012 Macco, Harry 4144 Cty Rd. W, De Pere, WI 54115
$50.00 $50.00
06/12/2012 Loehlein, John P. 1311 Partridge Rd., De Pere, WI 54115
$37.50 $37.50
05/11/2012 Schierl, Paul J. 1815 Rainbow Ave., De Pere, WI 54115
RETIRED $250.00 $250.00
06/12/2012 Nystrom, William K.
832 Bomier St., De Pere, WI 54115
$35.00 $35.00
06/12/2012 Lasslo, Erin 2015 Swanstone Cir., De Pere, WI 54115
$50.00 $50.00
06/12/2012 Koch, Linda L. 5374 Moonlite Dr., De Pere, WI 54115
RETIRED $100.00 $250.00
06/12/2012 Loehlein, Cynthia 1311 Partridge Rd., De Pere, WI 54115
$37.50 $37.50
06/12/2012 Lasslo, Stephen J. 2015 Swanstone Cir., De Pere, WI 54115
$50.00 $50.00
Monetary
Date Full Name Address Occupation Employer Name
Employer Address
Amount YTD
06/28/2012 Jacque, James Michael
1819 Renaissance Ct., Green Bay, WI 54313
PLUMBING INSPECTOR
City of Green Bay
100 N. Jefferson St., Green Bay, WI 54301
$250.00 $250.00
06/28/2012 Jacque, Mary Josephine
1819 Renaissance Ct., Green Bay, WI 54313
HOMEMAKER $250.00 $250.00
06/12/2012 Hickey, John W. 1437 Traeger St., Green Bay, WI 54304
$50.00 $100.00
06/12/2012 Hamann, Nancy D. 558 Pinehurst Ave., Green Bay, WI 54302
RETIRED $125.00 $250.00
06/12/2012 Hanson, Cheryl A. 2168 Oakwood Dr., Green Bay, WI 54304
$100.00 $100.00
06/12/2012 Pallini, Christina S. 1571 Mesa Dr., Green Bay, WI 54313
$100.00 $100.00
06/12/2012 Pallini, Jeff J. 1571 Mesa Dr., Green Bay, WI 54313
$100.00 $100.00
06/20/2012 Paulson, Kay L. 1410 Crystal Lake Cir. #4, Green Bay, WI 54311
$25.00 $25.00
06/12/2012 Vanevenhoven, William O.
4083 Old Car Ct., De Pere, WI 54115
$25.00 $25.00
06/12/2012 Petri, Thomas N5329 De Neveu Lane #46081, Fond Du Lac, WI 54937
$50.00 $50.00
06/12/2012 Vanevenhoven, Susan A.
4083 Old Car Ct., De Pere, WI 54115
$25.00 $25.00
06/12/2012 Hamann, Jay R. 558 Pinehurst Ave., Green Bay, WI 54302
RETIRED $125.00 $250.00
06/09/2012 Struebing-Van Boxtel, Susan
1731 Lost Dauphin Rd., De Pere, WI 54115
$100.00 $100.00
06/12/2012 Cowles, Robert L. 300 W. St. Joseph St., Green Bay, WI 54301
$25.00 $25.00
06/12/2012 Graul, Mark B. 726 Meadowbrook Ct., Green Bay, WI 54313
OWNER Arena Strategy Group
1263 Main St., #211, Green Bay, WI 54302
$250.00 $250.00
06/12/2012 Gretz, Kenlyn T. 3118 Sunray Ln., Green Bay, WI 54313
PRESIDENT & CEO
AmeriCollect 1851 S. Alverno Rd., Manitowoc, WI 54220
$75.00 $115.00
06/20/2012 Frink, James H. 225 Rosemont Dr., Green Bay, WI 54301
$50.00 $50.00
06/27/2012 Dhein, Jere 2555 Parkwood Dr., Green Bay, WI 54304
$100.00 $100.00
06/11/2012 Dillenburg, David V.
1520 Woodland Dr., Green Bay, WI 54313
$100.00 $100.00
Monetary
06/20/2012 Heidel, Richard 667 Hickory Dr., Hobart, WI 54155
$100.00 $100.00
06/28/2012 Heuer, Ron E3530 Townline Rd., Kewaunee, WI 54216
CONSULTANT Self Employed
E3530 Townline Rd., Kewaunee, WI 54216
$150.00 $150.00
06/25/2012 Swanson, Mary A. 101 Cherry St., Unit 406, Green Bay, WI 54301
$50.00 $50.00
06/25/2012 Swanson, David A. 101 Cherry St., Unit 406, Green Bay, WI 54301
$50.00 $50.00
06/12/2012 Weber, Rebecca L.
2811 Antler Trl., Green Bay, WI 54313
$50.00 $50.00
06/08/2012 Wanezek, Warren M.
2365 Donarski Ct., Green Bay, WI 54302
$100.00 $100.00
06/12/2012 Sladek, Thomas G.
2634 Sequoia Ln., Green Bay, WI 54313
$50.00 $75.00
06/25/2012 Zignego, Timothy 6158 Hwy 167, Hartford, WI 53027
EXECUTIVE Zignego Co., Inc.
W226 N 2940 Duplainville Rd., Waukesha, WI 53186
$250.00 $250.00
06/09/2012 Smithwick, Vi 3702 S. Clay St., Green Bay, WI 54301
$50.00 $50.00
06/12/2012 Slavik, Gerald M. 4292 Stagecoach Rd., Green Bay, WI 54311
$25.00 $25.00
06/21/2012 Weyers, Colleen I. PO Box 12057, Green Bay, WI 54307
HOUSEWIFE $125.00 $125.00
06/12/2012 Sieker, Terry V. 2040 Sieker Ln., Greenleaf, WI 54126
$25.00 $25.00
06/12/2012 Shibler, Daniel J. 6994 Bunker Hill Rd., Greenleaf, WI 54126
$25.00 $25.00
06/25/2012 Zignego, Jill A. 2474 Powder Hill Rd., Hartford, WI 53027
HOMEMAKER $250.00 $250.00
06/25/2012 Zignego, Daniel A. 2424 Powder Hill Rd., Hartford, WI 53027
GENERAL CONTRACTOR
Zignego Co., Inc.
W226 N 2940 Duplainville Rd., Waukesha, WI 53186
$250.00 $250.00
06/12/2012 Zeuske, Cathy S. 2234 Skyline Pines Dr., Green Bay, WI 54313
DIRECTOR Taxpayers Network
721 Cardinal Lane #105, Green Bay, WI 54313
$250.00 $250.00
06/21/2012 Weyers, Ronald A. PO Box 12057, Green Bay, WI 54307
RETIRED $125.00 $125.00
06/12/2012 Shibler, Ann V. 6994 Bunker Hill Rd., Greenleaf, WI 54126
$25.00 $25.00
06/12/2012 Clemedtson-Sieker, Linda
2040 Sieker Ln., Greenleaf, WI 54126
$25.00 $25.00
Monetary
06/12/2012 Becker, Richard 8633 State Hwy 42, Two Rivers, WI 54241
$25.00 $25.00
04/22/2012 Hagen, Charles L. 2314 Adams St., Two Rivers, WI 54241
OWNER Hagen IT 1630 28th St, Two Rivers, WI 54241
$250.00 $250.00
04/22/2012 Hagen, Clarice 2314 Adams St., Two Rivers, WI 54241
BUSINESS MANAGER
Hagen IT 1630 28th St, Two Rivers, WI 54241
$250.00 $250.00
06/12/2012 Fradette, Jaclyn 1138 State Hwy 32, Pulaski, WI 54162
INSIDE SALES SPECIALIST
KI 1330 Bellevue St., Green Bay, WI 54302
$125.00 $125.00
06/25/2012 Zignego, Peter 5197 Hwy E, Slinger, WI 53086
EXECUTIVE Zignego Co., Inc.
W226 N 2940 Duplainville Rd., Waukesha, WI 53186
$250.00 $250.00
06/12/2012 Kiel, Mary 7403 Sandy Bay Rd., Two Rivers, WI 54241
$75.00 $75.00
06/12/2012 Hansen, Dr. Chris John
2541 Valley Dr., Manitowoc, WI 54220
DENTIST Self Employed
1833 University Ave., Green Bay, WI 54302
$100.00 $150.00
06/12/2012 Weekes, Barbara L.
1718 Platt St., Manitowoc, WI 54220
$98.00 $98.00
06/25/2012 Wolf, Ann M. 1416 N. 9th St., Manitowoc, WI 54220
$50.00 $50.00
06/12/2012 Fradette, Chad M. 1138 State Hwy 32, Pulaski, WI 54162
DIRECTOR OF ENVIRONMENTAL SERVICES
Mach IV Engineering and Surveying LLC
211 N. Broadway, Suite 114, Green Bay, WI 54303
$125.00 $125.00
06/26/2012 Reines, Bruce J. 10420 Natural Springs Ave., Las Vegas, NV 89129
RETIRED $200.45 $200.45
06/12/2012 Braunel, Collin 4526 Broadway St., Manitowoc, WI 54220
$50.00 $50.00
06/12/2012 Desjarlais, Robert E.
17624 Kasmer Rd., Mishicot, WI 54228
$100.00 $100.00
06/14/2012 Timm, Melvin L. 7065 Woodenshoe Rd., Neenah, WI 54956
$100.00 $100.00
06/11/2012 Kriegl, George A. N62 W37843 Wadebridge Rd., Oconomowoc, WI 53066
$50.00 $50.00
06/25/2012 Wolf, Gregg A. 1416 N. 9th St., Manitowoc, WI 54220
$50.00 $50.00
06/18/2012 Chesmore, Greg 133 E. Garfield Ave., Milwaukee, WI 53212
$50.00 $50.00
06/12/2012 Desjarlais, Diane M.
17624 Kasmer Rd., Mishicot, WI 54228
$100.00 $100.00
Monetary
06/12/2012 Kosmoski, Paul 1964 W. Telemark Cir., Green Bay, WI 54313
HOMEBUILDER Kos Management
1270 Main St., Green Bay, WI 54302
$200.00 $200.00
06/12/2012 Antonneau, Ronald R.
P.O. Box 1256, Green Bay, WI 54305
DIRECTOR- GOVERNMENT RELATIONS
Wisconsin Public Service Corporation
P.O. Box 19001, Green Bay, WI 54307
$200.00 $200.00
06/12/2012 De Wolfe, Gary D. 2036 Wintercress Dr., Green Bay, WI 54313
$50.00 $50.00
06/12/2012 Kallies, Timothy J. 2428 Pinehurst Cir., Green Bay, WI 54302
$25.00 $60.00
06/12/2012 Reif, Jim PO Box 45, Francis Creek, WI 54214
HOMEBUILDER Jim Reif Builders
PO Box 250, Francis Creek, WI 54214
$250.00 $250.00
06/12/2012 Gagan, Mary 1796 Christie Ct., De Pere, WI 54115
$100.00 $100.00
06/20/2012 Conrardy, Dr. James J.
1757 Camarillo Ct., De Pere, WI 54115
DENTIST Self Employed
125 Siegler St., Green Bay, WI 54303
$200.00 $200.00
06/12/2012 Burger-Kugle, Susan
2073 E. Vista Cir., De Pere, WI 54115
POLICY CONSULTANT
Humana, Inc. 1100 Employers Blvd., Green Bay, WI 54344
$200.00 $200.00
04/30/2012 Peters, Kenneth 1720 Remington Ridge Way, De Pere, WI 54115
$100.00 $100.00
06/12/2012 Weyers, Larry L. 939 Urbandale Ave., De Pere, WI 54115
$75.00 $100.00
06/12/2012 Sroda, Brad J. 3288 Eiler Rd., De Pere, WI 54115
$50.00 $85.00
06/12/2012 Quinette, Susan 4012 Half Crown Run, De Pere, WI 54115
DIRECTOR Humana, Inc. 1100 Employers Blvd., Green Bay, WI 54344
$200.00 $200.00
Conduit Contribution
06/12/2012 LeClair, Michael J. 1810 East St., Two Rivers, WI 54241
$50.00 $50.00
06/12/2012 LeClair, Lisa M. 110 Thiede Rd., Two Rivers, WI 54241
$25.00 $25.00
06/12/2012 LeClair, Paul G. 110 Thiede Rd., Two Rivers, WI 54241
$25.00 $25.00
06/12/2012 Kiel, Sr., William E.
7403 Sandy Bay Rd., Two Rivers, WI 54241
$75.00 $75.00
06/15/2012 Framness, Rupert A.
11018 San Rd., Whitelaw, WI 54247
$50.00 $50.00
06/15/2012 Framness, Ellen B 11018 San Rd., Whitelaw, WI 54247
$50.00 $50.00
Sub Total $7,733.45
Monetary
Comment(s): Food for fundraiser
Comment(s): Printing of poster and placards for fundraiser
Comment(s): Campaign computer
06/12/2012 Gosser, Jay 1984 Swan Pointe Ter., De Pere, WI 54115
$50.00 $50.00
06/12/2012 Becker, Paul 8633 State Hwy 42, Two Rivers, WI 54241
$100.00 $100.00
Comment(s): Campaign computer
06/13/2012 Hagen, Clarice 2314 Adams St., Two Rivers, WI 54241
BUSINESS MANAGER
Hagen IT 1630 28th St, Two Rivers, WI 54241
$75.00 $325.00
Comment(s): Food for fundraiser
06/13/2012 Hagen, Charles L. 2314 Adams St., Two Rivers, WI 54241
OWNER Hagen IT 1630 28th St, Two Rivers, WI 54241
$75.00 $325.00
06/12/2012 Kuehn, Kevin 2158 Charles St., De Pere, WI 54115
$20.00 $20.00
Sub Total $320.00
In-Kind
06/12/2012 Schillinger, Patrick J.
714 Iron Horse Way, Green Bay, WI 54311
$50.00 $50.00
06/12/2012 Peterson, Vernon J.
1222 Prairie Rose Lane, Green Bay, WI 54313
$25.00 $25.00
06/05/2012 Neta, Nyle 2491 Golden Meadow Dr., Green Bay, WI 54311
$100.00 $100.00
06/12/2012 Nick, Barbara A. 3125 Crusade Lane, Green Bay, WI 54313
$50.00 $80.00
06/12/2012 Borgard, Lawrence T.
4140 Crooked Stick Ct., Oneida, WI 54155
$25.00 $25.00
06/14/2012 Culotta, Jason 1201 Hazelcrest Dr., Watertown, WI 53094
DIRECTOR OF TAX & TRANSPORTATION POLICY
WMC PO Box 352, Madison, WI 53701
$250.00 $250.00
06/20/2012 Hansen, Dr. Chris John
2541 Valley Dr., Manitowoc, WI 54220
DENTIST Self Employed
1833 University Ave., Green Bay, WI 54302
$200.00 $350.00
06/12/2012 Cloninger, Charles A.
7179 CTH D, Greenleaf, WI 54126
$50.00 $50.00
05/31/2012 Pearson, John W. 304 Parkside Ct., Kimberly, WI 54136
RETIRED $200.00 $200.00
Sub Total $2,600.00
Conduit Contribution
Total UnItemized Contributions $0.00
Loan Forgiven (-): $0.00
Total $10,653.45
Non-Monetary (-): $0.00
Total Anonymous Contributions $0.00
Grand Total $10,653.45
SCHEDULE 1-B RECEIPTS Contributions from Committees
(Transfers-In)
Complete Committee Name: Jacque for Assembly
06/25/2012 Pro-Life WI Victory Fund PAC 19270 North Hills Drive, Brookfield, WI 53045
$250.00 $250.00
05/01/2012 WI Petroleum Mrktrs & C-Store Assoc. PAC
121 S Pinckney St Ste 300, Madison, WI 53703
$250.00 $250.00
02/20/2012 Waste Management Employees PAC
701 Pennsylvania Ave., NW, Suite 590, Washington, DC 20004
$250.00 $250.00
02/20/2012 Koch Industries Inc. PAC 600 14th Street, NW Suite 800, Washington, DC 20005
$500.00 $500.00
04/05/2012 RPAC - Wisconsin 4801 Forest Run Road, Suite 201, Madison, WI 53704
$500.00 $500.00
05/10/2012 WI Truck Operators (W-TON) P.O. Box 44849, Madison, WI 53744-4849
$100.00 $100.00
04/30/2012 WI Insurance Alliance PAC 44 East Mifflin Street, Suite 901, Madison, WI 53703
$250.00 $250.00
04/30/2012 AGCWI PAC 4814 East Broadway, Madison, WI 53716 $250.00 $250.00
04/30/2012 Wisconsin Credit Union Legislative Action Fund
N25W23131 Paul Road, Suite 500, Pewaukee, WI 53072-5779
$250.00 $250.00
Sub Total $2,600.00
Monetary
Non-Monetary (-): $0.00
Grand Total $2,600.00
Total $2,600.00
Date Full Name Address Amount YTD
SCHEDULE 1-C RECEIPTSOther Income and Commercial Loans
Complete Committee Name: Jacque for Assembly
Total $0.00
Date Full Name Address Amount YTD
SCHEDULE 2-A DISBURSEMENTS Gross Expenditures
Complete Committee Name:
Comment(s): Candidate brochure
05/14/2012 Kuehn Printing 401 N. Quincy St., Green Bay, WI 54301
Printing - Brochures
$408.28
Comment(s): Postage for fundraising
06/07/2012 US Post Office 300 Packerland Dr., Green Bay, WI 54303
Postage $45.00
Sub Total $453.28
Monetary
Comment(s): Campaign computer
Comment(s): Campaign computer
06/13/2012 Hagen, Clarice 2314 Adams St., Two Rivers, WI 54241
Office Supplies
$75.00
06/12/2012 Gosser, Jay 1984 Swan Pointe Ter., De Pere, WI 54115
Fundraiser - Hall Rental
$50.00
Comment(s): Food for fundraiser
06/12/2012 Becker, Paul 8633 State Hwy 42, Two Rivers, WI 54241
Fundraiser - Food & Beverage
$100.00
Comment(s): Food for fundraiser
06/12/2012 Kuehn, Kevin 2158 Charles St., De Pere, WI 54115
Printing - Copies
$20.00
06/13/2012 Hagen, Charles L. 2314 Adams St., Two Rivers, WI 54241
Office Supplies
$75.00
Comment(s): Printing of poster and placards for fundraiser
Sub Total $320.00
In-Kind
Non-Monetary (-): $0.00
Grand Total $773.28
Total $773.28
Date Full Name Address Vendor Name Vendor Address
Expense Purpose
Amount
Jacque for Assembly
SCHEDULE 2-B DISBURSEMENTS Contributions To Committees
