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Report of Receipts and Disbursements

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Report of Receipts and Disbursements 04/15/2014 23 : 46 Image# 14960797585 PAGE 1 / 161 REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3 For An Authorized Committee Office Use Only 1. NAME OF TYPE OR PRINT Example: If typing, type 12FE4M5 COMMITTEE (in full) over the lines. Elisabeth Jensen for Congress P.O. Box 1053 ADDRESS (number and street) Check if different than previously Lexington KY 40588 reported. (ACC) 2. FEC IDENTIFICATION NUMBER CITY STATE ZIP CODE STATE DISTRICT C C00545988 3. IS THIS NEW AMENDED REPORT (N) OR (A) KY 06 4. TYPE OF REPORT (Choose One) (b) 12-Day PRE -Election Report for the: (a) Quarterly Reports: Primary (12P) General (12G) Runoff (12R) April 15 Quarterly Report (Q1) Convention (12C) Special (12S) July 15 Quarterly Report (Q2) M M / D D / Y Y Y Y in the October 15 Quarterly Report (Q3) Election on State of January 31 Year-End Report (YE) (c) 30-Day POST -Election Report for the: General (30G) Runoff (30R) Special (30S) Termination Report (TER) M M / D D / Y Y Y Y in the Election on State of M M / D D / Y Y Y Y M M / D D / Y Y Y Y 5. Covering Period 01 2014 through 03 31 2014 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 Treasurer Laura A. D'Angelo M M / D D / Y Y Y Y 04 15 2014 Signature of Treasurer Laura A. D'Angelo [Electronically Filed] Date NOTE: Submission of false, erroneous, or incomplete information may subject the person signing this Report to the penalties of 2 U.S.C. §437g. Office Use FEC FORM 3 Only (Revised 02/2003) FE5AN018 Image# 14960797586 SUMMARY PAGE FEC Form 3 (Revised 02/2003) of Receipts and Disbursements PagePAGE 2 2 / 161 Write or Type Committee Name M M / D D / Y Y Y Y M M / D D / Y Y Y Y Report Covering the Period: From: 01 To: 03 31 2014 Elisabeth Jensen for Congress COLUMN A COLUMN B This Period Election Cycle-to-Date 6. Net Contributions (other than loans) (a) Total Contributions (other than loans) (from Line 11(e)) .... ฀ ฀, ฀, . ฀ ฀, ฀, 353619.90 . (b) Total Contribution Refunds (from Line 20(d)) .................................. ฀ ฀, ฀, . ฀ ฀, ฀, . (c) Net Contributions (other than loans) 126025.78 (subtract Line 6(b) from Line 6(a)) ...... ฀ ฀, ฀, . ฀ ฀, ฀, . 7. Net Operating Expenditures (a) Total Operating Expenditures 104677.74 (from Line 17) ...................................... ฀ ฀, ฀, . ฀ ฀, ฀, . (b) Total Offsets to Operating 0.00 Expenditures (from Line 14) ................ ฀ ฀, ฀, . ฀ ฀, ฀, . (c) Net Operating Expenditures 189579.17 (subtract Line 7(b) from Line 7(a)) ...... ฀ ฀, ฀, . ฀ ฀, ฀, . 8. Cash on Hand at Close of Reporting Period (from Line 27) ................. ฀ ฀, ฀, 268159.48 . 9. Debts and Obligations Owed TO the Committee (Itemize all on Schedule C and/or Schedule D) ................ ฀ ฀, ฀, . 10. Debts and Obligations Owed BY the Committee (Itemize all on 100000.00 Schedule C and/or Schedule D) ................ ฀ ฀, ฀, . 01 For further information contact: Federal Election Commission 999 E Street, NW Washington, DC 20463 2014 Toll Free 800-424-9530 Local 202-694-1100 FE5AN018 Image# 14960797587 DETAILED SUMMARY PAGE FEC Form 3 (Revised 12/2003) of Receipts PagePAGE 3 3 / 161 Write or Type Committee Name Elisabeth Jensen for Congress M M / D D / Y Y Y Y M M / D D / Y Y Y Y Report Covering the Period: From: 01 2014 To: 03 31 2014 COLUMN A COLUMN B I. RECEIPTS Total This Period Election Cycle-to-Date 11. CONTRIBUTIONS (other than loans) FROM: 353619.90 (a) Individuals/Persons Other Than Political Committees 76938.65 (i) Itemized (use Schedule A) ........... ฀ ฀, ฀, . ฀ ฀, ฀, 261727.73 . 26287.13 (ii) Unitemized ................................... ฀ ฀, ฀, . ฀ ฀, ฀, 61528.73 . (iii) TOTAL of contributions 126025.78 103225.78 from individuals ....................... ฀ ฀, ฀, . ฀ ฀, ฀, 323619.90 . (b) Political Party Committees ................. ฀ ฀, ฀, . ฀ ฀, ฀, . (c) Other Political Committees 22800.00 30000.00 (such as PACs) ................................... ฀ ฀, ฀, . ฀ ฀, ฀, . (d) The Candidate .................................... ฀ ฀, ฀, . ฀ ฀, ฀, . (e) TOTAL CONTRIBUTIONS 0.00 (other than loans) (add Lines 11(a)(iii), (b), (c), and (d)) .. ฀ ฀, ฀, . ฀ ฀, ฀, . 12. TRANSFERS FROM OTHER AUTHORIZED COMMITTEES .................... ฀ ฀, ฀, . ฀ ฀, ฀, . 13. LOANS: (a) Made or Guaranteed by the Candidate ........................................... ฀ ฀, ฀, . ฀ ฀, ฀, . (b) All Other Loans ................................... ฀ ฀, ฀, . ฀ ฀, ฀, . (c) TOTAL LOANS (add Lines 13(a) and (b)) .................... ฀ ฀, ฀, . ฀ ฀, ฀, . 100000.00 14. OFFSETS TO OPERATING EXPENDITURES (Refunds, Rebates, etc.) ............................01 ฀ ฀, ฀, . ฀ ฀, ฀, . 15. OTHER RECEIPTS 223.22 (Dividends, Interest, etc.) ........................... ฀ ฀, ฀, . ฀ ฀, ฀, . 16. TOT AL RECEIPTS (add Lines 11(e), 12, 13(c), 14, and 15) 126249.00 453843.12 (Carry Total to Line 24, page 4) ............ ฀ ฀, ฀, . ฀ ฀, ฀, . FE5AN018 Image# 14960797588 DETAILED SUMMARY PAGE FEC Form 3 (Revised 02/2003) of Disbursements PagePAGE 4 4 / 161 II. DISBURSEMENTS COLUMN A COLUMN B Total This Period Election Cycle-to-Date 17. OPERATING EXPENDITURES ..................... ฀ ฀, ฀, . ฀ ฀, ฀, . 18. TRANSFERS TO OTHER AUTHORIZED COMMITTEES ..................... ฀ ฀, ฀, . ฀ ฀, ฀, . 19. LOAN REPAYMENTS: (a) Of Loans Made or Guaranteed by the Candidate ................................. ฀ ฀, ฀, . ฀ ฀, ฀, . (b) Of All Other Loans .............................. ฀ ฀, ฀, . ฀ ฀, ฀, . (c) TOTAL LOAN REPAYMENTS (add Lines 19(a) and (b)) ..................... ฀ ฀, ฀, . ฀ ฀, ฀, . 20. REFUNDS OF CONTRIBUTIONS TO: (a) Individuals/Persons Other Than Political Committees .................. ฀ ฀, ฀, . ฀ ฀, ฀, . (b) Political Party Committees .................. ฀ ฀, ฀, . ฀ ฀, ฀, . (c) Other Political Committees (such as PACs) .................................... ฀ ฀, ฀, 104677.74 . ฀ ฀, ฀, . (d) TOTAL CONTRIBUTION REFUNDS 0.00 (add Lines 20(a), (b), and (c)) .............. ฀ ฀, ฀, . ฀ ฀, ฀, . 21. OTHER DISBURSEMENTS ......................... ฀ ฀, ฀, . ฀ ฀, ฀, 189579.17 . 22. TOT AL DISBURSEMENTS (add Lines 17, 18, 19(c), 20(d), and 21) 268159.48 ฀ ฀, ฀, . ฀ ฀, ฀, . III. CASH SUMMARY 246588.22 23. CASH ON HAND AT BEGINNING OF REPORTING PERIOD ............................................... ฀ ฀, ฀, . 24 TOTAL RECEIPTS THIS PERIOD (from Line 16, page 3) ..................................................... ฀ ฀, ฀, . 372837.22 25. SUBTOTAL (add Line 23 and Line 24) .................................................................................. ฀ ฀, ฀, . 26. TOTAL DISBURSEMENTS THIS PERIOD (from Line 22) ...................................................... ฀ ฀, ฀, . 126249.00 27. CASH ON HAND AT CLOSE OF REPORTING PERIOD (subtract Line 26 from Line 25) .............................................................................................. ฀ ฀, ฀, . FE5AN018 Image# 14960797589 FOR LINE NUMBER: PAGE 5 OF 161 SCHEDULE A (FEC Form 3) Use separate schedule(s) (check only one) for each category of the 11a 11b 11c 11d ITEMIZED RECEIPTS Detailed Summary Page 12 13a 13b 14 15 Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee to solicit contributions from such committee. NAME OF COMMITTEE (In Full) Elisabeth Jensen for Congress Full Name (Last, First, Middle Initial) Steve . A. Date of Receipt Mailing Address 19 Foxley Ln M M / D D / Y Y Y Y 23 City State Zip Code Transaction ID : C9134645 Frankfort KY 40601-4862 FEC ID number of contributing Amount of Each Receipt this Period federal political committee. C Name of Employer Occupation , , . Kentucky Public Health Association Executive Director Receipt For: 2014 Election Cycle-to-Date Primary General Other (specify) , , . Full Name (Last, First, Middle Initial) Steve . Date of Receipt B. Mailing Address 19 Foxley Ln M M / D D / Y Y Y Y 02 21 2014 City State Zip Code Transaction ID : C9282905 Frankfort KY 40601-4862 FEC ID number of contributing Amount of Each Receipt this Period federal political committee. C 1000.00 Name of Employer Occupation , , . Executive Director Receipt For: Election Cycle-to-Date Primary General Other (specify) 1750.00 , , . Full Name (Last, First, Middle Initial) Steve . Date of Receipt C. Mailing Address 19 Foxley Ln M M / D D / Y Y Y Y 03 25 2014 City State Zip Code Transaction ID : C9295406 Frankfort KY 40601-4862 FEC ID number of contributing federal political committee. 01 C Amount of Each Receipt this Period 250.00 Name of Employer Occupation , , . Kentucky Public Health Association Executive Director Receipt For: Election Cycle-to-Date Primary General Other (specify) , , . 1500.00 SUBTOTAL of Receipts This Page (optional) ............................................................................ , , . TOTAL This Period (last page this line number only) ............................................................... , , . FEC Schedule A (Form 3) (Revised 02/2009) Image# 14960797590 FOR LINE NUMBER: PAGE 6 OF 161 SCHEDULE A (FEC Form 3) Use separate schedule(s) (check only one) for each category of the 11a 11b 11c 11d ITEMIZED RECEIPTS Detailed Summary Page 12 13a 13b 14 15 Any information copied from such Reports and Statements may not be sold or used by any person for the purpose of soliciting contributions or for commercial purposes, other than using the name and address of any political committee
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