State of West Virginia Campaign Financial Statement (Long Form) in Relation to the 2016 Election Year Candidate or Committee Name Candidate or Committee's Treasurer Steptoe & Johnson Good Government Fund Teresa W. Helmick Political Party (for candidates) Treasurer's Mailing Address (Street, Route, or P.O. Box) PO Box 1588
[email protected] Office Sought (for Candidates) District/Division City, State, Zip Code Daytime Phone # Charleston, WV 25326 304-520-4392 Election Cycle Reporting Period (check one): Check if Applicable: Primary - First Report Pre-primary Report Post-primary Report Amended Report You must also check box of General - First Report X Pre-general Report Post-general Report appropriate reporting period Final Report Zero balance required. PAC must also file Form F-6 Non-Election Cycle Reporting Period: Dissolution Annual Report 2016 Calendar Year Due last Saturday in March or within 6 days thereafter REPORT TOTALS Fill in totals at the completion of the report. RECEIPTS OF FUNDS: Totals for this CASH BALANCE SUMMARY Period Beginning Balance $37,939.68 Contributions $210.00 (ending balance from previous report) Monetary Contributions from all Fund-Raising + $0.00 Total Monetary Contributions + $210.00 Events Total Other Income + $0.00 Receipt of a Transfer of Excess Funds + $0.00 Subtotal: a. = $38,149.68 Total Monetary Contributions: = $210.00 In-Kind Contributions + $0.00 Total Expenditures Paid $32,691.43 Total Contributions: = $210.00 Total Disbursements of Excess Funds + $0.00 Repayment of Loans + $0.00 Other Income $0.00 Subtotal: b. = $32,691.43 Loans Received + $0.00 Total Other Income: = $0.00 Ending Balance: = $5,458.25 (Subtotal a.