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Minnesota Campaign Finance and Public Disclosure Board Suite 190 . Centennial Office Building . 658 Cedar Street . St. Paul MN 55155-1603 . 651/296-5148 . 800/657-3889 e-mail at: [email protected] Report of Receipts and Expenditures for Political Committees and Political Funds Period Covered: January 1 through December 31, 2011 Filing Instructions = This report may be filed by facsimile. Fax number: 651/296-1722 or 800/357-4114 = Do not use pencil or red ink. = All information on this report is public information. = Address questions to Board staff at 651/282-6894 or 800/657-3889 Committee or fund information Treasurer Name Registration number Dale Carpenter 60054 Committee or fund name Minnesotans United for All Families (Ballot) Treasurer address PO Box 582841 Treasurer city, state, zip Minneapolis, MN 55458 Treasurer telephone (daytime) (651) 330-6852 Exception Report Check one of the boxes belowonly if applicable and provide the requested information. Check this box only if your committee or fund received no contributions and made no No change statement expenditures during this period. Do not use this statement if there was any monetary change. If there was no change: Provide the current cash balance: , and sign here I, the treasurer or deputy treasurer (check one) Date certify there has been no change Amendment Check this box if your committee or fund is filing this report to amend a previously filed report. Provide date of the report being amended: Termination* Check this box if your committee or fund has dissolved. Do not check this box unless the committee has settled all its debts and disposed of all its assets in excess of $100. * If your committee is terminating you must also complete a Statement of Termination. You may print a copy of the form from the Board's web site at: www.cfboard.state.mn.us/forms/PAC/PAC_Statement_of_Termination.pdf This document is available in alternative formats to individuals with disabilities by calling 651/296-5148; 800/657-3889; or through the Minnesota Relay Service at 800/627-3529 COMMITTEE OR FUND TRANSACTION SUMMARY 1 Beginning cash balance 01/01/2011 $0.00 In-kind A RECEIPTS: Cash (Col. 1) Blank Total (Col. 4) (Col. 2) (Col. 3) 2 Total contributions received Sch. A1-CR $1,235,340.26 $220,512.81 $1,455,853.07 3 Receipts from loans payable Sch. A2-LP $0.00 $0.00 4 Miscellaneous income Sch. A2-MISC $1,811.25 $1,811.25 5 TOTAL RECEIPTS Sum #2 to #4 $1,237,151.51 $220,512.81 $1,457,664.32 Cash (Col. 1) Unpaid bills In-kind Total (Col. 4) B DISBURSEMENTS: (Col. 2) (Col. 3) 6 Expenditures Sch. B1-EXP $420,412.58 $0.00 $220,512.81 $640,925.39 Contributions to principal 7 Sch. B2-CAN $0.00 $0.00 $0.00 campaign committees Contributions to political party 8 Sch. B2-PTY $0.00 $0.00 $0.00 units Contributions to political 9 Sch. B2-PAC $0.00 $0.00 $0.00 committees and funds 10 Independent expenditures Sch. B3-IND $0.00 $0.00 $0.00 See required form on page 16 11 Ballot Question Expenditure * $0.00 $0.00 $0.00 TOTAL EXPENDITURES AND 12 Sum #6 to #11 $420,412.58 $0.00 $220,512.81 $640,925.39 DISBURSEMENTS 13 Ending Cash Balance 12/31/2011 #1 + #5 - #12 $816,738.93 *If your committee or fund made ballot question expenditures, you must complete a Ballot Question Expenditures form. Your may print a copy of the form from the Board's web site at: www.cfboard.state.mn.us/forms/ballot_question_expenditures_report.pdf NOTES AND LOANS SUMMARY Total of all notes and loans owed by your committee as of the last day covered by this report, including all previous years. CERTIFICATION I , , certify that this report is complete, true, and correct. (print or type name) Signature of treasurer or deputy treasurer(check one) Date Any person who signs and certifies to be true a report or statement which the person knows contains false information, or who knowingly omits required information, is guilty of a gross misdemeanor and is subject to a civil penalty of up to $3,000. Registration # 60054 Schedule A1 - CR - Contributions Received Make photocopies of this page if additional space is needed Page 1 of 227 Date Name and full address of contributor Committee 1 Cash 2 In-kind (List item and fair 3 Total If contributor is an individual list the registration market value) (Cash & name of employer (if self-employed, list number in-kind) 'self' & disclose the occupation) 07/01/2011 A1 Movers $500.00 $500.00 401 11th Ave S Used Furniture: Desks, Chairs, Ste 200 Whiteboards Hopkins, MN 55343-7815 N/A 07/07/2011 Jonathan Abram $1,000.00 $1,000.00 2300 Willow Lane S St Louis Park, MN 55416-3863 Dorsey & Whitney 11/09/2011 Cynthia Bemis Abrams $250.00 $250.00 8400 W 109th St Bloomington, MN 55438-7200 Self-employed - Leadership consultant/PR 09/19/2011 Advance Consulting LLC $786.66 $786.66 10 Russell Ct Food, Beverages at Event Minneapolis, MN 55410-2549 N/A 12/15/2011 Lisa Agrimonti $500.00 $500.00 2021 James Ave Saint Paul, MN 55105-1721 Briggs & Morgan 07/14/2011 Rebecca Albers $500.00 $750.00 467 Marshall Ave Saint Paul, MN 55102-1719 Northwest Companies, Inc. Total non-itemized receipts $186878.65 $149.51 $187028.16 TOTALS $1235340.26 $220512.81 $1455853.07 To p. 3, line To p. 3, line 2, col. 3 To p. 3, line 2, 2, col. 1 col. 4 It is unlawful to use this information for commercial purposes Committee Name Minnesotans United for All Families (Ballot) Registration # 60054 Schedule A1 - CR - Contributions Received Make photocopies of this page if additional space is needed Page 2 of 227 Date Name and full address of contributor Committee 1 Cash 2 In-kind (List item and fair 3 Total If contributor is an individual list the registration market value) (Cash & name of employer (if self-employed, list number in-kind) 'self' & disclose the occupation) 11/16/2011 $250.00 12/18/2011 Susan Albrecht $250.00 $250.00 1520 Wild Ridge Trail Newport, MN 55055 Macy's 12/29/2011 Alliance for a Better Minnesota $10,000.00 $10,000.00 1600 University Ave W Ste 309 Saint Paul, MN 55104-3800 N/A 05/26/2011 Cristine Almeida $500.00 $5,286.30 407 2nd St NE Minneapolis, MN 55413 Self-employed - Attorney 06/13/2011 $2,710.42 Food 08/08/2011 $957.87 Room Rental, Food, AV, Setup, Beverages for Meeting Total non-itemized receipts $186878.65 $149.51 $187028.16 TOTALS $1235340.26 $220512.81 $1455853.07 To p. 3, line To p. 3, line 2, col. 3 To p. 3, line 2, 2, col. 1 col. 4 It is unlawful to use this information for commercial purposes Committee Name Minnesotans United for All Families (Ballot) Registration # 60054 Schedule A1 - CR - Contributions Received Make photocopies of this page if additional space is needed Page 3 of 227 Date Name and full address of contributor Committee 1 Cash 2 In-kind (List item and fair 3 Total If contributor is an individual list the registration market value) (Cash & name of employer (if self-employed, list number in-kind) 'self' & disclose the occupation) 08/25/2011 $118.01 Food & Beverages for Meeting 12/16/2011 $1,000.00 12/19/2011 Linda Alter Capell $250.00 $250.00 2565 Franklin Ave Apt 104 Saint Paul, MN 55114 University of Minnesota 11/10/2011 Barbara Anderson $500.00 $550.00 10275 Lancaster Bay Woodbury, MN 55129-8527 Retired 12/19/2011 $50.00 11/17/2011 John G Anderson $500.00 $500.00 2785 County Road 24 Long Lake, MN 55356-9632 Wisconsin State Senate Total non-itemized receipts $186878.65 $149.51 $187028.16 TOTALS $1235340.26 $220512.81 $1455853.07 To p. 3, line To p. 3, line 2, col. 3 To p. 3, line 2, 2, col. 1 col. 4 It is unlawful to use this information for commercial purposes Committee Name Minnesotans United for All Families (Ballot) Registration # 60054 Schedule A1 - CR - Contributions Received Make photocopies of this page if additional space is needed Page 4 of 227 Date Name and full address of contributor Committee 1 Cash 2 In-kind (List item and fair 3 Total If contributor is an individual list the registration market value) (Cash & name of employer (if self-employed, list number in-kind) 'self' & disclose the occupation) 07/26/2011 Lee Anderson $10,000.00 $10,000.00 4006 W 44th St Edina, MN 55424-1033 General Mills 10/24/2011 Sandy E Anderson $120.00 $120.00 940 Melwood Ct Madison Lake, MN 56063-7601 Education Minnesota 11/30/2011 Joseph Andrews $200.00 $200.00 3814 W Calhoun Pkwy Minneapolis, MN 55410-1171 Thomson Reuters 06/09/2011 Andy Welti for State $500.00 $500.00 Representative 54506 275th Ave Plainview, MN 55964 Candidate Committee 12/15/2011 Sharon D Armstrong $125.00 $125.00 401 N 2nd St Unit 317 Minneapolis, MN 55401-1585 Winthrop Weinstine 12/30/2011 Annette Atkins $500.00 $500.00 1225 Lasalle Ave Apt 1307 Minneapolis, MN 55403-2331 Saint John's University Total non-itemized receipts $186878.65 $149.51 $187028.16 TOTALS $1235340.26 $220512.81 $1455853.07 To p. 3, line To p. 3, line 2, col. 3 To p. 3, line 2, 2, col. 1 col. 4 It is unlawful to use this information for commercial purposes Committee Name Minnesotans United for All Families (Ballot) Registration # 60054 Schedule A1 - CR - Contributions Received Make photocopies of this page if additional space is needed Page 5 of 227 Date Name and full address of contributor Committee 1 Cash 2 In-kind (List item and fair 3 Total If contributor is an individual list the registration market value) (Cash & name of employer (if self-employed, list number in-kind) 'self' & disclose the occupation) 12/31/2011 William Atmore $1,000.00 $1,000.00 4428 Fremont Ave S Minneapolis, MN 55419 Anesthesiology P.A.
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