a. name b. position c. addressethics.la.gov/campaignfinancesearch/la-23831.pdf · curtis zeringue...
TRANSCRIPT
LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
7833 Office Park Blvd.
Baton Rouge, LA 70809
David Kestel (337)478-1511
Stacy Marie
COMMITTEE’S REPORT(filed by committees that support or oppose one or more candidates and/or propositions and that are not candidate committees)
1. Full Name and Address of Political Committee
This report covers from through
3. Type of Report:
180th day prior to primary
90th day prior to primary
30th day prior to primary
10th day prior to primary
10th day prior to general
40th day after general
Annual (future election)
Monthly
Amendment to prior report
4. All Committee Officers (including Chairperson, Treasurer, if any, and any other committee officers)
5. Candidates or Propositions the Committee is Supporting or Opposing (use additional sheets if necessary)
7. a. Name of Person Preparing Report
b. Daytime Telephone
8. WE HEREBY CERTIFY that the information contained in this report and the attached schedules is true and correct to the best of our knowledge ,
information and belief, and that no expenditures have been made nor contributions received that have not been reported herein, and that no information
required to be reported by the Louisiana Campaign Finance Disclosure Act has been deliberately omitted .
Signature of Committee/Chairperson Daytime Telephone
Daytime TelephoneSignature of Committee Treasurer, if any
Form 202, Rev. 3/98, Page Rev. 5/01
ACCOUNTANT CRYSTAL GUIDRY
(225)926-1986
X
This day of , .
OFFICE USE ONLY
May 2011
Schedule A-1
Schedule A-3
Schedule E-3
Schedule E-4
Report Includes Schedules:
Report Number: 23831
Additional officers listed on attached sheet
Date Filed:
a. Name b. Position c. Address
Chairperson
Treasurer
DAVID KESTEL
TREASURER STACY MARIE
825 W. Prien Lake Road
Lake Charles, LA 70601
205 Woodbridge Drive
Lafayette, LA 70508
6. Is the Committee supporting the entire ticket of a political party? Yes No If “yes”, which party?
a. Name & Address of Candidate/Description of Proposition b. Office Sought c. Political Party d. Support/Oppose
5/10/2011
4/1/2011 4/30/2011
2. Date of Primary
10th
2/9/2011
Page 1 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
4. All Committee Officers (including Chairperson, Treasurer, if any, and any other committee officers)
a. Name b. Position c. Address
OfficerDR. GARY DEWITT 1400 Peterman Drive
Alexandria, LA 71301
OfficerEDWARD L DONALDSON,
JR
2960 Gause Blvd
Suite E
Slidell, LA 70461
OfficerMARTY B GARRETT 12071 Bricksome Ave
Baton Rouge, LA 70816
OfficerROGER GRIMBALL DDS 910 S. Geglis Pkwy
Sulphur, LA 70663 5102
OfficerDR. H. KIRT TOUCHSTONE III PO Box 737
Bernice, LA 71222
OfficerDR. RUSSELL L WESTFALL,
DDS
1271 7th Street
Slidell, LA 70458 2041
OfficerGARY L ROBERTS 8510 Line Ave
Shreveport, LA 71106
OfficerDR. CURTIS ZERINGUE P. O. Drawer E
Mathews, LA 70630
Page 2 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SUMMARY PAGE
RECEIPTS This Period
1. Contributions (Schedule A-1)
2. In-kind Contributions (Schedule A-2)
3. Campaign paraphernalia sales of $25 or less
4. TOTAL CONTRIBUTIONS (Lines 1 + 2 +3)
5. Other Receipts (Schedule A-3)
6. Loans Received (Schedule B)
7. Loan Repayments Received (Schedule D)
8. TOTAL RECEIPTS (Lines 4 + 5 + 6 + 7)
DISBURSEMENTS This Period
9. General Expenditures (Schedule E-1)
10. In-Kind Expenditures (Schedule E-2)
11. Contributions made to Candidates (Schedule E-3)
12. TOTAL EXPENDITURES (Lines 9 + 10 + 11)
13. Other Disbursements (Schedule E-4)
FINANCIAL SUMMARY Amount
17. Funds on hand at beginning of reporting period (Must equal funds on hand at close from last report or -0- if first report for this committee)
18. Plus total receipts this period (less in-kind contributions received) (Line 8 above minus line 2 above)
19. Less total disbursements this period (less in-kind expenditures) (Line 16 above minus line 10 above)
20. Funds on hand at close of reporting period
Form 202, Rev. 3/98, Page Rev. 3/98
14. Loan Repayments Made (Schedule B)
15. Funds Loaned (Schedule D)
16. TOTAL DISBURSEMENTS (Lines 12 + 13 + 14 + 15)
$ 5,606.00
$ 0.00
$ 0.00
$ 5,606.00
$ 8,000.00
$ 0.00
$ 0.00
$ 13,606.00
$ 0.00
$ 0.00
$ 70,500.00
$ 70,500.00
$ 171.88
$ 0.00
$ 0.00
$ 70,671.88
$ 336,880.62
$ 13,606.00
$ 70,671.88
$ 279,814.74
Page 3 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SUMMARY PAGE (continued)
INVESTMENTS Amount
21. Of funds on hand at beginning of reporting period (Line 17, above), amount held in
investments (i.e., savings accounts, CD’s, money market funds, etc.)
22. Of funds on hand at close of reporting period (Line 20, above), amount held in
investments
SPECIAL TRANSACTIONS This Period
23. Contributions received from political committees
(From Schedules A-1 and A-2)
24. All proceeds from the sale of tickets to fundraising events
(Receipts from the sale of tickets are contributions and must also be reported on
Schedule A-1)
25. Proceeds from the sale of campaign paraphernalia
(Receipts from the sale of campaign paraphernalia are contributions and must also
be reported on Schedule A-1 or Line 3 above)
26. Expenditures from petty cash fund
(Must also be reported on Schedule E-1)
NOTICE
A political committee must register in each calendar year in which it will have over $500 of financial activity. The
registration is accomplished by filing a Statement of Organization form and paying the $100 filing fee. Statements of
Organization are filed annually by January 31. Any committee which realizes that it will have over $500 of financial activity
after January 31 must register within ten days of its realization of that fact. However, if this occurs during the ten day
period prior to an election the Statement of Organization must be filed within three days.
Political committees must file reports of receipts and disbursements on an annual basis. Annual reports are due by
February 15 and should cover the preceding calendar year. Also, committees must file reports of receipts and
disbursements on the same schedule as the candidates it supports or opposes. Reports are also due in connection with
propositions (ballot issues) the committee supports or opposes. Schedules of reporting and filing dates for all elections
Form 202, Rev. 3/98, Page Rev. 3/00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
Page 4 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
ISAAC APPLETON
7742 Office Park Blvd. Ste. A1
Baton Rouge, LA 70809
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
J W BARRIOS
116 Rue Beauregard
Lafayette, LA 70508
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
MARIA BLAKE
912 W Morris Ave
Hammond, LA 70403
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
NOLAN BOUDREAUX, JR.
4001 Lapalco Blvd
Ste 10
Harvey, LA 70058
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
JOSEPH CAMPO
4141 Veterans Memorial Blvd
Ste 205
Metairie, LA 70002
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
MICHELLE CARLTON
340 Veterans Blvd
Denham Springs, LA 70726
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 426.00
$ 0.00
Page 5 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
SHADONNA COLEMAN
1103 Hodges St.
Apt. 4
Lake Charles, LA 70601
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
KEVIN COLLINS
6619 Airline Dr.
Ste. B
Metairie, LA 70003
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DR STEVEN D COLLINS
18512 Bay Ridge Ct.
Baton Rouge, LA 70817
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
GLEN CORCORAN
3701 Highway 59
Ste. E
Mandeville, LA 70471
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
GALEN CRAWFORD
239 Chapelview Ct.
Baton Rouge, LA 70815
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
FRANCIS DAUTERIVE
1126 Belair Blvd
Slidell, LA 70460
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 426.00
$ 0.00
Page 6 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$3.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DAMON DIMARCO
309 Gretna Blvd
Gretna, LA 70053
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
CHRIS DOUCET
906 N Union St.
Opelousas, LA 70570
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
JON FEERICK
PO Box 260
Grand Coteau, LA 70541
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
HONEY FIASCONARO
218 Golden Leaf Lane
Pineville, LA 71360
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DAVID FINLEY
901 N 3rd St.
Monroe, LA 71201
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
RACHEL FLOYD
PO Box 891
Jena, LA 71342
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 358.00
$ 0.00
Page 7 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
GREG FOLSE
510 Guilbeau Rd. Ste. C2
Lafayette, LA 70506
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
CHAD GARDNER
625 S. Washington St.
Bastrop, LA 71220
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
KURT GAUTHIER
2235 Worley Dr.
Alexandria, LA 71301
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
HARRY GOODWIN
509 Bon Ami St.
Deridder, LA 70634
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
ROGER GRIMBALL DDS
910 S. Geglis Pkwy
Sulphur, LA 70663 5102
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
E K HARMON
PO Box 598
Youngsville, LA 70592
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 426.00
$ 0.00
Page 8 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DON HARRIS
605 Rue De Brille
New Iberia, LA 70563
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
MARSHALL HARRISON
614 Connell Park Lane
Baton Rouge, LA 70806
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
THOMAS HATHORN
402 Pinegrove Dr.
Pineville, LA 71360
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
WILLIAM HEATH
1107 Louisa St.
Rayville, LA 71269
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
PERRY HOLLEMBEAK
2001 E 70th St.
Ste. 108
Shreveport, LA 71105
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
CARY HOPPE
3701 Williams Blvd
Ste. 253
Kenner, LA 70065
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 426.00
$ 0.00
Page 9 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DANA JACKSON
1628 Gentilly Dr.
Shreveport, LA 71105
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
H D JONES III
2235 Worley Dr.
Alexandria, LA 71301
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DAVID KESTEL
825 W. Prien Lake Road
Lake Charles, LA 70601
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
GLENN KIDDER
12036 Justice Ave
Baton Rouge, LA 70816
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
MICHELLE LEBLANC
PO Box 232
Paulina, LA 70763
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
BRYNN LEROUX
9000 Airline Hwy
Ste. 100
Baton Rouge, LA 70815
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 426.00
$ 0.00
Page 10 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
VIRGINIA LOCKE
402 Pinegrove Dr
Pineville, LA 71360
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
GEORGE MARSE
5400 Rebecca Blvd
Kenner, LA 70065
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
CHARLES MCCABE
250 Meadowcrest St.
Ste. 204
Gretna, LA 70056
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
RICHMOND CORLEY
PO Box 10
Madisonville, LA 70447
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DANIEL MELANCON
102 Mystic Blvd
Houma, LA 70360
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
MATTHEW MELANCON
201 E Butcher Switch
Lafayette, LA 70507
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 380.00
$ 0.00
Page 11 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DR MARK M MEREDITH
P. O. Box 70
Grayson, LA 71435
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
CHRISTOPHER OWENS
3511 Cypress St.
West Monroe, LA 71291
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DANIEL PAIGE
341 Pastureview Drive
Baton Rouge, LA 70810
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
LOUIS PASSAUER, JR
231 Saint Ann Drive
Ste 1
Mandeville, LA 70471
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
BARRY PETRY
611 State Street
Jennings, LA 70546
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
JOSEPH PORTER
4451 Bluebonnet Blvd
Ste B
Baton Rouge, LA 70809
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 426.00
$ 0.00
Page 12 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
ESPERANZA PRATO
2816 1st Ave
Lake Charles, LA 70601
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
MELVIN PROCELL
5220 Highway 79
Homer, LA 71040
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
MICHAEL PUISSEGUR
201 Rue Louis XIV
Lafayette, LA 70508
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
PHILIP PUNEKY
74180 Jack Lloyd Rd.
Abita Springs, LA 70420
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
GREG ROBERTSON
1201 Texas Ave
Alexandria, LA 71301
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
ROBERT ROONEY II
100 Smart Place
Slidell, LA 70458
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 426.00
$ 0.00
Page 13 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
CLINT SANDEFER
1291 Florida Ave. SW
Denham Springs, LA 70726
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
MICHAEL SCEROLER
PO Box 394
Watson, LA 70786
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
KENNETH SCHOTT
4809 Alphonse Dr
Metairie, LA 70006
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DENIS SIMON
9804 Bluebonnet Blvd
Ste. B
Baton Rouge, LA 70810
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
MITCHELL THERIOT
102 Mystic Blvd
Houma, LA 70360
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
TIMOTHY THOMAS
PO Box 598
Youngsville, LA 70592
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 426.00
$ 0.00
Page 14 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
ALEXIS UNDERHILL
9027 Hayden Dr.
Shreveport, LA 71106
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DANIEL WEAVER
715 W College St
Lake Charles, LA 70605
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
STEPHANIE WEAVER
715 W. College St
Lake Charles, LA 70605
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
ROBERT WESTERMAN
7931 Jefferson Hwy
Baton Rouge, LA 70809
04/29/2011
$0.00$71.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
STEVEN WORLEY
PO Box 1540
Ferriday, LA 71334
04/29/2011
$0.00$200.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DR TIMOTHY P FONTENOT
149 N 3rd St
Eunice, LA 70535
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 555.00
$ 0.00
Page 15 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$100.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
OAK HILL PERIODONTICS
10723 N Oak Hills Pkwy # B
Baton Rouge, LA 70810
04/29/2011
$0.00$50.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
VALERIE HEMPHILL
2272 Barataria Blvd
Marrero, LA 70072
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DR AMBROSE M MARTIN, III
2610 Esplanade Ave
New Orleans, LA 70119
04/29/2011
$0.00$50.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
LAURIE MOELLER
932 Bonnebel Blvd
Metairie, LA 70005
04/29/2011
$0.00$50.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DR STEPHEN E SEARCY
3839 W Congress St
Suite B
Lafayette, LA 70506
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
SAMMY TOM
6817 Gen Haiy
New Orleans, LA 70124
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 300.00
$ 0.00
Page 16 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DR THOMAS E MCNEELY
745 Olive St
Suite 204
Shreveport, LA 71104
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
NELSON DALY
4450 Bluebonnet
Suite B
Baton Rouge, LA 70809
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
MARIA BURMASTER
2272 Barataria
Marrero, LA 70072
04/29/2011
$0.00$50.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
CHARLES FOY
400 Pine Street
Madisonville, LA 70447
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
WARREN THOMAS
1018 10th St.
Lake Charles, LA 70601
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DR DENNIS R PREAU
519 River Oaks Dr
Covington, LA 70433
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 175.00
$ 0.00
Page 17 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
KEITH KYLER
11964 Coursey Blvd
Baton Rouge, LA 70816
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
ERIC LAVESPERE
2005 Forsythe Ave
Monroe, LA 71201
04/29/2011
$0.00$100.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DANIEL WEAVER
715 W College St
Lake Charles, LA 70605
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
CURTIS LEBLANC
415 N. Main St.
Breaux Bridge, LA 70811
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DR ERIC A SANDERS
2620 Country Club Rd
Lake Charles, LA 70605
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
BUDDY QUINN
120 Professional Drive
c/o King Scott
West Monroe, LA 71291
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 225.00
$ 0.00
Page 18 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
JOHN LITTLE
8629 Hwy 17
Winnsboro, LA 71295
04/29/2011
$0.00$50.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DR CHARLES F HUDSON
1808 Highway 190 West
Suite D
DeRidder, LA 70634
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
LEONARD WISE
PO Box 1910
Morgan City, LA 70381
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
BOB ELLIS
3840 Hwy 22 #300
Mandeville, LA 70471
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
MICHAEL STACEY
921 Shirley Road
Bunkie, LA 71322
04/29/2011
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
DR RAYMOND H JOHN
2001 Forsythe Ave
Monroe, LA 71201
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 175.00
$ 0.00
Page 19 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-1: CONTRIBUTIONS (Other than In-Kind Contributions)
The following information must be provided for all contributions received by the committee during this reporting period,
except for in-kind contributions, whether received from a political committee or some other person or entity. Contributions
made by the committee are reported on SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES. Information on in-kind
contributions is reported on SCHEDULE A-2: IN-KIND CONTRIBUTIONS. In Column 1, check “yes” if the contributor is a
political committee and “no” if not. For anonymous contributions, see SCHEDULE F. Totals and subtotals at bottom of the
page are optional. Completion of totals and subtotals may assist in calculating totals that must be reported on the Summary
Page.
1. Name and Address of Contributor 2. Contributions this Reporting Period 3. Total this Year
a. Date(s) b. Amount(s)
$0.00$25.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
THOMAS MCCOY III
4432 Conlin St.
Ste. 1B
Metairie, LA 70006
04/29/2011
$0.00$5.00
POLITICAL COMMITTEE? PARTY COMMITTEE?
ROSS DENICOLA
6509 Government St Ste A
Baton Rouge, LA 70806
04/29/2011
4. SUBTOTAL (this page)
5. TOTAL (complete only on last page of this schedule)
6. CONTRIBUTIONS FROM POLITICAL COMMITTEES ONLY:
SUBTOTAL (this page) TOTAL (complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
N/A
N/A
$ 30.00
$ 5,606.00
$ 0.00 $ 0.00
Page 20 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-3: OTHER RECEIPTS
This schedule is used to report those receipts that are not “contributions”; that is, monies received by the committee that are
not paid to it for the purpose of supporting, opposing or otherwise influencing the nomination or election of candidates to
public office or supporting or opposing propositions or questions submitted to the voters . Examples include interest or
investment income. Receipts should be reported on this schedule only if they have not been reported elsewhere in
this report. The explanation of the receipt should state the reason the payment was made to the committee.
1. Name and Address of Source 4. Amount3. Date2. Explanation
$1,000.00SEN. JOHN ALARIO CAMPAIGN FUND
1063 Muller Pkwy
Westwego, LA 70094
04/01/2011Voided Check-Returned
Contribution-Senator John Alario
$1,000.00SHERRI SMITH CHEEK
9973 Mansfield Road
Keithville, LA 71047
04/01/2011Voided Check-Returned
Contribution-Sen. Sherri smith
Cheek
$2,000.00GERALD LONG CAMPAIGN FUND
P. O. Box 151
Winnfield, LA 71483
04/01/2011Voided Check-Returned
Contribution-Sen. Gerald Long
$500.00DALE ERDEY CAMPAIGN FUND
P. O. Box 908
Livingston, LA 70754
04/01/2011Voided Check-Returned
Contribution-Sen. Dale Erdey
$500.00DAN MORRISH CAMPAIGN FUND
119 W. Nezpique St
Jennings, LA 70546
04/01/2011Voided Check-Returned
Contribution-Sen. Dan Morrish
$500.00NEIL RISER CAMPAIGN FUND
216 Main Street
Columbia, LA 71418
04/01/2011Voided Check-Returned
Contribution-Sen. Neil Riser
$1,000.00REP. CHARLES E KLECKLEY CAMPAIGN
FUND
130 Jamestown Rd
Lake Charles, LA 70605
04/01/2011Voided Check-Returned
Contribution-Rep. Charles
Kleckley
$250.00ROGERS POPE CAMPAIGN FUND
P. O. Box 555
Denham Springs, LA 70727
04/01/2011Voided Check-Returned
Contribution-Rep. Rogers Pope
5. Total OTHER RECEIPTS during this reporting periodForm 202, Rev. 3/98, Page Rev. 3/98
Page 21 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE A-3: OTHER RECEIPTS
This schedule is used to report those receipts that are not “contributions”; that is, monies received by the committee that are
not paid to it for the purpose of supporting, opposing or otherwise influencing the nomination or election of candidates to
public office or supporting or opposing propositions or questions submitted to the voters . Examples include interest or
investment income. Receipts should be reported on this schedule only if they have not been reported elsewhere in
this report. The explanation of the receipt should state the reason the payment was made to the committee.
1. Name and Address of Source 4. Amount3. Date2. Explanation
$250.00REGINA BARROW CAMPAIGN FUND
3552 Monterrey Drive
Baton Rouge, LA 70814
04/01/2011Voided Check-Returned
Contribution-Rep. Regina Barrow
$1,000.00JIM TUCKER CAMPAIGN FUND
732 Behrman Highway
Ste. C-2
Terrytown, LA 70056
04/01/2011Voided Check-Returned
Contribution-Rep. Jim Tucker
5. Total OTHER RECEIPTS during this reporting periodForm 202, Rev. 3/98, Page Rev. 3/98
$ 8,000.00
Page 22 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES
The following information must be provided for direct contributions made to candidates or their campaign committees, during
this reporting period, except for in-kind expenditures. All candidates listed on this schedule should also be listed on the
Cover Page in Item 5. Report all in-kind expenditures, including those made to candidates, on SCHEDULE E-2: IN-KIND
EXPENDITURES. Totals and subtotals at bottom of the page are optional. Completion of totals and subtotals may assist in
calculating totals that must be reported on the Summary Page.
1. Name and Address of Recipient Candidate
b. Amount(s)a. Date(s)
2. Contributions Made this Reporting Period
ALARIO PAC
1063 Muller Pkwy
Westwego, LA 70094
04/12/2011 $ 2,500.00
SHARON BROOME
P. O. Box 52783
Baton Rouge, LA 70810
04/12/2011 $ 2,000.00
JOEL CHAISSON
P. O. Box 1255
Destrahan, LA 70047
04/12/2011 $ 3,000.00
DALE ERDEY CAMPAIGN FUND
P. O. Box 908
Livingston, LA 70754
04/12/2011 $ 500.00
BUTCH GAUTREAUX CAMPAIGN FUND
1103 Eighth Street
Morgan City, LA 70380
04/12/2011 $ 500.00
VISION PAC
3501 Holiday Drive
Ste. 225
New Orleans, LA 70114
04/12/2011 $ 1,000.00
LYDIA JACKSON CAMPAIGN FUND
330 Marshall St.
Ste. 706
Shreveport, LA 71101
04/12/2011 $ 2,000.00
ERIC LAFLEUR CAMPAIGN FUND
P.O. Box 617
Ville Platte, LA 70586
04/12/2011 $ 2,000.00
4. TOTAL (optional - complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
3. SUBTOTAL (optional) $ 13,500.00
Page 23 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES
The following information must be provided for direct contributions made to candidates or their campaign committees, during
this reporting period, except for in-kind expenditures. All candidates listed on this schedule should also be listed on the
Cover Page in Item 5. Report all in-kind expenditures, including those made to candidates, on SCHEDULE E-2: IN-KIND
EXPENDITURES. Totals and subtotals at bottom of the page are optional. Completion of totals and subtotals may assist in
calculating totals that must be reported on the Summary Page.
1. Name and Address of Recipient Candidate
b. Amount(s)a. Date(s)
2. Contributions Made this Reporting Period
JOE MCPHERSON
880 Robinson Bridge Road
Woodworth, LA 71485
04/12/2011 $ 500.00
MIKE MICHOT
P.O. Box 80372
Lafayette, LA 70598
04/12/2011 $ 2,250.00
FRED H MILLS CAMPAIGN FUND, JR
1010 Martin Street
Parks, LA 70582
04/12/2011 $ 1,000.00
WILLIE L MOUNT CAMPAIGN FUND
P. O. Box 3004
Lake Charles, LA 70602
04/12/2011 $ 1,000.00
EDWIN R. MURRAY CAMPAIGN FUND
1540 North Broad Street
New Orleans, LA 70119
04/12/2011 $ 2,000.00
KAREN CARTER CAMPAIGN FUND
1215 Prytania Street
Ste. 364
New Orleans, LA 70130
04/12/2011 $ 2,000.00
MIKE WALSWORTH CAMPAIGN FUND
4007 White's Ferry Road
Ste. A
West Monroe, LA 71291
04/12/2011 $ 2,000.00
CYNTHIA WILLARD-LEWIS CAMPAIGN FUND
7500 Bullard Ave.
Ste. 102
New Orleans, LA 70128
04/12/2011 $ 250.00
4. TOTAL (optional - complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
3. SUBTOTAL (optional) $ 11,000.00
Page 24 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES
The following information must be provided for direct contributions made to candidates or their campaign committees, during
this reporting period, except for in-kind expenditures. All candidates listed on this schedule should also be listed on the
Cover Page in Item 5. Report all in-kind expenditures, including those made to candidates, on SCHEDULE E-2: IN-KIND
EXPENDITURES. Totals and subtotals at bottom of the page are optional. Completion of totals and subtotals may assist in
calculating totals that must be reported on the Summary Page.
1. Name and Address of Recipient Candidate
b. Amount(s)a. Date(s)
2. Contributions Made this Reporting Period
NEIL ABRAMSON CAMPAIGN FUND
365 Canal Street
Suite 2740
New Orleans, LA 70130
04/12/2011 $ 500.00
JAMES ARMES III CAMPAIGN FUND
2255 University Pkwy
Leesville, LA 71446
04/12/2011 $ 1,500.00
REGINA BARROW CAMPAIGN FUND
3552 Monterrey Drive
Baton Rouge, LA 70814
04/12/2011 $ 500.00
RICHARD BURFORD
671 Highway 171
Suite E
Stonewall, LA 71078
04/12/2011 $ 500.00
SIMONE CHAMPAGNE CAMPAIGN FUND
1407 Main Street
Jeanerette, LA 70544
04/12/2011 $ 1,500.00
CHARLES CHANEY CAMPAIGN FUND
P.O. box 8
Rayville, LA 71269
04/12/2011 $ 1,500.00
PATRICK CONNICK CAMPAIGN FUND
1335 Barataria Blvd.
Ste. B
Marrero, LA 70072
04/12/2011 $ 1,500.00
PATRICK CORTEZ CAMPAIGN FUND
1720 Kaliste Saloom Road
Ste. D-4
Lafayette, LA 70508
04/12/2011 $ 1,500.00
4. TOTAL (optional - complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
3. SUBTOTAL (optional) $ 9,000.00
Page 25 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES
The following information must be provided for direct contributions made to candidates or their campaign committees, during
this reporting period, except for in-kind expenditures. All candidates listed on this schedule should also be listed on the
Cover Page in Item 5. Report all in-kind expenditures, including those made to candidates, on SCHEDULE E-2: IN-KIND
EXPENDITURES. Totals and subtotals at bottom of the page are optional. Completion of totals and subtotals may assist in
calculating totals that must be reported on the Summary Page.
1. Name and Address of Recipient Candidate
b. Amount(s)a. Date(s)
2. Contributions Made this Reporting Period
JEAN DOERGE CAMPAIGN FUND
732 Main Street
Minden, LA 71055
04/12/2011 $ 500.00
NOBLE ELLINGTON
4272 Front Street
Winnsboro, LA 71295
04/12/2011 $ 1,500.00
JIM FANNIN CAMPAIGN FUND
320 6th Street
Jonesboro, LA 71251
04/12/2011 $ 1,000.00
BRETT GEYMANN CAMPAIGN FUND
P.O. Box 12703
Lake Charles, LA 70612
04/12/2011 $ 1,500.00
MICKEY GUILLORY CAMPAIGN FUND
P. O. Box 986
Eunice, LA 70535
04/12/2011 $ 2,500.00
JOE HARRISON CAMPAIGN FUND
P.O. Drawer 1809
Gray, LA 70359
04/12/2011 $ 1,500.00
LOWELL HAZEL CAMPAIGN FUND
1013 Main Street
Pineville, LA 71360
04/12/2011 $ 2,250.00
DOROTHY S HILL CAMPAIGN FUND
529 Tramel Road
Dry Creek, LA 70637
04/12/2011 $ 500.00
4. TOTAL (optional - complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
3. SUBTOTAL (optional) $ 11,250.00
Page 26 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES
The following information must be provided for direct contributions made to candidates or their campaign committees, during
this reporting period, except for in-kind expenditures. All candidates listed on this schedule should also be listed on the
Cover Page in Item 5. Report all in-kind expenditures, including those made to candidates, on SCHEDULE E-2: IN-KIND
EXPENDITURES. Totals and subtotals at bottom of the page are optional. Completion of totals and subtotals may assist in
calculating totals that must be reported on the Summary Page.
1. Name and Address of Recipient Candidate
b. Amount(s)a. Date(s)
2. Contributions Made this Reporting Period
ROBERT JOHNSON CAMPAIGN FUND
P. O. Box 467
Marksville, LA 71351
04/12/2011 $ 500.00
KAY K KATZ
207 C. Louisville Ave
Monroe, LA 71201 5823
04/12/2011 $ 500.00
JOHN LABRUZZO CAMPAIGN FUND
1427 Choctaw Ave
Metairie, LA 70005
04/12/2011 $ 500.00
EDDIE LAMBERT CAMPAIGN FUND
P.O. Box 241
Gonzales, LA 70707
04/12/2011 $ 1,500.00
BERNARD LEBAS CAMPAIGN FUND
115 Southwest Railroad Avenue
Ville Platte, LA 70586
04/12/2011 $ 2,250.00
WALT LEGER III CAMPAIGN FUND
600 Carondelet Street
9th Floor
New Orleans, LA 70130
04/12/2011 $ 1,500.00
ANTHONY LIGI JR. CAMPAIGN FUND
4425 Clearview Pkwy
Ste. B
Metairie, LA 70006
04/12/2011 $ 1,500.00
TOM MCVEA
PO Box 217
Jackson, LA 70748
04/12/2011 $ 1,500.00
4. TOTAL (optional - complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
3. SUBTOTAL (optional) $ 9,750.00
Page 27 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES
The following information must be provided for direct contributions made to candidates or their campaign committees, during
this reporting period, except for in-kind expenditures. All candidates listed on this schedule should also be listed on the
Cover Page in Item 5. Report all in-kind expenditures, including those made to candidates, on SCHEDULE E-2: IN-KIND
EXPENDITURES. Totals and subtotals at bottom of the page are optional. Completion of totals and subtotals may assist in
calculating totals that must be reported on the Summary Page.
1. Name and Address of Recipient Candidate
b. Amount(s)a. Date(s)
2. Contributions Made this Reporting Period
REP. NICKIE MONICA CAMPAIGN FUND
330 Belle Terre Blvd Ste. 101
LaPlace, LA 70068
04/12/2011 $ 500.00
JIM MORRIS CAMPAIGN FUND
P.O. Box 217
Oil City, LA 71061
04/12/2011 $ 1,500.00
KEVIN PEARSON CAMPAIGN FUND
1349 Corporate Square
Ste. 6
Slidell, LA 70458
04/12/2011 $ 500.00
ROGERS POPE CAMPAIGN FUND
P. O. Box 555
Denham Springs, LA 70727
04/12/2011 $ 1,000.00
SCOTT SIMON CAMPAIGN FUND
P. O. Box 1297
Abita Springs, LA 70420
04/12/2011 $ 2,500.00
MERT SMILEY CAMPAIGN FUND
18590 Highway 16
Ste. 5
Port Vincent, LA 70726
04/12/2011 $ 1,500.00
REP. GARY L. SMITH CAMPAIGN FUND
P. O. Box 189
Norco, LA 70079
04/12/2011 $ 1,500.00
REP. PATRICIA H. SMITH CAMPAIGN FUND
251 Florida Street Ste. 300
Baton Rouge, LA 70801
04/12/2011 $ 1,500.00
4. TOTAL (optional - complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
3. SUBTOTAL (optional) $ 10,500.00
Page 28 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE E-3: CONTRIBUTIONS MADE TO CANDIDATES
The following information must be provided for direct contributions made to candidates or their campaign committees, during
this reporting period, except for in-kind expenditures. All candidates listed on this schedule should also be listed on the
Cover Page in Item 5. Report all in-kind expenditures, including those made to candidates, on SCHEDULE E-2: IN-KIND
EXPENDITURES. Totals and subtotals at bottom of the page are optional. Completion of totals and subtotals may assist in
calculating totals that must be reported on the Summary Page.
1. Name and Address of Recipient Candidate
b. Amount(s)a. Date(s)
2. Contributions Made this Reporting Period
CHARMAINE STIAES CAMPAIGN FUND
4030 St. Claude Avenue
New Orleans, LA 70117
04/12/2011 $ 1,500.00
REP. MACK WHITE CAMPAIGN FUND
35055 LA Highway 16 Ste. 2A
Denham Springs, LA 70706
04/12/2011 $ 1,500.00
REP. PATRICK WILLIAMS CAMPAIGN FUND
609 Texas Street
1st Floor
Shreveport, LA 71101
04/12/2011 $ 1,500.00
REP. THOMAS WILMOTT CAMPAIGN FUND
2002 20th Street
Ste. 204A
Kenner, LA 70062
04/12/2011 $ 1,000.00
4. TOTAL (optional - complete only on last page of this schedule)
Form 202, Rev. 3/98, Page Rev. 3/98
3. SUBTOTAL (optional)
$ 70,500.00
$ 5,500.00
Page 29 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE
SCHEDULE E-4: OTHER DISBURSEMENTS
This schedule is used to report those disbursements that are not “expenditures”; that is, monies paid by the committee that
are not paid for the purpose of supporting, opposing or otherwise influencing the nomination or election of a candidate to
public office or supporting or opposing a proposition or question submitted to the voters . Examples include the payment of
taxes or the refund of contributions. Disbursements should be reported on this schedule only if they have not been reported
elsewhere in this report. The explanation of the disbursement should state the reason the payment was made by the
committee.
1. Name and Address of Recipient 4. Amount2. Date 3. Explanation
DAMON DIMARCO
309 Gretna Blvd
Gretna, LA 70053
04/29/2011 Overpayment $ 3.00
DR CECIL C GADDIS
P. O. Box 891
Jena, LA 71342
04/29/2011 Refunded Contribution $ 71.00
MITCHELL THERIOT
102 Mystic Blvd
Houma, LA 70360
04/29/2011 Refunded Contribution $ 71.00
CAMPUS FEDERAL CREDIT UNION
P. O. Box 98036
Baton Rouge, LA 70898
04/29/2011 Service Charge $ 26.88
5. Total OTHER DISBURSEMENTS during this reporting periodForm 202, Rev. 3/98, Page Rev. 3/98
$ 171.88
Page 30 of 30 23831Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE