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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 Telephone Signature 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 23831 Report Number LOUISIANA DENTAL POLITICAL ACTION COMMITTEE

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Page 1: a. Name b. Position c. Addressethics.la.gov/CampaignFinanceSearch/LA-23831.pdf · CURTIS ZERINGUE Officer P. O. Drawer E Mathews, LA 70630 Report Number 23831 Page 2 of 30 LOUISIANA

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

Page 2: a. Name b. Position c. Addressethics.la.gov/CampaignFinanceSearch/LA-23831.pdf · CURTIS ZERINGUE Officer P. O. Drawer E Mathews, LA 70630 Report Number 23831 Page 2 of 30 LOUISIANA

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

Page 3: a. Name b. Position c. Addressethics.la.gov/CampaignFinanceSearch/LA-23831.pdf · CURTIS ZERINGUE Officer P. O. Drawer E Mathews, LA 70630 Report Number 23831 Page 2 of 30 LOUISIANA

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

Page 4: a. Name b. Position c. Addressethics.la.gov/CampaignFinanceSearch/LA-23831.pdf · CURTIS ZERINGUE Officer P. O. Drawer E Mathews, LA 70630 Report Number 23831 Page 2 of 30 LOUISIANA

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

Page 5: a. Name b. Position c. Addressethics.la.gov/CampaignFinanceSearch/LA-23831.pdf · CURTIS ZERINGUE Officer P. O. Drawer E Mathews, LA 70630 Report Number 23831 Page 2 of 30 LOUISIANA

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

Page 6: a. Name b. Position c. Addressethics.la.gov/CampaignFinanceSearch/LA-23831.pdf · CURTIS ZERINGUE Officer P. O. Drawer E Mathews, LA 70630 Report Number 23831 Page 2 of 30 LOUISIANA

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

Page 7: a. Name b. Position c. Addressethics.la.gov/CampaignFinanceSearch/LA-23831.pdf · CURTIS ZERINGUE Officer P. O. Drawer E Mathews, LA 70630 Report Number 23831 Page 2 of 30 LOUISIANA

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

Page 8: a. Name b. Position c. Addressethics.la.gov/CampaignFinanceSearch/LA-23831.pdf · CURTIS ZERINGUE Officer P. O. Drawer E Mathews, LA 70630 Report Number 23831 Page 2 of 30 LOUISIANA

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

Page 9: a. Name b. Position c. Addressethics.la.gov/CampaignFinanceSearch/LA-23831.pdf · CURTIS ZERINGUE Officer P. O. Drawer E Mathews, LA 70630 Report Number 23831 Page 2 of 30 LOUISIANA

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

Page 10: a. Name b. Position c. Addressethics.la.gov/CampaignFinanceSearch/LA-23831.pdf · CURTIS ZERINGUE Officer P. O. Drawer E Mathews, LA 70630 Report Number 23831 Page 2 of 30 LOUISIANA

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

Page 11: a. Name b. Position c. Addressethics.la.gov/CampaignFinanceSearch/LA-23831.pdf · CURTIS ZERINGUE Officer P. O. Drawer E Mathews, LA 70630 Report Number 23831 Page 2 of 30 LOUISIANA

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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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