COMMITTEE IDENTIFICATION Name of Committee CAMPAIGN FINANCE REPORT WISCONSIN LOCAL COMMITTEE Is this report an Amendment? n Yes Anna for Dane Address P.O. Box 6094 City, State, ZIP Monona, WI, 53716 OFFICE USE ONLY Please check if address is different than previously reported NAME OF REPORT July 2018 Continuing Pre-election 2018 September 2018 Continuing Spring (X) SUMMARY OF RECEIPTS AND DISBURSEMENTS Column A Column B Audited Totals 1. RECEIPTS This Period YTD Office Use Only A. Contributions including Loans from Individuals $ 297.23 $ 2,381.00 B. Contributions from Committees (Transfers-In) $ - C. Other Income and Commercial Loans $ - TOTAL RECEIPTS (Add totals from 1A, 1B, and 1C) $ 297.23 $ 2,381.00 2. DISBURSEMENTS A. Gross Expenditures $ 1,648.19 $ 1,548.30 B. Contributions to Committees (Transfers-Out) $ - TOTAL DISBURSEMENTS (Add totals from 2A and 2B) $ 1,648.19 $ 1,548.30 CASH SUMMARY Cash Balance at Beginning of Report $ 1,044.00 Total Receipts $ 297.23 2,381 Subtotal $ 1,341.23 2381 Total Disbursements $ 1,648.19 1548 CASH BALANCE AT END OF REPORT $ (306.96) 832.7 INCURRED OBLIGATIONS (at close of period) $ - LOANS (at close of period) $ - I certify that I have examined this report and to the best of my knowledge and belief it is true, correct and complete. Type or Print Name of Candidate or Treasurer Signature of Candidate or Treasurer Date 7/19/2018 Anna Gouker Email: anna@annafordane.com Daytime Phone (608) 852-3971 NOTE: The information on this form is required by ss. 11.0204, 11.0304, 11.0404, 11.0504, 11.0604, 11.0804, 11.0904, Wis. Stats. Failure to provide the information may subject you to the penalties of ss.11.1400, 11.1401, Wis. Stats. Print the completed report and file with your local clerk or election commission by the filing deadline. ETHCF-2LE (01/16)
SCHEDULE 1-A Contributions Including Loans from Individuals IN-KIND CONDUIT DATE LAST FIRST ADDRESS CITY ST ZIP OCCUPATION AMOUNT YTD COMMENTS 03/23/18 Derge Ellen 137 Reynolds St Cottage Grove WI 53527 social worker $ 20.00 $ 20.00 03/23/18 Smulian Elizabeth 329b E Lincoln Ave. Milwaukee WI 53207 grants manager $ 20.00 $ 20.00 03/29/18 Marquardt Kaitlin 609 E Gorham St Apt 102 Madison WI 53703 software engineer $ 50.00 $50 05/24/18 Gouker Anna 123 Shato Ln Monona WI 53716 writer loan from $ 67.23 $ 67.23 candidate loan from 05/29/18 Gouker Anna 123 Shato Ln Monona WI 53716 writer $ 140.00 $ 207.23 candidate
SCHEDULE 1-B Contributions from Committees IN- KIND DATE COMMITTEE NAME Ethics ID# ADDRESS CITY ST ZIP AMOUNT YTD COMMENTS
SCHEDULE 1-C Other Income and Commercial Loans DATE NAME ADDRESS CITY ST ZIP REASON FOR INCOME AMOUNT COMMENTS
SCHEDULE 2-A Gross Expenditures IN-KIND DATE NAME ADDRESS CITY ST ZIP PURPOSE AMOUNT COMMENTS 03/21/18 Staples 6580 Monona Dr Monona Wisconsin 53716 office supplies $ 72.57 03/21/18 NGP VAN 1445 New York Ave. NW, Suite 200 Washington DC 20005 robo calls $ 67.25 03/22/18 Wells Print & Digital Services 3121 Watford Way Madison Wisconsin 53713 door cards $ 520.21 03/23/18 Fundrazr 200-171 Water Street Vancouver BC Canada V6B 1A7 Service Fee $ 1.88 03/23/18 Fundrazr 200-171 Water Street Vancouver BC Canada V6B 1A7 Service Fee $ 1.88 03/29/18 Fundrazr 200-171 Water Street Vancouver BC Canada V6B 1A7 Service Fee $ 4.25 03/31/18 USPS 112 Owen Road Monona Wisconsin 53716 PO box renewal fee $ 28.00 03/31/18 Verizon Wireless 140 West St New York New York 10013 campaign phone renewal $ 32.03 03/31/18 Facebook 1 Hacker Way Menlo Park California 94025 campaign ads $ 34.74 03/31/18 Facebook 1 Hacker Way Menlo Park California 94025 campaign ads $ 151.36 03/31/18 NGP VAN 1445 New York Ave. NW, Suite 200 Washington DC 20005 robo calls $ 64.68 03/31/18 UW Credit Union 3500 University Ave Madison Wisconsin 53705 paper statement fee $ 3.00 04/02/18 Wix 235 W 23rd St New York New York 10011 website maintenance fee $ 15.95 04/03/18 Facebook 1 Hacker Way Menlo Park California 94025 campaign ads $ 26.94 04/03/18 Facebook 1 Hacker Way Menlo Park California 94025 campaign ads $ 223.06 04/10/18 Knotty Tie Company 989 Santa Fe Dr Denver Colorado 80204 volunteer thank-you gift $ 43.00 04/10/18 Lands' End 1 Lands End Lane Dodgeville Wisconsin 53733 volunteer thank-you gift $ 48.30 Sarah Lyngdal - beauty 04/10/18 consultant 1128 Erin St Apt 3 Madison Wisconsin 53715 volunteer thank-you gift $ 30.00 04/30/18 Facebook 1 Hacker Way Menlo Park California 94025 campaign ads $ 37.61 04/30/18 UW Credit Union 3500 University Ave Madison Wisconsin 53705 paper statement fee $ 3.00 05/04/18 Wix 235 W 23rd St New York New York 10011 website maintenance fee $ 15.95 05/08/18 Facebook 1 Hacker Way Menlo Park California 94025 campaign ads $ 8.49 05/29/18 Facebook 1 Hacker Way Menlo Park California 94025 campaign ads $ 192.09 05/31/18 UW Credit Union 3500 University Ave Madison Wisconsin 53705 paper statement fee $ 3.00 06/04/18 Wix 235 W 23rd St New York New York 10011 website maintenance fee $ 15.95 06/30/18 UW Credit Union 3500 University Ave Madison Wisconsin 53705 paper statement fee $ 3.00