Kelsey Johnson Pre General

Campaign Finance &
Public Disclosure Board

First Floor South . Centennial Office Building . 658 Cedar Street . St. Paul MN 55155-1603 . 800/657-3889 . TTY 800/657-3529
Report of Receipts and Expenditures

for Principal Campaign Committee
Period Covered: 8/24/2015 through 11/24/2015
Committee Information:
Registration number:
17875
Committee name:
Kelsey (Johnson) 4 MN House VC
Candidate name:
Johnson, Kelsey
Office and District:
House District: 3A
Treasurer name:
Johnson, Kelsey
Treasurer address:
4206 Turner Rd
Gnesen Twp MN 55803
Received by the Board December 1, 2015
Special Report Indicators
No change since
last report
The committee received no contributions and made

no expenditures during the reporting period.
Previous Report Cash Balance:
Current Cash Balance:
Amendment
This report amends a previously filed report for the same period.
Termination
The committee has settled all its debts, disposed of all its assets in excess of $100 and
dissolved.
Report of Receipts and Expenditures

CF Reporter Version 2.4.3
Printed December 1, 2015

Service Pack 24
Page 1 of 1
Committee Transaction Summary

Johnson, Kelsey House Dist. 3A Committee
Reg Num 17875
Principal Campaign Committee
Beginning cash balance 8/24/2015 (should be the same

as the previous year ending cash balance)
Receipts
Individual contributions
3
4
0.00
Cash
In-Kind
Total
Sch. A1 - IND
12,800.00
1,400.00
14,200.00
Lobbyist contributions
Sch. A1 - LOB
4,210.00
0.00
4,210.00
Political committee and political fund

contributions
Sch. A1 - PCF
1,500.00
0.00
1,500.00
Political party & terminating principal

campaign committee contributions
Sch. A1 - PTY/
TERM PCC
Other contributions
Sch. A1 - OTH
Public Subsidy Payment
Sch. A1 - PS
Receipts from loans payable
Sch. A2 - LP
Miscellaneous income
Sch. A2 - MISC
10
Total Receipts
Sum #2 to #9
18,510.00
1,400.00
19,910.00
Disbursements
11
Campaign expenditures
Sch. B1 - CE
12
State ballot question expenditures (Not

local referendums)
Sch. B1 - BQ
13
Total Campaign Expenditures
Sum #11 to #12
14
Non-campaign disbursements
Sch. B1 - NCD
15
Contributions to other principal

campaign committees
Sch. B2 - PCC
16
Contributions to political parties
Sch. B2 - PTY
17
Contributions to political committees

and political funds
Sch. B2 - PCF
18
Other disbursements
Sch. B3
19
Total Expenditures and Disbursements
#13 to #18
20
Ending cash balance on 11/24/2015
#1 + #10 - #19
21A
Total Outstanding balance of all loans incurred during the current year
21B
Total outstanding balance of all loans incurred during any year prior to the reporting year Sch. C
21C
Total Outstanding balance of all loans
Sum #21A + #21B
22A
Total unpaid obligations incurred during the current year
Line 19
22B
Total unpaid obligations incurred during any year prior to the reporting year
Sch. D
22C
Total unpaid obligations
Sum #22A + #22B
23
Total debt of committee
Sum #21C + #22C
Cash
Unpaid Bills
In-Kind
Total
13,424.08
0.00
0.00
13,424.08
13,424.08
0.00
0.00
13,424.08
188.31
0.00
1,400.00
1,588.31
13,612.39
0.00
1,400.00
15,012.39
4,897.61
Loans and Unpaid Obligations Summary

Sch. A2-LP
Certification
I certify that this report is complete, true and correct.
Kelsey Johnson
Signature of Candidate, Treasurer, or Deputy Treasurer
December 1, 2015
Date
Certified Electronically By Valid Person

Any person who signs and certifies to be true a report or statement which the person knows contains false information, or who knowingly omits
required information, is subject to a civil penalty imposed by the Board of up to $3,000 and is subject to criminal prosecution for a gross misdemeanor.
Committee Transaction Summary


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Schedule A1-IND
Individual Contributions Received

Reg Num 17875
Abram, Jon
2300 Willow Lane S St. Louis Park, MN 55416
Employer: Dorsey Whitney
Date
11/03/15
Cash
250.00
In Kind
0.00
Total
250.00
Bonoff, Terri
3325 E Eldorado Trail Minnetonka, MN 55305
Employer: Self
Date
09/02/15
Cash
1,000.00
In Kind
0.00
Total
1,000.00
Cash
250.00
In Kind
0.00
Total
250.00
Cash
0.00
In Kind
600.00
Total
600.00
Larson, Cheryl
4206 Turner Rd Gnesen Twp, MN 55803
Employer: Self
Date
09/02/15
Cash
500.00
In Kind
0.00
Total
500.00
Lundquist, Rick
6679 Schultz Lake Rd Duluth, MN 55803
Self-employed self
Date
10/24/15 In Kind: Fundraising Food
Cash
0.00
In Kind
300.00
Total
300.00
Mihas, Tracy
2722 N Yucatan St Arlington, VA 22213
Employer: Mondelez Corp
Date
10/03/15
Cash
500.00
In Kind
0.00
Total
500.00
Newcomer, Kristine
14204 Windsor Road Minnetonka, MN 55345
Employer: Self
Date
09/09/15
Cash
250.00
In Kind
0.00
Total
250.00
Norris, George
4299 Crescent Dr Duluth, MN 55803
Self-employed Radiologic Association
Date
10/24/15
Cash
250.00
In Kind
0.00
Total
250.00
Rosenbaum, Bob
1920 Iving Ave S Minneapolis, MN 55403
Employer: Dorsey Whitney
Date
11/03/15
Cash
250.00
In Kind
0.00
Total
250.00
Dachis, Gary
16900 Cedarhurst St Wayzata, MN 55391
Employer: Self
Date
11/06/15
Knopf, Matthew
3325 E Eldorado Trl Minnetonka, MN 55305
Employer: Delta Airlines
Date
11/03/15 In Kind: Food for fundraiser
Schedule A1-IND Individual Contributions Received


Service Pack 24
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Rutzick, Ryan
3564 Shady Oak Dr Minnetonka, MN 55305
Self-employed ALL Inc.
Date
10/15/15
10/15/15 In Kind: Food for fundraiser
Cash
500.00
0.00
500.00
In Kind
0.00
500.00
500.00
Total
500.00
500.00
1,000.00
Shermoen, Matt
426 Shorewood Drive International Falls, MN 56649
Employer: Self Employed
Date
10/01/15
Cash
250.00
In Kind
0.00
Total
250.00
Stanoch, Tammy
3300 Hazelwood W Wayzata, MN 55391
Employer: Carlson Company
Date
11/03/15
Cash
250.00
In Kind
0.00
Total
250.00
Tan, Francis
22 Lundy Lane Wayland, MA 01778
Employer: Thermo Fisher Scientific Inc.
Date
09/15/15
Cash
500.00
In Kind
0.00
Total
500.00
Volin Lehr, Natalie

67 Otis Ave St Paul, MN 55104
Employer: Carolson Rezidor Hotel Group
Date
11/03/15
Cash
250.00
In Kind
0.00
Total
250.00
Cash
In Kind
Total
Total of itemized
5,000.00
1,400.00
6,400.00
Total of non-itemized
7,800.00
0.00
7,800.00
Cash
In Kind
Total
Totals
12,800.00
1,400.00
14,200.00
Total
Schedule A1-IND
Individual Contributions Received
Schedule A1-IND Individual Contributions Received


Service Pack 24
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Schedule A1-LB
Lobbyist Contributions Received

Reg Num 17875
Crosson, Joshua (Registered Id: 3141)

50 CAN dba MinnCAN 2800 University Ave SE Ste 202 Minneapolis, MN 55414
Employer: MinnCAN
Date
Cash
09/20/15
250.00
Schedule A1-LB
In Kind
0.00
Total
250.00
Cash
In Kind
Total
Total of itemized
250.00
0.00
250.00
3,960.00
0.00
3,960.00
Cash
In Kind
Total
Totals
4,210.00
0.00
4,210.00
Lobbyist Contributions Received
Schedule A1-LB Lobbyist Contributions Received


Service Pack 24
Page 1 of 1
Schedule A1-PCF
Political Committee/Fund Contributions Received

Reg Num 17875
Northwest Petroleum NPPAC (Registered Id: 40069)

3244 Rice St St Paul, MN 55126-3047
Date
11/02/15
Cash
500.00
In Kind
0.00
Total
500.00
Cash
1,000.00
In Kind
0.00
Total
1,000.00
Cash
In Kind
Total
Total of itemized
1,500.00
0.00
1,500.00
0.00
0.00
0.00
Cash
In Kind
Total
1,500.00
0.00
1,500.00
womenwinning State PAC (Registered Id: 40268)

2610 University Ave W Ste 325 St Paul, MN 55114
Date
11/03/15
Schedule A1-PCF
Political Committee/Fund Contributions Received
Totals
Schedule A1-PCF Political Committee/Fund Contributions Received

Service Pack 24

Page 1 of 1
Schedule B1-CE
Campaign Expenditures

Reg Num 17875
Vendor: Allegra Print

7141 Shady Ok Rd
Eden Prairie, MN 55344
Date
Specific purpose of expenditure
09/28/15
Advertising - Print: Printing
Paid
Unpaid
In Kind
Total
773.86
0.00
0.00
773.86
Vendor: Cook County News

15 1st Ave W
Grand Marais, MN 55604
Date
11/05/15
11/12/15
Advertising - Print: Subscription and Print Ad

Advertising - Print: Print Ads
Vendor Total: Cook County News
Paid
Unpaid
In Kind
Total
197.25
615.25
812.50
0.00
0.00
0.00
0.00
0.00
0.00
197.25
615.25
812.50
Vendor: Denney, Eric

6696 Bergstrom Rd
Duluth, MN 55803
Date
10/24/15
Public Relations/ Fundraising Service:

Consultant
Consulting
Vendor Total: Denney, Eric
11/16/15
Paid
Unpaid
In Kind
Total
400.00
0.00
0.00
400.00
100.00
0.00
0.00
100.00
500.00
0.00
0.00
500.00
Paid
Unpaid
In Kind
Total
854.70
0.00
0.00
854.70
Paid
Unpaid
In Kind
Total
529.30
0.00
0.00
529.30
Paid
Unpaid
In Kind
Total
407.00
0.00
0.00
407.00
Vendor: Duluth News Tribune

424 W First St
Duluth, MN 55802
Date
11/12/15
Vendor: Ely Echo

15 E Chapman St
Ely, MN 55731
Date
11/12/15
Vendor: Lynette's Portrait Design

102 S 21st Ave W
Duluth, MN 55806
Date
10/26/15

Photography Consulting
Schedule B1-CE Campaign Expenditures


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Page 1 of 2
Vendor: North Star Interactive

1602 US-71
International Falls, MN 56649
Date
10/01/15
10/09/15
10/23/15
10/27/15
11/12/15

Advertising - Print: Direct Mail
Advertising - Print: Lit Design
Advertising - Print: Print
Vendor Total: North Star Interactive
Paid
Unpaid
In Kind
Total
1,450.00
566.00
4,835.11
96.00
422.91
7,370.02
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1,450.00
566.00
4,835.11
96.00
422.91
7,370.02
Vendor: Tower News

510 Main St
Tower, MN 55790
Date
11/13/15
Paid
Unpaid
In Kind
Total
378.00
0.00
0.00
378.00
Vendor: Whitepages.com
1301 5th Ave
Suite 1600
Seattle, WA 98101
Date
09/15/15
Mailing / Voter List Rent/Purchase: Address

List Lookup
Mailing / Voter List Rent/Purchase: Mail list
Mailing / Voter List Rent/Purchase: Mailing List
Vendor Total: Whitepages.com
09/15/15
10/15/15
Schedule B1-CE
Paid
Unpaid
In Kind
Total
99.00
0.00
0.00
99.00
99.00
99.00
297.00
0.00
0.00
0.00
0.00
0.00
0.00
99.00
99.00
297.00
Inkind
Total
Campaign Expenditures
Paid
Unpaid
Total of itemized:
11,922.38
0.00
0.00
11,922.38
Total of non-itemized:
1,501.70
0.00
0.00
1,501.70
Totals:
13,424.08
Paid
Schedule B1-CE Campaign Expenditures

Unpaid
0.00
Inkind
Total
0.00
13,424.08

Service Pack 24
Page 2 of 2
Schedule B1-NCD
Noncampaign Disbursements

Reg Num 17875
Vendor: Knopf, Matthew

3325 E Eldorado Trl
Minnetonka, MN 55305
Date
Paid
Unpaid
In Kind
Total
11/03/15
Food, beverages for fundraising event:

Fundraising Food
In Kind: Food for fundraiser
0.00
0.00
600.00
600.00
Vendor: Lundquist, Rick

6679 Schultz Lake Rd
Duluth, MN 55803
Date
Paid
Unpaid
In Kind
Total
10/24/15

Fundraising Food
In Kind: Fundraising Food
0.00
0.00
300.00
300.00
Vendor: Rutzick, Ryan

3564 Shady Oak Dr
Minnetonka, MN 55305
Date
Paid
Unpaid
In Kind
Total
10/15/15

Fundraiser food
In Kind: Food for fundraiser
0.00
0.00
500.00
500.00
Inkind
Total
Schedule B1-NCD
Noncampaign Disbursements
Paid
Unpaid
Total of itemized:
0.00
0.00
1,400.00
1,400.00
Total of non-itemized:
188.31
0.00
0.00
188.31
Inkind
Total
1,400.00
1,588.31
Paid
Totals:
Schedule B1-NCD Noncampaign Disbursements

188.31
Unpaid
0.00

Service Pack 24
Page 1 of 1

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Campaign Finance &

Public Disclosure Board

Report of Receipts and Expenditures

Kelsey (Johnson) 4 MN House VC

Office and District:

Received by the Board December 1, 2015

Special Report Indicators

The committee received no contributions and made

Report of Receipts and Expenditures

Printed December 1, 2015

Committee Transaction Summary

Principal Campaign Committee

Beginning cash balance 8/24/2015 (should be the same

Political committee and political fund

Political party & terminating principal

Public Subsidy Payment

Receipts from loans payable

State ballot question expenditures (Not

Total Campaign Expenditures

Sum #11 to #12

Contributions to other principal

Contributions to political parties

Contributions to political committees

Total Expenditures and Disbursements

Ending cash balance on 11/24/2015

Total Outstanding balance of all loans

Sum #21A + #21B

Total unpaid obligations incurred during the current year

Total unpaid obligations

Sum #22A + #22B

Total debt of committee

Sum #21C + #22C

Loans and Unpaid Obligations Summary

Certified Electronically By Valid Person

Committee Transaction Summary

Printed December 1, 2015

Individual Contributions Received

Johnson, Kelsey House Dist. 3A Committee

Principal Campaign Committee

Schedule A1-IND Individual Contributions Received

Printed December 1, 2015

Volin Lehr, Natalie

Individual Contributions Received

Schedule A1-IND Individual Contributions Received

Printed December 1, 2015

Lobbyist Contributions Received

Johnson, Kelsey House Dist. 3A Committee

Principal Campaign Committee

Crosson, Joshua (Registered Id: 3141)

Lobbyist Contributions Received

Schedule A1-LB Lobbyist Contributions Received

Printed December 1, 2015

Political Committee/Fund Contributions Received

Johnson, Kelsey House Dist. 3A Committee

Principal Campaign Committee

Northwest Petroleum NPPAC (Registered Id: 40069)

womenwinning State PAC (Registered Id: 40268)

Political Committee/Fund Contributions Received

Schedule A1-PCF Political Committee/Fund Contributions Received

Printed December 1, 2015

Johnson, Kelsey House Dist. 3A Committee

Principal Campaign Committee

Vendor: Allegra Print