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KANSAS GOVERNMENTAL ETHICS COMMISSION
RECEIPTS AND EXPENDITURES REPORT OF A CANDIDATE FOR STATE OFFICE
January 10,2017
FILE WITH SECRETARY OF STATE SEE REVERSE SIDE FOR INSTRUCTIONS
FILED
JAN 09 Lbll
KRIS W. KOBACH SECRETARY OF STATE
A. Name of Candidate: t?-IVI m ; c (lNl"-s{--O).....
Address: 7 ho/'I. {0yC Lv)'\. ,H",'r"t S )v
City and Zip Code: Wj e-it.x.../ Co "7 :,2../ ~
Office Sought: I(C"10UY g="1?{'.es-e.ctW(';~
County: S-et~.r--W" vic. IJ
District: Ie 5---'-----
B. Check only if appropriate: __ Amended Filing Termination Report
C. Summary (covering the period from October 28,2016 through December 31, 2016)
1. Cash on hand at begilming of period .. b/~1 r C;'lf
2. Total Contributions and Other Receipts (Use Schedule A) .. '7/:h,0 0
3. Cash available this period (Add Lines 1 and 2) .. bgb3/11~
4. Total Expenditures and Other Disbursements (Use Schedule C) . 4.hS:;t,qg 5. Cash on hand at close of period (Subtract Line 4 from 3) . ')6/ fJ ,<flo
6. In-Kind Contributions (Use Schedule B) {)
7. Other Transactions (Use Schedule D) 0
D. "I declare that this report, including any accompanying schedules and statements, has been examined by me and to the best of my knowledge and belief is hue, conect and complete. I understand that the intentional failure to file this document or intentionally filing a false document is a class A misdemeanor."
GEe Form Rev, 2016
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
(} 4,1'\1\ I'YI I
,ec' 014~ S f-uJ-.-<
(Name of Candidate)
Date
)1-5"I~
11--!5 ,.-Ib
i/-5If.:;
11-5--Ik
1'O-l'6 -
110
j) -5--(b
Name and Address of Contributor
K1n n{.5 Ph'\!! 't's sf" 7~ cJ 'is iG,'y~< 1/; ~w
lvi u:v:t c (P 1 ;). ~ :~
f)etLl"Ylc:;.... 21'-#<..1 Ko f t-f{l7- tJ ~.!"'e ~
LJid'tL ..... &7,2.0 ""
JwL:n.. fr,' 01' i
I '" ~~-t S~h,r,ltlse. C:-v {.Ji tHI 7'1 1'71.2"3 v
Cto e. ~ IS, 6i ~ I'I:-,t.J-J+t<e '" , fyO (~''1''~ 0 0 I
th\ ~l-u.,... IOi);} §COZ.I
' v W'nl~c'i1i e. ;£'1 v.: 1f/7 N ..s-h"eer....... l.ff~ He~+m ... ks 'i7vb'J,..
.2. (:; Ctdv d-<h~~s '1 :t.2 ~
Occupation of Individual Giving More
Than $150
j}ttOYl1~1
r~+AJ..
Cosh
v""
Check Appropriate Box
Check Loan E funds Other
V
v"
,/'
( v
V
Amount of Cash, Check,
Loan or Other Receipt ,
:152J
51)
5D
jS-O
5"0
5:l
Subtotal This Page 7C~
Complete if last page of Schedule A
Total Itemized Receipts for Period r;O~
Total Unitemized Contributions ($50 or less) JO Sale of Political Materials (Unitemized) 0 Total Contributions When Contributor Not Known 0
TOTAL RECEIPTS TillS PERIOD (to line 2 of Summary) '11l- I OD
Page J-- of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
(;4-1"1 111" ~ f~/,M1. s.hn. (Name of Candidate)
Date
II-l;10
i o,/y/) 1,~3li)
12-~\
11-J1rip
1(J - :)/
,~
j2-lS;
lip
Name and Address
cS,""o l(tj ~Il' II s ,St-v.-J-1!.-8/e s 8'01) ,fJ ,trj"y" k.~t"" IAJ ~_f.,..,j:(- i~':'" &7'.1..i Lf , , -
,L-LI~ "'6 ~~; ~'- .C('-€J.:,;;(
'/1/ W OJ) \.tJ'/{(.50 {;:J i C~ 0 7:l u
C. ~ \<. YY'le~(1., (('0\,""1"-iM- C,.. .s-'~l ~:.)
131 t.L w gg >tv 6t"" ji: I b"'7
l-el1e)L< K~ l.,f.,;;.i;
n~ 1"'-0 ~"c1-er :~\, 3;\t)~ _.5$1) Q £.I. ~ Y\ ~ ;;n- fIJ IN -;f 1./ u)..
L.J [_ s1"")/1,;,. ,fh.-,I L? t 1.vC I \
/} S ?s v
LJ #'-<Y~7117 U); u~t.- k<; b7'J..<:tb
~
Purpose of Expenditure or Disbursement
CC:"f\ Ve-.s~ i' 6;'OTV
bc,,","'z.. -fees
fJ..1,L ?~~~ ,J
'~
~"o..J-V\i> oS
Cl'\ (J~ L.--,0;"y: &-wh.~
/fJ&rII\'u· .,
-:tee.
-s:---+-a:,~ s;.,.. cyeeit.5 0'~S
Amount
I tOO, DD )
lfj";f;O
3J 'vO I C/O,
3,1'7
/ ').9-.. w
Subtotal This Page tf-)Lf3.9f
Complete if last page of Schedule c
Total Itemized Expenditures This Period iJ-1- VJJ ~I Total Unitemized Expenditures of$50 or less q, bf TOTAL EXPENDITURES & OTHER DISBURSEMENTS TillS PERIOD (to line 2 of Summary) 4).5),,1r J
PageS ot.!.)__