Campaign Finance Receipts and Expenditures Report Poage 1 f 1

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Campaign Finance Receipts Governmental Ethics Commission & Expenditures Report 109 W. 9th, Suite 504 Topeka, KS 66612 October 27 2014 Phone (785) 296-4219 Fax (785) 296-2548 www.kansas.gov/ethics

Check only if appropriate D Amended Filing D Termination Report Campaign Finance Organization Name: Security Benefit Life Insurance PAC Filing Report Address: 1 Security Benefit Place Address2: City: Topeka Zip: Chairperson Home Phone: Chairperson Business Phone: (785) 438-3362 D Party Committee [y;j PAC SUMMARY (covering the period from July 25 2014 through October 23 2014) 1 CASH ON HAND AT BEGINNING OF PERIOD $1,711.66 2 TOTAL CONTRIBUTIONS AND OTHER RECEIPTS (Schedule A) view/print $14,744.00 3 CASH AVAILABLE THIS PERIOD (Add Lines 1 and 2) $16,455.66 4 TOTAL EXPENDITURES AND OTHER DISBURSEMENTS (Schedule C) view/print $9,000.00 5 CASH ON HAND AT CLOSE OF PERIOD Subtract Line 4 from 3) $7,455.66 6 IN-KIND (NON-MONETARY) CONTRIBUTIONS (Schedule B) view/print $0.00 7 OTHER TRANSACTIONS (Schedule D) view/print $0.00 "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 true, correct and complete. I understand that the intentional fa ilure to file this document or intentionally filing a false document is a class A misdemeanor." Electronically filed on : 10/24/20141 :49:55 PM Signature of Treasurer: Kevin R. Davis

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http://www.kssos.org/elections/cfr_v iewer/reports/exp _report_ main.aspx 10/26/2014 Campaign Finance Schedule A Report Page 1 of 1

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SCHEDULE A

CONTRIBUTIONS AND OTHER RECEIPTS

Committee: Security Benefit Life Insurance PAC Occupation And Type of Payment Name and Address Industry of Individual Date Amount of Contributor Cash, Check, Loan, Other Giving More Than $150 David Keith Senior Vice 10/23/14 PO Box 146 Other President Finance and $75.00 Maple Hill KS 66507 Insurance George Kelly 10/23/14 29 Canterbury Rd. Other RVP Wholesaler $150.00 Denville NJ 7834 Daniel Pieper Programmer Analyst 10/23/14 6900 W. 1OOth Terr Other $75.00 IV Finance and Insurance Overland Park KS 66212 James Schmank Vice President Finance 10/23/14 5801 SW Turnberry CT Other $75.00 and Insurance Topeka KS 66614 Anne Trebino Senior Vice 10/23/14 1007 New Boston CT Other President Finance and $60.00 Lawrence KS 66049 Insurance Kevin Watt Vice President Finance 10/23/14 6106 SW 40th TER Other $150.00 and Insurance Topeka KS 6661 0 Security Benefit 09104114 1 Security Benefit Pl Other $4,000.00 Topeka KS 66636 Security Benefit 09/12/14 1 Security Benefit Pl Other $10,000.00 Topeka KS 66636 Total Itemized Receipts for Period $14585.00 Total Unitemized Contributions ($50 or less) $159.00 Sale of Political Materials (Unitemized) $0.00 Total Contributions When Contributor Not Known $0.00 TOTAL RECEIPTS THIS PERIOD $14744.00

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http://www.kssos.org/elections/cfr_viewer /reports/schedule_a _report.aspx 10/26/2014 Campaign Finance Schedule C Report Page 1of3

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SCHEDULE C

EXPENDITURES AND OTHER DISBURSEMENTS

Committee: Security Benefit Life Insurance PAC Purpose of Expenditure or Disbursement Date Name and Address Candidate Name & address if Amount independent or in-kind expenditure in excess of $300 Donation/Contrib Derek Schmidt 09/09/14 PO Box 804 $1 ,000.00 Independence KS 67301

Donation/Contrib Ken Selzer 09/09114 12504 Buena Vista $2,000.00 Leawood KS 66209

Donation/Contrib 09/09/14 13803 W 53rd St $250.00 Shawnee KS 66216

Donation/Contrib 09/09114 1 Security Benefit Pl $250.00 Topeka KS 66636

Donation/Contrib Ramon Gonzalez 09/09/14 PO Box 12 $250.00 Perry KS 66073

Donation/Contrib John Edmonds 09/09/14 PO Box 1816 $250.00 Great Bend KS 67530

Donation/Contrib 09/09/14 329 Yorkshire Road $250.00 Topeka KS 66606

Donation/Contrib John Wilson 09/09/14 1923 Ohio St $250.00 Lawrence KS 66046

09/09/14 Donation/Contrib $250.00

http://www.kssos.org/elections/cfr_viewer /reports/schedule_c _report.aspx 10/26/2014 Campaign Finance Schedule C Report Page 2 of 3

Harold Lane 2202 SE Monroe Topeka KS 66605 Donation/Contrib 09109114 12018 South Clinton St $250.00 Olathe KS 66061

Donation/Contrib Barbara Bollier 09/09/14 9610 Overhill Rd $250.00 Mission Hills KS 66208

Donation/Contrib 09/09/14 1346 SW Wayne Avenue $250.00 Topeka KS 66604-2606

Donation/Contrib Ron Ryckman Jr. 09109114 14234 W. 158th St $250.00 Olathe KS 66062

Donation/Contrib Dan Hawkins 09109114 9406 Harvest Ln $250.00 Wichita KS 67212

Donation/Contrib Pete DeGraff 09/09/14 1545Ell9th $250.00 Mulvane KS 67110

Donation/Contrib Steven Anthimides 09/09/14 2725 South Mason Terr $250.00 Wichita KS 67216

Donation/Contrib Jan Pauls 09109114 101 East 11th Ave $250.00 Hutchinson KS 67501

Donation/Contrib 09/09/14 1900 SW Briarwood Dr. $250.00 Topeka KS 66611

Donation/Contrib Scott Schwab 09/09/1 4 14953 W 140th Terr $250.00 Olathe KS 66062

09/09/14 Donation/Contrib $250.00 3209 N 131st St Kansas City KS 66109

http://www.kssos.org/elections/cfr_ viewer/reports/schedule_ c_ report.aspx 10/26/2014 Campaign Finance Schedule C Report Page 3of3

Donation/Contrib 09109114 PO Box 7141 $250.00 Overland Park KS 66207

Donation/Contrib Roderick Houston 09109114 4902 Looman $250.00 Wichita KS 67220

Donation/Contrib 09/09/14 416 Esat 7th St $250.00 Wellsville KS 66092

Donation/Contrib Linda Gallagher 09109114 7804 Monrovia St $250.00 Lenexa KS 66216

Donation/Contrib Fred Patton 09109114 339 NE 46th $250.00 Topeka KS 6661 7

Donation/Contrib 09/09/14 21704 W 57th Terr $250.00 Shawnee KS 66218

Total Itemized Expenditures This Period $9000.00 Total Unitemized Expenditures of $50 or less $0.00 TOTAL EXPENDITURES & OTHER DISBURSEMENTS THIS PERIOD $9000.00

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http://www.kssos.org/elections/cfr_viewer /reports/schedule_ c_ report.aspx 10/26/2014