KANSAS GOVERNMENTAL ETHICS COMMISSION
RECEIPTS AND EXPENDITURES REPO..,.,)+-T--===-=~---, OF A POLITICAL OR PARTY COMMITTgE FILED October 29, 2012 OCT 26 2012
FILE WITH SECRETARY OF STATE KRISWKOBACH SEE REVERSE SIDE FOR INSTRUCTI01~SSECRETARY Or: STATE
A. Name of Committee: Kansas Medical Society Political Action Committee
Address: 6_2_3_S_W_1_0_th_A_v_e_. _
City and Zip Code: _T_o_p_e_k_a_,_K_S_6_6_6_12 _
This is a (check one): __Party Committee Political Committee
B. Check only if appropriate: __Amended Filing __ Termination Report
C. Summary (covering the period from July 27, 2012 through October 25,2012) 1. Cash on hand at beginning of period . $153,934.67 2. Total Contributions and Other Receipts (Use Schedule A) .. 12,842.00 3. Cash available this period (Add Lines 1 and 2) . 166,776.67 4. Total Expenditures and Other Disbursements (Use Schedule C) . 78,000.00 5. Cash on hand at close ofperiod (Subtract Line 4 from 3) . $ 88,776.67 6. In-Kind Contributions (Use Schedule B) . 7. Other Transactions (Use Schedule D) ..
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 true, correct and complete. I understand that the intentional failure to file this document or intentionally filing a false document is a class A misdemeanor."
10/25/12 oJ..,t ~ Date Sig~~ture of Treasurer
GEe Form Rev, 2001 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Medical Society Political Action Committee
Occupation & Industry of Date Name & Address Cash, Check, Loan, Amount of Cash, Check Individual Giving More of Contributor Other Loan or Other Receipt Than $150
8/14/2012 Gerald Hamilton MD Physician Check ($150.00) 23401 Prairie Star Pkwy Ste 300 Healthcare Industry Shawnee Mission, KS 66227-7246
8/14/2012 Rory Howard MD Physician Check ($132.00) 555 W 15th St Healthcare Industry Liberal, KS 67901-2467
8/14/2012 Dylan YuMD Physician Check ($150.00) 3630 SW Fairlawn Rd Healthcare Industry Topeka, KS 66614-3966
8/24/2012 KC Docs PAC KS-West Physician Group Check ($8,220.00) 3036 Gillham Rd Healthcare Industry Kansas City, MO 64108
9/11/2012 Alan Clement MD Physician Check ($150.00) 2040 Hutton Rd Ste 102 Healthcare Industry Kansas City, KS 66109-4564
9/11/2012 Mehmood Hashmi MD Physician Check ($150.00) 1414 SW 8th Ave Healthcare Industry Topeka, KS 66606-1535
9/11/2012 Jeffrey Leichter MD Physician Check ($150.00) 1133 College Ave A104 Healthcare Industry Manhattan, KS 66502-2700
9/11/2012 Joshua Thomas DO Physician Check ($150.00) 2207 Brookfield Dr Healthcare Industry Salina, KS 67402-4646
9/11/2012 Matthew Turner MD Physician Check ($150.00) 1301 W 12th Ave Ste 207 Healthcare Industry Emporia, KS 66801-1234
9/11/2012 James Appelbaum MD Physician Check ($150.00) 8919 Parallel Pkwy Ste 555 Healthcare Industry Kansas City, KS 66112-8912
9/11/2012 Mark Basham MD Physician Check ($150.00) 110 E 16th St Healthcare Industry Eureka, KS 67045-1067
9/11/2012 Tammy Bataglia MD Physician Check ($150.00) 1 Mt Carmel Way Healthcare Industry Pittsburg, KS 66762-7587
Subtotal This Page ($9,852,00)
Page 1 of 4 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Medical Society Political Action Committee
Occupation & Industry of Date Name & Address Cash, Check, Loan, Amount of Cash, Check Individual Giving More of Contributor Other Loan or Other Receipt Than $150
9/11/2012 Regina Carolina MD Physician Check ($150.00) 1301 N 47th St Healthcare Industry Kansas City, KS 66102-4503
9/11/2012 Trent Davis MD Physician Check ($150.00) 520 S Santa Fe Ave Ste 300 Healthcare Industry Salina, KS 67401-4190
9/11/2012 Peter DeWitt MD Physician Check ($150.00) 1101 N Main St Healthcare Industry McPherson, KS 67460-2302
9/11/2012 Sol Enriquez MD Physician Check ($150.00) 10507 W 126th Ter Healthcare Industry Shawnee Mission, KS 66213-2356
9/11/2012 John Evans MD Physician Check ($150.00) 1500 SW 10th Ave Ste 2 N Healthcare Industry Topeka, KS 66606-1301
9/11/2012 David Finkle MD Physician Check ($150.00) 9100 W 74th St Healthcare Industry Shawnee Mission, KS 66204-4004
9/11/2012 Eric Friskel MD Physician Check ($150.00) 2800 W 67th St Healthcare Industry Shawnee Mission, KS 66208-1837
9/11/2012 Brent Hrabik MD Physician Check ($150.00) 1301 W 12th St Ste 101 Healthcare Industry Emporia, KS 66801-2590
9/11/2012 Khanna Poonam MD Physician Check ($150.00) 14818 Sherwood St Healthcare Industry Shawnee Mission, KS 66224-1873
9/22/2012 Gerald Lindholm MD Physician Check ($150.00) 700 Medical Ctr Dr Ste 210 Healthcare Industry Newton, KS 67114-4446
9/11/2012 Stephen Lund MD Physician Check ($150.00) 10105 Barton St Healthcare Industry Overland Park, KS 66214-2624
9/11/2012 Stephen Lund MD Physician Check ($150.00) 10105 Barton St Healthcare Industry Overland Park, KS 66214-2624
Subtotal This Page ($1,800.00)
Page 2 of 4 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Medical Society Political Action Committee
Occupation & Industry of Date Name & Address Cash, Check, Loan, Amount of Cash, Check Individual Giving More of Contributor Other Than $150 Loan or Other Receipt
9/11/2012 Raymond Magee MD Physician Check ($50.00) 601 SW Corporate View Rd Healthcare Industry Topeka, KS 66615-2715
9/11/2012 Dilip Patel MD Physician Check ($40.00) 1000 Lincoln St Healthcare Industry Emporia, KS 66801-2449
9/11/2012 Lawrence Shank MD Physician Check ($150.00) 305 W 15th St Healthcare Industry Liberal, KS 67901-4659
9/11/2012 Joseph Simone MD Physician Check ($150.00) 8901 W 74th St Ste 285 Healthcare Industry Shawnee Mission, KS 66204-2287
9/11/2012 Richard Uhlig MD Physician Check ($150.00) 100 E Helen St Healthcare Industry Herington, KS 67449-1606
9/11/2012 Linda Warren Physician Check ($100.00) 205 S Hanover St Healthcare Industry Hanover, KS 66945-8924
9/11/2012 Roger Warren MD Physician Check ($100.00) 205 S Hanover St Healthcare Industry Hanover, KS 66945-8924
9/11/2012 Donald White MD Physician Check ($150.00) P.O. Box 1449 Healthcare Industry Coffeyville, KS 67337-0937
9/11/2012 James Whitten MD Physician Check ($150.00) 12909 Westgate St Healthcare Industry Shawnee Mission, KS 66213-2365
9/11/2012 Daryl Zerbe MD Physician Check ($150.00) PO Box 1607 Healthcare Industry Salina, KS 67402-1607
Subtotal This Page ($1,190.00)
Page 3 of 4 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Kansas Medical Society Political Action Committee (Name ofParty Committee or Political Committee)
Occupation & Industry of . Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check, Date of Contributor Than $150 Loan or Other Cash Check Loan E funds Other Receipt
.... $0.00 Subtotal This Page
Complete if last page of Schedule A
Total Itemized Receipts for Period $12,842.00
Total Unitemized Contributions ($50 or less)
Sale ofPolitical Materials (Unitemized)
Total Contributions When Contributor Not Known . ,. TOTAL RECEIPTS TmS PERIOD (to line 2 of Summary) . $12,842.00
Page _4_ of_4_ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Medical Society Political Action Committee Purpose of Expenditure Date Narne and Address List candidate name & address if independent or Amount in-kind expenditure in excess of $300 $
08/20/12 Shanti Gandhi Campaign Contribution 500.00 5802 Clarion Lakes Way Topeka, KS 66610
10/01/12 Robert "Bob" Grant Campaign Contribution 250.00 202 S. Appleton Frontenac, KS 66763
10/01/12 Michelle Hucke Campaign Contribution 250.00 1914 South Locust Pittsburg, KS 66762
10/01/12 Bill Feuerborn Campaign Contribution 500.00 1600 Park Rd. Garnett, KS 66032
10/01/12 Jene Vickrey Campaign Contribution 500.00 502 S. Countryside Dr. Louisburg, KS 66053
10/01/12 Richard ProeW Campaign Contribution 500.00 510 Pine Ridge Rd. Parsons, KS 67357
10/01/12 Craig McPherson Campaign Contribution 250.00 11091 W. 133rd Ter. Apt. 7 Overland Park, KS 66213
10/01/12 Edwin Bideau Campaign Contribution 250.00 14 S. Rutter Chanute, KS 66720
10/01/12 Jim Kelly Campaign Contribution 500.00 309 S. 5th Independence, KS 67301
10/01/12 Virgil Peck Campaign Contribution 500.00 Box 277 Tyro, KS 67364
10/01/12 Fred Rinne Campaign Contribution 250.00 610 Madison Fredonia, KS 66736
10/01/12 Keith Esau Campaign Contribution 250.00 11702 S. Winchester St. Olathe, KS 66061
Subtotal This Page $4,500.00
Page _1 of--.H SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Medical Society Political Action Committee Purpose of Expenditure Date Narne and Address List candidate name & address if independent or Amount in-kind expenditure in excess of $300 $
10/01/12 Robert Montgomery Campaign Contribution 250.00 107 W. Cedar Olathe, KS 66061
10/01/12 Amanda Grosserode Campaign Contribution 250.00 12601 West 99th St. Lenexa, KS 66215
10/01/12 Brett Hi1dabrand Campaign Contribution 250.00 16820 W. 67th St., Apt. 407 Shawnee, KS 66217
10/01/12 John Rubin Campaign Contribution 500.00 13803 W. 53 rd St. Shawnee,KS 66216
10/01/12 Rob Bruchman Campaign Contribution 250.00 5016 W. 108th Terr., #522 Overland Park, KS 66211
10/01/12 Barbara Bollier Campaign Contribution 500.00 691 0 Overhill Rd. Mission Hills, KS 66208
10/01/12 Marla Brems Campaign Contribution 250.00 8610 Mackey St. Overland Park, KS 66212
10/01/12 Kelly Meigs Campaign Contribution 500.00 7842 Rosehill Rd. Lenexa, KS 66216
10/01/12 Christopher Waldschmidt Campaign Contribution 250.00 7201 W. 72nd St. Overland Park, KS 66204
10/01/12 Larry Campbell Campaign Contribution 250.00 15803 S. Avalon Olathe, KS 66062
10/01/12 Ray Merrick Campaign Contribution 500.00 6874 West 164th Ter. Stillwell, KS 66085
10/01/12 Jerry Lunn Campaign Contribution 500.00 14512 Horton St. Overland Park, KS 66223
Subtotal This Page $4,250.00
Page _2_ of--l1 SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Medical Society Political Action Committee Purpose of Expenditure Date Narne and Address List candidate name & address if independent or Amount in-kind expenditure in excess of $300 $
10/01/12 James Todd Campaign Contribution 500.00 9731 W. 115th Ter. Overland Park, KS 66210
10/01/12 Lance Kinzer Campaign Contribution 500.00 12549 S. Brougham Olathe, KS 66062
10/01/12 Louis Ruiz Campaign Contribution 500.00 2914 W. 46th Ave. Kansas City, KS 66103
10/01/12 Kathy Wolfe Moore Campaign Contribution 500.00 3209 N. 131 5t St. Kansas City, KS 66109
10/01/12 Stan Frownfelter Campaign Contribution 250.00 4527 Gibbs Rd. Kansas City, KS 66106
10/01/12 Willie Dove Campaign Contribution 250.00 14715 Timber Lane Bonner Springs, KS 66012
10/01/12 Charles Macheers Campaign Contribution 250.00 21704 W. 57th Terrace Shawnee, KS 66218
10/01/12 John Bradford Campaign Contribution 250.00 125 Rock Creed Loop Lansing, KS 66043
10/01/12 Jana Goodman Campaign Contribution 250.00 410 South Broadway Leavenworth, KS 66048
10/01/12 Melanie Meier Campaign Contribution 250.00 713 Oak St. Leavenworth, KS 66048
10/01/12 Tom Sloan Campaign Contribution 250.00 772 Hwy.40 Lawrence, KS 66049
10/01/12 Paul Davis Campaign Contribution 250.00 1731 Indiana Lawrence, KS 66044
Subtotal This Page $4,000.00
Page _3_ of--.H. SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Medical Society Political Action Committee Purpose of Expenditure Date Narne and Address List candidate name & address if independent or Amount in-kind expenditure in excess of $300 $
10/01/12 Ramon Gonzalez Campaign Contribution 250.00 312 Elm St. Perry, KS 66073
10/01/12 Marvin Kleeb Campaign Contribution 500.00 14206 Eby Overland Park, KS 66221
10/01/12 Scott Schwab Campaign Contribution 500.00 14953 W. 140th Ter. Olathe, KS 66062
10/01/12 Dr. Ron Highland Campaign Contribution 500.00 27487 Wells Creek Rd. Wamego, KS 66547
10/01/12 Annie Tietze Campaign Contribution 500.00 329 SW Yorkshire Rd. Topeka, KS 66606
10/01/12 Mike Burgess Campaign Contribution 500.00 6009 SW 23rd St. Topeka, KS 66614
10/01/12 Ken Corbet Campaign Contribution 500.00 10351 SW 61 51 St. Topeka, KS 66610
10/01/12 Becky Nioce Campaign Contribution 250.00 825 SW Oakley Ave. Topeka, KS 66606
10/01/12 Don Hill Campaign Contribution 500.00 1720 Luther St. Emporia, KS 66801
10/01/12 Richard Carlson Campaign Contribution 250.00 26810 Jeffrey Rd. St. Marys, KS 66536
10/01/12 Randy Garber Campaign Contribution 500.00 2424 Timberlane Ter. Sabetha, KS 66534
10/01/12 Jerry Henry Campaign Contribution 500.00 3515 Neosho Rd. Cummings, KS 66016
Subtotal This Page $5,250.00
Page ---±- of-.l1 SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Medical Society Political Action Committee Purpose of Expenditure Date Name and Address List candidate name & address if independent or Amount in-kind expenditure in excess of $300 $
10/01/12 Vern Swanson Campaign Contribution 250.00 1422 5th St. Clay Center, KS 67432
10/01/12 Allan Rothlisberg Campaign Contribution 250.00 113 Byrd Street Grandview Plaza, KS 66441
10/01/12 Lee Modesitt Campaign Contribution 250.00 1200 Fremont #15 Manhattan, KS 66502
10/01/12 Tom Phillips Campaign Contribution 500.00 1530 Barrington Drive Manhattan, KS 66503
10/01/12 Tom Moxley Campaign Contribution 500.00 1852 S. 200th Rd. Council Grove, KS 66846
10/01/12 1.R. Claeys Campaign Contribution 500.00 2356 Montclair Dr. Salina, KS 67401
10/01/12 lohn E. Barker Campaign Contribution 500.00 103 Wassinger Ave. Abilene, KS 67410
10/01/12 Marc Rhoades Campaign Contribution 500.00 1006 Lazy Creek Drive Newton, KS 67114
10/01/12 Clark Shultz Campaign Contribution 500.00 515N.Ash#9 McPherson, KS 67460
10/01/12 Will Carpenter Campaign Contribution 250.00 6965 SW 18 th St. El Dorado, KS 67042
10/01/12 Peggy Mast Campaign Contribution 500.00 765 Road 110 Emporia, KS 66801
10/01/12 David Crum Campaign Contribution 500.00 2903 Lakeshore Dr. Augusta, KS 67010
Subtotal This Page $5,000.00
Page _5_ of-H SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Medical Society Political Action Committee Purpose of Expenditure Date Name and Address List candidate name & address if independent or Amount in-kind expenditure in excess of $300 $
10/01/12 Ron Ryckman Campaign Contribution 250.00 14234 W. 158 th St. Olathe, KS 66062
10/01/12 Ed Trimmer Campaign Contribution 500.00 1402 E. 9th Ave Winfield, KS 67156
10/01/12 Larry Alley Campaign Contribution 500.00 517 Quail Nest Rd. Winfield, KS 67156
10/01/12 Kasha Kelley Campaign Contribution 500.00 PO Box 1111 Arkansas City, KS 67005
10/01/12 Jim Howell Campaign Contribution 250.00 125 E. Buckhorn Rd. Derby, KS 67037
10/01/12 Pete DeGraaf Campaign Contribution 250.00 1545 E. 119th Mulvane, KS 67110
10/01/12 Dan Heflin Campaign Contribution 500.00 714 N. Yale Wichita, KS 67208
10/01/12 Steve Brunk Campaign Contribution 250.00 8119 Champions Ct. Wichita, KS 67226
10/01/12 Jim Ward Campaign Contribution 500.00 3100 E. Clark Wichita, KS 67211
10/01/12 Mark Kahrs Campaign Contribution 500.00 201 N. Post Oak Rd. Wichita, KS 67206
10/01/12 Joseph Scapa Campaign Contribution 500.00 2209 S. White Cliff Ln. Wichita, KS 67207
10/01/12 Steve Huebert Campaign Contribution 500.00 619 N. Birch Valley Center, KS 67147
Subtotal This Page $5,000.00
Page _6_ of--.H. SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Medical Society Political Action Committee Purpose of Expenditure Date Narne and Address List candidate name & address if independent or Amount in-kind expenditure in excess of $300 $
10/01/12 Gene Suellentrop Campaign Contribution 500.00 6813 W. Northwind Cir. Wichita, KS 67206
10/01/12 Brenda Landwehr Campaign Contribution 500.00 2837 N. Edwards Wichita, KS 67204
10/01112 George F. (Joe) Edwards II Campaign Contribution 250.00 256 VanArsdale Haysville, KS 67060
10/01112 Mario Goico Campaign Contribution 250.00 1254 N. Pine Grove Ct. Wichita, KS 67212
10/01112 Benny Boman Campaign Contribution 500.00 1914 Euclid Wichita, KS 67213
10/01112 Rick Lindsey Campaign Contribution 250.00 2542 S. Mead Wichita, KS 67216
10/01112 Les Osterman Campaign Contribution 500.00 1401 W. Dallas Wichita, KS 67217
10/01112 Phil Hermanson Campaign Contribution 500.00 5338 S. Mosley Wichita, KS 67216
10/01112 Dennis Hedke Campaign Contribution 250.00 1669 N. Sagebrush St. Wichita, KS 67230
10/01112 Dan Hawkins Campaign Contribution 500.00 9406 Harvest Ln. Wichita, KS 67212
10/01112 Joe Seiwert Campaign Contribution 250.00 1111 E. Boundary Rd. Pretty Prairie, KS 67570
10/01112 Jan Pauls Campaign Contribution 500.00 101 E. 11 th Hutchinson, KS 67501
Subtotal This Page $4,750.00
Page _7_ of-.H SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Medical Society Political Action Committee Purpose of Expenditure Date Name and Address List candidate name & address if independent or Amount in-kind expenditure in excess of $300 $
10/01/12 Steven R. Becker Campaign Contribution 250.00 11309 East 69th Buhler, KS 67522
10/01/12 Mark E. Hutton Campaign Contribution 500.00 7118 W. Clearmeadow Ct. Wichita, KS 67205
10/01/12 Susan Concannon Campaign Contribution 500.00 921 N. Mill Beloit, KS 67420
10/01/12 Steven Johnson Campaign Contribution 250.00 10197 S. Hopkins Rd. Assaria, KS 67416
10/01/12 Troy L. Waymaster Campaign Contribution 500.00 112 N. Fairview Ave. Luray, KS 67649
10/01/12 Travis Couture-Lovelady Campaign Contribution 500.00 2680 Three Rd. Palco, KS 67657
10/01/12 EberPhelps Campaign Contribution 500.00 3103 Olympic Ln. Hays, KS 67601
10/01/12 John Edmonds Campaign Contribution 500.00 209 NE Ten Rd. Great Bend, KS 67530
10/01/12 Marshall Christmann Campaign Contribution 250.00 816 South Grand Lyons, KS 67554
10/01/12 Jack Thimesch Campaign Contribution 250.00 234 N. Henderson Cunningham, KS 67035
10/01/12 Ronald Ryckman Campaign Contribution 500.00 503 N. Cedar St. Meade, KS 67864
10/01/12 Kyle Hoffman Campaign Contribution 500.00 1318 Avenue T Coldwater, KS 67029
Subtotal This Page $5,000.00
Page _8_ of-H SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Subtotal This Page $5,750.00
Page _9_ of--.H. SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Medical Society Political Action Committee Purpose of Expenditure Date Narne and Address List candidate name & address ifindependent or Amount in-kind expenditure in excess of $300 $
10/01/12 Kelly Kultala Campaign Contribution 250.00 12232 Hubbard Rd. Kansas City, KS 66109
10/01/12 Steve Fitzgerald Campaign Contribution 500.00 3100 Tonganoxie Rd. Leavenworth, KS 66048
10/01/12 Kay Wolf-Moore Campaign Contribution 1,000.00 8339 Roe Prairie Village, KS 66207
10/01/12 Jim Denning Campaign Contribution 1,000.00 8416 W. 115th St. Overland Park, KS 66210
10/01/12 Julia Lynn Campaign Contribution 1,000.00 18837 W. 115th Ter Olathe, KS 66061
10/01/12 Mary Pilcher-Cook Campaign Contribution 1,000.00 13910 W. 58th PI Shawnee, KS 66216
10/01/12 JeffMelcher Campaign Contribution 1,000.00 11424 Canterbury Circle Leawood, KS 66211
1% 1/12 Caryn Tyson Campaign Contribution 1,000.00 PO Box 191 Parker, KS 66072
10/01/12 Jacob LaTurner Campaign Contribution 1,000.00 204 E. Euclid St. Pittsburg, KS 66762
10/01/12 Forrest Knox Campaign Contribution 1,000.00 17120 Udall Rd. Altoona, KS 66710
1% 1/12 Jeff King Campaign Contribution 500.00 1212 N. 2nd St. Independence, KS 67301
10/01/12 Ty Masterson Campaign Contribution 500.00 1539 Phyllis Ln. Andover, KS 67002
Subtotal This Page $9,750.00 SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Subtotal This Page $11,500.00
Page ----lL of-H SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Medical Society Political Action Committee Purpose of Expenditure Date Narne and Address List candidate name & address if independent or Amount in-kind expenditure in excess of $300 $
10101112 Susan Wagle Campaign Contribution 1,000.00 4 N. Sagebrush Wichita, KS 67230
10101112 Carolyn McGinn Campaign Contribution 500.00 11047 N. 87th W. Sedgwick, KS 67135
10101112 Steve E. Abrams Campaign Contribution 500.00 4579 242nd Rd. Arkansas City, KS 67005
10101112 Mitch Holmes Campaign Contribution 1,000.00 211 SE 20th Ave. St John, KS 67576
10/01112 TenyBruce Campaign Contribution 1,000.00 5301 N. Centennial Rd. Nickerson, KS 67561
10101112 Jay Scott Emler Campaign Contribution 500.00 1457 Shawnee Road Lindsborg, KS 67456
10/01112 Elaine Bowers Campaign Contribution 1,000.00 10504 SW Indianola Augusta, KS 67010
10/01112 Pat Apple Campaign Contribution 500.00 PO Box 626 Louisburg, KS 66053
10/01112 Garrett Love Campaign Contribution 1,000.00 101 Esca1anta Montezuma, KS 67867
10/01112 Larry R. Powell Campaign Contribution 1,000.00 2209 Grandview Dr. E. Garden City, KS 67846
10/01112 Ralph Ostmeyer Campaign Contribution 1,000.00 Box 97 Grinnell, KS 67738
10101112 Don Schroeder Campaign Contribution 250.00 708 Charles St. Hesston, KS 67062
Subtotal This Page $9,250.00 SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Kansas Medical Society Political Action Committee Purpose of Expenditure Date Name and Address List candidate name & address if independent or Amount in-kind expenditure in excess of $300 $
10/01/12 Sharon Schwartz Campaign Contribution 500.00 2051 20th Rd. Washington, KS 66968
10/02/12 Connie O'Brien Campaign Contribution 250.00 22123211 th St. Tonganoxie, KS 66086
10/02/12 Jim Howell Campaign Contribution 500.00 125 E. Buckhorn Rd. Derby, KS 67037
10/03/12 Republican House Campaign Committee Campaign Contribution 2,500.00 PO Box4157 Topeka, KS 66604
10/22/12 Larry Paul Hibbard Campaign Contribution 250.00 858 EE75 Rd. Toronto, KS 66777
Subtotal This Page $4,000.00 SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS Kansas Medical Society Political Action Committee (Name of Party Committee or Political Committee)
Name and Address Purpose of Expenditure Date To Whom Expenditure is Made Amount Ifindependent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address
$0.00
Complete if last page of Schedule c
Total Itemized Expenditures This Period $78,000.00
Total Unitemized Expenditures of $50 or less
$78,000.00
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