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87~R~ ~ Date Signature Oftreasurer ' KANSAS GOVERNMENTAL ETHICS COMMISSION RECEIPTS AND EXPENDITURES REPOR:;...T~--=-==-=-::~_-, OF A POLITICAL OR PARTY COMMITT.tlb FILED October 27, 2014 MAR 11 2015 FILE WITH SECRETARY OF STATE KRISW.KOBACH SEE REVERSE SIDE FOR INSTRUCTIONLS2SE~C~RE~TA~RY.:...:o::::.f..:;.S1.::..:.AT:..:E----I A. Name of Committee: Kansas Chiropractic Political Action Committee Address: 1334 South Topeka Blvd City and Zip Code: Topeka, KS 66612 This is a (check one): __Party Committee .f Political Committee B. Check only if appropriate: L Amended Filing __Termination Report C. Summary (covering the period from July 25, 2014 through October 23,2014) 1. Cash on hand at beginning ofperiod '" . 14945.44 2. Total Contributions and Other Receipts (Use Schedule A) . 4623.87 3. Cash available this period (Add Lines 1 and 2) .. 19569.31 4. Total Expenditures and Other Disbursements (Use Schedule C) . 1~.5S0.00 5. Cash on hand at close ofperiod (Subtract Line 4 from 3) .. 7019.31 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 ofmy knowledge and beliefis 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." 10/26/14 .,87~r~ ~ Date Signature ofTreasurer ' . GEe Form Rev, 2014 SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS Kansas Chiropractic Political Action Committee (Name of Party 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 Kansas Chiropractic Assoc 07/29/14 1334 South Topeka Blvd $4,623.87 Topeka, KS 66612 .f " $4,623.87 Subtotal This Page {,,{ " Page __of__ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS Kansas Chiropractic Political Action Committee (Name ofParty Committee or Political Committee) Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made Ifindependent or in-kind expenditure in excess of $300 is made for a candidate, list candidate Dame & address Les Osterman for Representative - $200.00 09/17/14 1401 Dallas CtLn\....~ Wichita, KS 67217 CJl'\.-h­ Mark Hutton for Representative 09/17/14 7118 Cedarmeadow Court $200.00 Wichita, KS 67205 COvtvf~ Oo".--t-r" . Patricia Sloop for Representative 09/17/14 1950 S. Webb Road HM #121 $200.00 (1'-. F~ a,,-~r. Wichita, KS 67207 a <f)-­ Paul Davis For Governor 09/17/14 PO Box 2848 L1~.~~ $1,000.00 Topeka, KS 66601 ~f\--+r I Peggy Mast for Representative 09/17/14 765 Road 110 $250.00 "> Emporia, KS 66801 C1-n--p ....A. b'_'() - {:6h+-r Pete DeGraaf for Representative 09/17/17 1545 E 119th St ~~ $200.00 Mulvane, KS 67110 Lb,,+-.,­ Randy Garber for Representative 09/17/14. 2424 Timberline Terr $200.00 D/l. 11~ Co~h-; Sabetha, KS 66534 I t" Ray Merrick for Representative 09/17/14 6874 W 164thTerr ~P-Y~ ~1'-+, $500.00 Stilwell, KS 66085 -­ Representative Susan Concannon 09/17/14 921 N Mill Street $500.00 ~f',.+-r 7 Beloit, KS 67420 8~~ Rob Olson for Senate 09/17/14 15944 S. Clairborne Street $250.00 Olathe, KS 66062 ~~~+--r-~ Roderick Houston for Rep 09117/14 4902 Looman ~~ Oc,r....:1-r - $200.00 Wichita, KS 67220 -':"'7: ~/ . $3,700.00 Subtotal This Page Page _£_ of L/ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS Kansas Chiropractic Political Action Committee (Name ofParty Committee or Political Committee) Purpose ofExpenditure Name and Address Amount Date To Whom Expenditure is Made Ifindependent or in-kind expenditure in excess of $300 is made for a candidat~ list candidate name & address Ron Ryckman Jr. House of Rep. 09/17/14 14234 W 158th St Cr;~~-p~ L6~--i--r $250.00 Olathe. KS 66062 Scott Schwab for Representative 09/17/14 14953 W 140th terr $500.00 Olathe, KS 66062 ~~ Ca~'+--r-- Senator Elaine Bowers 09/17/14 1236 N 150th Rd. ~a~ $250.00 Concordina, KS 66901 t2eJ r-<J., - Senator Mary Pilcher-Cook 09/17/14 13910 West 58th place CCv~v~~ $250.00 Shawnee,KS 66216 COr--+-r-: Steve Jones for Representative 09/17/14 416 E 7th St Q~~~C:,~ $200.00 Wellsville, KS 66092 Tom Burroughs for Representative 09/17/17 3131 S 73rd Ter $500.00 Kansas City, KS 66106 ~ Cb"h.-J-r - Couture-Lovelady for House of 09/17/14 Rep PO Box 34 $150.00 Palco, KS 67657 Lh~G:M-.:~ Amanda Grosserode House of Rep 09/17/14 12601 West 99th St ~~"- Ctt--~.- $200.00 Lenexa, KS 66215 Barbara Ballard for Representative 09/17/14 6910 Overhill Road . $200.00 Mission Hills, KS 66208 CkP~~Co~h Brownback for Governor 09/17/14 PO Box 3739 C~ $1,000.00 Topeka, KS 66604 4L,..J--r·­ Bud Estes for Representative 09/17/14 1405 Elbow Bend ~p ~ $200.00 Dodge City, KS 67801 acif?'- L61'- .J-r­ $3,700.00 Subtotal This Page Page ~ of ~ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS Kansas Chiropractic Political Action Committee (Name of Party Committee or Political Committee) Purpose of Expeuditure Name and Address Amount Date To Whom Expenditure is Made Ifindependent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address Jeff Longbine for Senate 09/17/14 2801 Lakeridge Road COrLP~ 4-r-~ $250.00 Emporia, KS 66801 Jene Vickrey for Representative 09/17/14 502 S. Countryside Dr $250.00 ~-y--v't--r-" Louisburg, KS 66053 Ct-VlvP~~ Jim Kelly for Representative 09/17/14 309 South 5th $200.00 Independance,KS 67301 ~~~J-y Jim Ward for Representative 09/17/14 3100 E. Clark St $250.00 Wichita, KS 67211 ~f~~l'--l· v John Edmonds for Representative 09/17/14 PO Box 1816 $200.00 Great Bend, KS 67530 C~'f\'--P~ ~r-J r John Wilson for Representative 09/17/17 1923 Ohio Street $200.00 Lawrence, KS 66046 ~P?.-L-~ ~ ~~- Julie Menghini for Representative 09/17/14 1207 E. Quincy Pa-L~ $200.00 Pittsburg, KS 66762 Co- M- Uorl-r Kansans for Selzer, Inc 09/17/14 7113 W 135th St#353 $1,000.00 Overland Park, KS 66223 ~fVk~ ~-+y- Kathy Wolf-Moore for Rep 09/17/14 3209 North 131 St $200.00 Kansas City. KS 66109 ~~ (6r--.+r Laura Kelly for Senate 09/17/14 2345 SW Greenwood Ave $250.00 J::! ..D~. LI-en..J-y Topeka, KS 66606 CovIL. e (\ Kent Thompson for Representative 09/17/14 PO Box 626 ~f~ ~rJ-r $200.00 lola, KS 66749 $3,200.00 ("I __ lI~.A..J.._lI rrll.:_ TL.- •• SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS Kansas Chiropractic Political Action Committee (Name ofParty Committee or Political Committee) Purpose of Expenditure Name and Address Amount Date To Whom Expenditure is Made Ifindependent or in-kind expenditure in excess of $300 is I made for a candidate, list candidate name & address Dan Hawkins for Representative 09/17/14 9406 Harvest Lane $200.00 Wichita, KS 67212 CWr.f'~~' David Haley for Senate 09/17/14 936 Cleveland Ave "'-f'~ ~rJJ $250.00 Kansas City, KS 66101 CiA Don Hill for Representative 09/17/14 1720 Luther Street C~\<;-r' $200.00 Emporia, KS 66801 L1~'1 Garrett Love for Senate 09/17/14 PO Box 1 $250.00 Montezuma, KS 67867 CCl.~~'\ Lbt---+ H. Lane for State Representative 09/17/14 2202 SE Monroe St C1Y1Lf~ $200.00 Topeka, KS 66605 Q0L Hensley for Senate 09/17/17 2226 SE Virginia Ave $250.00 Topeka, KS 66605 Ch/fV--PaLA'" i61'-'1 , ~ Joe Scapa for Representative 09/17/14 2209 S. White Cliff Lane $100.00 Wichita, KS 67207 ~6LV,r\ ~i ...., Lucas Cosens for Representative 09/17/14 1015 E. Oak C~~Lb~+- $500.00 Fort Scott, KS 66701 - { Iq~b-, Subtotal This Page .
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