r FILEIf'A~S GOVERNMENTAL ETHICS COMMISSION R.ECEIPTS AND EXPENDITURES REPORT JAN {} 92018 bF A POLITICAL OR PARTY COMMITTEE KA/s W. KOBACH January 10,2018 L ECRETARY OF STATE I - FILE WITH SECRETARY OF STATE SEE REVERSE SIDE FOR INSTRUCTIONS
A. NftJDe of CQmmittcc: ~A.~anS8' Good ~O~8mm.~un~ . _ Address: clo 5845 SW 29th Street
City and Zip Code: Topeka 66614·2462
This is a (check one): _.._ Party Committee ~ Political Committee
B. Check only ifappropriate: __" Amended Filing __Termination Report
C. Summary (covering the period from January 1,2017 tbrough December 31,1017) L. Cash on hand at beginning ofperiod .. 16732.02 2. Total Contributions and Other Receipts (Use Schedule A) .. 45000.00 3. Cash available this period (Add Lines I and 2) . 81732.02 36550.00 4, Total Expenditures and Ocher Disbursements (Usc Schedule C) .. --'_.'-_._"'-' 5. Cash on hand at close of period (Subtract Line 4 tiom 3) . 25182.02 6. In-Kind Contributions (Use Schedule '9) 0.00 7. Other Trrmsllctions (Use Schedule D) !:OO
D. "r declare that this report, including any 8ccompanyins schedules and statements, has been e~l1mined by me and to the best of my knowIed80 and belief is true, correct and complete. I understand that the intentionlll failure to tile this document or intentionally flUng a false document is a class A misdemeanor,"
S;gnttture ofTrcasurer I I .1 GEe Form Rev, 20)7 I I I i I I SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS HCA Kansas Good Government Fund (Name of Party Comml;.ee or PolitIcal Commlnee)
Occupation of Check Amount of Name and Address Individual GIving More Appropriate Bol Cash. Check. Dafe or Contributor Than $150 Loan or Otber C..h Chell ~. Eroad, Ot' Re(elpt enorah Medical Center Hospital 08/15/17 5721 West 119th Street $11.250.00 Overland Park KS 66221 V
Overland Park Regional Med etr HospItal 08/21/17 10500 Quivira $11.250.00 Overland Park KS 66215 V
Wesley Medical Center Hospital 08/28/17 550 N. Hillside V $22.500.00 Wichita KS67214
$45,000.00
Complete if last page of Schedule A
Total Itemized Receipts for Period $45.000.00
Total Unilemized Contributions ($50 or less)
Sale of Political Malenals (Unitemized)
Total Contributions When Contributor Not Known
Page __of__ SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS HCA Kansas Good Govemment Fund ( Name of Party Committee or Political Committee)
Name and Address Purpose of EllpendUure Date To Whom Expendlturt is Made Amount IfIDdepeade.t or In-JUnd expendIture In eseesl of 5300 Is made for a c:aDdldate, Ust candl.date name" addret. See attachment to Schedule C $36,550.00
$36,550.00
Complete If last page ofSchedule C
Total itemized Expenditures This Period $38,550.00
Total Unitomized Expenditures of $50 or loss
$36,550.00
Pagc __of__ HCA Kansas Good Government Fund SCHEDULEC EXPENDITURES AND OTHER_._- DISBURSEMeNTS D." Name HameAdd,.._ Amount Jan· De~ 17 0612612017 Governmenta' Ethics Comml••lon 901 S. Kan..s lit Floor Topeka, KS 66612 300.00 08/0712017 Hawtt-In. for State RepresentatIve Rep. Daniel HawlDoug Blex 3131 CR 2600 Independence KS 67301 250.00 09/1912017 Bollier for State Senate Sen. Barbara Boltier 6910 0vert1111 Road Mission HjU. KS 66208 250.00 0911912017 Bower. for State Senate Sen. Elaine Bowers 1326 N. 150th Roed Concordl. KS 66901 250.00 09/1912017 Brfm for State Representative Rep. Sheleo Brim 6756 Longview Shawnee, KS 66218 250.00 09/1912017 BUrriS for State Representative Rep. Jesse Burris do 1545 e. 119th Street Mulvane KS 671 to 250.00 09/1912017 Burroughs for State RepresentatIVe Rep. Tom BurrOUghs 3131 S. 73rd Terrace Kansil City, KS 66106 250.00 0911912017 Campbell for State RepreMntative Rep. Larry Carnpben 16954 S. Mur-Len ~52 Olathe, KS 66062 250.00 0911912017 Carlin for State Representative Rep. Sydney earnn Box 32 Manhattan, KS 66505 250.00 0911912017 Carmichael for State Representat . Rep. John Carmichael 1475 N. lieunett Wl<:ttlta KS 67203 250.00 09/1912017 Carpenter, Blake for State Repre . Rep. Blake Carpenter 2425 N. Newberry Apt. 3202 Derby KS 67037 250.00 0911912017 Claeys for State Representative Rep. J. R. Claeys 2157 Redhewk Lane Salina KS 67041 25000 0911912017 Clayton for State Repre.."taUve Rep. Stepllenle Clayton 9826 Woodson Drive Ovenal'd Park, KS 6... 250.00 09/1912017 Concannon for State Repreaentat... Rep. Suean Concannon 921 N. Mill 801011, KS 67420 250.00 09/1912017 COle for State Representative Rep. Tom COle 14814 W. 71st Terrace Shawnee KS 66216 25000 09/19/2017 Crum, Steven for Slale Rtpresen .. Rep. Steven Crum 356 L1neen Lane Haysville KS 67080 250,00 09/19/2017 Oavill, Erin fQr Stale Repreaentatl . Rep. frio Devia12Q18 S. Clinton Olathe. KS 66061 0.00 09/19/2017 Delperdang for State Representat... Rep. Leo Oelperaang 2103 N. Pintalt Wichita, KS 672:>$ 250.00 09/19/2017 Denning for State Senate Sen. Jim C>ennlnll8416 W. 115lh Street Overland Pa~ KS 66210 500.00 09/1912017 0011 for State Senate Sen. John DoU 2927 Cllff Place Garden City KS 87846 250.00 09/1912017 Dove for Stale Repruenlatlve Rep. Willie Dove Box 349-9349 Bonner Springs, KS 66012 25000 09/1912017 Elliott for Slat. Representative Rep. Roger ElIlot112015 E. Tamarac Wld1ita KS 67206 500.00 0911912017 E111$ for State Repreaentative Rep. Ronald Ellis 9199 K4 Highway Meriden KS 665t2 250.00 09/19/2017 Eplee for Stale Repreeentative Rep. John Eplee 163 Deer Run AtctQon KS 66002 250.00 09/1912017 Estes for State Senate Sen. Maynard (BUd) eat., 1405 Elbow Bend Oo(fge City KS 67601 250.00 09/1912017 Faust-Goudeau for State Senate Sen. Oletha Fauat-Go1.ldeau Box 20335 Wichita, KS 87208 ~.oo 09/1912017 Finney for State Representative Rep. Gall Finney 1154 N. MadISOll Avenue WichIta, KS 67214 500.00· 09/1912017 Frownfelter for State Represental... Rep. Stan Frownfelter 5225 Crnt Drtve Kans•• City KS 6E1106 250.00 0911912017 Gallagher for State Representative Rep. Linda Gallagher 78Q.4 Monrovia Street Lenexa KS 66216 250.00 09/19/2017 Goddard for Stote Senate sen. Den Goddard 3420 Mosher Road Parsons KS 67357 250.00· 09/1912017 Hawk for State Senate Sen. Tom H~ 2500 Woodheven Court Manhattan KS 66502 250.00 09/1912017 Helgerson for State Representative Rep. Henry Helgerson 12 e. Peach Tree Lane Wichita KS 67207 250.00· 09/1912017 Henderson for Stat. Repl'81J8ntatl. .. Rep. Broderk:k Henderson 2710 N. 8th Street Kan,as City KS 66101 250.00 0911912017 Hensley for State Senale Sen. Anthony Hensley 2226 S.E. Virginia Topeka, KS 66605 250.00 0911912017 Hilderbrand for State Senate Sen. Richard Hilderbrand 10337 SE 107th 51. Terr. Galena KS 66739 250.00 09/19/2017 Hinemlln for State Representative Rep. Don Hineman 116 S. Longhorn Road Dighton, KS 67839 500.00 09119/2017 Hoffman for State Rtpreaentatlve Rep. Kyle Hortman 1319 Avenue T Coldweter. KS 67029 250.00· 09/1912017 Holland for State Senate Sen. Tom Holland Box 165 Baldwin City KS 66006 250.00 09/1912017 Holacher for Stat. Repreaentlltive Rep. Cindy Hol6cher Box 4781 Olethe KS 66063 ~.OO· 09/19/2017 Huebert 'or Stale Representative Rep. Steve Huebert 619 N. Birch Valley Center, KS 67147 250.00 09/1912017 Humphries for Kanaas HOUle Rep. Su.,n Humphries Bole 884 Andover, KS 67002 250.00 0911912017 Johnson. SIeve for State Repres ... Rep. Steven Johnson 10197 S. Hopkins Road Assaria, KS 67416 250.00 09/1912017 Judd-Jenkins for State Represent... Rep. Anita JuclchJenklna 225 N "COO Street Arkansas City, KS 67005 250.00 09/1912017 Kelly for State Representative Rep. Jim Kelly 309 S. 5th Independence. KS 67301 250.00· 0911912017 Kelty for State Senate Sen. Laura Kelly 234 SW Greenwood Ave. Topeka. 1<5 66606·1228 250.00 09/19/2017 Kerschen for State Senate Sen. 0." Kersenen 645 S. 263rd West Garden Plein KS 67050 250.00· 09/1912017 Ke,singer for Slate Representative Rep. J.n Kenlnger 12605 Walmer Street Overland Park KS 66209 500.00 0911912017 Koeslen for Stalo RepreMntatJve Rep. Joy Koesten 3310 W. , 37th Slroot LOlMOOO KS 66224 260.00 09/1912017 Lakin for State Ropreaontatlve Rep. G,.g lakin 2825 W. Milro Circle Wld\lt. KS 672Q.4-231e 250.00 09/19/2017 Landwehr for State Representative Rep. Brenda Landwehr 2611 N. Bayside Court Wld1ita. KS 67205 250.00 091t9l2017 longblne for Slate Senale sen. Jeff Longbine Box 1903 Emporia, KS 66801 250.00 09/19/2017 Lusk for Stale Representative Rep. Nancy Lu&!< Box 35 Overland Park:, KS 66201-0035 250.00 09/1912017 LV$k.er for State ReprnenlaUve Rep. Adam Luper 452 S. 210th Sireet Front.n.~ KS 66763 250.00 0911912017 Lynn tor State Sonate sen. JuUa Lynn Bole 25631 Overland Pari( KS 6622~ 250.00 09/1912017 Markley for State Reprnentatlva Rep. Patty Marttley 12312 Nlemen Road Overland Pe~. KS 66213 250.00 09/1912017 Masterson 'or State Senate Sen. Ty Masterson Box 424 Andover, KS 67002 250.00 0911912017 McGinn for State Senate Sen. Carolyn McGinn P. O. Bo/( A Secfgwlck KS 67135 250.00 09/1912017 Murnan for State Representative Rep. Monica Murnan 1313 Mallory Court Pittsburg KS 66762 250.00 HCA Kansas Good Govemment Fund SCHEDULE C EXPENDfTURES AND OTHER DISBURSEMENTS
Date Name Name Add,.... Amount 09/1912017 Neighbor 'or State Representetive Rep. Cindy Neighbor 10405 W. 52nd Teuace Shawnee. KS 66203 250.00 09/19/2017 Oheeboslm for State Repr..ental.. Rep. Ke1.ehl OhaeboJ.lm 2330 N. Ollver .511 Wichita KS 87220 250.00 09/1912017 O'-on, Rob for State Senate Sen. Rob Oleon 15944 S. Clalrtlome Street Olethe KS 68062 250.00 09/1912017 O'terman for State R.prewntatlve Rep. Lealie Osterman 1401 W. D.1In Wichita, KS 67217 250.00 09/1912017 Ousley for State Repre8entatlYe Rep. Jarrod O~y 6800 Farley ~rriam, KS 66203 250.00 09/1912017 Parker foI' State Representallve Rep. Brett Par1
Jan· Dec: 17 38,550.00·