N~OfC~~~: I~t, £.. ik4sethics.ks.gov/CFAScanned/House/2020ElecCycle/202010/H079...7719 3. Cash...
Transcript of N~OfC~~~: I~t, £.. ik4sethics.ks.gov/CFAScanned/House/2020ElecCycle/202010/H079...7719 3. Cash...
KANSAS GOVERNMENTAL ETHICS COMMISSION
RECEIPTS AND EXPENDITURES REPORT OF A CANDIDATE FOR STATE OFFICE I1~C~/~O
OCr IJ October 2 6,2020 /(S GOvern, ~ (/ 2020
FILE WITH SECRETARY OF STATE '!!Jell/a/tin' SEE REVERSE SIDE FOR INSTRUCTIONS 1Cs CofiJfiJ: Issiq9
A N~OfC~~~: ~~~~~~r_,~/_~~~~~~~~~~= _ Address: I~t, £.. 16&~ City and Zip Code: ~~ '~7'lO'counti?fM(~ Office Sought: ik4s ~-f ~~M;;eSDistrict 77Lr;
B. Check only if appropriate: __ Amended Filing _~ Tennination Report
C. Summary (covering the period from July 24, 2020 through October 22, 2020) gt 1. Cash on hand at beginning of period 7'(tt ;;;..-
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2. Total Contributions and Other Receipts (Use Schedule A) ! 2. J 7719
3. Cash available this period (Add Lines 1 and 2) 2~ {r'c, N 4. Tot.1 Expenditures and Other Disbursements (Use Schedllle C) ~•.1.'t~.~f'l'ig~ 5. Cash on band st close ofpenod (Subtract Line 4 from 3) /~( ..~.'[:~ ..:tQ-,S! 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 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."
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Date Signature of Candidate or T~ t.-> 1.'" -2-'2..."1- ..... ~~ 2. C2e.i!
GEe Form Rev, 2020
SCHEDULE A CD CONTRIBUTIONS AND OTHER RECEIPTS
(Name of Candidate)
Date Name and Address
of Contributor
I
Occupation of Individual Giving More
Than S150
Check Approprinte Box
Cash Chock Loon
Amount of C~sh. Check,
Loan or Other Receipt
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SCHEDULE AGJ CONTRIBUTIONS AND OTHER RECEIPTS
(Name of Candidate)
Date
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Name and Address of Contributor
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Occupation of Check Amount of Individual Giving More Appropriate Box Cash, Check,
Th~n $150 Loan or Other CnJh Cltfclc 1,QAn !.!l!!!!!! ReceiptOther
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Complete if last page of Schedule A
Total Itemized Receipts for Period
Total Unitemized Contributions (S50 or less)
Sale of Political Materials (Unitemized)
Total Contributions When Contributor Not Known
TbTAL R:EC'E niTSnns PERIOD ,<toH~~,2of s~lTJmilljr>::-,'.
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Page ;l.. ofl
SCHEDULEAW CONTRIBUTIONS AND OTHER RECEIPTS
(Name of Candidate)
Occupation of Check Name lind Address Individual Giving More Appl"opriate Box
Date of Contributor Than $150 C..,h Checl< loon II: /'unrl.
~
Amount of C~sh, Check, Lo~n or Other
Receipt
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Complete iflast page of Schedule A Q2..,77D
Total Itemized Receipts for Period 'IlIJ tz '7?D
Total Unitemized Contributions ($50 or less)
Sale ofPolitical Materials (Unitemized)
Total Contributions When Contributor Not Known
Page __ of__
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Amount
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Purpose of Exptnditurc or Disburscment
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Complete jf last page 0 f Schedule c
Name and AddreuDatt
'1-l(
( Narne 0 f Candidatc)
~
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S-'Cf~ Total Itemized Expenditure~ This Period
Page of
SCHEDULE I!J C. OTHER TRANSACTIONS
~ I- de:t0JeP:
Ib-'c.(
Date
IIJ-1
Name nnd Addre~s Nntun of i\ceount or LoaD Payable or Lain ReceIvable
Balance at elo'c of Period
Complete iflast page of Schedule D
Pagc __ of_
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
C-h--;;.I ~~ V'(Name of Candidate)
Date Name and Address PurJlO~t: of Ex,pendlture
or Disbursement Amount
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