L Political Committee - Kansasethics.ks.gov/CFAScanned/PACs/2018ElecCycle/201801/PAC102_201801.pdfkansas governmental ethics commission. receipts and expenditures reporr----- of a

--------------------------------

KANSAS GOVERNMENTAL ETHICS COMMISSION

RECEIPTS AND EXPENDITURES REPORr-------OF A POLITICAL OR PARTY COMMITTE 8 RECeiVED

JAN 1 0 ?D18January 10, 2018

FILE WITH SECRETARY OF STATE KRISw'K08ACH SEE REVERSE SIDE FOR INSTRUCTIONS SECAETAAYOFSTATE

A. Name of Committee: _K_A_N_A_C_R_N_A_P_A_C _

10437 W 125th TerAddress:

City and Zip Code: _O_v_e_rl_n_d_P_a_r_k_,_K_S_6_6_2_1_3 _

LThis is a (check one): __ Party Committee Political Committee

B. Check only if appropriate: __ Amended Filing __ Tennination Report

C. Sununary (covering the period from January 1,2017 through December 31, 2017)

1. Cash on hand at beginning of period .. 15,731.72

2. Total Contributions and Other Receipts (Use Schedule A) . 18,178.5

3. Cash available this period (Add Lines 1 and 2) .. 33,910.22

4. Total Expenditures and Other Disbursements (Use Schedule C) .. 30,899.03

5. Cash on hand at close of period (Subtract Line 4 from 3) . 3,011.19

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 intentional

1/6/17

filing a false document is a class A misdemeanor."

Date Signature of Treasurer

GEe Form Rev, 2017

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

KANA CRNA PAC

(Name of Party Committee or Political Committee)

Date Name and Address

of Contributor

Occupation of Individual Giving More

Than $150 Cash

Check Appropriate Box

CI\I:~k Loan E funds ""OthCr""

Amount of Cash, Check,

Loan or Other Receipt

01/23/17 Micah Reece 3724 N 154th St Basehore, KS 66007

CRNA .; $105.91

01/27/17 Kyle Nevills 14270 Liberty Cir Wamego, KS 66547

CRNA .; $10.00

02/14/17 Amber Tiberio 2547 W 146th Ter Leawood, KS 66224

CRNA .; $50.00

02/27/17 KANA 5135 Harborside Ct Wichita, KS 67204

Professional Assoc .; $425.50

01/24/17 Adriane Fain 609 W9th Pittsburg, KS 66762

CRNA .f $1,164.90

02/16/17 Krista Zoge/man 630 Sunnyslope St Emporia, KS 66801

CRNA .; $193.90

02/20/17 Brian Tarnow 15561 Eby St Overland Park, KS 66221

CRNA .; $96.80

03/31/17

04/03/17

KANA 5135 Harborside Ct Wichita, KS 67204

Gerald Darger 603 N 9th Kiowa, KS 67070

Professional Assoc

CRNA

.;

.f

$95.00

$145.35

04/03/17 Renee Sinclair 2551 Z Rd Webber, KS 66970

CRNA .f $192.93

04/03/17 John Canady 3708 Persimmon Cir Manhattan, KS 66503

CRNA .; $193.90

Subtotal This Page $2,674.19

Page -I-- of <gl


KANA CRNA PAC


Date

04/03/17

04/03/17

04/04/17

05/24/17

05/08/17

05/08/17

05/16/17

05/24/17

05/24/17

05/11/17

05/12/17

Name and Address of Contributor

Micah Reece 3724 N 154th St Basehore, KS 66007

David Hart 3510 SW Alameda Dr Topeka,KS

Josie Bell 12715 S Hagan Ct Olathe, KS 66062 II

KANA 5135 Harborside Ct Wichita, KS

Kyle Nevills 14270 Liberty Cir Wamego. KS 66547

Amber Tiberio 2547 W 146th Ter Leawood, KS 66224

Lori Harris 3207 Northwood Ct Newton, KS 67114

Carol Elliott 14901 Rosehill Rd Olathe, KS 66062

Miscellaneous Cash

Kenneth Conde 8011 W 147th Ter Overland Park, KS 66223

Lynn Dunford 1705 Old Manor Rd Garden City, KS 67846

Subtotal This Page


Than $150

CRNA

Cash

Check Approp.·iate Box

Check Lolln E funds Qih;;'"

.;



$116.22

CRNA .; $97.77

CRNA .; $242.45

Professional Assoc .; $276.04

CRNA .; $50.00

CRNA .; $75.00

CRNA .; $50.00

CRNA .; $150.00

.; $15.00

CRNA .; $48.26

CRNA .; $486.17

$1,606.91


KANA CRNA PAC


Date

05/11/17

05/11/17

05/11/17

05/11/17

05/11/17

05/11/17

05/11/17

05/12/17

05/12/17

05/16/17

05/17/17


Ami Keltner 4608 Cherry Hills Dr Lawrence, KS 66047

Brenda DeMint 13900 Westgate St Overland Park, KS 66221

Samuel Moore 2009 SW Wildwood Ln Topeka, KS 66611

Rebecca Lucke 5135 Harborside Ct Wichita, KS 67204

Paul Hertel 5041 Mund Dr Shawnee, KS 66218

Albert Giambrone 912 Overhill Dr Manhattan, KS 66503

Scott Dobson 4208 Tanei! Dr Manhattan, KS 66502 II

Danielle Stenger 3100 Eagle Ridge Rd Milford, KS 66514

Kyle Nevills 14270 Liberty Cir Wamego. KS 66547

Debbie Stennes 2305 W 104th St Leawood, KS 66206

Josie Bell 12715 S Hagan Ct Olathe, KS 66062

Subtotal This Page


Than $150

CRNA

Cash


Check Loan E funds ~

.;

Amount of Cash, Checl(,


$146.70

CRNA .; $968.00

CRNA

.f $242.45

CRNA .f $146.70

CRNA ,f $242.45

CRNA .; $96.80

CRNA .; $241.10

CRNA .; $146.70

CRNA ,f $242.45

CRNA ,f $96.80

CRNA

.f $96.80

$2,666.95

Page 3 of r:t


KANA CRNA PAC



of Contributor


Than $150 Cash


Check LOlm E funds O'th«'"


Loan 01" Othel" Receipt

05/18/17

05/14/17

06/26/17

06/05/17

05/24/17

06/25/17

07/24/17

07/24/17

08/08/17

09/29/17

09/18/17

Sean Hoskinson 2402 N Cranbook St Wichita, KS 67226

Donald Pekrul 5818 NW Glenwood Dr Topeka, KS 66617


Thomas Donnelly 9428 163rd PI Stilwell, KS 66085

Donna Vierthaler 2866 N Wilderness Ct Wichita, KS 67226

Charlene McDonald 1258 N Forestview Ct Wichita, KS 67235

Kyle Nevills 14270 Uberty Cir Wamego, KS 66547

Amber Tiberio 2547 W 146th Ter Leawood, KS 66224



Rebecca Lucke 5135 Harborside Ct Wichita, KS 67204

CRNA

CRNA

Professional Assoc

CRNA

CRNA

CRNA

CRNA

CRNA

Professional Assoc

Professional Assoc

CRNA

.;

.;

.;

.;

.;

.;

t/

.;

t/

.f

.;

$96.80

$1,067.80

$90.00

$96.80

$242.45

$145.35

$20.00

$50.00

$722.74

$1,887.70

$19.44


Page £ of5


KANA CRNA PAC


Occupation of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check,

Date of Contributor Than $150 Loan or Othe.· Cash Check Loan E funds

Receipt~

Amber Tiberio CRNA 10/23/17 2547 W 146th Ter .; $50.00

Leawood, KS 66224

Kyle Nevills CRNA 10/23/17 14270 Liberty Cir .; $30.00

Wamego, KS 66547

Thomas DoneHy CRNA

~10/25/17 9428 163rd PI $48.25 Stilwell, KS 66085

KANA Professional Assoc

~11/06/17 1258 N Forestview Ct $1,564.00 Wichita, KS 67235

Maegan Gerhardt CRNA .;11/20/17 2237 W Concord Dr $242.45 Olathe, KS 66061

Ashleigh Pauly CRNA .;11/20/17 25717 W 63rd St S $242.45 Viola, KS 67149

Melissa Moffitt-Craft CRNA .;11/20/17 1103 Sunny Ln $145.35 Pratt, KS 67124

KANA Professional Assoc .;12/06/17 1258 N Forestview Ct $1,060.40 Wichita, KS 67235

Amber Tiberio CRNA .;12/08/17 2547 W 146th Ter $50.00 Leawood, KS 66224

Kyle Nevills CRNA .;12/08/17 14270 Liberty Cir $10.00 Wamego, KS 66547

Aric De Young CRNA

~12/13/17 2057 N Glen Wood Ct $96.80 Wichita, KS 67230


--Page.6 of;;1


KANA CRNA PAC



of Contributor


Than $150 ClIsh


Check LOlln E funds Other



12/13/17 Andrea Jack 507 SOak St Pratt, KS 67124

CRNA .; $970.70

12/14/77 Jacob Goe 15533 Woodward, St Overland Park, KS 66223

Student .; $23.97

12/14/17 Michael Pruss 311 N 14th St Manhattan, KS 66502

CRNA .; $96.80

12/15/17 Donna Nyght 13863 W 57th Ter Shawnee, KS 66216

CRNA .; $485.20

12/15/17 Paul Hertel 5041 Mund Rd Shawnee, KS 66218

CRNA .; $96.80

12/15/17 Jessica Coppock 7624 Hadley St Overland Park, KS 66204

CRNA .; $96.80

12/15/17 Brian Tarnow 15561 Eby St Overland Park66221

CRNA .; $96.80

12/18/17 Laurissa Beckman 2102 W 47th Ter Westwood, KS 66205

SRNA .; $23.97

12/18/17 Cindy Goe 15533 Woodward 5t Overland Park,KS 66223

CRNA .; $96.80

12/19/17 Andrea Winters 2552 N Fox Run Ct Wichita, KS 67226

CRNA .; $145.35

12/19/17 Alish Basnet 3414 E Central Apt 312 Wichita, KS 67208

SRNA .; $23.97


/

PageLOf~


KANA CRNA PAC

(Name of Patty Committee or Political Committee)

Date

12/22/17

11/20/17

12/12/17

12/13/17

12/14/17

12/14/17

12/14/17

12/14/17

12/30/17


Zach Schroeder 1325 Harvest Rd Apt A Hays, KS 67601

Jason Thompson 15245 Melrose St Overland Park, KS 66221

Jason Burk 1306 Rainbow DR Towanda, KS 67144

Jill Monaghan 1139 S Everett St Wichita, KS 67213

Albert Giambrone 912 Overhill Rd Manhattan, KS 66503

Donald Pekrul 5818 NW Glenwood Dr Topeka, KS 66617

Krista Ruvalcaba 630 Sunnyslope St Emporia, KS

Cheryl Regehr 4121 E English St Wichita, KS 67218

Jeremy Horsch 735 Bramerton St Andover, KS 67002


Than $150

CRNA

CRNA

CRNA

CRNA

CRNA

CRNA

CRNA

SRNA

CRNA

Cllsh

Check Appl'opriate Box

Check Lonn E funds ~

.f

.f

.;

.;

.f

.f

.f

.f

.f

Amollnt of Cash, Check,


$96.80

$291.00

$96.80

$121.07

$121.07

$198.75

$48.25

$23.97

$96.80

Subtotal Tbis Page $1,094.51

page~of~


KANA CRNA PAC (Name of Party Committee or Political Committee)

Occupation of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check,

Date of Contributor Than $150 Loan or Other CadI Check Loun E funds

Receipt~

Subtotal This Page $0.00

Complete if last page of Schedule A

Total Itemized Receipts for Period $18,178.50

Total Unitemized Contributions ($50 or less)

Sale of Political Materials (Unitemized)

Total Contributions When Contributor Not Known

TOTAL RECEIPTS THIS PERIOD (to line 2 of Summary) $18,178.50

Page g/ of ~

SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

KANA CRNA PAC



To Whom Expenditure is Made

KS Governmental Ethics Commission

Purpose of Expenditure Amount

If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address

06/05/17 fee

$300.00

08/13/17 Hawkins for State Rep 9406 Harvest Lane Wichita, KS 67212 0

Square Inc WEB

Bank of America

Schmidt for Attorney General Box 804 Independence, KS 67301

Vickrey for State Rep 502 S Countryside Dr Louisburg, KS 66053

Aurand for State Rep 810 Shady Ln Belleville, KS 66935

Landwehr for State Rep 2611 N Bayside Ct Wichita, KS 67205

Sloan for State Rep 772 Hwy 40 Lawrence, KS 66049

Contribution $500.00

12/01/17 Sercice fee

$29.03

12/28/17 Check Printing

$70.00

12/18/17 Contribution

$1,000.00


$250.00


$250.00


$250.00


$250.00

12/18/17 Campbell for State Rep 15954 S Mur-Len Olathe, KS 66062


12/18/17 Burroughs for State Rep 3131 S 73rd Ter Kansas City, KS 66106



Page L otJL


KANA CRNA PAC


Purpose of Expenditure Name and Address Amount

Date To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address

Phelps for State Rep Contribution 12/18/17 3103 Olympic Ln $250.00

Hays, KS 67601

Carlin for State Rep Contribution 12/18/17 Box 32 $250.00

Manhattan, KS 66506

Finney for State Rep Contribution 12/18/17 1754 N Madison Ave $250.00

Wichita, KS 67214

Frownfelter for State Rep Contribution 12/18/17 5225 Crest Dr $250.00

Kansas City, KS 66106

Proehl for State Rep Contribution 12/18/17 510 Pine Ridge Rd $250.00

Parsons, KS 67357

Schroeder for State Rep Contribution 12/18/17 708 Charles St $250.00

Hesston I KS 67062

Wolfe-Moore for State Rep Contribution 12/18/17 3209 N 131st St $250.00

Kansas City, KS 66109

Whipple for State Rep Contribution 12/18/17 4455 S Washington Ct $250.00

Wichita, KS 67216

Hoffman For State Rep Contribution 12/18/17 1318 Ave T $250.00

Coldwater, KS 67029

Garber for State Rep Contribution 12/18/17 2424 Timberlane Tar $250.00

Sabetha, KS 66534

Johnson for State Rep Contribution 12/18/17 10197 S Hopkins Rd $250.00

Assaria, KS 67416


Page 2. of---i1


KANA CRNA PAC






12/18/17 Alford for State Rep 4179 E Rd 19 Ulysses, KS 67880


12/18/17 Claeys for State Rep 2157 Redhawk Ln Salina, KS 67401


12/18/17 Houser for State Rep 6891 SW 10th St Columbus, KS 66725


12/18/17 Sutton for State Rep 215 W Park St Gardner, KS 66030


12/18/17 Concannon for State Rep 921 N lVIill Beloit, KS 67420


12/18/17 Jennings for State Rep PO Box 295 Lakin, KS 67860


12/18/17 Hibbard for State Rep 858 EE75 Rd Toronto, KS 66777


12/18/17 Clayton for State Rep 9825 Woodson Dr Overland Park, KS 66207


12/18/17 Rooker for State Rep 4124 Brookridge Dr Fairway, KS 66205


12/18/17 Highland for State Rep 27487 Wells Creek Rd Wamego, KS 66547


12/18/17 Finch for State Rep 101 W 2nd St Ottawa, KS 66067



Page .~~ or-/L


KANA CRNA PAC

(Name of Party Committee 01' Political Committee)




If independent or in-kind expenditure in excess of $300 is made for a candidate, Jist candidate name & address

12/18/17 Alcala for State Rep 520 NE Lake Topeka, KS 66616


12/18/17 Gallagher for State Rep 7804 Monrovia St Lenexa. KS 66216


12/18/17 Swanson for State Rep 1422 5th St Clay Center, KS 67432


12/18/17 Williams for State Rep 506 Stone Lake Ct Augusta, KS 67010


12/18/17 Smith for State Rep 1970 Rd 3 Weskan I KS 67762


12/18/17 Clark for State Rep 819 N Washington St Junction City, KS 66441


12/18/17 Lewis for State Rep 910 NE 30th Ave Stjohn, KS 67576


12/18/17 Parker for State Rep 9807 W 104th St Overland Park, KS 66212


12/18/17 Rahjes for State Rep 1798 E 900 Rd Agra, KS 67621


12/18/17 Helgerson for State Rep 12 E Peach Tree Ln Wichita, KS 67207


12/18/17 Koesten for State Rep 3310 W 137th St Leawood, KS 66226



pagelt- 0f1


KANA CRNA PAC




Tarwater for State Rep 16006 Meadow Ln Stilwell, KS 66085

Kessinger for State Rep 12605 Walmer St Overland Park, KS 66209

Orr for State Rep 30111 H Rd Fowler, KS 67844

Amberger for State Rep Box 103 Great Bend, KS 67530




$250.00


$250.00


$250.00


$250.00

12/18/17 Lusker for State Rep 452 S 210th St Frontenac, KS 66763

Thompson for State Rep Box 626 lola, KS 66749

Powell for State Rep 14481 W 122nd St Olathe, KS 66062 0

Holscher for State Rep Box 4781 Olathe, KS 66063

Lakin for State Rep 2825 W Milro Circle Wichita, KS 67204



$350.00


$350.00


$350.00


$350.00

12/18/17 Murman for State Rep 1313 Mallory Ct Pittsburg, KS 66762


12/18/17 Blex for State Rep 3131 CR 2600 Independence, KS 67301




KANA CRNA PAC

(Name ofParty Committee or Political Committee)

Date

12/18/17

12/18/17

12/18/17

12/18/17

12/18/17

12/18/17

12/18/17

12/18/17

12/18/17

12/18/17

12/18/17

Purpose of Expenditure Name and Address

To Whom Expenditure is Made If independent or in-kind expenditure in excess of $300 is made for a candidate, list candidate name & address

Rafie for State Rep Contribution Box 23796 Overland Park, KS 66283

Pettey for State Senate Contribution 5316 Lakewood St KansasnCity, KS 66106

Hensley for State Senate Contribution 2226 SE Virginia Topeka, KS 66605

Wagle for State Senate Contribution 4 Sagebrush Wichita, KS 67230

Pyle for State Senate Contribution 2979 Kingfisher Rd Hiawatha, KS 66434

Pilcher-Cook for State Senate Contribution 13910 W 58th PI Shawnee, KS 66216

Olson for State Senate Contribution 15944 Clairborne St Olathe, KS 66062

Faust-Goudeau for State Senate Contribution Box 20335 Wichita, KS 67208

Schmidt for State Senate Contribution 5906 SW 43rd Ct Topeka, KS 66610 a Kelly for State Senate Contribution 234 SW Greenwood Ave Topeka, KS 66606

Francisco for State Senate Contribution 1101 Ohio Lawrence I KS 66044

Amount

$350.00

$250.00

$250.00

$250.00

$250.00

$250.00

$250.00

$250.00

$250.00

$250.00

$250.00


Page-kof (I


KANA CRNA PAC


Date Name and Add.·ess




12/18/17 Lynn for State Senate PO Box 25631 Overland Park, KS 66225


12/18/17 Skubal for State Senate 6503 W 134th Ter Overland Park, KS 66209


12/18/17 Alley for State Senate 517 Quail Nest Rd Winfield, KS 67156


12/18/17 Hawk for State Senate 2600 Woodhaven Ct Manhattan KS 66502


12/18/17 Awerkamp for State Rep 807 W Linn St STMarys, KS 66536


12/18/17 Smith for State Rep 627 Kennebeck St Burlington,KS 66839


12/18/17 Mastroni for State Rep 102 Fairway Dr LaCrosse, KS 67548


12/18/17 Schreiber for State Rep Box 2331 Emporia, KS 66801


12/18/17 Judd-Jenkins for State Rep 225 N C St Arkansas City, KS 67005


12/18/17 Baker for State Rep 278 Lake Rd Council Grove, KS 66846


12/18/17 Ralph for State Rep 2009 Frederick Dr Dodge City, KS 67801



Page -2of---./1


KANA CRNA PAC






12/18/17 Brim for State Rep 6756 Longview Shawnee, KS 66218


12/18/17 Delperdang for State Rep 2103 N Pintail Wichita, KS 67235


12/18/17 Horn for State Rep 2121 Vermont St Lawrence, KS 66046


12/18/17 Henderson for State Rep 2710 N 8th St Kansas City, KS 66101


12/18/17 Osterman for State Rep 1401 W Dallas Wichita, KS 67217


12/18/17 Dove for State Rep Box 349-9349 Bonner Springs, KS 66012


12/18/17 Crum for State Rep 356 Kinden Ln Haysville, KS 67060


12/18/17 Trimmer for State Rep 1402 E 9th Ave Winfield, KS 67156


12/18/17 Hineman for State Rep 116 S Longhorn Rd Dighton, KS 67839


12/18/17 Kelly for State Rep 309 S 5th Independence, KS 67301


12/18/17 Phillips for State Rep 1530 Barrington Dr Manhattan, KS 66503



Page J ofJ


KANA CRNA PAC





If independent or in~kind expenditure in excess of $300 is made for a candidate, list candidate name & address

12/18/17 Ellis for State Rep 9199 K4 Hwy Meriden, KS 66512


12/18/17 Barker for State Rep 103 Wassinger Ave Abilene, KS 67410


12/18/17 Waymaster for State Rep 3528 192nd St Bunker Hill, KS 67626


12/18/17 Ryckman, Jr for State Rep 14234 W 158th St Olathe, KS 66062


12/18/17 Bowers for State Senate 1326 N 150th Rd Concordia, KS 66901


12/18/17 Denning for State Senate 8416 W 115th St Overland Park, KS 66210


12/18/17 Kerschen for State Senate 645 S 263 W Garden Plain, KS 67050


12/18/17 Wilborn for State Senate 1504 Heritage PI McPherson, KS 67460


12/18/17 Berger for State Senate 2603 Heather Parkway Hutchinson, KS 67502


12/18/17 Taylor for State Senate Box 322 Stafford, KS 67578


12/18/17 SUllentrop for State Senate 6813 W Northwind Circle Wichita, KS 67205



Page ----l- of~


KANA CRNA PAC





If independent or in-kind expenditul'e in excess of $300 is made for a candidate, list candidate name & address

12/18/17 Givens for State Senate 1525 Country Club Rd EI Dorado, KS 67042


12/18/17 Goddard for State Senate 3420 Mosher Rd Parsons, KS 67357


12/18/17 Hardy for State Senate 816 Highland Ave Salina, KS 67401


12/18/17 Bollier for State Senate 6910 Overhill Rd Mission Hills, KS 66208


12/18/17 Billinger for State Senate Box 594 Goodland, KS 67735


12/18/17 McGinn for State Senate PO BoxA Sedgwick, KS 67135


12/18/17 Masterson for State Senate Box 424 Andover, KS 67002


12/18/17 Estes for State Senate 1405 Elbow Bend Dodge City, KS 67801


12/18/17 Longbine for State Senate Box 1903 Emporia, KS 66801


12/18/17 Doll for State Senate 2927 Cliff PI Garden City, KS 67846


12/18/17 Hilderbrand for State Senate 10337 SE 107th St 66739



Page I () of4


KANA CRNA PAC

( Name of Party Committee or Political Committee)


To Whom Expenditure is Made Purpose of Expenditure

Amount If independent or in-kind expenditure in excess of $300 is

made for a candidate, list candidate name & address

Subtotal This Page $0.00

Complete if last page of Schedule C

Total Itemized Expenditures This Period $30,899.03

Total Un itemized Expenditures of $50 or less

TOTAL EXPENDITURES & OTHER DISBURSEMENTS THIS PERIOD (to line 4 of Summary)

$30,899.03

pagelLof$

Documents

L Political Committee - Kansasethics.ks.gov/CFAScanned/PACs/2018ElecCycle/201801/PAC102_201801.pdfkansas governmental ethics commission. receipts and expenditures reporr----- of a