KANSAS GOVERNMENTAL ETHICS COMMISSION

RECEIPTS AND EXPENDITURES REPORT OF A CANDIDATE FOR STATE OFFICE

July 25, 2016

FILE WITH SECRETARY OF STATE SEE REVERSE SIDE FOR INSTRUCTIONS

A. Name of Candidate Keith P Humphrey

'"'E"''~t\r· ""'· ~ I .I-· •-t. L l U._l·..,; i_.,:_/

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Address 2924 N Rough Creek Rd

City and Zip Code Derby, KS 67037 County Sedgwick

Office Sought Senate District No. 28

B. Check only if appropriate: 0 Amended Filing 0 Termination Report

C. Summary (covering the period from 01/01/2016 through 07/21/2016

1. Cash on hand at beginning of period $0.00

2. Total Contributions and Other Receipts (Use Schedule A) $46,505.00 ........... ~ .......................................................... .

3. Cash available this period (Add Lines 1 and 2) $46,505.00

4. Total Expenditures and Other Disbursements (Use Schedule C) $2,185.64 ....................................... . ...................... .

5. Cash on hand at close of period (Subtract Line 4 from 3) $44,319.36

6. In-Kind Contributions (Use Schedule B) $1,494.95 ...................................................................................................

7. Other Transactions (Use Schedule D) $17,000.00

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."

Ld Date Signature of Candidate or Treasurer

GEC Form Rev 2016

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Geraldine Flaharty 1836 E. Fernwood Street Retired Teacher/State

06/13/2016 Wichita, KS 67216-2869 Rep. D [Z] D Retired

John Schlicher 139 N Brendonwood Ct

06/09/2016 Wichita, KS 67206-2101 D [Z] D

Judy Pierce 5328 S Stoneborough Ct Wichita Labor Fed.

05/04/2016 Wichita, KS 67217-6520 D [Z] D Labor Union President

Bill Docking 29750 87th Dr Community Banker

05/04/2016 Arkansas City, KS 67005-6268 D [Z] D Finance

Carol J. Bacon 316 S Terrace Dr

05/18/2016 Wichita, KS 67218-1404 D D D

William & Jennifer Morales 2005 Burnwood Ct Business owners

05/24/2016 Brookfield, WI 53045-4814 D [Z] D Aviation

Bob Scott 4055 N Tyler Rd

05/25/2016 Maize, KS 67101-8733 D [Z] D

Amount of Cash, Check,

Loan or E funds Other Other Receipt

D $200.00

D $100.00

D $500.00

D $1,000.00

[Z] $100.00

D $1,000.00

D $100.00

I Subtotal This Page $3,000.00 I

Page 2 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Richard Hite 1440 N Gatewood St Legal

06/24/2016 Apt 26 D 0 D Wichita, KS 67206-1253 Legal

Shelbie Konkel 1336 SW Overlook Dr

04/26/2016 Apt4 D D D Topeka, KS 66615-1488

Pat Lehman 515 W Mania St Retired

07/17/2016 Wichita, KS 67204-4062 D 0 D Retired Aviation

Matthew Calcara 10761 Burbank Blvd

05/28/2016 Ste B D D D North Hollywood, CA 91601-2518

Michael Bayouth 636 S Eastern St

05/14/2016 Apt 101 D D D Wichita, KS 67207-2468

Don & Lynn Stephan 1440 N Gatewood St Retired

05/25/2016 Apt 15 D 0 D Wichita, KS 67206-1253 Retired

Lawrence Union 5596 Amoroso Dr

05/26/2016 Fort Myers, FL 33919-3402 D D D

Amount of Cash, Check,

Loan or Efunds Other Other Receipt

D $250.00

0 $5.00

D $50.00

0 $50.00

0 $100.00

D $250.00

0 $50.00

I Subtotal This Page $755.00 I

Page 3 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Tracer Repair and Overhaul INC.

07/20/2016 935 Elm Grove Rd D 0 D Elm Grove, WI 53122-2572

Keith Peter Humphrey 2924 N Rough Creek Rd CEO

07/08/2016 Derby, KS 67037-9394 D D 0 Aviation

William & Jennifer Morales 2005 Burnwood Ct Business owners

05/24/2016 Brookfield, WI 53045-4814 D 0 D Aviation

Lee and Mary Elizabeth Kinch 601 S Honeybrook Ln Attorney

05/25/2016 Derby, KS 67037-3614 D 0 D legal

Bruce Buhr 1706 N Chapel Hill St Medical

06/17/2016 Wichita, KS 67206-5501 D 0 D Medical

Tami Bradley 2929 N Pepper Ridge Ct

06/03/2016 Wichita, KS 67205-3511 D 0 D

Les and Courtney L Ruthven 27 41 N Wilderness Ct Psychologist

05/11/2016 Wichita, KS 67226-2100 D 0 D Medical

Amount of Cash, Check,

Loan or E funds Other Other Receipt

D $1,000.00

D $15,000.00

D $1,000.00

D $250.00

D $500.00

D $25.00

D $200.00

I Subtotal This Page $17,975.00 I

Page 4 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Kathryn Lancendorfer 1556 Clay St

05/11 /2016 Apt2 D D D San Francisco, CA 94109-3851

William Thompson 2503 N Persimmon St

07/18/2016 Derby, KS 67037-4239 D D D

Patrick Cantwell 2021 N Broadmoor St Education

05/06/2016 Apt 102 D [Z] D Wichita, KS 67206-1076 Education

Roger King 1975 Arlington

07/21/2016 Topeka, KS 66601 [Z] D D

Bill Vann 705 S Forewood Rd Retired

06/13/2016 Arkansas City, KS 67005-9384 D [Z] D Retired

Lisa Kay Vayda 14400 E Sport Of Kings St Pharmacist

04/26/2016 Wichita, KS 67230-7139 D D D Healthcare

Eun Sook Kim 515 S Main St

07/18/2016 Apt 201 D [Z] D Wichita, KS 67202-3705

Amount of Cash, Check,

Loan or E funds Other Other Receipt

[Z] $35.00

[Z] $35.00

D $250.00

D $20.00

D $100.00

[Z] $50.00

D $100.00

I Subtotal This Page $590.00 j

Page 5 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Jane Byrnes 322 S Lorraine Ave

05/04/2016 Wichita, KS 67211-2134 D lZl D

Judy E Loganbill 215SErieSt

07/17/2016 Wichita, KS 67211-2120 D lZl D

Judy E Loganbill 215 S Erie St

05/25/2016 Wichita, KS 67211-2120 D lZl D

Daniel Housholder 7705 E Killarney Ct Medical

06/02/2016 Wichita, KS 67206-1654 D lZl D Medical

Paul Feleciano II 815 W Barbara Ave Retired

07/17/2016 Wichita, KS 67217-3115 D lZl D Retired

Al D Short 15238 US Highway 160 Vice President

05/16/2016 Winfield, KS 67156-7520 D lZl D Aviation

Jenny L Gholson-Morris 338 W 35th St S

07/18/2016 Wichita, KS 67217-3514 D D D

Amount of Cash, Check,

Loan or E funds Other Other Receipt

D $40.00

D $50.00

D $50.00

D $500.00

D $150.00

D $500.00

lZl $20.00

I Subtotal This Page $1,31 o .oo I

Page 6 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Robert Matson 13040 Decant Dr

05/06/2016 Poway, CA 92064-1119 D D D

Mark Varrato 2240 Jason St Retired Officer

04/26/2016 Merritt Island, FL 32952-5582 D D D Navy

Allison K. Lemons 6713 E 10th St N Professor

05/04/2016 Wichita, KS 67206-1327 D [Z] D

Jane Byrnes 322 S Lorraine Ave

05/18/2016 Wichita, KS 67211-2134 D [Z] D

Laborers' Local No. 1290 2600 Merriam Ln

07/20/2016 Kansas City, KS 66106-4606 D [Z] D

Julia Craft 1730 S Tamarisk Cir

05/04/2016 Wichita, KS 67230-7649 D D D

Roger Bell 2350 N Mclean Blvd

06/03/2016 Wichita, KS 67204-5337 D [Z] D

Amount of Cash, Check,

Loan or E funds Other Other Receipt

[Z] $50.00

[Z] $500.00

D $100.00

D $25.00

D $1,000.00

[Z] $100.00

D $125.00

I Subtotal This Page $1,900.00 I

Page 7 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Kate Pearle Davis 255 Winterberry Dr

05/10/2016 Athens, GA 30606-3272 D D D

Lifestyle Mobile Home Park INC.

07/21/2016 11700 E Waterman St D [Z] D Lot 201 Wichita, KS 67207-1460

Kevin Mcwhorter 102 S Breezy Pointe Cir Finance

05/13/2016 Wichita, KS 67235-1425 D [Z] D Finance

Joan Warren 6220 E 10th St N

07/06/2016 Wichita, KS 67208-2605 D D D

Lynn Rogers 912 N Spaulding Ave

05/25/2016 Wichita, KS 67203-3260 D [Z] D

Tariq (Ted) Farid 13900 E Pinnacle Dr

07/17/2016 Wichita, KS 67230-1542 D D D

Patricia Butin 2833 N Plumthicket Cir

06/13/2016 Wichita, KS 67226-2175 D [Z] D

Amount of Cash, Check,

Loan or E funds Other Other Receipt

[Z] $100.00

D $500.00

D $500.00

[Z] $50.00

D $100.00

[Z] $50.00

D $50.00

I Subtotal This Page $1,350.00 I

Page 8 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Peggy Browning 7373 E 29th St N

07/21/2016 E205 D [Z] D Wichita, KS 67226-3425

Charles Hubbard PO Box 205

05/04/2016 Derby, KS 67037-0205 D [Z] D

Fredrick Seaton 1900 Kitch Rd Retired Editor/

05/04/2016 Winfield, KS 67156-8405 Publisher D [Z] D Publishing

Margaret McNulty Benefiel 14925 E Black Oak Ct

06/09/2016 Wichita, KS 67230-7601 D [Z] D

Jerred McKee 418 Poyntz Ave

05/26/2016 Apt 309 D D D Manhattan, KS 66502-6069

Pat Lehman 515 W Manlo St Retired

05/17/2016 Wichita, KS 67204-4062 D [Z] D Retired Aviation

Susan Ellis 6904 E Stonegate St

05/11/2016 Ste 300 D [Z] D Wichita, KS 67206-1136

Amount of Cash, Check,

Loan or E funds Other Other Receipt

D $100.00

D $100.00

D $300.00

D $100.00

[Z] $10.00

D $200.00

D $100.00

I Subtotal This Page $910.00 I Page 9 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Joan Warren 6220 E 10th St N

07/17/2016 Wichita, KS 67208-2605 D lZl D

SEIU Missouri State Council PAC

07/08/2016 5585 Pershing Ave D lZl D Ste 170 Saint Louis, MO 63112-1762

Barbara S Coats 2324 W 13th St N Physician

05/24/2016 Wichita, KS 67203-1927 D lZl D Medical

Jane Carter 308 E Capitol St NE Labor Economist Ill

03/31/2016 Apt 2 D D D Washington, DC 20003-3899 Labor

Mikel Stout 1440 N Gatewood St Legal

05/12/2016 Apt 1 D lZl D Wichita, KS 67206-1253 Legal

Mert and Connie Buckley 16 N Sagebrush St Attorney

06/13/2016 Wichita, KS 67230-6610 D lZl D Legal

Paul Davis 1536 Alvamar Dr Attorney

06/20/2016 Lawrence, KS 66047-1606 D lZl D Legal

Amount of Cash, Check,

Loan or E funds Other Other Receipt

D $50.00

D $1,000.00

D $250.00

lZl $300.00

D $250.00

D $250.00

D $250.00

I Subtotal This Page $2,350.00 I Page 10 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Anna Anderson 20 N Linden Dr Retired banker

05/25/2016 Wichita, KS 67206-2449 D 0 D Retired

Melissa A Gregory 1440 N Gatewood St Retired

05/24/2016 Apt46 D 0 D Wichita, KS 67206-1253 Business

Paul Treadwell 10101 E47thStS Real Estate Developer

07/21/2016 Derby, KS 67037-9114 D 0 D Development

Eric Kurtz 2509 Coppercreek Banker

05/13/2016 Ponca City, OK 74604-2448 D 0 D Finance

Plumbers and Pipefitters Local Union No. 441

06/13/2016 1330 E 1st St N D 0 D Ste 115 Wichita, KS 67214-4000

Lee and Mary Elizabeth Kinch 601 S Honeybrook Ln Attorney

05/11/2016 Derby, KS 67037-3614 D 0 D legal

Sally Fahrenthold 6515 E 30th St N

07/07/2016 Unit 2900 D 0 D Wichita, KS 67226-1271

Amount of Cash, Check,

Loan or E funds Other Other Receipt

D $250.00

D $500.00

D $500.00

D $250.00

D $1,000.00

D $250.00

D $50.00

I Subtotal This Page $2,800.00 1

Page 11 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Pat Lehman 515 W Manic St Retired

05/04/2016 Wichita, KS 67204-4062 D lZl D Retired Aviation

Jenny L Gholson-Morris 338 W 35th St S

06/18/2016 Wichita, KS 67217-3514 D D D

Joanne Brady 6304 Genoa Way

04/24/2016 Aurora, CO 80019-2173 D D D

Anna Brigatino 3937 Bucknall Rd Sales

05/25/2016 Campbell, CA 95008-2661 D D D IT

Bill Vann 705 S Forewood Rd Retired

06/03/2016 Arkansas City, KS 67005-9384 D lZl D Retired

Leah Weston 8601 NW 26th St

04/05/2016 Sunrise, FL 33322-2913 D D D

Jim Lawing 115 N Crestway St

05/25/2016 Wichita, KS 67208-3839 D lZl D

Amount of Cash, Check,

Loan or E funds Other Other Receipt

D $100.00

lZl $20.00

lZl $25.00

lZl $250.00

D $100.00

lZl $50.00

D $10.00

I Subtotal This Page $555.00 I

Page 12 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Novelene G Ross 1202 W. River Blvd. B108 retired art museum

05/13/2016 AptA40 curator D D D Wichita, KS 67203 culture

Vicki Flores 2309 N Longwood Cir

07/17/2016 Wichita, KS 67226-1115 D 0 D

Jess Duncan 1550 N Woodridge Dr

06/02/2016 Wichita, KS 67206-3604 D D D

Howard Sherwood PO Box 9163 Owner

06/17/2016 Wichita, KS 67277-0163 D 0 D Heavy Highway Construction

Daniel Housholder 7705 E Killarney Ct Medical

05/13/2016 Wichita, KS 67206-1654 D 0 D Medical

Flora Bishop 2227 W Ventoso Rd

06/13/2016 Wichita, KS 67204-1729 D 0 D

Ron Tracy 3415 S Southwood Ct

05/25/2016 Wichita, KS 67217-3441 D 0 D

Amount of Cash, Check,

Loan or E funds Other Other Receipt

0 $250.00

D $50.00

0 $25.00

D $1,000.00

D $100.00

D $50.00

D $50.00

I Subtotal This Page $1,525.00 I

Page 13 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Carolyn Bakri 15101 E Castle Dr

06/13/2016 Wichita, KS 67230-9208 D [2] D

Martha S Housholder MD 7705 E Killarney Ct

05/25/2016 Wichita, KS 67206-1654 D [2] D

William Rogers 19911 Soth Valley Pride Road

04/25/2016 Pretty Praire, KS 67570 D D D

KNEA PAC 715 SW 10th Ave

07/01/2016 Topeka, KS 66612 D [2] D

Keith D Stevens 231 N Crestway St finance

05/25/2016 Wichita, KS 67208-3841 D [2] D Finance

Ron Campbell PO Box 997 Legal

06/03/2016 Wichita, KS 67201-0997 D [2] D Legal

Donald D Enos 1640 Lexington Rd

05/31/2016 Wichita, KS 67218-4716 D [2] D

Amount of Cash, Check,

Loan or E funds Other Other Receipt

D $100.00

D $100.00

[2] $100.00

D $1,000.00

D $100.00

D $200.00

D $30.00

I Subtotal This Page $1,630.00 I

Page 14 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Brad L Beachy 4525 E 2nd St N

06/21/2016 Wichita, KS 67208-3905 D [Z] D

Wichita/Hutchinson Labor Federation, AFL-CIO COPE

07/07/2016 3219 W Central Ave D [Z] D Wichita, KS 67203-4915

Lisa Kay Vayda 14400 E Sport Of Kings St Pharmacist

05/25/2016 Wichita, KS 67230-7139 D [Z] D Healthcare

Patty Neises 1742 E 125th St S Finance

05/04/2016 Geuda Springs, KS D [Z] D 67051-8060 Finance

Mark Krusor 7 Braid Hill Dr Attorney

05/04/2016 Winfield, KS 67156-6303 D [Z] D Legal

Rebecca Craft 2004 S Welsh St Management

06/27/2016 Wichita, KS 67230-7623 D D D Semiconductor test

Carole Garretson 26 N Cypress Dr

06/01/2016 Wichita, KS 67206-2537 D D D

Amount of Cash, Check,

Loan or E funds Other Other Receipt

D $50.00

D $500.00

D $100.00

D $250.00

D $150.00

[Z] $500.00

[Z] $50.00

[ Subtotal This Page $1,600.00 [

Page 15 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Drew De Soto Humphrey 15720 Bull Run Rd

04/28/2016 Apt 181H D D D Miami Lakes, FL 33014-2189

Frank Vopat 503 N Forestview St

05/25/2016 Wichita, KS 67235-8103 D [ZJ D

Joy Hustead 4714 N Portwest Cir

06/02/2016 Wichita, KS 67204-2359 D [ZJ D

Don Allison 7124 E Rockhill St Retired

07/17/2016 Wichita, KS 67206-1060 D [ZJ D Retired

Jeff and Patti Ayesh 1044 N Rutland St

05/25/2016 Wichita, KS 67206-3823 D [ZJ D

Jack and Gloria Focht 1551 N Waterfront Pkwy Legal

06/02/2016 Ste 100 D [ZJ D Wichita, KS 67206-6605 Legal

Patricia Sherwood 933 N Tara Ln Business Owner

06/17/2016 Wichita, KS 67206-1835 D [ZJ D Construction

Amount of Cash, Check,

Loan or E funds Other Other Receipt

[ZJ $35.00

D $100.00

D $100.00

D $500.00

D $100.00

D $250.00

D $1,000.00

I Subtotal This Page $2,085.00 I

Page 16 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Mary Ellen and Harry Williford 960 N Valleyview St Business

06/24/2016 Wichita, KS 67212-4546 D 0 D Business

Keith Peter Humphrey 2924 N Rough Creek Rd CEO

03/04/2016 Derby, KS 67037-9394 D D 0 Aviation

Paul Treadwell 10101 E 47th St S Real Estate Developer

05/24/2016 Derby, KS 67037-9114 D 0 D Development

Anita L Jones 1440 N Gatewood St Retired

05/13/2016 Apt 25 D 0 D Wichita, KS 67206-1253 Retired

Dee Ann DeRoin 1617 Massachusetts St

07/13/2016 Lawrence, KS 66044-4255 D D D

John and Barbara P Fuller 6900 E Zimmerly St Engineering

05/18/2016 Wichita, KS 67207-2822 D 0 D Engineering

Judy L Burgess 7700 E 13th St N

07/13/2016 Unit 68 D D D Wichita, KS 67206-1289

Amount of Cash, Check,

Loan or E funds Other Other Receipt

D $500.00

D $2,000.00

D $250.00

D $200.00

0 $50.00

D $250.00

0 $100.00

I Subtotal This Page $3,350.00 I

Page 17 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Susan Lohrey Moeder 104 7 W River Blvd Landscape Architect

05/25/2016 Wichita, KS 67203-3339 D 0 D Landscaping

Pat L Ciotti 2468 S Bennett Ave

06/20/2016 Wichita, KS 67217-1806 D 0 D

Keith D Stevens 231 N Crestway St finance

05/25/2016 Wichita, KS 67208-3841 D 0 D Finance

Allison K. Lemons 6713 E 10th St N Professor

06/03/2016 Wichita, KS 67206-1327 D 0 D

Paul Francis Babich 9400 E Wilson Estates

05/24/2016 Parkway Unit 504 D 0 D Wichita, KS 67206

Jenny L Gholson-Morris 338 W 35th St S

05/18/2016 Wichita, KS 67217-3514 D D D

David and Debra Seely 1115 W River Blvd

05/10/2016 Wichita, KS 67203-3340 D 0 D

Amount of Cash, Check,

Loan or E funds Other Other Receipt

D $200.00

D $25.00

D $100.00

D $50.00

D $100.00

0 $20.00

D $100.00

I Subtotal This Page $595.00 I

Page 18 of 23

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Check Occupation & Industry of Appropriate Box

Date Name and Address of Individual Giving More Contributor Than $150 Cash Check Loan

Connie Bonfy 430 S Commerce St

06/27/2016 Wichita, KS 67202-4601 D D D

Kansas Contractors Association Political Action

06/21/2016 Committee D [Z] D 800 SW Jackson St Ste 100 Topeka KS 66612-1216

Maria C Cecilia Blackwell 6500 E 21st St N

05/31/2016 Unit 23 D [Z] D Wichita, KS 67206-3905

Pete Desoto 428 ND St Retired

05/06/2016 Lompoc, CA 93436-5418 D [Z] D Retired

Margot Breckbill 618 N Doreen Ct

07/21/2016 Wichita, KS 67206-1649 D [Z] D

Complete if this is the last page of Schedule A

Total Itemized Receipts for Period

Total Unitemized Contributions

Sale of Political Materials (Unitemized)

Total Contributions When Contributor Not Known

TOTAL RECEIPTS TlllS PERIOD (to line 2 of Summary)

Amount of Cash, Check,

Loan or E funds Other Other Receipt

[Z] $100.00

D $1,000.00

D $50.00

D $1,000.00

D $75.00

$46,505.00

$0.00

$0.00

$0.00

$46,505.00

j Subtotal This Page $2,225.00 j

Page 19 of 23

Keith P Humphrey

SCHEDULEB IN-KIND CONTRIBUTIONS

(Name of Candidate, Party Committee or Political Committee)

Date Name and Address of List Occupation & Contributor Industry for Those

Giving an In-Kind of More Than $150

Keith Peter Humphrey

07/21/2016 2924 N Rough Creek Rd Derby, KS 67037-9394

Thomas R Docking Morris Laing Evans 05/25/2016 125 S Crestway St Brock & Kennedy

Wichita, KS 67218-1309 Legal

Jill S Docking Investment Broker, 05/25/2016 125 S Crestway St Financial Services

Wichita, KS 67218-1309 Finance

Keith Peter Humphrey

05/31/2016 2924 N Rough Creek Rd Derby, KS 67037-9394

Complete if last page of Schedule B

Total Itemized (over $100) In-Kind Contributions

Total Unitemized ($100 or less) In-Kind Contributions

Description of In-Kind Value of Contribution In-Kind

Contribution

Mail Chimp account $30.00 fees

Fundraiser expenses $1,000.00

Fundraiser expenses $449.95

Charge to boost $15.00 Facebook post

$1,494.95 $0.00

TOTAL IN-KIND CONTRIBUTIONS TIDS PERIOD (to line 6 of Summary) $1,494.95

!Subtotal This Page $1,494.951

Page _1Q_ of _1]_

SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Date Name and Address Purpose of Expenditure or Disbursement Amount

04/09/2016 United States Postal Service postage - Fundraising Expenses $47.00 300 W 2nd St N Wichita, KS 67202

05/05/2016 Office Max Mailing items - Postage/Shipping $84.87 613 S Dugan Rd Ste 100 Wichita, KS 67209-2355

03/04/2016 Meritrust Transfer to Business Membership Account. - $25.00 1257 N Buckner St Miscellaneous Derby, KS 67037-2721

06/02/2016 Sage Payment Solutions processing fees - Fundraising Expenses $56.46 12120 Sunset Hills Rd Ste 500 Reston, VA 20190-5858

05/04/2016 United States Postal Service Postage - Postage/Shipping $141.00 300 W 2nd St N Wichita, KS 67202

03/30/2016 NGPVAN Account Fees - Fundraising Expenses $450.00 110115th St NW Ste 500 Washington, DC 20005-5006

06/06/2016 NGPVAN Account Fees - Fundraising Expenses $450.00 1101 15th St NW Ste 500 Washington, DC 20005-5006

05/02/2016 Sage Payment Solutions processing fees - Fundraising Expenses $0.40 12120 Sunset Hills Rd Ste 500 Reston, VA 20190-5858

Subtotal This Page $1,254.731

Page __ll_ of -11_

SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS

Keith P Humphrey (Name of Candidate, Party Committee or Political Committee)

Date Name and Address Purpose of Expenditure or Disbursement Amount

05/04/2016 Valley Offset Printing Print materials - Printing $382.70 160 S Sheridan Ave Valley Center, KS 67147-4701

07/05/2016 Sage Payment Solutions processing fees - Fundraising Expenses $39.05 12120 Sunset Hills Rd Ste 500 Reston, VA 20190-5858

04/25/2016 Valley Offset Printing Print materials - Printing $95.68 160 S Sheridan Ave Valley Center, KS 67147-4701

05/26/2016 Kansas Secretary of State Filing Fee - Filing Fee $145.00 120 SW 10th Ave Topeka, KS 66612-1226

05/02/2016 Sage Payment Solutions processing fees - Fundraising Expenses $56.70 12120 Sunset Hills Rd Ste 500 Reston, VA 20190-5858

04/29/2016 Valley Offset Printing Print materials - Printing $211.78 160 S Sheridan Ave Valley Center, KS 67147-4701

Complete if last oa2e of Schedule C Total Itemized Exoenditures This Period $2,185.64

Total Unitemized Expenditures $50 or less $0.00

TOTAL EXPENDITURES & OTHER DISBURSEMENTS $2,185.64

THIS PERIOD (to line 4 of Summary)

Subtotal This Page $930.91 I

Page --22._ of -21_

Keith P Humphrey

SCHEDULED

OTHER TRANSACTIONS

(Name of Candidate, Party Committee or Political Committee)

Date Name and Address Nature of Account or Loan Payable or Loan Receivable

Keith Peter Humphrey Loan from candidate 07/08/2016 2924 N Rough Creek Rd

Derby, KS 67037-9394

Keith Peter Humphrey Loan from candidate 03/04/2016 2924 N Rough Creek Rd

Derby, KS 67037-9394

Complete if last page of Schedule D

TOTAL OTHER TRANSACTIONS (to line 7 of Summary)

I Subtotal this Page

Balance at Close of Period

$15,000.00

$2,000.00

$11,000.00 /

$17.000.00 I

Page 23 of 23