131/27/213213 14:135 3157888715 THE UPS STORE DERBY PAGE 132/138 i KANSAS GOV*RNMENTAL ETHICS COMMISSION RECEIPTS AND EXPENDITURES REPORT OF A POLITICAL OR P ARTY COMMITTEE .January 10,20.;; RECEIVED FILE WITH SECRETARY OF STATE JAN 272020 SEE REVERSE SIDE. FOR Political Committee B. Check only if appropriate: __ Amended Filing __ Termination Report . 1. Cash on hand at beginning of period 2. Total Contributions and Other Receipts (Use Schedule A) 3. Cash available this period (Add Lines 1 and 2) 4. Total Expenditures and OthertOisbursements (Use Schedule C) I 5. Cash on hand at close of perio,d (Subtract Line 4 from 3) 6. In-Kind Contributions (Use Schedule B) ..e- 7. Other Transactions (Use Schedule D) . . ·3801/79 .. 73DS.-D[) _. 1/./ () to, 71 .. ..Ljtj/9.Si , .. (P/372:; D. HI declare that this report, any'accompanying schedules and statements, has been examilled by roe 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· tionally filing a false document is a class A misdemeanor." Date GEe Form Rev, 2017
7
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131/27/213213 14:135 3157888715 THE UPS STORE DERBY PAGE 132/138 i
KANSAS GOV*RNMENTAL ETHICS COMMISSION
RECEIPTS AND EXPENDITURES REPORT OF A POLITICAL OR PARTY COMMITTEE
.January 10,20.;; RECEIVED
FILE WITH SECRETARY OF STATE JAN 272020 SEE REVERSE SIDE. FOR INSTRUCTI~~~
Ol'ernmenr~
~ Political Committee
B. Check only ifappropriate: __ Amended Filing __ Termination Report .
1. Cash on hand at beginning ofperiod
2. Total Contributions and Other Receipts (Use Schedule A)
3. Cash available this period (Add Lines 1 and 2)
4. Total Expenditures and OthertOisbursements (Use Schedule C)I
5. Cash on hand at close ofperio,d (Subtract Line 4 from 3)
6. In-Kind Contributions (Use Schedule B) ..e7. Other Transactions (Use Schedule D) ~
. .·3801/79 .. 73DS.-D[)
_ . 1/./() to, 71 .. ..Ljtj/9.Si
, .. (P/372:;
D. HI declare that this report, includ.i.n~ any'accompanying schedules and statements, has been examilled by roe and to the best ofmy knowledge! and belief is true, correct and complete. I understand that the intentional failure to file this document or· tionally filing a false document is a class A misdemeanor."
1~27-202.0 Date
GEe Form Rev, 2017
01/27/2020 14:05 3167888715 THE UPS STORE DERBY PAGE 03/08
.....-~---.---~~Loan or Other CUh .CUdt. x-. ~~ Receipt
§O(y{),D() ,I
/130,00
;. ....
v tOD,DO
V 760. 0tJ
V ,2tJO~()O
/.9}/8/11 ~J t:J~7ft . i
4/~ Kf, &?aL"3{)
:Page _/_ofL .
01/27/2020 14:05 3157888715 THE UPS STORE DERBY PAGE 04/08
.',
. Date Name lIDd Address
of Contributor ..
. Check . Amount of Appropriate Box ow.. Chedf,
~-r-'"--.......--,....,..--i Loan ~ Otber Receipt
•. page ofSchedule A
Total Ttemjred ~ fur: P~od
0.00
. Page £orL
PAGE 05/08THE UPS STORE DERBV01/27/2020 14:05 3157888715
SCBEDULEC EXPENDl1rIDlES AND OTBERDISBURSEMENTS
(N~~'D~~ 1"oJJ!o!e of:ExoePaitnre ,
i
Jtig4epeod~ or ~kbtd expenditure in'~ofS300isName aDiI. Address. Dam To. WhOlD:bpcn~ fslMade _ madefor a eandi~ list caDdidate Barno &- adches8 Am.OJUrt
PAGE 07/08THE UPS STORE DERBY01/27/2020 14:05 3157888715
I . . ...
: Porpo.tt: of1ii}pnulHnre I
Jttudependent or in_d upenditnre mexces.s ofS300 b Name aDd Addn:ss' ~re 'fuWhom ~dttureh!l\ofsde . made to J' :t ca.ndlcbtte, Jist~didafe name &: address Amonnt .\ .
01/27/2020 14:05 3157888715 THE UPS STORE DERBY PAGE 08/08
SCHEDULEC EXPENDI'ifURES AND OTHER DISBURSEMENTS
~~~~~ (Name of Party Committee or POltlcacomIiiittee
Purpose of ExpenditureI Name and Addtless
If iodependllJlt or io-kJnd e.)fpenditure In ucess of $300 18To Whom Expendltur;e .i.s Made AmountDate ro~de for 8 candidate., list candidate. Dame & address