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KANSAS GOVERNMENTAL ETHICS COMMISSION CEIPTS AM) EXPENDITURES REPORT F A CANDIDATE FOR STATE OFFICE OFc 2 6 J~~~ OCTOBER 30,2006 @ C..r,ZnO5,&, t!hkAT FIL OF STATE AND CANDIDATE'S COUNTY ELECTION &$@R , .r SEE REVERSE SIDE FOR INSTRUCTIONS A. Name of Candidate: COrey MOhn ;5"q , , 1 ' 1 0 9 - , . 1. , ', - 1 --LL/ Address: 21626 W. 53rd Street City and Zip Code: Shawnee 66226 County: Johnson Office Sought: State House of Representatives District: 39 B. Check only if appropriate: 4 Amended Filing Termination Report C. Summary (covering the period from July 21,2006 through October 26,2006) 1. Cash on hand at beginning of period .......................................................................... $2250.00 2. Total Contributions and Other Receipts (Use Schedule A) $21,224.37 ........................................ 3. Cash available this period (Add Lines 1 and 2) .......................................................... $23,474.37 4. Total Expenditures and Other Disbursements (Use Schedule C) ............................... $14,834.67 5. Cash on hand at close of period (Subtract Line 4 from 3) ........................................... $8,639.70 6. In-Kind Contributions (Use Schedule B) ......... $1 495.00 7. Other Transactions (Use Schedule D) .............. $0 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." - Date Signature of Treasurer GEC Form Rev, 2001 Print Page
Transcript
Page 1: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

KANSAS GOVERNMENTAL ETHICS COMMISSION

CEIPTS AM) EXPENDITURES REPORT F A CANDIDATE FOR STATE OFFICE

OFc 2 6 J~~~ OCTOBER 30,2006

@ C..r,ZnO5,&, t!hkAT

FIL OF STATE AND CANDIDATE'S COUNTY ELECTION &$@R , .r

SEE REVERSE SIDE FOR INSTRUCTIONS

A. Name of Candidate: COrey MOhn ;5"q , , 1 ' 1 0 9 - , . 1. ,

', - 1 --LL/ Address: 21 626 W. 53rd Street

City and Zip Code: Shawnee 66226 County: Johnson

Office Sought: State House of Representatives District: 39

B. Check only if appropriate: 4 Amended Filing Termination Report

C. Summary (covering the period from July 21,2006 through October 26,2006)

1. Cash on hand at beginning of period .......................................................................... $2250.00

2. Total Contributions and Other Receipts (Use Schedule A) $21,224.37 ........................................

3. Cash available this period (Add Lines 1 and 2) .......................................................... $23,474.37

4. Total Expenditures and Other Disbursements (Use Schedule C) ............................... $1 4,834.67

5. Cash on hand at close of period (Subtract Line 4 from 3) ........................................... $8,639.70

6. In-Kind Contributions (Use Schedule B) ......... $1 495.00

7. Other Transactions (Use Schedule D) .............. $0

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."

- Date Signature of Treasurer

GEC Form Rev, 2001

Print Page

Page 2: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE A CONTRIBCrTIONS AND OTHER RECEIPTS

Corey Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Political Committee)

Name and Address of Contributor

Judy Klapmeyer

0106 1321 SW Mic 0 Say Dr Blue Springs, MO 64015

Maggie Wagner

Kansas City, MO 64131

KS 3rd ~ m ~ r e s s i o n a l District Caucus

811 6/06 Lawrence, KS 66049'

I I Evan P a w 1 8110106 1 12281 ~ r ~ e n n e s s e e Qr., Unit 203 Aurora, CO 80012

St. Charles. MO 63303

Jennifer Hartigan 811 0/06 6220 Northwood Ave.

St. Louis, MO 63112

324 Collins Ave., Apt. 2 Cincinnati. OH 45202

Diana Stultz 811 1/06 736 NW Rosaceae

Blue Springs, MO 64015

Blue Springs. MO 64014

Patricia McCarmick

811 1/06 15406 E. 45th Place Independence, MO 64055

1 i

Check I .4mount Oecupatioa of Individunl I Appropriate Box I Cmh, Cheek, Giving More Thnn $150 tTq-xz

Political organlzatlbn

Llarketing Manager /o/o

Loan or -1 Other Receipt I

Page 3: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Corey Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Political Cornittee)

Page 3.00 of

I

Date

8/12/06

8/12/08

811 3/06

8/14/06

811 4/06

811 4/06

8'14/06

8/14/06

811 5/06

8/15/06 I

Name and Address of Contributor

Mary Weiss Heritage House #301 - 660 N. Spring Independence. Mo 64055

Claire Hundelt 2 Wydown Terrace St. Louis, Mo 63105

Maridella Carter 3019 Victoria Lane Blue Springs, MO 64015

Debbie Weiss 7831 W. 1 18th St. Overland Park, KS 66210

Ray Cox 824 S. 131 st Bonner Springs, KS 66012

Janet Fain 101 3 SW 23rd Blue Springs, MO 64015

Jan Rush 1 104 NW Cedar Lane Grain Valley. MO 04029

Michael Sarnara 1250 S. Michigan Ave. Chicago, IL 60605

Alicia Weir 3515 SW Meyer 6lvd. Blue Springs, Mo 64015

Susan Andenon 3966 Arsenal St. St, Louis, MO 63116

I

- Cash

0

0

I

Occupation of Individual Giving More Thnn $150

I

State Representative

I

Amount of Cnsh, Ched,

Loan or Other Receipt -

sloo.00

sroo.oo

$30.00

$100.00

5250.00

$25.00

$2500

otoo.00

uoo.m

$30.00 I

1

.

Ofher

0

I

Check Appropriate

Check

m

O M ~ O

U ~ O O

pj

m z m o I

Box

Loan

0

I

Page 4: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE A CONTRIBUTIONS BIND OTHER RECEIPTS

CoreY Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Political Committee)

Name and Address Occupation of Individual of Contributor Giving More Than $150

Professor of Education

I

8/16/06

811 7106

8/21/06

8/21/06

8/28/06

8'28106

8/31/06

<

8/31/06

9/5/06

I

rJ

0

Independence, MO 64055

Patricia Mohn 17616 E. 48th Terr Ct. S Independence. Mo 64055

Casey Mohn 228 Blue Bonnet Brighto~, CO 80601

Stephen Stoll 71'6 Richard Avenue Festus, MO 63028

James Davis 600 W. Polo Drive St. Louis, MO 63105

Amanda Mertens 1 13 E. Luray h e . Alexandria, VA 22301

Jim Nutter 1201 W. 66th St. Kansas City, MO 641 13

Ron Lybarger 23402 W. 45th Terrace Shawnee, K s 66226

Jana Humble 2636B S. 13th Street St. Louis, MO 631 18

Laborers Local Union #I290 PAC 2600 Merriam Lane Kansas City, KS 66106

I I

ssoo.oo

$5.00

$100.00

$50.00

$75.00

S250.00

$aoo.oo

$40.00

$300.00

I

Parents as Teachers Coordinator

Mortgage Advisor

Un~on

I I

~ U U D

l xzmo L K K l @

O m n o

Lmzl00

a

Page 5: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE A CONTRIBUTIONS ,4ND OTHER RECEIPTS

Carey Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Political Committee)

Name and Address I Occupation of Individunl of Contributor Giving More Than $150

9/1 1/06

Lifesaving Cures organization

Dyan Ortbal-Avalos 6014 Louisiana St. Louis, MO 631 11

911 7/06

Kansans for Lifesaving Cures P.O. BOX 188 Lawrence, KS 66044

110 W. 6th Topeka. KS 66603

I I

Kansas AFL-CIO Cope Fund Union

gl, 1/06.

Patricia Vebsky 6521 1st Avenue SW Cedar Rapids, IA 52405

9/16/06

911 6/06

Kimberly Martin 11580 Perkins Rd. #288 Baton Rouge, LA 70810

Kansas Contractors Association PAC P.0. BOX 5061 Topeka. KS 66605

7/06

I I Johnson Go. Dem. Central Committee I Johnson County

I

Roslyn Bethke 5633 Woodland Shawnee, KS 6621 8

911 7/06

2061 7 W. 96th St. Lenexa, KS 66229

I

Mark Parkinson 10590 Glenview Lane Olathe, KS 66061

Johnson Co. Dem. Central Committee

911 8/06 20617 W. 96th St. Lenexa, KS 66229

Democratic Party

Johnson County Democratic Party

Page 5.00 of

Check Appropriate Box

'mount of Cash, Check.

Page 6: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE A CONTRIBUTIONS AND OTHER FtECEIPTS

Corey Mohn, Mohn for Kansas

(Name of Canddate, Party Committee or Political Committee)

I

Date

911 8/06

91,

9,1 9/06

911 9/06

9120/06

9/20/06

9120106

9/20/06

9/21/06

912210~ I

Amount of Cash, Check,

Loan or Other Receipt

$500.00

S500.00

$lOo.Oo

1500.00

$500.00

$250.00

$100.00

5400.00

%OO.OO

I noo.oo

Other

C]

0

C]

0

0

I

Check Name and Address Occupntion of Individual Appropriate Box

of Contributor Giving More Than S150 '

KS National Education Assoc. PAC 71 5 SW 10th Avenue Topeka, KS 66612

Operating Engineers Local 101 PAC 6601 Winchester, Suite 280 Kansas C~ty, MO 64133

John Huber 5026 Leona St. Louis. MO 631 16

Carpenters Distr~ct Counc~l of KC 625 W. 39th St. Kansas City, MO 641 11

Kansas State UAW PAC 500 Kindelberger Road Kansas City, KS 661 15

Kansas Physical Therapy Assoc. PAC 214 SW 6th Ave., Su~te 205 Topeka, KS 66603

John Parisi 13013 El Monte Leawood, KS 66209

Kansas SF Insurance PAC 555 S. Kansas Ave., Suite 301 Topeka, KS 66603

KC Chamber of Commerce PAC 91 1 Main St., Suite 2600 Kansas City, MO 64105

Intl. Assoc. of Fire Fighters PAC Kansas City, KS 661 17

I

Public education organization

Union

Union

Union

Physical Therapy organization

Insurance agents and employees

Business organ~zat~on

Fire Fighters

I

Cash

0

0

0

0

0

0

0

I

Check

[JI

0

0

0

I [JI

Loan

0

0

0

0

0

0

0

I

Page 7: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE A CONTRIBUTIONS AND OTHER RECEJPTS

Corey Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Political Committee)

7 00 Page - of . . . . - - -. . . . - - - - - -

N m e and Address Occupation of Individual of Contributor Giving More Than $150

Kansas City. KS 661 03

9/22/06

"

9/25/06

9/25/06

9/25/06

9/26/06

9/26/06

9/27/06 Independence, MO 64050

Kansas City, MO 641 17

Kathleen Cook 5530 Noland Road Shawnee, KS 66216

Jeanne Kirkton 659 Tuxedo 8hd. St. Louis, MO 631 19

Jessica Avery 50 West River Center Blvd. M O O Covington, KY 41 01 1

Daniel Crabtree 3307 N. 111th Kansas City. KS 66109

Mary Baskett 22521 W. 53rd Terrace Shawnee, KS 66226

Pipefitters Local Union 533 8600 Hillcrest Rd. Kansas City, MO 64138

Plasterers' & Cement Masons #518 301 S. Main St.

Union

Union

0

0

mzmo 0

O O O I Z I

mzmn o n u

0

0

rs]

0

$50.00

$100.00

$30.00

$50.00

$50.00

$350.00

Page 8: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE A CONTRIBUTIONS AND OTHEX RECEIPTS

Corey Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Political Committee)

Date

9130106

1011106

I

Check Amount of Name and Address Occupntion of Individual Appropriate Box Cash, Check,

of Contributor Giving More Than $150 Loan or Caah Cheek Lorn Ocher Other Receipt

1 .

Betty Slegman 6547 Wenonga Terrace Mission Hills, Ks 66208 C] ~Ioo.oo

Sally Levitt 19707 W. 63id Terrace Shawnee, KS 66218 $50.0(

Roofers Local #20 Union 6321 Blue Ridge Blvd., Ste. 202 Raytown, MO 64133 C] C] 8150.0(

Phil Ruffin Investor P.O. B o x 17087 Wichita. KS 67217 0 0 $200.0[

United Transportation Union Union 533 Walnut, P.O. Box 537 Osawatomie, KS 66064 0 $400.0c

Deffenbaugh Industries, Inc. Disposal Services P.O. Box 3220 Shawnee, KS 66203 C] $500.OC

Kansas AFL-CIO COPE Fund Umon 11 0 West 6th Topeka. KS 66603 $100.00

United Steelworkers #241 Union P.O. Box 1238 El Dorado, KS 67042 $ZOo.oo

darilyn Anderson 2377 163rd Street 3asehor, KS 66007 lmzloo $50.00

Sreater KC Women's Political Caucus Women's issues group ).O. Box 10095 (ansas City, MO 641 71 I

Page 9: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Carey Mohn, Mohn for Kansas - (Name of? Candidate, Party Committee or Political Committee)

Date r Check Amount of

Name and Address Occupation of Individual Appropriate Box Cash, Check, of Contributor Giving LMore Than S150

Kansas City, KS 66106

John Smith

Chris Garcia 15409 Martha Street Basehor, KS 66007 $50.00

Lebert D. Shultz 1507 W. 89th St. srairie Village, KS 66207 cmmzKl $75.00

3avid A. Raffel 7019 NW Emerald Hills Drtve 'arkville, MO 64152 0 $100.00

Nillianl Roy lo617 W. 96th Street .enexa, Ks 66220 U D O O $50.00

laniel Keleti 12216 Alhambra St. .eawood, KS 66209 00[70 $5.00

bnsas State Troopers Law enforcement 1200 SW 10th Avenue ropeka, KS 66604 I

9.00 Page - of . . .

Page 10: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE A CONTRIBUTIONS AND OTHER R.ECEIPTS

Corey Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Political Committee)

Occupation of h d i ~ i d u a l Name and Address of Contributor Giving More Thnn S150

10/11/06

1106

011

10/11/06

1/06

10/13106

10/13/06

10/73/06

lo/131o6 Kansas City, MO 64120

I

Muriel Jared 528 S. Bluegrass Dr. Bonner Springs, KS 660 12

Boilermakers-Blacksmiths LEAP Fund 753 State Ave.. Suite 565 Kansas City, KS 66101

IBEW Local #I24 Fund 301 E. 103rd Terrace Kansas City, MO 641 14

Heavy Constructors Association 3101 Broadway St., Suite 780 Kansas City, MO 641 1 1

Jonathan Lewis 1407 W. Elm St. Arlington Heights, IL 60004

Johnson Co. Dem. Central Committee 20617 W. 96th St. Lenexa, KS 66229

KQHRA P.0. BOX 288 Eureka, KS 67045

Mid Continent Racing & Gaming Co. I01 Jules St. St. Joseph, MO 64501

lBEW Local 1464 COPE 6200 E. Connecticut Ave.

Unian

Union

Construction

Johnson County Democratic Party

Sport racing

Sport racing

Union

0 '

0

--

lmzlnu

o m n u

fl

0

0

0

0

$25.00

$500.00

16500.00

$500.00

$100.00

%OO.OO

5300.00

$250.00

Page 11: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

Cocey .Mohn, Mohn for Kansas

(~a rneGf Candidate, Party Comm~ttee or Political Committee)

1

Date

10/18/06

10/20/06

0/20/06

Name and Address of Contributor

Lynette Shaw 5225 Renner Rd. Shawnee, KS 66217

Sheet Metal Workers Local No. 2 2902 Blue Ridge Blvd. Kansas City, MO 64129

Roofers, Waterproofers, and Wkrs. 1660 L Street, NW - Suile 800 Washington. DC 20036

Phil Scaglia

Occupation of Individual Giving More Than $150

Energy executive

Un~on

Un~on

Consultant

Retired

Women's group

Energy corporation

Union

I

Amount of Cash, Check,

Lonn or Other Receipt

~ 5 0 . 0 0

$SoO.oo

1150.00

*

Cash

111

0

0/20/06

1 0 ~ 0 / 0 6

.,0~1/06

10121106

10/21/06

10;21/06

40,23106 1

$250.00

sqoo.oo

$50.00

$200.00

SlOO.00

9300.00

I s2so.00

I

2903 SW 13th Terrace Lee's Summit. M o 64081

Roger Miller P.O. BOX 417 Bonner Springs, Ks 66012

Doug Wells 5891 SW 29th S t ~ e f Topeka, KS 66614

John R. Van Keppel 13741 Pembroke Circle Leawood. KS 66204

Kansas Federation of Dem. Women 7821 Marty Overland Park, KS 66204

BP North America Employee PAC 4101 Winfield Road - 106D Warrenville, I1 60555

KC Bldg. and Construct. Trades 400S.MainStreet Independence, MO 64050

1

Check Appropriate

Check

lmzlon

I

Box

Loan

0

Other

c7

0

0

I 0

0

i 0

Page 12: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

Corey Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Political Committee)

Check Appropriate Box

Amount of Cash, Check,

Loan or Other Receipt

Occupation of Individual Giving more Than $150

Name and Address of Contributor

--

Cash I Cheek-

Eleanor Lowe 3301 W. 68th Shawnee Mission, KS 66208

Mainstream PAC P.O. Box 6073 Leawood, KS 66206

Mainstream values group

Carl Shewmaker 402 N. Main Street Eureka, KS 67045

City of Shawnee 1 1 1 10 Johnson Drive Shawnee, KS 66203

(Refund of Deposit)

KS Families United for Public Ed 15941 W. 65th Street Shawnee, KS 66217

Ronnie Newton 18561 Linwood Road Linwood, KS 66052

Business Manager

- - --

Teamsters Local 41 PAC 4501 Emanuel Cleaver II Blvd. Kansas City, MO 64130

Frank Woodbury IV 4921 Woodstock Street Shawnee, KS 6621 8

Complete if last page of Schedule A

I Total Itemized Receipts for Period 1 $21.124.00 1 --

I Total Unitemized ~ G i b u t i o n s ($50 or lz) I Sale o f Political Materials (Unitemized) I $0.00 1 I Total Contributions When Contributor Not Known I $0.00 1

12 Page - o f -

Page 13: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE B IN-KIND CONTRIBUTIONS

Corey Mohn, Mohn for Kansas --

; ~ m e of Candidate, Party Committee or Political Committee)

Complete if last page of Schedule B

of Contributor

W. 50th Street

St. Louis, MO 63109

Total Itemized (over $50) In-Kind Contributions $1,495.00

10/26/06

10126106

- - -

1 T O ~ Unitemized ($50 or less) lo-Kind Contributions

1 Page - of -

Susan Newton (Data Coordinator) 21 626 W. 53rd Street Shawnee, KS 66226

Casey Mohn (Computer Consultant) 228 Blue Bonnet Brighton, CO 80601

Communications services

Computer services - website development

$500.00

$495.00

Page 14: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE C EXPENDITURES AND OTHER DISBURSEMENTS

Corey Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Political Committee)

Date Name and Address I Purpose of Expenditure or Disbursement

USPS Postage Shawnee, KS 66226

Office Max Office supplies 15600 Shawnee Mission Parkway Shawnee, KS 66217

Office Max 15600 Shawnee Mission Parkway Shawnee, KS 66217

Office supplies

FedEx Kinkos Printing services 14904 87th Street Lenexa, K S 6621 5

Go0addy.com Web hosting 14455 N. Hayden Rd. Scottsdale, AZ 85260

The Record News 14690 Parallel Basehor, KS 66007

Printing services

City of Shawnee 1 1 1 10 Johnson Drive Shawnee, KS 66203

Room rental and deposit

I

Zorey 'Mohn Reimbursement for postage and office 21626 W. 53rd Street supplies 5hawnee, KS 66226

Amount

Page 15: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE C EXPENDXT'U'RJ3S AND OTHER DiSBUESEMEHTS

Corey Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Polihcal Committee)

Name and Address

UPS Store 22052 W. 66th St. Shawnee. KS 66226

USPS Shawnee, KS 66226

Brewer's Price Chopper 501 S. Commercial Dr. Bonner Springs, KS 66012

Brewer's Price Chopper 501 S. Commercial Dr. Bonner Springs, KS 66012

Brewer's Price Chopper 501 S. Commercial Dr. Bonner Springs, KS 66012

Price Chopper 5600 Hedge Lane Terrace Shawnee, KS 66226

Matchette Liquor 5566 Hedge Lane Terrace Shawnee. KS 66226

USPS Shawnee, KS 66226

Office Max 15600 Shawnee Mission Parkway Shawnee, KS 66217

Purpose of Expenditure or Disbursement

Amount

Printing services

Postage $78.0C

Event food

Event food

Event food

Event food $13.97

Event beverages

3ffice supplies $10.74

Page 16: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

1 s

SCHEDULE C EXPENDITURES .4ND OTHER DISBURSEMENTS

Corey Mohn. Mohn for Kansas -- (Name of Candidate, Party Committee or Political Committee)

o r Disbursement

9/28/06

9/29/06

10/4/06

,0/4/06

10/4/06

. 10/5/06

10/6/06

0/1 1 106

UPS Store 22052 W. 66th St. Shawnee, KS 66226

The Record News 14690 Parallel Basehor, KS 66007

Kansas Coordinated Campa~gn 700 SW Jackson St., Suite 706 Topeka, KS 66603

USPS Shawnee. KS 66226

UPS Store 22052 W. 66th St. Shawnee, KS. 66226

UPS Store 22052 W. 66th St. Shawnee, KS 66226

Brewer's Price Chopper SO1 S. Commercial Dr. Bonner Springs, KS 66012

10/1 1/06

NeoDems 7209 Eby Ave., #302 Merriam, KS 66204

Falcon Lakes Golf Course 4605 Clubhouse Drive Basehor, KS 66007

Printing services

Printing services

Campaign services

Postage

Printing services

Prmting services

Office supplies

Office Max 15600 Shawnee Mission Parkway Shawnee, KS 66217

$32.30

$522.34

$3,750.00

$39.00

$32.30

$1.84

$3.32

Printing services

Event room rental and service

$744.40

$650.00

Office supplies

$2.68

Page 17: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

SCHEDULE C E,YPENDITURES AND OTHER DISBURSEMENTS

Corey Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Political Committee)

Name and Address Purpose of Expenditure or Disbursement

Kansas Coordinated Campaign 700 SW Jackson St., Suite 706 Topeka, KS 66603

Campaign services

Lawrence Journal World c/o Shawnee Dispatch 10314 Shawnee Mission Parkway Shawnee, KS 66203

Advertising

Office Max Ofice supplies 15600 Shawnee Mission Parkway Shawnee, KS 66217

FedEx Kinkos Printing services 14904 87th Street Lenexa, KS 66215

UPS Store 22052 W. 66th Street Shawnee, KS 66226

Printing services

Corey Mohn 21 626 W. 53rd Street Shawnee, KS 66226

I Loan Payment

Amount

Complete if last page of Schedule C

Total Itemized Expenditures This Period

Total Unitemized Expenditures of $50 or less

4 Page o f -

$14,834.67

$0.00

TOTAL EXPENDITURES & OTHER DISBURSEMENTS THIS PERIOD (to line 4 of Summary) $1 4,834.67

Page 18: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

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KANSAS GOVERNMENTAL ETHICS COMMISSION~p," """~'

RECEIPTS AND EXPENDITURES REPORT £: L;f~~j\lo:;'"OF A CANDIDATEFOR STATEOFFICE . ~ ~ t" /;,,>...~~

n:-",

I.,Jt.l. :;;; 'fin'"OCTOBER 30, 2006 GOVQ - - ii.JiJ~

-~'T1entai E:th','C r-1<..- l'VEs, c-:';:'-:'-~omrnh,,),,-

FILEWITH SECRETARYOF STATEANDCANDIDATE'SCOUNTYEL~l~~-i~SEE REVERSE SIDE FOR INSTRUCTIONS O~'d.

A. Name of Candidate: Corey Mohn

Address: 21626 W. 53rd Street

Cityand Zip Code: Shawnee 66226

Office Sought: State House of Representatives

County: Johnson

District: 39

B. Check only if appropriate: I' Amended Filing - Tennination Report

C. Summary (covering the period from July 21, 2006 throtlgh October 26, 2006)

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) ,....................................

$5,255.00

$20,924.00

$26,179.00

$12,836.13

$13,342.87

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

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

6. In-Kind Contributions (Use Schedule B) $1,495.00

7. Other Transactions (Use Schedule D) $5,200.00

D. "I declare that this report, including any accompanying schedules and statements, has been examined by meand to the best of my knowledge and belief is true, correct and complete. I understand that the intentionalfailure to file this document or intentionally filing a false document is a class A misdemeanor."

11/2,1J00 ~~~ - ~Date Signature of Treasurer -.

GEC Form Rev, 2001

0-

Page 19: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

--SCHEDULE A

CONTRIBUTIONS A.NDOTHER RECEIPTS

Corey Mohn, Mohn for Kansas

(Name of Candidate, Party Committee or Political Committee)

Date

10/12/06

10/12/06

10/12/06

10/12/06

Name and Addressof Contributor

Occupation of IndividualGiving More Than $150

Check

Appropriate Box

Cash Check Loan Other

KS Families United for Public Ed15941 W. 65th StreetShawnee,KS 66217 DI[z]IDIDRonnie Newton18651 Linwood RoadLinwood, KS 66052

Business Manager

DI[l]IDIDTeamsters Local 41 PAC4501 Emanuel Cleaver /I Blvd.Kansas City, MO 64130 0 HZ]1010Frank Woodbury IV4921 Woodstock StreetShawnee,KS 66218 OI[Z]IDID

0101010

DIOIDID

DIDIDID

DIDIDID

DIDIDID

0101010

Pagc_of-

Amount of

Cash, Check,Loan or

Other Receipt

$100.00

$250.00

$125.00

$50.00

$525.00

--

Page 20: CEIPTS AM) EXPENDITURES REPORT OFc 2ethics.ks.gov/CFAScanned/House/2006ElecCycle/200610/H039CM_a… · Cincinnati. OH 45202 Diana Stultz 811 1/06 736 NW Rosaceae Blue Springs, MO

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