------ KANSAS GOVERNMENTAL ETHICS COMMISSION RECEIPTS AND EXPENDITURES REPORT RECEIVED OF A CANDIDATE FOR STATE OFFICE JUl 27 2018 July 30,2018 KS Governmental Ethics Commission FILE WITH SECRETARY OF STATE SEE REVERSE SIDE FOR INSTRUCTIONS A. Address: 9014 EScott St City and Zip County: _S_G _ Office Sought: State Representative District: 81 B. Check only if appropriate: Amended Filing Termination Report C. Summary (covering the period from January 1,2018 through July 26, 2018) 1. Cash on hand at beginning of period .. 0.00 2. Total Contributions and Other Receipts (Use Schedule A) .. 2255.00 3. Cash available this period (Add Lines 1 and 2) .. 2255.00 4. Total Expenditures and Other Disbursements (Use Schedule C) . 591.26 5. Cash on hand at close of period (Subtract Line 4 from 3) . 1663.74 6. In-Kind Contributions (Use Schedule B) ......... 223.00 7. Other Transactions (Use Schedule D) . 423.00 D. "f 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 truc, correct and complete. f understand that the intentional failure to file this document or intentionally filing a false document is a class A misdemeanor." - 7-27-2018 Date Signature"6f Candidate or Treasurcr GEe Form Rev, 2018
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KANSAS GOVERNMENTAL ETHICS COMMISSION
RECEIPTS AND EXPENDITURES REPORT RECEIVED OF A CANDIDATE FOR STATE OFFICE
JUl 2 7 2018 July 30,2018
KS Governmental Ethics CommissionFILE WITH SECRETARY OF STATE
SEE REVERSE SIDE FOR INSTRUCTIONS
A. N~e~Canili~~:_S_h_a_l_a_P_e_~_z~~~~~~~~~~~~~~~~~~~~~~_
Address: 9014 EScott St
City and Zip Code:~W_i_ch_i_ta~6_7_21_0~~~~~~~~~~~_ County: _S_G _
Office Sought: State Representative District: 81
B. Check only if appropriate: ~~ Amended Filing ~~ Termination Report
C. Summary (covering the period from January 1,2018 through July 26, 2018)
1. Cash on hand at beginning of period .. 0.00
2. Total Contributions and Other Receipts (Use Schedule A) .. 2255.00
3. Cash available this period (Add Lines 1 and 2) .. 2255.00
4. Total Expenditures and Other Disbursements (Use Schedule C) . 591.26
5. Cash on hand at close of period (Subtract Line 4 from 3) . 1663.74
6. In-Kind Contributions (Use Schedule B) ......... 223.00
7. Other Transactions (Use Schedule D) . 423.00
D. "f 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 truc, correct and complete. f understand that the intentional failure to file this document or intentionally filing a false document is a class A misdemeanor."
-7-27-2018
Date Signature"6fCandidate or Treasurcr
GEe Form Rev, 2018
Shala Perez (House 81) Reporting Period 1/1/2018 through 7/26/2018 Schedule A Page 1 of 2
Date Amount Method Last First Company Occupation Address City State Zip 5/24/18 100.00 Loan Perez Shala Perez for Kansas Candidate PO Box 781001 Wichita KS 67278
5/24/18 100.00 Loan Perez Shala Perez for Kansas Candidate PO Box 781001 Wichita KS 67278
7/5/18 500.00 Check Kansas National Education Association PAC Advocacy 715 SW 10th Ave Topeka KS 66612
7/14/18 50.00 Check Seiu Missouri State Council PAC PAC Advocacy 5585 Pershing Ave Ste 120 Saint Louis MO 63112
7/18/18 25.00 Cash Santos Gterin La Gueladguetza Supermarket LLC Grocery Store 2425 S Hillside St #300 Wichita KS 67216
7/18/18 50.00 Check Chhetri Sanjay Prime Auto Sales LLC Auto Store
Trade 3150 Southeast Blvd Wichita KS 67216
7/18/18 50.00 Check Velasquez Eric Tax Rapido LLC Small Business
Owner 2959 S Hillside St #400 Wichita KS 67216
7/18/18 100.00 Cash Tacos y Mas Restaurant 552 SOliver Wichita KS 67218
7/18/18 20.00 Cash Olivas Tire Shop Auto Store
Trade 2211 N Broadway Wichita KS 67219
7/18/18 50.00 Check Fox Brendon C. Educator 4321 E27st St N Wichita KS 67220
7/19/18 40.00 Cash Nasiri Habib Nasiri Auto Body Shop Auto Store
Trade 3146 Southeast Blvd Wichita KS 67216
7/19/18 100.00 Check Toubia Joumana J. Two Olives Small Business
Owner 2444 N Rock Rd Wichita KS 67226
7/19/18 50.00 Check Rosie's Hair Fashion Cosmetology 511 W 21st N Wichita KS 67203 7/19/18 50.00 Cash P&M Service Tax Services 2317 N Arkansas Ste. B Wichita KS 67204 7/19/18 5.00 Cash Estetica Cosmetology 2317 N Arkansas Ste. A Wichita KS 67204
7/19/18 100.00 Cash 3 Amigos Restaurant 2317 N Arkansas Ste. A Wichita KS 67204
7/19/18 100.00 Cash Mazanera Leonel Small Business
Owner 1129 N Gordon St Wichita KS 67203
7/19/18 20.00 Cash Gandara Jose L Cevicheria y Botanas La Isla LLC Restaurant 1935 N Broadway #107 Wichita KS 67214
7/19/18 100.00 Cash Medinatorres Jose Manuel Linas Restaurant VI LLC Restaurant 4910 ECentral Ave Wichita KS 67208
7/19/18 25.00 Cash Santiago Munoz 316 Meal Prep Restaurant 2959 S Hillside St #500 Wichita KS 67208 7/20/18 50.00 Cash Lopez Juan A Tacos Mexican Food LLC Restaurant 1930 E Pawnee St Wichita KS 67211
7/20/18 30.00 Cash Birrieria La Nieta De Villa Restaurant 2943 S Hillside St Wichita KS 67216
7/20/18 25.00 Cash Quality Imports Clothing Store
Trade 2959 S Hillside St #300 Wichita KS 67208
7/20/18 10.00 Cash Ortusala Letici Mexican Burrito Restaurant 3005 E Pawnee St Wichita KS 67211
7/20/18 50.00 Cash Ramirez Daniel Cactus Cantina & Grill Restaurant 2802 S Hydralic Ave Wichita KS 67216
7/20/18 100.00 Cash Cobos Francisco Danny Boy's Liquor 2247 N Arkansas Ave Wichita KS 67202
7/23/18 100.00 Check Flaharty Geraldine Retired 1816 E Fernwood St Wichita KS 67216
Shala Perez (House 81) Reporting Period 1/1/2018 through 7/26/2018 Schedule A Page 2 of 2
Date Amount Method Last First Company Occupation Address City State Zip 7/23/18 10.00 Cash Lopez Liquor Liquor 363 W 21st St Wichita KS 67203 7/24/18 30.00 Cash Garcia Cesar M Dulceria La Pelon a Grocery Store 1935 N Broadway Wichita KS 67214 7/24/18 25.00 Cash EI Molcajete Restaurant 1712 E47th St Wichita KS 67216 7/25/18 50.00 Check Sloop Patricia Retired 19505 Webb #121 Wichita KS 67207
7/25/18 50.00 Web Runkle Kevin Go Caves Small Business
Owner 2212 Duckcreek Ln Derby KS 67037
Shala Perez (House 81) Reporting Period 1/1/2018 through 7/26/2018 Schedule B Page 1 of 1
Date Value Description Last First Company Occupation Address City State Zip 5/22/18 120.00 Filing Fee Perez Shala Perez for Kansas Candidate PO Box 781001 Wichita KS 67278 6/24/18 45.00 Website Hosting Perez Shala Perez for Kansas Candidate PO Box 781001 Wichita KS 67278 6/24/18 29.00 Website Hosting Perez Shala Perez for Kansas Candidate PO Box 781001 Wichita KS 67278 6/26/18 29.00 Website Perez Shala Perez for Kansas Candidate PO Box 781001 Wichita KS 67278
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Shala Perez (House 81) Reporting Period 1/1/2018 through 7/26/2018 Schedule C Page 1 of 1
Date Amount Purpose Last First Company Address City State Zip 7/10/18 150.00 Website Graphics Jacques Designs LLC PO Box 382 Andover KS 67202 7/15/18 439.51 Campaign Materials BNV Printing 800 N Market Wichita KS 67214 7/25/18 1.75 Processing Fee Nation Builder 520 SGrand Ave Los Angeles CA 90071
Shala Perez (House 81) Reporting Period 1/1/2018 through 7/26/2018 Schedule 0 Page 1 of 1
Date Balance Nature of Loan or Account Last First Company Address City State Zip 5/22/18 120.00 Candidate filing fee Perez Shala PO Box 781001 Wichita KS 67278 6/24/18 45.00 Website: hosting Perez Shala PO Box 781001 Wichita KS 67278 6/24/18 29.00 Website hosting Perez Shala PO Box 781001 Wichita KS 67278 6/26/18 29.00 Website hosting Perez Shala PO Box 781001 Wichita KS 67278 5/24/18 100.00 Loan to campaign account Perez Shala PO Box 781001 Wichita
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Wichita KS 67278
5/24/18 100.00 Loan to campaign account Perez Shala PO Box 781001 KS 67278
