r--t~~ TL'1ANSAS GOVERNMENTAL ETHICS COMMISSION...
Transcript of r--t~~ TL'1ANSAS GOVERNMENTAL ETHICS COMMISSION...
r--t~~ l.....TL'1ANSAS GOVERNMENTAL ETHICS COMMISSION RECEIVED
JAN 11 2010 RECEIPTS AND EXPENDITURES REPORT
OF A CANDIDATE FOR STATE OFFICE
~ ON THORNBURGH January 10,2010
FILE WITH SECRETARY OF STATE AND CANDIDATE'S COUNTY ELECTION OFFICER SEE REVERSE SIDE FOR INSTRUCTIONS
SE CRETARY OF STATE
A. Name ofCandidate: _E_r_ic_P_a_y_n_e _
Address: 521 N. Bracken
City and Zip COde:_W_ic_h_i_ta_6_7_2_0_6 _ County: Sedgwick
Office Sought: State Representative District: 87 -----
B. Check only if appropriate: __Amended Filing __ Termination Report
C. Summary (covering the period from January 1, 2009 through December 31, 2009)
1. Cash on hand at beginning ofperiod . $0.00
2. Total Contributions and Other Receipts (Use Schedule A) .. $24,370.10
3. Cash available this period (Add Lines 1 and 2) .. $24,370.10
4. Total Expenditures and Other Disbursements (Use Schedule C) . $165.04
5. Cash on hand at close ofperiod (Subtract Line 4 from 3) .. $24,205.06
6. In-Kind Contributions (Use Schedule B) $473.42'
7. Other Transactions (Use Schedule D) $500.00
D. "I declare that this report, including any accompanying schedules and statements, has been examined by me and to the best ofmy 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."
1- 8-ID Date
GEe Form Rev, 2001
SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne (Narne of Candidate)
Date Narne and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other Receipt
Casb Check LoaD Otber
8/20/09 Eric &Cara Payne 521 N. Bracken Wichita, KS 67206
Manager Energy Sector .f .f $500.00
8/20/09 Melissa Mangan 804 N. Bracken Wichita, KS 67206
Attorney JudiciaVLegal t/ $500.00
8/20/09 Paul Mangan 804 N. Bracken Wichita, KS 67206
Crude Oil Schduling Oil t/ $500.00
8/21/09 Lee Bullock 517 E. Douglas, Apt. 505 Wichita, KS 67202
Accountant Oil .f $250.00
8/25/09 Sidney Reitz 1806 Stonebridge Ln Salina, KS 67401
Attorney Judicial/Legal .f $250.00
8/25/09 Susan Reitz 1806 Stonebridge Ln Salina, KS 67401
Retired
.f $250.00
8/25/09 Ken Wagnon 3445 N. Webb Rd Wichita, KS 67226
t/ $100.00
8/26/09 Andrew Frank 4217 Saddlehorn Dr Lawrence, KS 66049
Sales Manager Alchohollndustry .f $100.00
8/26/09 David Launder, Sr 4509W.64th Prairie Village, KS 66208
t/ $125.00
8/26/09 Blythe Launder 4509 W. 64th Prairie Village, KS 66208 .f $125.00
8/28/09 Matthew Murphy 11 Landings, Unit A Key Largo, FL 33037
Sales Director Financial .f $50.00
Subtotal This Page $2,750.00
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne (Narne of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other Receipt
Cash Check Loan Other
8/28/09 David Launder, Jr 46 W. 74th st Kansas City, MO 64114
Inside Sales Supervisor Manufacturing .f $250.00
8/28/09 Combined Energy Services P.O. Box 1388 Monticello, NY 12701
.f $50.00
8/29/09 Reed D. Miller 4615 Smith Joplin, MO 64804
.f $100.00
8/29/09 Thomas J. Link 4403 Cascade Rd, SE Grand Rapids, M149546
Owner Energy Sector .f $250.00
8/29/09 Judy Link 4403 Cascade Rd, SE Grand Rapids. MI49546
Accountant Accounting .f $250.00
8/29/09 Roland P. Penta 13 Bay View Terrace Geneva, NY 14456
.f $125.00
8/29/09 Beverly Penta 13 Bay View Terrace Geneva, NY 14456
.f $125.00
9/16/09 Joe Brooks 215 S. Clay Marshfield, MO 65706
Owner Energy Sector .f $250.00
9/16/09 John Brooks 215 S. Clay Marshfield, MO 65706
Owner Energy Sector .f $250.00
9/17/09 Robert B. Henson 2532 Stonepost Ln Salina, KS 67401
Dentist Medical .f $200.00
9/23/09 Ann Payne 100 River Place #4 Salina. KS 67401
Accounts Payable Energy Sector .f $500.00
Subtotal This Page $2,350.00
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Narne of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other Receipt
Calh Check Loa. Other
9/30/09 Vera L. Bothner 8212 W. Maple St Wichita, KS 67209
.f $50.00
9/30/09 Jim Bothner 8212 W. Maple St Wichita, KS 67209
.f $50.00
10/8/09 Charles B. Roth 3 Crestview Dr Salina, KS 67401
.f $50.00
10/25/09 David A. Payne 100 River Place #4 Salina, KS 67401
General Manager Energy Sector .f $500.00
11/2109 Christopher S. Crow 12621 E. Edgewood Dr Wichita, KS 67206
Sales Director Telecommunications .f $100.00
1117/09 Payne Oil Inc. 410 W. North St, Box 671 Salina, KS 67401
.f $500.00
11/14/09 Deanna Dakhil Ternes 6227 E. Brookview Ct Wichita, KS 67220
.f $25.00
11/14/09 Tyler Temes 6227 E. Brookview Ct Wichita, KS 67220
.f $25.00
11/14/09 Russell A. Jones 2331 Edgehill Rd Salina, KS 67401
.f $50.00
11/14/09 Jackie Jones 2331 Edgehill Rd Salina, KS 67401
.f $50.00
11/14/09 Douglas K. Blackman 511 Tumberry Cir Wichita, KS 67230
.f $50.00
Sub~otal This Page $1,450.00
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SCBEDULEA CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Name of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other Receipt
Cash Cluck Loan Other
11/14/09 Nancy Blackman 511 Turnberry Cir Wichita, KS 67230
~ $50.00
11/14/09 Clint Carrier 920 N. Sagebrush St Wichita, KS 67230
~ $25.00
11/14/09 Molly Carrier 920 N. Sagebrush St Wichita, KS 67230
~ $25.00
11/14/09 David J. Anderson 19 E. Douglas Eastborough, KS 67207
~ $25.00
11/14/09 Susie Anderson 19 E. Douglas Eastborough, KS 67207
~ $25.00
11/16/09 Christopher S. Crow 12621 E. Edgewood Dr Wichita, KS 67206
Sales Director Telecommunications ~ $100.00
11/16/09 Kathie Dakhil 1420 N. Linden Cir Wichita, KS 67206
Oncologist Medical .f $250.00
11/16/09 Shaker Dakhil 1420 N. Linden Cir Wichita, KS 67206
Oncologist Medical ~ $250.00
11/16/09 Kent Hodge 9112 E. Country Walk Wichita, KS 67206
.f $50.00
11/16/09 Kelly Hodge 9112 E. Country Walk Wichita, KS 67206
~ $50.00
11/16/09 Joel E. Parriott 1728 Uppermill Ter Salina, KS 67401
~ $50.00
Subtotal This Page $900.00
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Name of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other Receipt
Casb Check Loan Other
11/16/09 Lori Parriott 1728 Uppermill Ter Salina, KS 67401
.f $50.00
11/17/09 Kurtis G. Siemers 100 River Place #3 Salina, KS 67401
.f $50.00
11/17/09 Kitza Siemers 100 River Place #3 Salina, KS 67401
.f $50.00
11/17/09 David &Jeanette Mitchell 12710 Grant St Overland Park, KS 66213
.f $20.00
11/17/09 Ryan A. Payne #4 McArthur Ln Salina, KS 67401
Physician Medical .f $500.00
11/17/09 Sarah K. Payne #4 McArthur Ln Salina, KS 67401
Physician Medical .f $500.00
11/18/09 David Miller 133 E. Lake Dr Salina, KS 67401
.f $50.00
11/18/09 Linda Miller 133 E. Lake Dr Salina. KS 67401
.f $50.00
11/18/09 Grant Glasgow 5731 E. 39th St Bel Aire, KS 67220
.f $100.00
11/19/09 Lucas J. Meek 5123 Birch St Roeland Park, KS 66205
.f $50.00
11/19/09 Holly Meek 5123 Birch St Roeland Park, KS 66205
.f $50.00
Subtotal This Page $1,470.00
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Narne of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other ReceiptCash Check LoaD Other
11/19/09 Peter F. Brungardt 522 Fairdale Rd Salina, KS 67401
, $50.00
11/19/09 Rosie Brungardt 522 Fairdale Rd Salina, KS 67401
.{ $50.00
11/20/09 Richard A. Payne 225 Channel Rd Salina. KS 67401
.{ $100.00
11/20/09 Matthew Murphy 11 Landings, Unit A Key Largo, FL 33037
Sales Director Finance .{ $250.00
11/20/09 Salina Urology Associates, P.A. 501 S. Santa Fe, Ste 380 Salina, KS 67401
.{ $500.00
11/21/09 Darin Cartwright 14230 E. Boston Wichita, KS 67230
, $125.00
11/21/09 Olivia Cartwright 14230 E. Boston Wichita, KS 67230
.{ $125.00
11/21/09 George Keely 163 Freesia Ln Sunrise Beach, MO 65079
, $50.00
11/21/09 Holly Keely 163 Freesia Ln Sunrise Beach, MO 65079
, $50.00
11/21/09 Shannon Buchanan 2319 Meadow Ln Salina, KS 67401
, $125.00
11/21/09 Jo Buchanan 2319 Meadow Ln Salina, KS 67401
, $125.00
Subtotal This Page $1,550.00
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Narne of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate B'ox
Amount of Cash, Check,
Loan or Other Receipt
Cash Check Loan Other
11/21/09 Michael Lamone 2218 Hillside Dr Salina, KS 67401
.f $25.00
11/21/09 Bobbie Lamone 2218 Hillside Dr Salina, KS 67401
.f $25.00
11/21/09 Ann Jett 130 S. Estates Dr Salina, KS 67401
.f $50.00
11/23/09 Brandon Gray 58 S. Rollins Macon, MO 63552
.f $50.00
11/24/09 Combined Energy Services P.O. Box 1388 Montjcello, NY 12701
.f $100.00
11/24/09 Patrik Neustrom 15 Crestview Salina, KS 67401
.f $20.00
11/24/09 Jeff Geitz 5211 Plaza Ln Wichita, KS 67208
.f $25.00
11/24/09 Becka Geitz 5211 Plaza Ln Wichita, KS 67208
.f $25.00
11/25/09 Thomas M. Hemmer 214 Greenway Salina, KS 67401
.f $50.00
11/25/09 Maggie Hemmer 214 Greenway Salina, KS 67401
.f $50.00
11/25/09 Anne E. Aunins-Whiting 8507 E. Greenbriar Ct Wichita, KS 67226
.f $50.00
Subtotal This Page $470.00
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Narne of Candidate)
Date Narne and Address
of Contributor
PayPal P.O. Box 45950 Omaha, NE 68145
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate BOI
Amount of Cash, Check,
Loan or Other Receipt
Cash Check Loa. Other
11/25/09 .f $0.01
11/25/09 PayPal P.O. Box 45950 Omaha, NE 68145
t/ $0.09
11/27/09 Brett Payne 10412 Walnut Hollow Dr Oklahoma City, OK 73162
Teacher Education .f $300.00
11/27/09 Ben & Emily Weaver 5203 W. 77th Ter Prairie Village, KS 66208
.f $25.00
11/27/09 Mark Skidmore 24 Crestview Dr Salina, KS 67401
.f $20.00
11/28/09 Michael Ross 1185 Columbine Cir Salina, KS 67401
.f $25.00
11/28/09 Barbara Ross 1185 Columbine Cir Salina, KS 67401
t/ $25.00
11/28/09 Blake E. Reitz 2234 Marilla St Dallas, TX 75201
.f $50.00
11/28/09 Steven W. Brown 203 Greenway Rd Salina, KS 67401
.f $25.00
11/28/09 Martha Brown 203 Greenway Rd Salina, KS 67401
.f $25.00
11/28/09 Marjorie Hedman 1501 Inverness, #318 Lawrence, KS 66047
Retired
.f $250.00
Subtotal This Page $745.10
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne (Narne of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other Receipt
Cash Cheek Loan Other
11/28/09 Robert Hedman 1501 Inverness, #318 Lawrence, KS 66047
Retired
.f $250.00
11/30109 Elise H. Coyne 23 Bisbee Dr Rochester, MA 2770
.f $100.00
1211/09 Sara Reitz 125 S. Green St, #604A Chicago, IL 60607
.f $50.00
1211/09 James R. Lovullo 660 Briarcliff Salina, KS 67401
.f $20.00
1212/09 Bob Huseman 109 N. Douglas Salina, KS 67401
.f $20.00
1212/09 Randy D. Hassler 498 Upper Mill Hts Salina, KS 67401
.f $50.00
1212109 Lynda Hassler 498 Upper Mill Hts Salina, KS 67401
.f $50.00
1214/09 Services Group, Inc. 2533 N. Carson St, Ste 5910 Carson City, NV 89706
.f $250.00
1215/09 Colin Marsh 2455 S. Birch St Denver, CO 80222
.f $100.00
1215/09 Secca Marsh 2455 S. Birch St Denver, CO 80222 .f $100.00
1215/09 Jeremy H. Morace 4082 Valeta St, Unit 372 San Diego, CA 92110
.f $25.00
Subtotal This Page $1,015.00
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Narne of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other ReceiptCash Check LoaD Otber
1215/09 Lalya Morace 4082 Valeta St, Unit 372 San Diego, CA 92110
.f $25.00
1215/09 Joseph Frank 2021 E. Bank Ln Salina, KS 67401
Owner Construction .f $250.00
1215/09 Peggy Frank 2021 E. Bank Ln Salina, KS 67401
Owner Construction .f $250.00
12/5/09 Kathleen J. Brown Trust No. 1 100 River Place, #9 Salina, KS 67401
.f $250.00
1217/09 Lynn Larson 12209 N. 66th St Scottsdale, AZ. 85254
.f $25.00
1217/09 Cel &Larry Muff 103 S. Bradley Dr Salina, KS 67401
.f $30.00
1217/09 Home Bank &Trust Corrlpany Account Credit due to Check Deposit Error
.f $20.00
1218/09 Lee Bullock 517 E. Douglas, Apt. 505 Wichita, KS 67202
Accountant Oil .f $250.00
12110/09 Ernest J. Straub III 5034 Arapahoe Shawnee, KS 66226
Owner Construction .f $250.00
12/11/09 .MV Purchasing, LLC 250 N. Water, Ste 215 Wichita, KS 67202
.f $500.00
12111/09 Straub Construction Co., Inc. 7775 Meadow View Dr Shawnee, KS 66227
.f $500.00
Subtotal This Page $2,350.00
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne (Narne of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other Receipt
Cash Check Loan Other
12111/09 Robert E. Hodgdon 21405 W. 73rd Tar Shawnee, KS 66218
Owner Manufacturing .f $500.00
$50.00
$50.00
12112109 David Peterson 1500 S. Marymount Salina, KS 67401
.f
12/12/09 DuAnn Peterson 1500 S. Marymount Salina, KS 67401
.f
12112109 Nancy J. Hanahan 10001 W. 156th St Overland Park, KS 66221
Retired I
.f $250.00
12112/09 Mary Beth Jarvis 7705 E. Foster Wichita, KS 67206
Public Affairs Manufacturing .f $250.00
12112109 Don Jarvis n05 E. Foster Wichita, KS 67206·
Pilot Airline .f i $250.00
$100.00
$100.00
$25.00
$25.00
$100.00
$1,700.00
12114/09 Jill Miller 4615 Smith Joplin, MO 64804
.f
12115/09 Scott T. Post 941 Woodridge Ct Wichita, KS 67206
.f
12115/09 Jane B. Berkley 2031 Eastbank Ln Salina, KS 67401
.f
12/15/09 Mark Berkley 2031 Eastbank Ln Salina, KS 67401 .f
12116/09 Kent M. Berkley 837A Fairdale Rd Salina, KS 67401
.f
Subtotal This Pag~
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Name of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other Receipt
Cash Cbeck LoaD Other
12116/09 Debbie Berkley 837A Fairdale Rd Salina, KS 67401
.f $100.00
12/16/09 Alan &Roxie Eichelberger P.O. Box 77 Salina, KS 67401
.f $25.00
12117/09 CodyWray 2422 Highpoint Cir Wichita, KS 67205
.f $50.00
12/17/09 Robin Wray 2422 Highpoint Cir Wichita, KS 67205
.f $50.00
12117/09 Todd Michaelis 202 Millview Rd Salina, KS 67401
.f $50.00
12/17/09 Amanda Michaelis 202 Millview Rd Salina, KS 67401 I
.f $50.00
12118/09 Robert Mackenzie 3 Maritime Dr Wareham, MA 2571
.f $75.00
12/18/09 Linda Mackenzie 3 Maritime Dr Wareham, MA 2571
.f $75.00
12118/09 Bill & Melinda Hoffman 149 Mt Barbara Rd Salina, KS 67401
.f $25.00
12118/09 Tyler Heffron 818 N. Crest St Wichita, KS 67206
.f $25.00
12/18/09 Jenni Heffron 818 N. Crest St Wichita, KS 67206
.f $25.00
Subtotal This Page
..
$550.00
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Narne ofCandidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other ReceiptCa.h Cheek LoaD Other
12/19/09 Cory Mitchell 10528 Farley Overland Park, KS 66212
.f $25.00
12119/09 Emily Mitchell 10528 Farley Overland Park, KS 66212
.f $25.00
12119/09 John Lewis 20605 W. 96th St Lenexa, KS 66220
Owner Publishing .f $500.00
12119/09 Antonia M. Parks-PaYne 10412 Walnut Hollow Dr Oklahoma City, OK 73162
Fitness Director Energy Sector .f $200.00
12121/09 Mark Murphy 32 Lansdowne Dr Wichita, KS 67220
.f $75.00
12121/09 Lisen Cameron 21 Lydia's Island Rd Wareham, MA 2571
Occupational Therapist Medical .f $250.00
12/21/09 Laura Monahan 3825 N. Rushwood St Wichita, KS 67226
.f $25.00
12121/09 Bradley Monahan 3825 N. Rushwood St Wichita, KS 67226
.f $25.00
12122109 Koch Industries, Inc. 4111 E. 37th 5t North Wichita, KS 67220
.f $500.00
12/24/09 KS Chmbr of Cmrc & Ind. PAC 835 SW Topeka Blvd Topeka, KS 66612
.f $500.00
12126/09 Propane Central LLC Box 671, 514 N. 9th St Salina, KS 67402
.f $500.00
Subtotal This Page $2,625.00
Page~of~
SCBEDULEA CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Narne of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate BOI
Amount of Cash, Check,
Loan or Other Receipt
Cash Check Loan Other
12128/09 Andrew Frank 4217 Saddlehorn Dr Lawrence, KS 66049
Sales Manager Alchohol Industry .f $100.00
12/29/09 Kevin Campion 6337 Common Oaks Ct, Apt 105 Memphis, TN 38120
Auditor Accounting .f $200.00
12129/09 Ekwensi Griffith 3104 Blazing Sta.r Dr Topeka, KS 66609
Doctor Medical .{ $125.00
12129/09 Angela Hageman 3104 Blazing Star Dr Topeka, KS 66609
Doctor Medical .f $125.00
12130/09 Denise Marshall 7300 Falmouth St Prairie Village, KS 66208
.{ $25.00
12130/09 William Marshall 7300 Falmouth St Prairie Village, KS 66208
.f $25.00
12/30 Craig Harms 6 Sequoia Dr Wichita, KS 67206
Realtor Real Estate .f $500.00
12/31/09 David Murfin 900 N. Linden Wichita, KS 67206
Owner Oil .f $500.00
12131/09 Janet Murfin 901 N. Linden Wichita, KS 67207
Owner Oil .f $500.00
12/31/09 Edward &Laura Van Zante 8545 Haven St Lenexa, KS 66219
.f $30.00
12/31/09 Anthony &Leslie Alt 7667 Canterbury Prairie Village, KS 66208
.f $15.00
Subtotal This Page $2,145.00
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Narne of Candidate)
Occupation & Industry of Check Amount of Name and Address Individual Giving More Appropriate Box Cash, Check,
Date of Contributor Than $150 Ca.h Check Loan Other
Loan or Other Receipt
12131/09 Darren Murphy 5437 Prairie Hawk Dr Ber Airs, KS 67220
t/ $50.00
12131/09 Bev Moon 2929 21st Ave South, #309 Minneapolis, MN 55407
t/ $50.00
12131/09 Joe Moon 2929 21st Ave South, #309 Minneapolis, MN 55407
t/ $50.00
12/31/09 Home Equity, Inc. 250 N. Water, Ste 300 Wichita, KS 67202
t/ $500.00
12/31/09 Northern Equity, Inc. 250 N. Water, Ste 300 Wichita, KS 67202
t/ $500.00
\
Subtotal This Page $1,150.00
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SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS
Eric Payne
(Name of Candidate)
Date Name and Address
of Contributor
Occupation & Industry of Individual Giving More
Than $150
Check Appropriate Box
Amount of Cash, Check,
Loan or Other Receipt
Cash Check Loan Other
12/31/09 Equity Funding Company 250 N. Water, Ste 300 Wichita, KS 67202
.f \ $500.00
I
12131/09 Kansas Finance Co., Inc. 250 N. Water, Ste 300 Wichita, KS 67202
.f $500.00
12131/09 Stacy Fagan 4201 W. Memorial Rd Oklahoma City, OK 73134
.f $100.00
12/31/09 David Launder, Jr 46 W. 74th st Kansas City, MO 64114
Inside Sales Supervisor Manufacturing .f $50.00
Subtotal This Page $1,150.00
Complete if last page of Schedule A
Total Itemized Receipts for Period $21.475.00
Total Unitemized Contributions ($50 or less) $2,895.10
Sale ofPolitical Materials (Unitemized) $0.00
Total Contributions When Contributor Not Known $0.00
TOTAL RECEIPTS THIS PERIOD (to line 2 of Summary) $24,370.10
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SCHEDULEB IN-KIND CONTRIBUTIONS
Eric Payne
(Name of Candidate)
Date Name and Address of Contributor
List Occupation & Industry for Those Giving an In-Kind of More Than
$150
Description of In-Kind Contribution
Value of In-Kind
Contribution
Eric Payne Manager Candidate Filing & 8/10/09 521 N. Bracken Energy Sector Registration Fee $105.00
Wichita, KS 67206
10/17/09 Eric Payne 521 N. Bracken Wichita, KS 67206
Manager Energy Sector
American Majority Candidate Training Fee $50.00
Eric Payne Manager Fundraising Paper & 10/31/09 521 N. Bracken Energy Sector Envelopes $95.59
Wichita, KS 67206
Eric Payne Manager Fundraising Letter 11/3/09 521 N. Bracken Energy Sector Postage $105.30
Wichita, KS 67206
Eric Payne Manager Business Cards & Paper 1215/09 521 N. Bracken Energy Sector $29.53
Wichita, KS 67206
12/29/09 Eric Payne 521 N. Bracken Wichita, KS 67206
Manager Energy Sector
Stamps $88.00.
Subtotal This Page $473.42
Complete if last page of Schedule B
Total Itemized (over $100) In-Kind Contributions $210.30
Total Unitemized ($100 or less) In-Kind Contributions $263.12
TOTAL IN-KIND CONTRmUTIONS THIS PERIOD (to line 6 of Summary) $473.42
Page~of~
SCHEDULEC EXPENDITURES AND OTHER DISBURSEMENTS
Eric Payne
( Name of Candidate)
Purpose of Expenditure AmoontDate Name and Address or Disbursement
Home Bank &Trust Company Order Checks 12121/09 $22.501409 Greenwich Rd
Wichita, KS 67206
PayPal PayPal Transaction Fees 12131/09 $75.82P.O. Box 45950 Occurring 1211/09 - 12131/09
Omaha, NE 68145
Craig Harms Reimbursement for Website Fees 12131/09 $66.726 Sequoia Dr
Wichita, KS 67206
$165.04
Complete if last page of Schedule c
Total Itemized Expenditures This Period
Total Unitemized Expenditures of $50 or less
$142.54
$22.50
$165.04
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SCHEDULED OTHER TRANSACTIONS
Eric Payne (Name of Candidate)
Date Narne and Address Nature of Account or Loan Payable or Loan Receivable
Balance at Close of Period
8/20/09 Eric & Cara Payne 521 N. Bracken Wichita, KS 67206
Loan Payable $500.00
Subtotal Thi~ Page $500.00
Complete if last page of Schedule D
TOTAL OTHER TRANSACTIONS (to line 7 of Summary) $500.00
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