PIll 2012-0 '1-07 16; 18 - Kansas

[Pages:12]2012-0 '1-07 16; 18

MAST 6203431559? 7852965563

PIll

KANSAS GOVERNMENTAL ETHICS COMMIS

RECEIPTS AND EXPENDITURES REPORT OF A CANDIDATE FOR STATE OFFICE

January 10,2012

FILE WITH SECRETARY OF STA IE SEE REVERSE SIDE FOR INSTRUCTiONS

A. Name of Candidate: _P_E_G_G_Y_M_A_S_T_~_? Address: 765 ROAD 110 City and Zip COde:_E_M_P_O_R_IA Office Sought: STATE REPRESENTATIVE

_ ._.

_

County: _L_Y_O_N

[)istrict: __7__6

B. Check only if appropriate:

_ _ Amended Filing

_ _ Termination Report

. f

,

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_

__ I I .

I

I.

C. . Summary (covering the period from January 1,2011 through December31, 2011)

1. Cash on hand at beginning of period

_

.

2. Total Contributions and Other Receipts (Use Schedule A)

.

3. Cash available this period (Add Lines land 2) _

;

..

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 Conu'ibutions (Use Schedule B) .

7B.

7. Other Transactions (Use SChedule D)

.

. I

15005.88 9155.92 24161.80 7964.81? . 16196.99

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D. "[ declare that this report. including any accompanying schedules and statements, has been c,-.;amined by me

and to the besl of my knowledge and beliefis true"correct and complete. I understand that t}le in!t:nti~l1al

failure to file this document Or intenti-er)aJly filing a false document is a class A misdemeanor-"

JAN. 0612012

'L)~~l/~0-

Date

I

GEe Form Rev, 2001

RECErVED L~M a n ~nt?

.. ! ,."';

~W1.p

+

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2012-01-07 16;31

MAST 6203431559? 7852965563

P 8/11

Peggy Mast (Name of Candid(l\e)

SCHEDULE A

CONTRIBUTIONS AND OTHER RECEIPTS

Dote

Name llnd i\oclress of Contributor

.j

07/29/11

Hick.am Public Affairs900 S. Kansas Avenue

Topeka, Kansas 66612

Occupation & Industry of IndividulIl Giving !"lore Thlln SI~O

Consulling

Check Approprillte Bo];

c: ??n

ChfCk.

Loon .' t:: ru(,C1~ QrhC-T

.;

. Arnoun! of. Cllsh, Cbec~ LOlln 0/' Other

Receipt

--------- -

$10000

06/20/11 07/29/11

Kansas Bankers Association PO Box 4407

- Topeka, Kansas 6660Li

Kansas Clintraclo:s Association PO Box 5061 Topeka, Kansas 66605

PAC PAC

I

$250.00

I

[

I

$100.?OI

08/17/11

Kansas Committee fOf Rural Elect. PAC PO Box 790 Meade, Kansas 67884

I

$350.00 :

I

09/01/11

AT&T 220 SE 6th Avenue Topeka, Kansas

PAC

I

S25000

Kansas Hospital Association 09/01/11 215 SE 8th

PAC

I

Topeka, Kansas 66612

Kansas Medical Society 08/17/11 623 SW 10th Avenue

PAC

I

Topeka, Kansas 66612

MERCK

/ 10/31/11 One Merck Drive

PHARMAECEUTICAL

I

Whitehouse Station NJ

D

PEPSICO 10/17/11 555 W Monroe Street

SOFT DRINK

.(

Chicago, Illinois 60661-3716

$250.00

I I

$SOO.OO I

,-~

$200001 I

I ;21000

09/07/11

WAlGREENS 104 Wilmot Road Deerfield, Illinois 60015

PHARMACY

a

BLUE CROSS- BLUE SHIELD

INSURANCE

10/1 6/11 1133 SW Topeka Blvd

Topeka, Kansas 66629-0001

i:''::U:,~:1U(:;1~\'j:1t1.~I1(F~'~"~?"1'l:i""\~\:'j:?l",:;""\~\"I;:ji"":"I,-~",:;f,i;'g"~::'",'';I"?";.'":~"t"'!H,~d._~,~"~:.\:.l~"t;"\;i,!L;\,i~?.j'!1,?;:',,:t:,,-;,r:;::(;,;:~~" ni';\::i~:;?j~;iii;lq:" :i,::iliii''\';.I.. t " _

\

I'

$25000

.;

! .

$500.00

~ ::.T'

:':!: :,:'",:,.;,' ::....

:',"

$3,00000

2012-01-07 16:32

MAST 6203431559 ? 7852965563

PEGGY MAST (Name uf Candidate)

SCHEDULE A CONTRIBUTIONS AND OTHER RECEIPTS

P 9/11

. ;'

-!

Date

Name llnd Ac!c!re:;s of Contributur

Occupation &: Industry of

Individual Giving More

Than $150

Cbeck A pproprillte Box

Caah

Cn.t ................
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