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

Page_1_of~

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

Page_2_of~

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

Page_3_of~

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

Page_4_of~

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

Page_5_of~

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

Page_6_of~

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

Page_7_of~

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

Page_8_of~

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

Page_9_of~

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

Page~of~

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~

Page~of~

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

Page~of~

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

Page~of~

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

Page~of~

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

Page~of~

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

Page~of~

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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