2006/AUG/14/MON06:01 PM KTPA FAX No, 785 290 0476 p, 002

~JiiM

KANSAS'GOVERNMENTAL ETHICS COMMISSlJ)~. fr~~~;RBCEIPTS AND EXPENDITURES REPORT \e>~ -I t

OFAPOLITICAL'ORPARTY-COMMITT¥ 4uO ,. V1~~'.ov~ ! ,... ~"""tn 'j 4} , .

July 24, 2006 .,.~D;~l';h- <'0114" ~/O~, t::Sr "tl)' <a/i

.ow 8'1' 'Cs /'\ .

FILE WITH SECRETARy-oF STATE 'ki\:.iS7~'!!""/~SEE REVERSE SIDE FOR INSTRUCTIONS ~S~~~%11'.:.:

A. Name of Committee::Kansas 'Physical Therapy Association

Address; 2.14 SW 6th Av~Ste.205

City and Zip Code: Topeka66603

This is a (check one): - P.artyCommittee .-1' Political.Committee

B. Checkonly if appropriate: - AmendedFiling - TerminationReport

c. Summary(coveringthe period from January 1, 2006.through July 20, 2006)

1. Cash on handat beginningof period m'--"""''''''''''' m mn.'','

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

3. Cash available this period (Add Lines 1 an.d2) ., u""""'''''''''''''''''''''""

4. TotalExpendituresand OtherDisbursements(UseScheduleC) """"''''''''''''''

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

6. In-Kind Contn'butions (Use Schedule B) " m 5000.00

7. Other Transactions (Use Schedule D) ,

10833.41

19415.00

30248.41

3759.01

26489.40

D. "1 declare that this report, including any accompanying schedules and statements, has been exarrrined by meand to the best of my knowledge and belief is true, correct and complete. I understand that the intentionalfailure to file this documen\or intentioJlla1lyfiling a false document is a class A misdemeanor."

GEC Form Rev, ~OOJ

8/10/2006Date

--

~ m----

2006/AUG/J4/MON06:01 PM KTPA FAXNo,785 290 0476

~'SCHEDULE A

-CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Physical Therapy Association PAC

(Name of Candidate, Party Committee or Political'Committee)

Date Name.and Addressof Contrlbntor

Occnpation ofIndividualGiving More Than $150

CheckAppropriate Box

Cb~tk LoanCub Other

Physical Therapist

DIDIDI[l]Physical Therapist

,0 ID 101 [Z]

Physical Therapist

DIDIDlllJPhysical Therapist

DID lOll{]Physical Therapist

DI[l]IDIDPhysical Therapi3t

DI[l]IDIDPhysical Therapist

DIDIDI[l]Physical Therapist

DIDIDI[l]

DIDIDI[z]

DIDIDI[z]

PageL o:(~

p, 003

Amount ofCash, Check,

Loan orOther.Receipt.

$75.00

$75.00

$75.00

$75.00

$75.00

$75.00

$75.00 .

$75.00

$75.00

$75.00

$750.00

liliii&i

Eileen Husser!

3/30/06 I 1805 AbbottsfordNorman, OK

Dana Hayworth

3/30/06 I 9827 N WoodlawnValley Center, KS

Carla Sabus

4/10/06 15433 Oakview StShawnee,KS 66216

Tim Markus

3130/06 I PO Box 35Coldwater, KS

Nancy Scott

4/1/06 1706 NormalPltl:sburg, KS 66762

Brenda Hendrick .

3/30/06 110010 EClarkWichita, KS

Deborah Engels

3/30/06 I 502 MarrnationEIDorado. KS 67042

Lorena Leck

4/1106 I 5270 Skyline DrMission, KS 66205

Mark Gaddis

3/30/06 I 3305 E DouglasWichita. KS 67218

Jonathan Harris

3/30106 I 10416 texas StreetWichita, KS 67209

--

2006/AUG/14/MON06:01 PM KTPA FAXNo,785 290 0476

~SCHEDULE A

'CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Physical Therapy Association PAC

(Name of Candidate, Party Committee or Political Committee)

Date Name and Addressof Contributor

Occupation of IndividualGiving More Than $150

Physical Therapist

Physical Therapist

Physical Therapist

Physical Therapist

Susan Scholl

4/1/06 12102 Sa Lake RoadNewton.KS 67114

Physical Therapist

Diana Sherrard

3/30/06 I 424 CrestridgeCirWinfield, KS

Physical Therapist

Anthony Prusa

3130/06 1118 South Main StUlysses. KS 67880

Physical Therapist

Physical Therapist

Physical Therapist

Physical Therapist

p, 004

.Check

I

Amount of

Appropriate :Box . Cash, Check,t.oan 01."

c h I Cbet:\<; I x...: I Ot\rf:!;'.1OtberReceipt

DIDID/[l].

010101°OIOIDI[ZJ

DIDIDI[l]

DIDIDI[z]

DIDIDI[z]

DIDIDI0

DIDIDlrzJ

DIDIDI[z]

DIIlJIDID

Pag~ of3-

$175.00

$300.00

$500.00

$100.00

$195.00

$400.00

$300-00

$200.00

$150.00

$150.00

$2,470.00

~siS@jjB;.~~;;

MarciaTrebilcock

3/30/06 I 9110 Windwood CtWichita. KS 67226

Angie Land

4/10/06 I 903VineStWamego, KS 66547

Carl Glick

4/10/06 11107 Post Oak RdWichita, KS 67206

Je:anHiebert3/30/06 I 9215 Slater

Overland Park. KS 6621212

Olu Osunsanmi

4/1/06 I 2120 NWoodlawnWichita, KS 67208

Justin Hoover

3/30/06 I 830 N Spring Valley RdJunctionCity,KS 66441

William Newton

4/1/06 11300 E 5thWinfield, KS 67156

2006/AUG/14/MON06:01 PM KTPA FAXNo,785 290 0476--SCHEDULEA

.CONTRIBUTIONS AND OTHER RECEJJ>TS

Kansas Physical Therapy Association PAC

(Name of Candidate, party Committee or Political Committee)

Date Name and Addressof Contributor

CbecJ.i:.

Occupation ofIndividual I Appropriate BoxGivingMoreTban $150 .. Cub I Cbeck I 1,01... I OtheT

Physical Therapist

DHZJIDID.Physical Therapist

JDIDIDI0IOIDIDIIlJ

, '

Physical Therapist

Physical Therapist

OI[l]IDIDNancy Brox

4/1/06 ,130 Westview RdAndover, KS 67002

Physical Therapist

D 10 101 [Z],Charles Colby

3130/06 12277 NCovingtonCtWichita,KS 67205

Physical Therapist

DIDIOI[Z]Pam Persons

3/30/06 1 8189 SW Parallel StTowanda,KS 67144

Physical TherapIst

DIDIDI[{]Vinene Logan

4/1/06 112180 SW 78th TerrAndover, KS 67002

Physical Therapist

DI[z]IDID

3/30/06Arias Barnes108 East ThirdSmith Center, KS 66967 DI[ZJIDID

Physj~1 Therapist

Shena Herrmann

4/1/06 19320 Osia StWichita. KS 67207

Physical Therapist

DIDIDI[z]

Page~ of.1..

P. 005

AmountofCasb,Check,

Loan or '

Other Receipt

.$175.00 '

$175.00

$100.00

$600.00

$175.00

$100.00

$250.00

$175.00

$250.00

$100.00

$2,100.00

-

Jack Lucas

3/30/06 I 220 W 2nd StGoodland, KS 67735

Brian Boerner

4/10/06 12329 W Post Oak RdOlathe, KS 66061

Jackie Rawlings

4/10/06 I 700 Gi!h$pieManhaftan,KS 66502

Steve Wilson

3/30/06 I 3706W 18th St NWichita, KS 67203

- . -- p-.--

2006/AUG/14/MON06:01 PM KTPA FAXNo,785 290 0476

~SCHEDULE A

CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Physical Therapy Association PAC

(Name of Candidate,Party Committee or Political Conunittee)

p, 006

Date Name and Addressof Contributor

Occupation of }))dividuaIGiving More Tban $150

Anaount ofCash, Check,

Lt;IIlUorCash OWer. Other Receipt

Physical Therapist

0.10 101[lJPhysical Therapist

D/[z]IDIDIPhysical Therapist DIDIDI[z]

Physical Therapist

DIDIDI[l]Lisa Fischar

4/1/06 ,425 Liberty DrMcPherson, KS

Physical Therapist

DIDIDIIl]Kim Cunningham

3/30/06 I 624 N Seventh St .Wakeeney, KS 67672

Physical Therapist

DIDIDI[l]Joan Stephenson

a/30/06 I 9814W JamesburgWichita, KS 67200

Physical Therapist

DIDIDIlZ]Kathryn MacDonald

4/1/06 I 711 Genn DriveWamego, KS

Physical Therapist

DIDIDI0

3/30/06

Treva StrandPo Box 307Herrington,KS 67449 DIDIDI[ZJ

Physical Therapist

Steven Wilgers

4/1/06 16640 Sw Scathelock RdTopeka, KS 66614

Physical Therapist

DIDIDI[l]

page~of!i

$75.00

$75.00

$75.00

$75.00

$150.00

$75.00

$75.00

$150.00

$75.00

$75.00

$900.00

1IIIIIIII

Stacey Baker3/30/06 I 615 S MalcomAve

Chanute, KS 66720

Nolan Dyer4/10/06 I445a DavidsonDr

Independence.KS

II LaurelYounger

4/10100 I Box 277Ulysses. KS

Carolyn Cowart

3/30/06 I 8918 Wast 21st St NWichita. KS 67205

2006/AUG/14/MON06:01 PM KTPA FAXNo.785 290 0476-'SCHEDULE A

.CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Physical Therapy Association PAC

(N8.1;I).eof Candidate, Party Committee or Politioal Committee)

Date Nam~-and Addressof ContrIbutor

O(!c.upation .of IndividuaJGiving More Than $150

Physical Tharaplst

Physical Therapist

Physical Therapist

Physical Therapist

Physical Therapist

Physical Therapist

Physical Therapist

Physical Therapist

PhysIcal Therapist

Physical Therapist

P.007

CheckI

AmountofAppropriateBo:!:CashfCheck,

;LoanorCA$b.. I Check I Loao I Other :1 Other Receipt

D.lD IDIIZ]

DI[z]IDIDr--1

1

1711r--1LJ' l.£J IU D

DIIZJIDID

DI[z]IDID

DI[z]IDID

DIIZJIDID

DIDIDI[z]

DIDIDI[z]

DI[l]IDID

J:age6' Of..1...

-$200.00

$100.00 .

$250.00

$100.00

.$100.00

$100.00

$100.00

$100.00

$150.00

$200.00

'$1,400.00

;c~:'~'?,,"i;~~f; ~'.~~'=<?;:!t',,~.,.,' l' l """'.~.L ~ ,.,-;;::\"~~""'~'c'''''.; .~ ...'- .

Candy B<1hner

3/30/06 1.24155 Dogwood RdBelvue, KS 66407

Robert Manske

4/10/06 12623 W Keywest courtWichita. KS 67204

Ann Sundgren4/10/06 12020 N Webb Rd

Wichita, KS 67206

Kim Galbreath

3130/06 113508W82nd StreetLenex8, KS 66215

KarleneThompson3/30106 I Po Box 176

Hiawatha, KS 66434

Lois Maxwell

3/30/06 I1350B W 82d StreetLenexa, KS 66215

Pam Palmer

3/30/06 11614 West OxfordAndover, KS 67002

Susan Harms

3/30/06 I 3650 Everett RdManhattan.KS 66503

Daryl Menke3/30/06 I 2836 Bigham

Topeka, KS 66614

Sue Willey3/30/06 I 8713 W 19th st

Wiohita, KS 67212

- --

2006/AUG/14/MON06:01 PM KTPA FAXNo,785 290 0476--SCHEDULE A

CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Physical Therapy Association PAC-

(Name of Candidate, Party Conunittee or Political Conunittee)

Date 'Name and Addl."essof Contributor

Occupation of IndividualGjvin~ More Than $150

CbeckAppropr.l.ate :So:):

).,oat> Othe;-Cash Chedi:

'3/30/06Barbara Iman820 VillymacaElkhart, KS 67950

Physical Therapist

010101 [Zl

3/30/06

Cheri Kollman908 E 202 StHolt, KS

Physical Therapist

DIOIDI[Z]

4/10/06

Dan Bertholf1'13 Keliy StMedicine Lodge, KS 67104 [Z]

Physical Therapist

DIDIO

3130/06Bradley Lundford105 W Uncoil'!

Medicine Lodge, KS 67104

Physical Therapist

DIDIDI[l]Vickie McCandless

4/1/06 I 1240 Pin OakWichita., KS 67205

Physical Therapist

DIDIDI[l]Andy Tran

3/30/06 I 6930 E 35th Ct NWichita, KS 67226

Physical Therapist

0 IfZJ101DDavid Cervantes

3/30/06 I 524 S E Poor Farm RdEIDorado, Ks 67042

Physical Therapist

DIDIDI[l]Physical Therapi$t

DIDIDI[{JPhysical Therapist

OI[Z]IDIDPhysical Therapist

OIDIDI[Z]

Pasek. of..s...

p,008

Amount ofCash, Check.

Loan orOther Receipt

,$150.00

$75.00

$75.00 ,

$75.00

$150.00

$150.00

$150.00

$75.00

$150.00

$150.00

$1,200.00

-

Sue Harris-Voigt4/1/06 111304 Merridale

Wichita, KS 67207

Scott McLoughlin3/30/06 11001 6th Ave

Leavenworth.KS 66048

Brigitte Baggs4/1/Q6 I 3408 Downtain

Wichita KS 67224

- -- - - - -----

2006/AUG/14/MON06:01 PM KTPA FAXNo,7852900476 p,009

~SCHEDULE A

'CONTRIBUTIONS AND OTHER RECEIPTS

Kansas Physical Therapy Association PAC

(Name of Candidate, Party-Committee or Political Committee)

Date Name and Addressof ContrIbutor

Occupa.tion.of Individu.al.Giving More Than $150

Check Amount of

Appropdate Box Cash, CheckjLoan or .

(:11$" .Otber . Other Receipt

Physical Therapist

DI[l]IDID $750.00

PhysicalTherapist

D 10 1.01[Z] $800.00

I Physical Therapist DID DI[l] $250.00

Les Durst

3/30/06 I 521A S South Santa FeSaUna, KS 67401

Marl< Dwyer-4/10/06 114117 West 138 Place

Olathe, KS 66062

Carol Keller

-4/10/0611306 Deer TrailDerby, KS 67037

Paul Silovsky

3/30/06 I 5220 SW 17th StTopeka, KS 66604

Elliott Rodda

3/30/06 I 713 E 35th AvenueWinfield, KS 67156

Patricia Kluding

3/30/06 I 4912 W 78th StPrairie Village, KS 6620B

Kim Galbreath

3/30/06 113508 W 82nd StLenexa,KS 66215

Larry Nicholson

3/30/06 1214 SW 6th SteTopeka,KS 66603

Marcie Swift

3/30/06 I 2909 W 73rd StShawnee Mission, KS 66208

Alan Smith

3/30/06 11322 N Windmill RdDerby, KS 67037

2006/AUG/14/MON06:02 PM KTPA FAXNo,785 290 0476 p, 010

~SCHEDULE A

CONTRIBUTIONS AND'OTHER RECEIPTS

Kalisas Physical Therapy Association PAC

(Name of Candidate, Party Committee OtPolitical Committee)

Amountof

Date I NameandAddress I Occupation ofIndividuaJ Cash, Cbeck,of Contributor Givmg MOl."eThan$150 Loan or061..- Other Receipt

Sally \lbei>I~\ PhysicalTherapist 1010 "01D I3/30/06 I '3925JasmineDr .$150.00Wichita, KS .67226

William Reynolds PhysicaI"Therapist IDIDIDIIlJ,4/10/06 ,1201 Crown Rd $150.00Norfolk, NE

Karla Peter Physical Therapist

"0,10 IDI[{JI4/10/06 I 320 W Commerce $150.00Lyons,KS

Darwin Fisher PhysicalTherapist

3/30/06I20210SE90thSt 10IDIDI[l], $150.00Sawyer,KS 67134

HeatherSteed PhysicalTherapist

4/1/06 I8922 W Central ParkCrt D [Z]0101 $150.00Wichita,Ks 67205

DarrellRoths PhysicalTherapist

3/30/06 12601 North Central IDIOIDI[Z]I $150.00Dodge City, KS 67801

GerryBaalman PhysicalTherapist

Rt1 1010 IDI[{]I3/30/06 IGrinnell,KS $150.00

TaraRoberts PhysicalTherapist

4/1/06 I540 WickhamRd D 0 DI[Z]I $150.00Manhattan, KS

TraciWolfe PhysicalTherapist

3/30/06 13601 AmandaSt 10101DI[Z]1 $150.00Hutchinson, KS

Dawn Craig I Physical Therapist IDIDIDI[l]14/1/06 I517W Grant $75.00Lindsborg,KS

$1,425.00

page:L Of-1..

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2006/AUG/14/MON06:02 PM KTPA FAXNo,785 290 0476 p, O!!-SCHEDuLE A

,CONTRIBUTIONS AND OTHER RECEIPTS

-Kansas Physical therapy Association PAC

(Name of Candidate,Party Committee or Political Committee)

Date Name and Addressof Contributor

Occupation oUndividualGiving More Than $150

CheckI

Amount ofAppropriate Box ,Cash, Cbeck,

Loan orCash I Check I Loan I Otl,or I Other Receipt

DID IDI~I/~5-

,0101010

DIDIDID

DIOIDID

DIDIDID

DID/DID

0'/01010

'0101010

J[)5.6D,

Complete if last page of Schedule A

Total Itemized Receipts fo. Period

Total Unitemized Con1ribunons($50 or less)

Sale of Political Materials (UDiten:rized)Total Con1ributionsWhen Contributor Not Known

$15,770.00

$3,645.00

$0.00

$0.00

$19,415.00

Page~ of-

2006/AUG/14/MON06:02 PM KTPA FAXNo.785 290 0476--SCHEDULE B

IN-KIND CONTRIBUTIONS

Kan$as Physical Therapy AssociationPAC

(Nmne of Candidate, Party Committee or Political Coromittee)

Name, Address and Occupationof Contribntor

List occupation for those givingan in-kind more than $150

Steve Allison3/30/06 I 608 E Coronado Way

Payson.AZ 85541

Date Description ofIn-Kind

Contribution

presented a one day CE course anddonated honorarium

Gail Dayle3/30/061 3 Sherborne Wood

San Antonio, TX 7821'8

presented a one day CE course anddonated honorarium

Complete if last page of Schedule B

Total Itemized (over $50) In-Kind Contrloutions

Total Unitenrized ($50 or less) In-Kmd Con1nootions

P.012

Value ofIn-Kind

Contribution

$2.500.00

$2,500.00

$5,000.00

$5,000.00

$0.00

$5.000.00

Page-L Of-L

tS~~~1{~i2im&3'~

2006/AUG/14/MON06:02 PM KTPA FAXNo,785 290 0476 p,O!3

-..SCHEDULE C

EXPENDITURES AND OTHER DISBURSEMENTS

Kansas Physical Therapy Association PAC

(Name of Candidate, 'Party Committee or Political Committee)

Date Name and Address 'Purpose of Expenditnre.or Disbursement

Amount

KPTA

7/10/061214 SW 6th Ave Ste 205Topeka. KS 66603

reImburse food and beverage expensesfor Ce course on 3130/2006 :$1.338.63

KPTA7/10/061214 SW 6th Ave Ste 205

Topeka. KS 66603

reimburse travel expense for Gail Deyletravel to CE course $901.15

KPTA

7/10/061 214 SW 6th Ave Ste 205Topeka. KS 66603

reimburse travel expense for SteveAllison travel to CE course $762.60

KPTA

7/10/061 214 SW 6th Ave Ste205Topeka. KS 66603

purchase of raffle drum

$116_63

Stephanie Sharp for House Committee Contribution to Sharp for HouseCommittee $150.007/10/06

Jim Yonally for HouseCommittee

7/10/06 110039 MastinOverland Park, KS 66212

Contribution to Yonally for HouseCommittee $250.00

Kansas Governmental Ethics

07/10/061109 West 9th StreetTopeka, KS 66612

Annual Fee$240.00

$3,759.01

Complete if last page of Schedule C

PageL of-..L--Total Itemized Expenditures This Period $3,759.01

Total Unite:mized Expenditures of $50 or less $0.00

TOTAL EXPENDITURES & OTHER-DISBURSEMENTS$3,759_01TffiS PERIOD (to line 4 of Summary)