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KANSAS GOVERNMENTAL ETHICS COMMISSION

RECEIPTS AND EXPENDITURES REPORT FILED OF A CANDIDATE FOR STATE OFFICE

MAY 302018 January 10,2018

KRIS W. KOBACH

FILE WITH SECRETARY OF STATE SECRETARY OF STATE

SEE REVERSE SIDE FOR INSTRUC

A Name~Cmd~~e:_D_o_n~H_in_e_m~a_n~~~~~~~~~~~~~~~~~~~~~~_

Address: 116 S. Longhorn Road

City and Zip Code:~D_ig_h_t_o_n_6_7_8_3_9~~~~~~~~~~~_ County: Lane ~~~~~~-

State Representative District: 118OfBIce Sought: ~~~~~~~~~~~~~~~~~~_ -~~~~~-

B. Check only if appropriate: V Amended Filing __ Termination Report

D. "I 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 true, correct and complete. I understand that the intentional

5/30/2018

Date Signature of Candidate or Treasurer

failure to file this document or intentionally filing a lse document is a class A misdemeanor."

C. Summary (covering the period from January 1,2017 through December 31, 2017)

1. Cash on hand at beginning ofperiod .

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

3. Cash available this period (Add Lines 1 md 2) .

4. Total Expenditures and Other Disbursements (Use Schedule C) .

5. Cash on hmd at close ofperiod (Subtract Line 4 from 3) .

6. In-Kind Contributions (Use Schedule B) 2,068.09

7. Other Transactions (Use Schedule D) 15,606.55

74,388.73

22,950.00

97,338.73

16,534.60

80,804.13

GEe Form Rev, 2017

Schedule A - Contributions & Other Receipts Don Hineman for Representative 12131/2017

Date Name (or Organization) Address City State Zip Occupation Industry Method Contribution

4/2/2017 Caroline McKnight 5259 West 121 st Street Overland Park KS 66209 Online 100.00 9/10/2017 RAI Services PO Box 2990 Winstom-Salem NC 27102 Check 250.00 9/25/2017 BNSF Railroad 920 SE Quincy Topeka KS Check 500.00 10/1/2017 KS Hospital Association PAC 215 SE 8th Ave. Topeka KS 66603 Check 250.00 11/1/2017 KS Society of CPAs 114 SE 8th Ave. Topeka KS 66603 Check 250.00 11/1/2017 3M Corporation 3M Center, 225-4N-014 St. Paul MN 55144-1000 Check 250.00 11/1/2017 KS Cooperative Council 816 SW Tyler, Suite 300 Topeka KS 66612 Check 125.00 11/1/2017 American Chemistry Council 107 E. 5th Street, Suite 201 Des Moines IA 50309 Check 250.00 11/1/2017 Sunflower Electric Corp. P.O. Box 1020 Hays KS 67601 Check 500.00 11/1/2017 Phillips 66 414 NW 4th Street, Suite 110 Oklahoma City OK 73102 Check 500.00 11/1/2017 HCA KS Good Gov't Fund 5845 SW 29th Street Topeka KS 66614-2462 Check 500.00

10/30/2017 Security Benefit Life PAC One Security Benefit Place Topeka KS 66636 Check 250.00 11/12/2017 Thomas Baalman 202 S. Harrison Grinnell KS 67738 Online 50.00 11/12/2017 Steven Anderson 4504 Oak Tree Court Lawrence KS 66049 Online 100.00 11/13/2017 Robert Frey 1537 N. 85th Circle Kansas City KS 66112 Online 50.00 11/15/2017 Jackie Brockel 7519 W. Hale Ave. Wichita KS 67212 Online 100.00 11/13/2017 Gerald O. Schultz 2506 N. Coachman Dr. Garden City KS 67846 Check 250.00 11/15/2017 Janice Fahrenholtz P.O. Box 642 Tribune KS 67879 Check 50.00

8/30/2017 Allstate Insuranc;e Company 2775 Sanders Road Northbrook IL 60062-6127 Check 500.00 10/27/2017 Credit Union PAC of KS 901 SW Topeka Blvd. Topeka KS 66612 Check 500.00 9/26/2017 Centurytel, Inc. P.O. Box 4065 Monroe LA 71211 Check 500.00 11/7/2017 Johnson & Johnson PAC 1350 I Street NW, Suite 1210 Washington DC 20005 Check 250.00

10125/2017 KS Insurance PAC P.O. Box 55 Topeka KS 66601 Check 250.00 9/28/2017 Cerner Corporation PAC 2800 Rockcreek Parkway Kansas City MO 64117 Check 125.00

10/19/2017 Am. Family Insurance KS PAC 6000 American Parkway Madison WI 53783-0001 Check 250.00 10/16/2017 Prairie Band Potawatomi Nation 16281 Q Road Mayetta KS 66509 Check 250.00

12/4/2017 KS RITC PAC P.O. Box 4799 Topeka KS 66604 Check 500.00 12/4/2017 KS Beverage Association PAC 5845 SW 29th Street Topeka KS 66614 Check 500.00

11/21/2017 BlueCross BlueShield of Kansas 1133 SW Topeka Blvd. Topeka KS 66629 Check 500.00 12/5/2017 KS Automobile Dealers PAC 731 South Kansas Ave. Topeka KS 66603 Check 500.00

11/28/2017 LoanMax 10321 W. 75th St. Shawnee KS 66214 Check 250.00 10/27/2017 ITC Great Plains LLC 21785 Energy Way Novi MI 48377 Check 250.00 10/11/2017 Eli Lilly and Company PAC Lilly Corporate Center Indianapolis IN 46285 Check 250.00 10/17/2017 T-Mobile 12920 SE 38th Street Bellevue WA 98006 Check 200.00

10/4/2017 KS Cable PAC 900 S. Kansas Ave. Topeka KS 66612 Check 200.00 10/4/2017 GM PAC 22 Massaachusetts Ave, NW SI Washington DC 20001 Check 250.00 9/14/2017 Comcast 1701 JFK Boulevard Philadelphia PA 19103-2838 Check 250.00

10/10/2017 KS Healthcare Assoc. PAC 1100 SW Gage Blvd. Topeka KS 66604-1761 Check 250.00

Schedule B - In-Kind Contributions Candidate: Don Hineman 12131/2017

Date Name Address City State Zip Nature of transaction Amount 1212212017 Don Hineman 116 S. Longhorn Rd. Dighton KS 67839 Expenses: Laptop, Dropbox, Meals, 2,068.09

postage, and lodging. Itemization available

Total In-Kind Contributions 2,068.09

Schedule C - Expenditures and Other Disbursements Candidate: Don Hineman 12131/2017

Date Name Address City State Zip Purpose Amount 1/4/2017 Rob McKnight 5259 West 121st Street Overland Park

1/13/2017 Don Brent Photography 2/7/2017 KS Republican Party

2/21/2017 Don Hineman 2/25/2017 Leoti Standard 2/25/2017 Kring Associates 5819 Riggs Street Mission

317/2017 Mitch Rucker 3/25/2017 Maple Ranch 4/15/2017 Kring Associates 5819 Riggs Street Mission 4/15/2017 Hawver News Company 3823 SW Wood Valley Dr,Topeka 4/15/2017 Dighton Herald Box 426 Dighton 4/15/2017 Scott County Record P.O. Box 377 Scott City 7/14/2017 Mitch Rucker 7/17/2017 Colby Free Press 8/30/2017 Republican House Campaign Committee 9/24/2017 Gove County Advocate 10/3/2017 Mitch Rucker 11126/2017 Michael Steiner 11/2612017 Dighton Herald

12/14/2017 Mitch Rucker 12/24/2017 Dighton Herald 1212412017 Oakley Graphic

Jan-Dec Transfirst LLC 12202 Airport Way, Suite Broomfield

KS 66209 Campaign consultant Photos Convention hosting Postage, SurveyMonkey & Campaigner Subscription

KS 66202 IT Services Mileage Leadership Retreat

KS 66202 IT Services KS 66610-1124 Subscription KS 67839 Display ad KS 67871-0377 Display ad

Mileage reimbursement Subscription Contribution Subscription Mileage Reimbursement Conference & Lodging expense Advertisement Conference and lodging expense Subscription Subscription

CO 80021 Online payment services

2750,00 105.00 350.00 381.61 20.00

482.50 345.61

3332.00 272.00 180.00 63.00

108.00 325.28

99.00 5000.00

37.98 363.80

1542.04 73.00

584.32 39.00 41.00 39.46

Total Itemized Expenditures this Period 16534.60 Total Unitemized Expenditures of $50 or less 0.00 Total Expenditures and Disbursements this Period 16534.60

Schedule D • Other transactions

Date

Candidate: Don Hineman

Name Address

12/31/2017

City State Zip Nature of account or Loan Payable

Or Loan Receivable Amount Don Hineman

12/2212017 Don Hineman 116 S. Longhom Rd. 116 S. Longhorn Rd.

Dighton Dighton

KS KS

67839 67839

Loan carried forward (previous mileage) Loan - Expenses: Laptop, Dropbox, meals, postage, and lodging. Itemization available

10,613.08 2,068.09

12122/2017 Don Hineman 116 S. Longhorn Rd. Dighton KS 67839 Loan - Mileage, itemization available 2,925.38

Total Other Transactions 15,606.55