Polk County Republican Womens Club - 9628 - Scanned
Polk County Republican Womens Club - 9628 - Scanned
DR-2 DISCLOSURE
DISCLOSURE SUMMARY PAGE (Rev . 01/98) REPORT
SIGNATURE OF TREASURER (or person filing this report) TELEPHONE DATE SIGNED
Routine Penalties Due For Late Filed Reports Range from $20 to $800
I AM FILING A O9-y-0iBr- 19, ,? 0 0j/ REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate one 1-1
K IF AMENDMENT TO REPORT DATED oe -,le6-,,- /g, veoJz Local Committees, enter Date of Election
Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County tk Local Committees, enter County in
(You must continue to file reports until a Notice of Dissolution is filed .) which Election is held
CASH ON HAND at the end of this reporting period (if final report, balance must / '
be zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. .. .. .. .... .. .. $ /_ 3 63 . '71
a 543 - /Co ?g
SIGNATURE OF TREASURER (or person filing this report) TELEPHONE
Routine Penalties Due For Late Filed Reports Range from $20 to $80p
I AM FILING A 0C-4O h"o "' ~' 1 a?ODiv, REPORT FOR AN/A (1) ELECTION /(2)NON-E ECTION YEAR .
(report date) Indicate one 10
F1 Check if this is final (termination) report and attach Notice of Dissolution Form OR-3 . County & Local Comn~ ittees, enter County in
which Election is held
(You must continue to file reports until a Notice of Dissolution is filed.)
CASH ON HAND at the end of this reporting period .(if final report, balance must
be zero) (Attach DR-3). ... .. . . . .. .. ... . . . . .. . . .. . . .. ....., ....... .. ...... ....... .. ..... .. .. ... .. ., ... . .. .. . . .. . .... .. .. . . .. . .. $,
UNPAID BILLS (From Schedule D - Attach Schedule D) .. .. .. .. .. . . . .. .. .. . .. .. .. .. ... .. .... .. .. .. .. .... .. ..... .. .. .. . . . .. $
IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . .. .. ..... .. .. ...... .. .. .. ... .. ... .. .... .. .. . .. .. $
OUTSTANDING LOANS (From Schedule F - Attach Schedule F)..... .............. .. ......,._;..... ......_ ......... $
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?)
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)
FOI?,.INSTRUCTIONS, SEE -BACK OF FORNf SCHEDULE
B rvi0NETd~y
EXPENDITURES --MONEY SPENT FROM COMMITTEE ACCOUNT ., (Rev . 09/97) EXPENDITURES
?o I I~- ~~ ~ h c~ Id r7 rYl e A
~o ~ Prvrt
CK#
- io3~Z s ~D . o0
ID# Karen fhc l fl ts'I- er'
3 71 ,7 / ,?&-1 e,
CK# /off. ' ,~d ,l "sl~`c ~'II eon 6 ~U ~S
1D# s f o 3 lo`r"- S-F, Iolec~oZ PI-
6a3~F ~oS~-a
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CK#
O,~Il~ D~ 103ty Dos rJ7o~°~~s-zi~}, o3al ~~rrlfI~rs- hlp~!?~S ~/.~D
Purchases of certain campaign property costing $500 or more must also be inventoried on ScheciuJe,H . (Refer t(a,Schedule H- instrucfibris .)
Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the personlentity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(1).)
Page of
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
P it 6tOomolt S CU-b .
~9-c23 CK#
_SO'3i-1 ^for to ~~ .
11049 /Dar $ i ,oD
ID# s~l'ria 7fd 'w"et
v~b o-rr dss ~ .~',4
CK# ~'ecJt? ray ~v,r ' ~o
D 9 :~o-o ios'0 ose ice Um , .~ s re SkocJ a
ID# ¢z~ao SE i S.t J_
Desrl7eato~ ZA S'43 . $4A4 I d ~y
CK# "~ c-: n } I ,S w
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CK# GS'S iJ*_inV )0ost kef,
9-020
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10#
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1D#
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- - SUB-TOTAL- $
TOTAL (if last page of this, schedule) $ r
.. .ti SUB-TOTAL $
"
TOTAL (if last page of this schedule)
Purchases of certain campaign 'property costing $500 or more must also be inventoried on Schejqule H : (Refer to Schedule H instructions .)
Cxpenditures'to persons/entities providing consulting, advertising, fund=raising, polling, managing, organizing services must -also be detail itemized on .
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(1) :)
Page 4- of
FOR INSTRUCTIONS, SEE BACK OF FORM :. SCHEDULE
B MONETARY
" . 'EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 09/97) EXPENDITURES
STATE PAC COMMITTEES : NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE O CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE .' A UST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .
CK# /,453 UO t D
ID# G/en Oaks oarl7"yC( 3'{a kccm&JiPg
G leA7 Osrks ?J r "
et ffAa14 CK# ~n5~1 uJt?sf . 'Des ma rues 7-R _,('ar a n a.a / (cam 6 f l Sa " b'f
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I
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CK# /o s4 The-, at.o Irn es Z
;.A
S03Ia:" !e e-4;vn 300 . 00
ID# OM m ; oe TE/P taww t
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la* CK# 0/ive '// ,s'd3d S e le eX vn 0,0
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ID# .. ' .
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Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 56 .6'(a)(i)j
.
FOR INSTRUCTIOVS. SEE 8+4CK OF FORM SCHEDULE -
~'30o .OC7
IOGO SDaler, eke%urn.
ID# ~ co m m 4ee `iv E(Qe4 S
$o2, ,gta h S4,raQt
CK# I,t)2S f fps ,M .o:vws wft tna- ~
holelob ,owl 5CQ(PFa 3 Co. 00
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~~`l'l 3 3o I `T"" m 6° r-~,r,aon Road
CK# {~-.kQ wy . S * sans l ~o ~~~ :o-r~ `~ur
/ /0 6a G`' 300 .0~
ale ~i11Y\
ID# e°m 7-f~-pe ~o Etpe} >LaPek
CK#
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ID# /~~ Camwli -ee ~(o Elegy .`i!eutrl J
fy/o~
ro CK# Des /~10 ~i P5 zf} 5'o3a 1 00 . 0 ?
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Expenditures to personalentities providirV advert>sing. fund-r8ipng, polling. marlapirp. organizirtg.servwes must also be detail itemized on
Sdnedule G by the amount. Purpose. and =aoph type of azpendillure made by fm persaNentity an behalf of the candidate's cormettee. (Refer to
Schedule G instructions and Iowa Code St3.6(3)(I).)
Page
FOR iNSTRUCTIONS, SEE BACK OF FORM FORM
DR-2 DISCLOSURE
DISCLOSURE SUMMARY PAGE (Rev . 01/98) REPORT
Routine Penalties Due For Late Filed Reports Range from $20 to $800
I AM FILING A Deco b'."- ly , aoo-V REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate one
7 Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County & Local Committees, enter County in
which Election is held
(You must continue to file reports until a Notice of Dissolution is filed .)
CASH ON HAND at the end of this reporting period (if final report, balance must
be zero) (Attach DR-3). .. . . . .. .. .. . . . .. .. . . .. .. . . . . .. .. .. .. .. .. .: .. . . .. .. . . .. . . . .. .. .. .. .. ... .. .. . .......... . . . .. .. . .. .. .. . .. .. . $ S~: /~. .
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD .
CAUTION : Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
00-19 , 0 CK#
,ewe (r *a le S
I D#
~Pu~h .~ :ddy
CK#
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ID# ho e, G!)~ llg
0 9-~7-oc~ cK#
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ID#
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ID#
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CK# eQ sopY~?
09 " 1~0~ 3S'. O~
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I D#
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CK# )0 n« d tom , e-~J
0 9-19-00 used ~2 t
I D#
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CK#
49 - l9 -d fr S e sit o ~J ?~i o~eSCg
a ~G,oo
I D# accd4"°~ wt e- 1~"S
CK# Iowa 40
04. -67 .0-04
/Y
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ID# ,De a~ o~ rtd~i'sv-mot
CK# eaok :e fiales,lecd2/rv ~Za/es
09 20-0~
C°-oa ~a3 . oo
SUB-TOTAL
$18 ,13
TOTAL (if last page of this schedule)
' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page of _2-
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIRVTIONS -- MONEY TAKEN IN (JRev . 06/97) RECEIPTS
'Jricluding candidate's personal funds)
CHECK THIS BOX IF
CQMMITTEE NAME (Must be same as on State}h7ent of Organization) AMENDING FORM
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD .
CAUTION : Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT V IF FOR
RECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
I D#
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ID#
f~2ll f~fj or-- ~lhl
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ID# -
C K#
SUB-TOTAL
CK#
/o3y~ z F-,C'cJ ~ ~~~,6ers~;l 5 7p, o0
ID#
CK# 10,35-
T:~d ,~ .~s7~~`c~ 'I ryI eh'J 6~- c~u e,~ 3', Sv
ID#
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CK#
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CK#
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ID#
# 1039
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ID #
CK#
0 30 dL ,039 a SAM ca sAy- 6e 40 ~1rr i~- s<3
ID# '
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a®~ ~7 -off /t7 elo
. SUB-TOTAL
,TOTAL (if last page of this schedule) $
Purchases of certain campaign property coating $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .) "
Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(1) .)
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
CK#
SP. Do
- ID#
Oc~ -03
CK#
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o
ID#
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104S
ID#
J2/71 lJYt It ~P~
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ID#
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is
_ . SUB-TOTAL $ ~'
30~"
TOTAL (if last page of this schedule) $ ,
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H : (Refer to Schedule H instructions .)
Expenditures to persons/entities providing consulting, advertising, fundraising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(i) .)
(for Schedule B)
FOR INS ;F RUCTIONS, SEE BACK OF FORM SCHEDULE
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00
CK# ,t~
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' SUB-TOTAL $
Purchases of certain campaign property costing $500, or more, ust also be inventoried on Schedule H . (Refer to Schedble Wins tr:ctions .r~ : s ".
i A
Expenditures to persons/entities providing consulting, advertising, fund-raising, tolling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 566(3)(1))
. .
e
(for Schedule B)