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Polk County Republican Womens Club - 9628 - Scanned

This document is part of the Iowa Ethics & Campaign Disclosure Board set, which was up to date as of 2/20/2011. The documents in this set consist of every pdf posted on the IEC website, but they should not be considered a replacement to searching the official website: http://www.iowa.gov/ethics/ ----- Disclaimer: I am not selling this data or making any money by posting this data. I'm merely trying to find a better way to search the information on the Iowa Ethics & Campaign Disclosure Board website.

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Zach Edwards
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© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
0% found this document useful (0 votes)
49 views13 pages

Polk County Republican Womens Club - 9628 - Scanned

This document is part of the Iowa Ethics & Campaign Disclosure Board set, which was up to date as of 2/20/2011. The documents in this set consist of every pdf posted on the IEC website, but they should not be considered a replacement to searching the official website: http://www.iowa.gov/ethics/ ----- Disclaimer: I am not selling this data or making any money by posting this data. I'm merely trying to find a better way to search the information on the Iowa Ethics & Campaign Disclosure Board website.

Uploaded by

Zach Edwards
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 13

FOR INSTRUCTIONS, SEE BACK OF FORM FORM

DR-2 DISCLOSURE
DISCLOSURE SUMMARY PAGE (Rev . 01/98) REPORT

COMMITTEE NAME (Must be same as on Statement of Organization)


co

IMPORTANT : Indicate type of committee you are reporting for :


( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County%L
( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee
(8 )Support Slate of Candidates

SIGNATURE OF TREASURER (or person filing this report) TELEPHONE DATE SIGNED

Routine Penalties Due For Late Filed Reports Range from $20 to $800

SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :

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

STATEMENT OF CASH ON HAND


CASH ON HAND at the beginning of the reporting period . (This is the total
of all monies held by the committee . This amount MUST be the
same as the cash on hand at the end of the last reporting period,
or must be zero if this is first report filed .) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .' , $ 3 362:1
ADD TOTAL MONEY TAKEN IN THIS PERIOD

Schedule A : Cash Contributions total (Attach Schedule A) . . . . . . . . . . . . . . . . . . . . . . ., ., . . . . . . . . . . . . . . . . . . . . . . . .7,5-


Schedule F : Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . .
Schedule H : Total Sales of Campaign Property Attach Schedule H
(Schedule H applies to Candidates' Committees Only) s
SUB-TOTAL . . . . . $
SUBTRACT TOTAL MONEY SPENT THIS PERIOD

Schedule B : Expenditures total (Attach Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., ., 49a.2 " 8y


Schedule F : Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON HAND at the end of this reporting period (if final report, balance must / '
be zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. .. .. .. .... .. .. $ /_ 3 63 . '71

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) $
FOR INSTRUCTIONS, SEE BACK OF FORM FORM
DR-2 DISCLOSURE
DISCLOSURE SUMMARY PAGE (Rev . Of/ 8) REPORT

For Office U e Onl

C MMITT E NAME (M t be same as on Statement of Organization Comm . #


oI k t r ff~u kP D, bf ,c o K W 4 men 5 (2 rct f Indexed
Audited
IMPORTANT: Indicate type of committee you are reporting for: Computer
( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate
( 5 )County PAC ( 6 )Ballot IssuelFranchise Committee ( 7 )County/City Central Committee
( 8 )Support Slate of Candidates

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

SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :

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

OCHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election

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.)

STATEMENT OF CASH ON HAND


CASH ON HAND at the beginning of the reporting period . (This is the total
of all monies held by the committee. This amount MUST bed
same as the cash on hand at the end of the last reporting period,
or must be zero if this is first report fiJed.) .:. .. ................ ........... ....... .. ................. .. ...... ....., . . .. $
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) ............ ....... .. .. ...... .. .. .. ... . ..... .. . ..
Schedule F: Loans Received total (Attach Schedule F) .... .. . .. .. .. ..... .. .. .. .. .. .. .. ........... .. .. .. . .. ..
Schedule H . Total Sales of Campaign Property (Attach Schedule H) .... ...... ..... .. .... .. .... ... ...
(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL ..... $
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) .. .. . .. .. . .. .... ....... .. .... .. .. ...... .. ... ..Y. ... .. . ..
Schedt e F : Loan Repayments total (Attach Schedule F) ....... ..... .........:.................. ...... ... ..

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

STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE


[~ CHECK THIS BOX IF
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE
I'/\C CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD. . ,

COMMITTEE NAME (Must be same as on Statement of Organization)

?o I I~- ~~ ~ h c~ Id r7 rYl e A
~o ~ Prvrt

CANDIDATIL NAME AND ADDRESS TO WHOM PURPOSE AMOUNT


DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(iv1M/DDIYR) AND PAC
CHECK
NUMBER
ID#
h is/o
/033
~a
Al-107
s ce
CK#
~os~ _e ._"
dls~~osuz os~ , 97
ID# `

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
J~a ~ lS
CK#
O,~Il~ D~ 103ty Dos rJ7o~°~~s-zi~}, o3al ~~rrlfI~rs- hlp~!?~S ~/.~D

yes rgo,4 P~ z.44 6-03a I'


CK#
143 -2 0-'-c ; r v /Yi oX ~- : rN
ID# ~SSS Plea, 7I r-r,i¢r
Z) e s ,`/t -no oS ~} so3~ ! .X. i
CK# /o3 ~;_ ~a lq r' eP -7 s. ~~ de lopP-5 s"
ID# .'ESV-*, P /I7I~,e~nla~ l~v~
Des /I? o ; lies -X-A So3s-t'
CK#
,039 ~s~-rt ~Sjlor- At Ile ~Irr 4, -/3
01 .30-0~-
(
ID#
1~es r!'IoT~Jes ~, So3aD _
CK# .
af~° -ocf /0 el,~> 04 i elm X Q G A ,0, S kocv 5-
. " . SUB-TOTAL $
.TOTAL (iflast page of this schedule) $

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

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

' EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY .


(Rev. 09/97) EXPENDITURES

STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE


CANDIDATES . UST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .

COMMITTEE NAME (Must be same as on Statement of Organization)

P it 6tOomolt S CU-b .

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT


DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MMIDDIYR) AND PAC
CHECK
NUMBER
ID#
lk- ~0 t!o -A,' c-k e f S Sv(c~,

~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
o9-a4-aL SOS/ 4-~-f ; Ce Mox l5. Qs-
10#
CK# GS'S iJ*_inV )0ost kef,
9-020

CK#

10#
CK#
ID#
CK#

1D#
CK#

- - SUB-TOTAL- $
TOTAL (if last page of this, schedule) $ r

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :


Purchases of certain campaign property costing $500, or more giust also be inventoried on Schedule H . (Refer to Schedpl® H* ias t`ruFDons .J --
. . ti . : . - . _ , , .
Expenditures to persbns/entittes 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 __3 of '15,_


FOR trJ2TRUCTIONS, SEE BACK OF FORM SCHEDULE
.. x
. MONETARY
" _~FXPENDITURES
. -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev09197) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DES ;GNATED COLUMN AND THE F~ CHECK THIS BOX IF
PAC CHECK NUMBER FOR E)tGQ EXPENDITURE .A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .

COMMITTEE NAME (Must be same as on Statement of Organization)

~o l~L 0o" V Pep z AO ~% ay , loo m P,4 s

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT


DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MMIDDIYR) AND PAC
CHECK
NUMBER
1D#

CK# 1)2. " 4 :da/ts i0xZ.,4


ad -~,re s , Sa. 00
ID# .3-oao 5~ ~.fw~ s,Yrtest"
'r7 as i'!Zo ~n os ~ ~t So>~
cK#
lo`f Q S' ;ce la " -70
oruQ
ID# z.o 5 6 ~~G S,ir~eL`
'Des /ylo :nos =A ~~sr
rep-; 04 4
69 to ~/3 0~-~ ;ce ~ a ~C s~ le s ko c v
ID#

CK# /2& "Cot ;c-,

*9 _ -CK# ~ ~ ~oislo t~av l ~s ~o ~ ~


/I -0V /o4s- SQL s S
ID#
I~I7t vYtQ !~
CK# , {LCS ~Oa-sC~~
09 to 46- s
ID# 'L3 IGleccr Ar-
ae~ /llo~nos ~~ Sir
cK# 1~lldr ~`~~r,~~al n~~s l `~s Pr hoa".~
W-40.60
ID# ''~~st.~ /Bur Dr-
*30 g eno TAOS =A Go3i1
CK# Jow . . ., a!"t

.. .ti SUB-TOTAL $
"
TOTAL (if last page of this schedule)

THIS BOX APPLIES TO . CANDIDATES' COMMITTEES ONLY : .

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 .

COMMITTEE NAME (Must be same as on Statement of Organization)

l~01 ~~ ~0L~ rt L~ ~Q pct b ~ ~ ea-n ~rnert+ 9G~ 8'

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT


DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER

r }~c : rl~e r- fzor


C- _ br4.t (e+ :n II, A~ct7t $ '54Z . r9
CK#
/OSz O. skow le'cto ,r; apo,r
rl ; nn~a d~s i''l~nn s ,f~lo ~
la
,
ID# ~ 00si_Z` tr-r-r~r
iO lei fl{ l4VIVIM
,~aake~s T,'azt
i 4eorr"e ,_~ a r .a~ ; +-~ o rL
CK#DQuJ ,yr &&, r -F°r- 9 o et e Q c s :-~
T So
ID#

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
$'Od~eG Sic/ se SIzOw'~"~c(~e
ID# l
W~~ /I1Q o~dlt>X's . reslf?2fe '
Grlon.a.~loi7 '~v r
te wk 0,1
I
ID# G r&Adaneff85ar
~ S +a+e e P
/Zd~ 4,31 `~Lo cloria.~F%cam
lv1afo~ S.~-roet,
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
G: 70 13 Na) Sr~z . /ltee: al ~. v r) -tco r
la* CK# 0/ive '// ,s'd3d S e le eX vn 0,0
/4F'J
ID# .. ' .

' CK#

. SUB-TOTAL $ ~Gl00 ill


TOTAL (if last page of this schedule) $

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :


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, 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 -

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT


B MONETARY
(Rev. O9197) EXPENDITURES

STATE PAC COttNTTT'EES : NOTE. FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE


CANDIDATES . UST THE CANDIDATE MENTIRCATON NUMBER IN THE DESIGNATED COLUMN AND THE 0. CHECK THIS 13OX IF
PACCMECK NUMBER FOR EACH 0CPENDITURE.' A LIST OF tD h1UMBERS 15 AVAILABLE FROM THE IOWA AMENDING FORM
gTHICS 8 CAMPAIGN DISCLOSURE BOARD.

COMMITTEE MANE (Must be same as on Statement of Qrganizefdn)


~)dJJLCOu,. {~"'~( ; eo,,1 (,corna~ 9~a8
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE. AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MMDDIYR) AND PAC
CHECK
NUMBER
10# Pcm m% Tree -fo~loe,~ TDrh.a
~ ~ ^
47 GcO rtct'tibn F v ("
~LZSb l-l y~ri0/I >VO: ~lfQ"
1011--a-104- CK# .~b n s
*So » :~.. ft S o l 31 e G4 I oil\ (e $

1D# Porn at : eP -/o /eel


61a k-,s 2) r

~'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
~~° m tYf~ p `/ey e°e~ l3 ma I
~~`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#
/4, Ax /C, /0103
ID# /~~ Camwli -ee ~(o Elegy .`i!eutrl J
fy/o~
ro CK# Des /~10 ~i P5 zf} 5'o3a 1 00 . 0 ?
/o Grf.
ID# h o rrl~scrn -4,- Lw ress
!v ~42~pc~ io SS G "u.~ C/ Auk ~l ,
CK# 0/o n,Z. Cr ~~
blfsL
loln5 -Des 1hoir\OS SO.z(aG 3Q0 .DO

ID# G` re 5 tPy ~r Se rka4e,.


Z nd P Iod ~ /
ID I, a.. (b'(- CK#
rD /p!o 4::° 4 a ~R ( ka GCD ilar`~; D~ ~e r v lpC`~ ;Jr~ 1 Sb . OD
1~QS /If1°i(~BS~ SO~
SUB-TOTAL $
,2/QO O D
TOTAL (iflast paw of this schedule) $ , 9 Fhb
5/ ad .

THIS BOX APPLIES TO CANDIDATES' COMM1TrEES ONLY:


Purchases of certain campaign property costing &SW or more must aim to Inven6orted on Schedule H. (Refer to Schedule H instructions.)

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

C C 2. 0 2004 or Office Use Only


omm. #
C MMITT E NAME (M t be same as on Statement of Organizatioh
D wn4 c Pn e ~u It C: lt0 hdex
udited
IMPORTANT: Indicate type of committee you are reporting for: Computer
( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate
( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee
( 8 )Support Slate of Candidates

a ,Z3 - /t, 2_2 /o -i-) -D "'Z


SIGNATURE OF TREASURER (or person filing this report) TELEPHONE DATE SIGNED

Routine Penalties Due For Late Filed Reports Range from $20 to $800

SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :

I AM FILING A Deco b'."- ly , aoo-V REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate one

CHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election

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 .)

STATEMENT OF CASH ON HAND


CASH ON HAND at the beginning of the reporting period . (This is the total
of all monies held by the committee. This amount MUST be the
same as the cash on hand at the end of the last reporting period,
or must be zero if this is first report filed .) . .. ...... . . .. ... ..... . . .. .... .. .. .. ..... .. .. .. ...... .. .. .. .. .. .. .. ...... .. .. $ 3s9o.
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) . .. .. . .. .. .. .. . ..... .. .. .. ...... .. .. .. .. .. .. .. .. .
Schedule F: Loans Received total (Attach Schedule F) .. .. .. .. ... . . .. .. .. ...... .. .. .. .. .. .. .. .. .. .. .. .. .... .
Schedule H : Total Sales of Campaign Property (Attach Schedule H) .... .. .. .. .. .. .. .. .. .. .. .. .. .. ...
(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL .. .. . $
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) .. .. .. .. . . . .. .. . . . .. .. .. .. .. .. .......... .. .. .. .. ... . . . .. .. .
Schedule F: Loan Repayments total (Attach Schedule F) . . . .. .. .. .. ..... .. .. .:.......... . . .. .. .. ... .. . .. .. .

CASH ON HAND at the end of this reporting period (if final report, balance must
be zero) (Attach DR-3). .. . . . .. .. .. . . . .. .. . . .. .. . . . . .. .. .. .. .. .. .: .. . . .. .. . . .. . . . .. .. .. .. .. ... .. .. . .......... . . . .. .. . .. .. .. . .. .. . $ S~: /~. .

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?) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)
For Instructions, See Back of Form SCHEDULE
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 06/97) RECEIPTS
(Including candidate's personal funds)
0 CHECK THIS BOX IF
'COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Ao(k, 6b-n-4 4pit6j . - C-0f) WompN Cab

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#
o9-lfo-off c4 r`G dS ce-2
ID# ho e, G!)~ llg
0 9-~7-oc~ cK#
i5. o0
ID#

CK#

ID#
/
gg'y~(esl?Uw s ell! OO

t~P (P r) C rc~cr t
CK# eQ sopY~?
09 " 1~0~ 3S'. O~
P~o ~~o K,eS
I D#
~eposl~ LICa`tge
CK# )0 n« d tom , e-~J
0 9-19-00 used ~2 t

I D#
Axn e-J"7,

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
540") -
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#
/~'lu~ .`~ l Kn ~ller-
CK#
o~ as. o v
I D# ~ ~

CK#
fflesar7 h~~COdts d,~o .tx~
24A sh")
ID#
f~2ll f~fj or-- ~lhl
cK#
a~
1D#

CK# A-,y1 arm d r Spv ~'


.277. 00
s SGLo ~ °c~c .o~ S
Ifdo
g-~~-at~
I D# /J? orr~ `S

d '?a 7-0 CK# -ego lam' s~ loS - S le S~~ 7/ a 5"


ID# '
/_~e c_
~ r-"o e
cK#
v 9 a7-v~
I D#

C K#

- ' CK#

ID# -

C K#

SUB-TOTAL

,' - TOTAL (if last page ofthis schecluJef


$ a986 . .2s
' 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 samc as candidate, but there is no Page -~ of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
FOR INSTRUCTIONS, SEE'B,4CK OF FORM SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT . ' B IUONETARY


- ` (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 El CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD . --,

COMMITTEE NAME (Must be same as on Statement of Organization)

-?o l l,~_ 0o u,,, k All ..bI; .-, ldcqrneA5


CANDIDAT NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
ID#
/033 ~a h (5
CK#
;~~s'~-9 ~.
drs Q losu~ os~a - 97
ID# ~ `

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#
Dc, lS
~oS~a 9~ ,(~u Ifo`7~f 0
CK#
le ap S.

C'v~7 hY 1 a-~S
CK#
D~- '-off 114 37 0~" ;re 41 OX 10a r(Q~~ ~S ao .o~
ID#

# 1039
1()0 l,? y- eP t g ell de /OPPs
ID #

CK#
0 30 dL ,039 a SAM ca sAy- 6e 40 ~1rr i~- s<3
ID# '

CK#
a®~ ~7 -off /t7 elo
. SUB-TOTAL
,TOTAL (if last page of this schedule) $

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

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

" EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY


(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 0 CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .

COMMITTEE NAME (Must be same as on Statement of Organization)

~o lIL 0O"/ ~epa l ~,' m-,, Zt)d .71 e,4 s

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT


DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
ID#

CK#
SP. Do
- ID#

Oc~ -03
CK#
/o `f Q ~~ cc e (Y1
a
l~
SD K (e
S4-&+ ; one s
5 hu w
Q- ;~(c"e Ia
"
o

ID#

69 ~8"D to ~(3 D ;cc a x, 54 le s kd u~ " f~ v


I D#

~~tK e ~ar .city


"200 ©D
ID#

Ov CK#
104S
ID#
J2/71 lJYt It ~P~

%G It ,'c
ID#

CK# nct S ~oS7Pr' fJom~


llama ~P it ,~i'lt ~ l° 11 I ll . (o (o
ID#

C K#
is

_ . SUB-TOTAL $ ~'
30~"
TOTAL (if last page of this schedule) $ ,

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY : .

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) .)

Page IZI of -,3

(for Schedule B)
FOR INS ;F RUCTIONS, SEE BACK OF FORM SCHEDULE

' EXPENDITURES -- MONEY SPENT FROM . COMMITTEE ACCOUNT B MONETARY


' . (Rev . 09/97) EXPENDITURES
STATE PAC COMMITTEES : NOLTE : FOR CONTRIBUTIONS MADE 10 STATEWIDE OR LEGISLATIVE.
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF I
PAC .GHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AtNIENDING FORM
ETHICS & GANIPAIS;N DISCLOSURE BOARD

COMMITTEE NAME (lvfust be same as on Statement of Organization)

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT


DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(NIiNVDD YR) AND PAC j
CHECK
NUMBER
I D#
Po //CC c,(~ e S 8~l aQ.

W
Cn
00
CK# ,t~
p9-23-0(/ -~ D r- ~O t.LSG
Q' ~' l~a . 00
- i
- ID#

CK#
XO5 J ~e c,-;o
(may
y-Jr C"0~
0 f o S~ Z-(,e wm ' ~~ S le Skou] oz .
ID#

0 9 -a s los/ 4 4~ E 1 - C e /j1 o x t c- : n ~-
7 ; n

CK# I n ~o~ / r`u 9~ err-al - 04


09 e?0-,pt~-
ID# ~"-, .~ - . . - . . , . .

CK#

ID# -

C K#

I D#

C K#

ID#

- CK#

' SUB-TOTAL $

TOTAL (if last page of this schedule)

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

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)

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