Disclosure Summary Page 65Rn M 7-F,-Tae'R Dr-2: R Jf4Rnr, 5 Ualco4 '', I
Disclosure Summary Page 65Rn M 7-F,-Tae'R Dr-2: R Jf4Rnr, 5 Ualco4 '', I
I
FORM
DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
(Rev . 0712004) REPORT
COMMITTEE NAME (Must be same as on Statementof Organization) `-
65rn m I rr6,~ 7- F,-tAe`r ForOffice Use Only
Jf4rnr,5 n- UALCo4 ~'`~ , I . Comm. #
IMPORTANT: Indicate by # type of committee you are reporting for: Logged In
( 1 )StatewidelLegislative/Judge Standing for Retention Can ' 2 State PAC ( 3 )State Party Scanned
( 4 )CountyCentral Committee ( 5 )County Candidate ( Ity Candida 7 )School Board or Other Political
Subdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 1 oard or Other Political Subdivision PAC Computer
11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES ONLY:
Candidate Name Political Party (if applicable)
3A,rner S a- " ALaslk No~J ~__
Office Sought District (if Senate or House)
Stow Ctl~l 0_12- C,juclcr w
Late reports are subject to possible civil and criminal penalties.
~,, ~ -1 kk Z -( 06
OF PERSON FILING *PORT TELEPHONE DATE SIGNED`
Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County & Local Committees, enter County in
(You must continue to file reports until a DR-3 is filed.) which Election is held
**UNPAID BILLS (From Schedule D-Attach Schedule D) ... ..... ..... ...... ..... .... . .... ..... ..... .... . ...... ......... ..... ..... ..$ )L ,
*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . ..... .... . .... ..... ..... . .... ..... . .... . .... ., ... ..... .. $
**OUTSTANDING LOANS (From Schedule F - Attach Schedule F) ..... ... . . .... . ......... ..... .... . ......... . .... . ..... ..... .. $ '
CONSULTANT BREAKDOWN (Schedule G Attached?) -YES A NO
CANDIDATE COMMITTEES ONLY :
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
STATE COMMITTEES : Submit a reconciled campaign account bank statement in January of each year.
For Instructions, See Back of Form SCHEDULE
Reset Form
CONTRIBUTIONS - MONEY TAKEN IN A MONETARY
(Rev. 07/03) RECEIPTS
(Including candidate's personal funds)
(] CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement ofOrganization) AMENDING FORM
~\ ,Aw\ I -7-rrc4. F,~z"tcf ~ s 0" 4ALco
STATE CANDIDATES NOTE: IFA CONTRIBUTION IS RECEIVED FROM ASTATE PAC (POLITICALACTION COMMITTEE). UST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER INTHE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICSAND CAMPAIGN
DISCLOSURE BOARD.
CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use ofinformation copied from reports and statements for soliciting contributions or
for any commercial purpose by any person otherthan statutory political committees.
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT d IF FOR
RECEIVED rd a bw) TO CANDIDATE' RECEIVED FUND-
(MMlDDYR) AND PAC CHECK (ilappyabe) REygER
NUMBER INCOME
Ip
J
EU Iz CK# ~1 4o SP ~~aSS (Z--c $ Z-on"
E:1
IDS
ID#
E]
K(t uzop e- Hoi rs
i -7 R 2t , 40 r~
CK#
SioJw C(,-cq ) LP- 5z (176 I `ve 1b
ID# Slou>e CATq tj"4e i3llltxiFQ&S
, LS 1 V 7- L
I ~'7.v tGS l (93 ) C4-CY 1 I a V INvk vv E]
S
ID# 0 (S a,2t kb Eli
[-~
lU 1 Z,LL b CK# /\) 6 N K 4
I a- c-4 l i,~ F I i 03 F
ID#
' , pl~~ X-1 (-L 0- = V c2--vu YZ0 O~Fj2TS l1 fv ~r-
6G 5 ~~ Qv
~( lZl ~~ CK#
3SZlo S :L~ i n~ jeA~ S~ SiOva tyll~ El
ID#
CK#
ID#
CK#
J1E]1
ID#
CK#
_.
ID#
CK#
SUB-TOTAL
s 00
TOTAL (ff lastpage of this schedule) O
` Disdas<xe latereWres candidate committees to dlsdase tl-0retatWmshp ofanyrelative ma" a contritrution to the L$ 06
commiflee. ReWirxrship mustbeshown tothe Vwd degree of cwrsancont
mamage) . tf surname oroontnbutor is the same as candidate. but there is no
tamrliai relationship, enter 'not applicable` in the relationship column. rrnr Crharita 6~
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form SCHEDULE
ID# S 1[ OU ,,, Li -c
CK# S~A-t/u,QiA Srt ~~ ,zl
ID# S,zci~
S , vU
LU~ai cK# 5c-ie.l~ V' Cwh,(q rc
ID#
I
ID#
ALYYX AT I
t o 3 ~~ 'V~ G1
cK#
IUV `
ID# 'cJu rSL1~ ;
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CK#
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ID#
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f ~s Q Ucc t~ ~~ t
CK# Lr<ZZ ~L `e~5"f
t(1 C,1 't 51 (G f
SUB-TOTAL $
TOTAL (iflast page of this schedule)
1 '~T 1
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form SCHEDULE
qL -y c -z -r e-[~ Eo r
COMMITTEE NAME (Must be same as on Statement of Organization)
L q G- -t
(1, C~-,1~ .l Co4
A-~ ~ S
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MMIDDNR) AND PAC
CHECK
NUMBER
ID#
U S PS
`i r CK#
S ( U'j ~( G(.~L( A SWIG I
ID# US PS
1 006'a
)(1 I~fG`i CK# S~ uJx Llzy 1A Y (a
ID#
0S PS P01/ncp 4.
CK#
t1 Uvy CAT t4 ylO t
ID#
VIA FN /~- e-D S waa p
CK# -
~o~-~a> .~D1?v~Slw>~~r s~
fZv .9?
NS
ID#
4Pc-10 S G--
lD CK# CMG b N Dam. U rc-
S L aU C,t-tiq M ~l101
ID#
CK# 1-f
i UCZ' I ~~ iA-
S( ow C-c
ID# VS ~ S ~vS~4Cs2- -
CK# ~, . - 4 z,7 . <v
SIOUV iAS1Ia1 _
I ID# ~s ~S l?GSrtA~
i~(3 50 ~ U(I
(G) CK#
SI 6'V ~ Y 16
SUB-TOTAL $
TOTAL (if last page of this schedule)
r
s
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 personlenfty on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 613A .402(3)(i).)
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset FornL
SCHEDULE
MONETARY
EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT B
(Rev. 07103) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST 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 .
CK#
ID#
CK#
ID#
CK#
1D#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL $
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions.)
Expenditures to personslentfies 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 persoNentity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 68A .402(3)(1).)
Page
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
D INCURRED
COMMITTEE NAME (Mustbe same as on Statement of Organization) (Rev . 0819(3)1 INDEBTEDNESS
a
G ;nn t TT'T~~~ L-Ve.
t D CHECK THIS BOX
Ic IF AMENDING
NOTE: Debts previously reported that remain unpaid must be included on this ., . ResetForm FORM
Schedule, as wall as any new obligations incurred in this period.
SUB-TOTAL $
'If actual figure is unknown, show "estimated" beside the figure . Page I of
(for Schedule D
NOTE: This schedule reports money loaned to the committee which is deposited in the committee account. CHECK THIS BOX IF
AMENDING FORM
TOTAL UNPAID LOANS FROM AT REPORTING PERIOD $
PART 1- MONETARY LOANS RECEIVED THIS REPORTING PERIOD PART II - MONETARY LOAN REPAYMENTS MADE TH13 REPORTING PERIOD
(Original source of loan, such as a bank, must be shown if a third party is (Loans forgiven must be reported on Schedule E - In-kind Contributions.)
involved. Include loans from candidate's personal funds.)
DATE NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT DATE PAID NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT
RECEIVED (Include Endorser's Name, If Applicable) TO CANDIDATE OF LOAN (MM/DD/YR) (Include Endorser's Name, If Applicable) TO CANDIDATE' REPAID
MM/DDIYR If livable If A livable
j/5rn~s
to lz4k -~ ~luGSt~-t~tw
Sc tN~ GI - t:~ 1 t4St lct~{ 5~1 ..F
33I ~ ~} ~
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ZZ-G !~( N S A, l~
C
,/
'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) . If surname of contributor is
the same as candidate, but there is no familial relationship, enter "not applicable" in the
relationship column when it applies . Page I of
(for Schedule F)