Académique Documents
Professionnel Documents
Culture Documents
/0 -Z8 -ay
SIGNATURE OF PERSON FILING R DATE SIGNED
I AM FILING A /0'2 B`-0Y (Fred4s 6{c,t a 1ft~~ REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate by #
El 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
SUB-TOTAL . .. . . $ ao j (V s3 .s3
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B : Expenditures total (Attach Schedule B) (**also see debts and loans below) . . . . 171 7Zf~ .lg
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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
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 J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
CK# , ~-, 0
A. Ih V. 0. 'R , A) ~b . 00
ID# hlir5lfe~ LIVA/
.1-12-,o ~,~le~K~r r4 re
CK#(~a 7$ o°
v q Q
Des /(o urea, -A
.
, tea,
ID#
~ebb~e P,i~~a~
CK# (0l9 ZD ~'~h Trios L
ID#
ae nn l e tie Ile r
CK# Y~ ~o /D
D d ..41 A
1D#
sht..Set,n` t7 er ,
CK# 70') Pin e
3 93 e A w lS. Op
' i ID#
AN
'
GkUJEAl
SRI
CK# 40g .7 slsT sr -r 1,-1
2Z D e 466 , rA pi14 SD, od
1D# /ht I~ELE ST/4-XKEN3WZ C-
6 MW OA m Puz Adg a GT
CK#
Zz A-W a N TA Q ez
IV) A-R tl > N J Lk A 1<in/S
CK# 'LO .:j6S
D s~ - V"rle l~~ loo, o
CK#
300,00
e02 2 d 1/ -" is /2 G0 ~(/
' 1D# J
r-.e .~.~ lCl'use
j>6 6oX 7q
CK#
SUB-TOTAL
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 Page -~ of
familial relationship, enter "not applicable" in the relationship column. (for Schedule A)
For Instructions, See Back of Form SCHEDULE
Reset: Ft
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
0 CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement 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 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
E:1
ID# ,
1r-2C_y lNloetl,u- ~1VE l GE
1$1I Cou n Gtr I24
CK#
0 126104_ ~" 0 00
i ID#
vma-s Wu_bel
CK# ass E . M4tJalrf 6-
'
' / ID# '
Y~ la. Gk
W _ . , .)
CK# ~'70Z G~...rd v,u~l
.4
o - lk X-
ID#
LINDA- floakj--.1s
/ I la E
CK#
93 r
A- 16 ) ,,-
_. N .4- 5000
3e.rn t o Sa 9au-
CK# 50l S.
s o _ ~''Jl.~ a'o 0 0
y r ID#
7-
dM Narak
CK# 140 3 co ccn 4-y 4,41sb 44
0 oy 2N iA N S, o
_ ,
ID#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL
' Disdosure 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 Page o~ of ~ _
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
tVtt lNJ I KU(
; I ICJNS, SEE BACK OF FORM ~~F*'== SCHEDULE
s e.X+ro 4- SCs.C..4e
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# OslCairraoiq tkr4Ld1 a 9 / s
)0-1f-0q CK# P. o. &,x S30 . 0-0
~LFf os Icu, lo o6, 0:A- SZ5 7 7 8co
ID#
Abet- S(%aror " Nt(4PyW - D)%3 p4q i
i0-~~ CK# NcW bla"o~ ,z~ 81 CFO
(Z4
ID# AA t r &'o l1 W L4 h'E4 ws
~ iS~ l4y
1 C /S~0~ ~'~'FCI~" 2la o0
j CK#
1 g 130 Pflq BOX
4 ,% f v)dt
ID# rot A4t rrar, .'Fn+c-
/won
Dts PIt7 j4d
/a-18aLf CK# 50(70 1Z2. ''
131 MOyaY-4
ID# To" Crier ZKt .
fl'd
CK# 6/0 Fasf S 'r~~ yxll
l98
13ZL pa1l4,zow4 S'oL1f
I D# KT S S K ad.I`
yj (o gia5 41 k- 30
/a -Z L-c CK# j jq aHut+"tv~,~ f2.Sn1 ~ gGs
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 68A .402(3)(i) .)
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B
(Rev. 07/03) 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 8 CAMPAIGN DISCLOSURE BOARD .
CK#
ID#
CK#
ID#
CK#
1D#
CK#
I D#
CK#
1D#
CK#
1D#
CK#
SUB-TOTAL $ 00
y0U
TOTAL (ff last page of this schedule) $ 141
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 68A .402(3)(i) .)
Page Z of
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev . 06197)1 CONTRIBUTIONS
T- t tY1+~i-sV`"~ -~ 19
1 P>'\0 we ~~
D
1t
Lot-,
'~ha N~ c,q-I 1 ~
©
~~y
(>C~ ~ ~ RAa; o ids ~~ 0
''ivy a ^' 12~ ~
1b T-Nt
n14
E:1
~c 1 ~-- - Gas Cad
F-1
F-1
E:1
'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page
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
familial relationship, enter "not applicable" in the relationship column .
FOR INSTRUCTIONS, SEE BACK OF FORM
SCHEDULE
COMMITTEE NAME(Must be same as on Statement of Organization) F LOANS
(Rev . 07/03) RECEIVED
& REPAID
ru, 'N
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 LAST REPORTING PERIOD $
PART I - MONETARY LOANS RECEIVED THIS REPORTING PERIOD PART II - MONETARY LOAN REPAYMENTS MADE THIS REPORTING PERIOD
(Original source of loan, such as a bank, must be shown if a thirdparty 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/DD/YR) (If Applicable*) (If Applicable)
*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 of
(for Schedule F)