06/03/2005 FRI 08 :29 FAX

002

Revised 07104

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD Form DR-OTC

Y`, 510 EAST 12T", SUITE 1A ONE-TIME CONTRIBUTION IN

DES MOINES, IA 50319 EXCESS OF $7S0 BY A
Fax : (515)281-3701 PERMANENT ORGANIZATION
www.ftswa.govlethics For office use onk
Indexed
ONE-T CONTRIBUTION IN EXCESS OF $750 Audited
BY A PERMANENT ORGANIZATION Checked

Iowa Code section 68A.402(8) requires a permanent organization that contributes in excess of computer
$750 to register and file reports as a PAC. This form is intended to serve those purposes . Tbg
form must be filed with the Board on or before the tenth day of the date the check wasissued .
ORGANIZATION MAKING CONTRIBUTION :'

GUEN~.CiitJ (- C~u RR~PlE'S LNG

Qa
Name
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Mailing Address City. State. Zip Code

Email
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ress (Optional) %J k- - Area Code & Telephone No_

CONTACT PERSON FOR THE ORGANIZATION:

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Do-kt~ zo~a 5a~4a

Mailing Address Chy.,State tip
(Je~t~~ilnnov.er'~~eS .so .rY, 563'- 6S9 - q I81
Email Address (Optionei) Area Code Telephwne Number

CANDIDATE OR COMMITTEE RECEIVING THE CONTRIBUTION:

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(21r1zF.vs 70 / <f/
Name of candidate or committee
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Making Address City, Sate, Zip code
Date of Contribution Amount
?/11!; 06 3,632 -
Email Addross (if available) Area Code & Telephone Number 4 fv-Gs'
Dare of Election Courtly Of Applicable)
ff contribution to candidate, disclose source of original funds used to make /lJA
such eorttrib ulton (attach addltlonat pages if necessary) . If In-Idnd Contribution, Describe
Criteria to use [his form:
7. One campaign contribution to excess of $750 was made to a state or local candidate. party, political committee (PAC) for either a
candidate or a ballot issue, or any other orgaffation that advocates the election or dereat of a candidate or ballot issue,
2. Must be a permanent organization not established for election purposes.
3. No person gave money to the organization forthe purpose of the organization then using die money to make the contribution .
4. If the contribution was made to a candidate, no funds from a corporation or other prohibited contributor under Iowa Code section
OW503ware used to make the contribution (1his does not apply to a conlrlbudon made to a ballot issue committee) .
5. Only one contribution to any camp*n committee except fora ballot Issue eommlnee was made In a calendar year. No more than one
contribution may be made to any one ballot issue wrmniuee during a ballot Issue election . If more than one contribution and the total
amount of the contributions exceed 4750, the organization must reg'wior with the Board as a political committee (PAC)within 10 days of
crossina the $750 threshold.

Statement of Affnmation:

1, ~J' \ONCAMbtr~afirm that the contdbutton reported above is accurate. I further affirm, that the information concerning the organization Is
correct and true to the best of knowledge. I understand that by flung this form, I am subject to the Laws found in Iowa Code chapter GOA and
administrative rules found In chapter 351 . I also understand that the failure to timely file this form leads to the Imposition of dvil penalties and the
intentional failure t,file the form may lead to add~Eionat rsvtiand crimirwl sanctions.

G 3 -100 S
Date

inn inn M
YTIa SO :VT IIHZ SOOZ/ZO/90
 WELLS FARGO BANK MONTANA, NA 93-516
404 WEST BROADWAY 929
WENDLING QUARRIES INC . LEWISTOWN, MT 59457
P.O . BOX 230
DeWITT, IA 52742
PH . (563) 659-9181

DATE CHECK NO . AMOUNT

**Pay exactly : One thousand 00/100 dollars** 5/31/2005 7124236 $1000 .00--------
PAY TO THE ORDER OF:

"Keep the Commission"

C/O Jim Sattler, Inc .
3801 River Ridge NE
Cedar Rapids Iowa 52402

11'712423611' 1:0929051681 : 499080324111'