IYUII-ee -Cou' 14 :18 I A ETHICS CAMPAIGN DI SCLO 15152813?01 P .

03i08

FC'NF;-INSTRUCTIONS, SEE BACK OF FORM

CHECK ONE: FORM STATEMENT
of
(iii This is an Initial' Statement of Organization DR-1
(REV . 05/20091 I ORGANIZATION
LJ This is an amended' Statement of Organization
'An initial Statement of Organization must be filed MMtin 10 days of tho commttoes 3=e0ln9 oonhibuliona, For Offlce Use Otdy
marring expenditures, or Incurring indebladneas exceeding $750, Amendments must be filed within 30 days of Comet, S
a change, Penalties may be imposed for fats-filed Statements of organization_ A candidate Mitt art open Inde~ad
committee that exceeds 3750 in activity for anottw offiw shall file within 10 days either 9 now or amended Audited
OR-1 disclosing information concerning the campaign forthe now office sought. Computer

COMMITTEE NAME 1 J"

MacDonald for Sheriff

IMPORTANT: Indloete type of committee you are reporting for L
for Retention Candidate ( 2 )Stetowlde PAC ( 7 )$fats Party (4 )County Central Committee
(1 )$totswlderLSglelative/Judge Standing Candidate (B )Co>ralty PAC (9 )City PAC
(ti )County Candidate I; 6 )City Candidate (T )School Board or Othat Political Subdivision
10 School Board or Other Political Subdivision PAC 11 L l Ballot Issue
COMMITTEE TREASURER man0ato for all commlltwa CONINfTTEE CHAIR mandatory excs " t for s candidate's commltbe
Name 4 Name
Steven H MacDonald
MaVAddress 1 Mailing Address
90 l ecumse
Zip Code 1 .1 City, State l 1 Zip Code
City, Stately
Farragut IA 51039

Phone ( ~) 9007- Phone ( )

a-Mall a-Mad
iNDiCATE PURPOSE OF COMMITTEE Check One Box Advocate foriagalnst candidele(s) Advocate forlageinst ballot lssue(a)
Comment or deacdi tion :
All Candidates Enter,
Office Sought: Sheriff
District
2004
Political Party of applicable) Year Standing forElection:
County/Local Candidates and Local Ba IotfFranahlee Corrtmtttees Enter. 60 04 and 111212004
6004
Dale of Llecdon;
Countr= Fremont

Bank Account Name i n me A Addraw or Parent Entl (PACs. if applicable) . '

Affiliate. or Sggnsor

Steven H MacDonald
Name of Financial In6Gtutlonitype of Account ~" Mailing Address
905 Tecumseh

state ~. Zip
Mailing Address 1 City 4 "I

Farragut to 51639

City 1 1 State ZIP

Phone ( 9P)
s-MaB

STATEMENT OF AFFIRMATION: By nling this document the committee eforms the following :

1 . The committea and at persona connected with the committee understand that they are subject to the law In Iowa Code txiapters 66A and680 andthe admlnietragve
Tutee In ChWptar $51 of the Iowa Adminiatnrfve Code .

2. That lows Code eadlon 66A,402 and Tine 351-4.9 require the filing of disclosure reports and that the !allure to Me those reports on or before the required dire dates
subjects the candidate or chairperson (In the case of committees olharthan a candidate's committee) to the automatic awesemsnt of a CIvlt penalty and the possible
Imposition of other criminal and civil sanctions
.

3. That Iowa Code section e6A,405 and rules 351-4,39 through 4 .43 require the plawnerlt of the wexrds'paid rqrby, end the rame of the committee on all political
materlats except for those Items exempted by statute or rule, A committee filing tnls aterement for ourpows of using the shonar'pald forby' end who have rot crossed
the $760 shall notify the board that the 6750 threshold will not be Crossed.
4. That Iowa Code section e6A,503 and rules 351--4,44 through 4 .92 prohibit the recsIPt of cofporate contributlotm by all committees except forstatewide and local ballot
Issue PACs.
5, A candidate and a earidldMe'a committee may only expend campaign funds as permitted try Iowa coda sections 66A.301 through 66A,303 and rule 351-A .26.
6_ That the committee will continue Wfile diadaeure reports until all activity has ceased . Committee funds spent, debts resolved, and a find report and a statement of
dlwoIunonJ&N-3)*a9 befn tiled

Slgnalum of Canduaw OR,iur all ottereommltlaw, Chehpewn oals3lorod

AAIHHHS AZNII00 ,LNOwaH3 XV,d OT :9T 900Z/ZZ/TT

vooZ