Nov 12 05 03 :43p GORDON & ROBERTA KOKENGE 712-542-4054 p .

I
FOR 1NSTRUC nOIVS, SEE BACK OF FORM FORM
Reset Form
DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
(Rev .0712004) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization)
For Office Use Only
Comm . #
IMPORTANT : Indicate by # type of committee you are reporting for. Logged In
( 1 )StatewideJLegislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party Scanned
(4 )County Central Committee( 5 )County Candidate (13 )City Candidate (7 )School Board or Other Political
Subdivision Candidate (e)County PAC (9)City PAC ( 10 )School Board or Other Polfical Subdivision PAC Computer
11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES ONLY :
Candr I e Name Political Party (if applicable)

Office Sought District (if Senate or House)

Late reports are subject to possible civil and criminal penalties.

TELEPHONE DATE SIGN D

1 AM FILING A Z2'e :5 REPORT FOR (1) ELECTION 1(2)NON-ELECTION YEAR.

(report date) Indicate by #

Local Committees, enter Date of Election

/6HECK IF AMENDMENT TO REPORT DATED
vf1 lip ~- .
L heck if this is final (termination) report and attach Notice of Dissolution Form OR-3 . County S Local Committees, enter County in
which Election Is
(You must continue to file reports until a DR-3 is filed.)
2

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period. (Total of all funds 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 .) .. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . $
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A : Cash Contributions total (Attach Schedule A) ('also see in-kind below) . . .. . . . . . . . . .. . . . .
Schedule F : Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . ... . . . . . . . . .. . . . . . . . . . . . U
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) ("also see debts and loans below) . . . . .. . . . . . .
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) . . ... . . . .. .. . . . . . . . . . . . . . . ... . . . . . . . . . . . . . ._. . . . .. . . . . . . . . . .. ._ . . . . . . . . . . . .._ . . . . . . . . . . . . . . . . . .. . . .... . . . . . . . . . .. . . . $

"UNPAID BILLS (From Schedule D -Attach Schedule D) . . .. . . . . . . . . . . . . . . ... . . . . . . . . . . . . .. .... . . . . .. . . . . . . ... . . . . . . . . . . . . . . . .. . . . .$ D

'IN KIND CONTRIBUTIONS (From Schedule E -Attach Schedule E) . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ yyd I~Z_
""OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . .... . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . .. $ O
CONSULTANT BREAKDOWN (Schedule G Attached?) - YES ---NO
CANDIDATE COMMITTEES ONLY :
H)
VALUE OF CAMPAIGN PROPERTY (From Schedule H -Attach Schedule_ $
STATE COMMITTEES: Submit a reconciled campaign account bank statement in January of each year .

v~ J
Nov 12 05 03 :43p GORDON a ROBERTA KOKENGE 712-542-4054 p .3

FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

IN-KIND
"matron) (Rev . Ofil97) CONTRIBUTIONS
comMITTEE NAME (Mustbe same as on Statement of

~Ci rrl_s' L d 2 !f/rJ ~

HECK THIS BOX IF
AMENDING FORM
Reset Form

DATE RELATIONSHIP DESCRIPTION ESTIMATED d IF FOR

TO CANDIDATE OF IN KIND FAIR MARKET FUND-RAISER
RECEIVED NAME AND ADDRESS
' (if applicable) CONTRIBUTION VALUE CONTRIBUTION
(MMIDD(YR) OF CONTRIBUTOR

lo--31-w «7 Pi-m-41-ne ' E:1

s

0
0
0

'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives
Page 3 of
(for Schedule E)
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 .