Vous êtes sur la page 1sur 6

FOR INSTRUCTIONS, SEE BACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 I DISCLOSURE


(Rev. 07/2004) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization)

Cedra Rapids Building Trades Council CRAC Building Trades PAC Comm . #
IMPORTANT: Indicate by # type of committee you are reporting for. 12 Logged In
( 1 )StatewidelLegislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party Scanned
(4 )County Central Committee( 5 )County Candidate (6 )City Candidate (7 )School Board or Other
Political Subdivision Candidate (8 )CountyPAC (:9 )City PAC ( 10 )School Board or Other Political Computer
Subdivision PAC ( 11 ) Local Ballot Issue' i i z a ;;, :,:. Audited
CANDIDATE COMMITTEES ONLY :
Candidate Name Politi Party (if applicable)
Late reports are subject to
~' 204 possible civil and criminal
Office Sought penalties.

ZCZ-A-1, 'L~
SIGNATURE OF PERSON FILING REPORT DATE SIGNEO

October 19, 2004


I AM FILING A REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR.
(report date) Indicate by # El

Local Committees, enter Date of Election


EICHECK IF AMENDMENT TO REPORT DATED

County & Local Committees, enter County in


El Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . which Election is held
(You must continue to file reports until a DR-3 is filed.)

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 10,933 .97
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) ......... . 6,308.50
Schedule F: Loans Received total (Attach Schedule F) ................... ........ ............. ...... ........ .
Schedule H: Total Sales of Campaign Property (Attach Schedule H) ...... ..... ........ ...... ........ .
(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL ..... $ 17,242 .47
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ("also see debts and loans below) ... . 12 .200.00
Schedule F: Loan Repayments total (Attach Schedule F) ......... ...... ........................ .............
CASH ON HAND at the end of this reporting period (if final report balance must 5,042.47
be zero) (Attach DR-3) ....... ..... ... ..... ...... . .... ... ..... ... ..... ........ ........ ...... ..... ........ ........ ............. .. .$

"*UNPAID BILLS (From Schedule D -Attach Schedule D) ... ... ..................... ...... ........ ........ ........ ..... ...$
"IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) ............................................... $
*''OUTSTANDING LOANS (From Schedule F-Attach Schedule F) .. ........ .............. ..... ... ..... ... ........ .. .$
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?)
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 07103) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Cedar Rapids Building Trades Council CR/IC Building Trades PAC

STATE CANDIDATES NOTE : IF ACONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PACCHECK 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

ID# Asbestos Workers Local 81


5000 J Street SW Local Union X75.00
08/04/04
CK# CedarRapids, IA 52404
lD# Carpenters Local 308
350 Waconia Court SW Local Union 500.00
08/04/04 CK#
Cedar Rapids, IA 52404

Lj
ID# I.B .E .W . 405
1211 Wiley Blvd. SW Local Union 525.00
08/04/04 CK#
Cedar Rapids, IA 52404
ID#
Glaziers Local 581
520 12th Street Local Union 24.00
08/04/04 CK#
Rock Island, IL 61201
lD# Ironworkers Local 89
5000 J Street SW Local Union 150.00
08/04/04 CK#
Cedar Rapids, IA 52404
ID# Laborers Local 43
5000 J Street SW Local Union 390.00
08/04/04 CK# Cedar Rapids, IA 52404
ID# Millwrights Local 2158
2707 ^2nd Street Local Union 100.00
08/04/04 CK#
Bettendorf, IA 52722
ID# Operating Engineers Local 234
1211 Wiley Blvd . SW Local Union 45 .00
08/04/04 CK#
Cedar Rapids, IA 52404
ID#
Painters Local 447
5000 J Street SW Local Union 150.00
08/04/04 CK#
Cedar Rapidsw, IA 52404
ID# Plumbers & Pipefitters Local 125
1839 16th Avenue SW Local Union 750.00
08/04/04 CK# Cedar Rapids, IA 52404
SUB-TOTAL

TOTAL (if last page of this schedule)

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 sumame 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

CONTRIBUTIONS - MONEY TAKEN IN


A MONETARY
(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
Cedar Rapids Building Trades Council CR/IC Building Trades PAC

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 ANDCAMPAIGN
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
I Dft Roofers Local 182
08/04/04 22010 Ave. NW Local Union $75.00
CK# Cedar Rapids, IA 52405
ID#
Sheet Metal Workers Local 262
08/04/04 CK# 1211 Wiley Blvd . SW Local Union 285 .00
Cedar Rapids, IA 52404

E]
ID#
Teamsters Local 238
08/04/04 CK# 5000 J Street SW Local Union 75 .00
Cedar Rapids, IA 52404

El-
ID#
Asbestos Workers Local 81
10/01/04 CK# 5000 J Street SW Local Union 75.00
Cedar Rapids, IA 52404
ID# Bricklayers Local 3
10/01/04 CK# 190 Sky View Avenue Local Union 240.00
Fairfax, IA 52228
ID# Carpenters Local 308
10/01/04 350 Waconia Court SW Local Union 191.50
CK#
Cedar Rapids, IA 52404
ID# Carpenters Local 1260
10/01/04 705 S.Chnton St. Local Union 112.50
CK#
Iowa City, lA 52240
ID# I.B .E .W . Local 405
10/01/04 1211 Wiley Blvd . SW Local Union 525 .00
CK#
Cedar Rapids, IA 52404
ID#
Glaziers Local 581
10/01/04 CK# 520 12th Street Local Union 25 .50
Rock Island, IL 61201
ID# Laborers Local 43
10/01/04 CK# 5000 J Street SW Local Union 260.00
Cedar Rapids, IA 52404
SUB-TOTAL

TOTAL (if last page of this schedule)

' 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

CONTRIBUTIONS - MONEY TAKEN IN


A MONETARY
(Rev . 07103) RECEIPTS
(Including candidate's personal funds)
Q CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Cedar Rapids Building Trades Council CR/IC Building Trades PAC

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 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID# Laborers Local 1238
10/01/04 705 S. Clinton St. Local Union $400 .00
CK# Iowa City, 1A 52240

ID# Millwrights Local 2158


10/01/04 2707 62nd Street Local Union 150 .00
CK#
Bettendorf, IA 52722
ID#
Painters Local 447
10/01/04 5000 J Street SW 100 .00
CK# Local Union
Cedar Rapids, IA 52404
ID#
Plumbers & Fitters Local 125
10/01/04 1839 16th Avenue SW 750 .00
CK# Local Union
Cedar Rapids, IA 52404
ID# Sheet Metal Workers Local 263
10/01/04 1211 Wiley Blvd. SW Local Union 285 .00
CK#
Cedar Rapids, IA 52404
ID# Teamsters Local 238
10/01/04 5000 J Street SW Local Union 50 .00
CK# Cedar Rapids, IA 52404

ID#

CK#

ID# a

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL

TOTAL (if last page of this schedule)

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 3
marriage) . If sumame 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 EOtM SCHEDULE

EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT B


(Rev. 07/03)
MONETARY
EXPENDITURES

STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE CHECK THIS BOX IF
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .

COMMITTEE NAME (Must be same as on Statement of Organization)


Cedar Rapids Building Trades Council CRAC Building Trades PAC
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# Sullivan For School Board Lisbon School District Election
08/03/04 577 Green Ridge Road 200,00
CK# 5031 Lisbon, IA 52253 $

ID# Iowa Democratic Party Political Contribution


08/24/04 5000.00
CK#5032

ID# .D .P . House Truman Fund Political Contribution


08/31/04 1000.00
CK#5033

ID# I.D .P. Senate Truman Fund Political Contribution


08/31/04 1000 .00
CK#5034

ID#17447 Lonny Pulkrabek for Johnson County Political Contribution


Sheriff 500.00
09/08/04 CK# 5035 4698 Fox Lane NE
T-- 1-4- TA r,))An
ID#17265 Jim Houser for Supervisor Committee Political Contribution
09/22/04 05 Rock Valley Dr . SW 500.00
CK#3036 :War Rapids, IA. 52404

ID# 17261 u Barron for Supervisor Political Contribution


d~/ 000 Linden Dr . SE 500.00
~~ CK#5037 Cedar Rapids, IA 52403

'D#0272 Zeller for SheriffCommittee Political Contribution


09/22/04 61 Jacolyn Dr . NW 500.00
CK# 5038 edar Rapids, IA 52405

SUB-TOTAL $ 9200.00
TOTAL (if last page of this schedule) $

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 person/entity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code fi8A.402(3)(i) .)
1
Page Of 2

(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM I j SCHEDULE

EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT B


(Rev . 07/03)
MONETARY
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.

COMMITTEE NAME (Must be same as on Statement of Organization)

Cedar Rapids Building Trades Council CRAC Building Trades PAC


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

11285 Friends and Neighbors of Tom Fiegen Political Contribution


09/22/04 3 Lombard St. $ 500.00
CK#5039 larence, IA 52216

1572 Roger Grobstich for State Political Contribution


09/22/04 epresentative
CK#5040 500.00
350 Wok Creek Trail
TA 671'22

I D#1353 Owen for Iowans Political Contribution


09/22/04 63 Oliphanr St. 500.00
CK#5041 West Branch, IA 52358

11507 Pettengill for Iowans Political Contribution


09/22/04 .O .Box 76 500.00
CK#5042 t. Auburn, IA 52313

11516 Rielly for Senate Political Contribution


09/22/04 113 North Market St.
CK#5043 500.00
Oskaloosa, IA 52577

11535 Citizens for Zirkelbach Political Contribution


09/22/04 37 West First St.
CKt044 500.00
onticello, IA 52310

ID#

CK#

1D#

CK#

SUB-TOTAL $ 3000,00
TOTAL (if last page of this schedule) $ 12200,00

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 item¢ed 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 6aA.402(3)(i) .)

Page 2 of

(for Schedule B)

Vous aimerez peut-être aussi