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CA 9FAIGN DISCLOSURE
Iowa Ethics and Campaign BD.
Disclosure Board
510 E. 12'", Ste. 1A
Des Moines, Iowa 50319 2007 JUL 23
FOR INSTRUCTIONS, SEE BACK OF FORM AM 10" 49
Fax: 515-281-4073
DISCLOSURE SUMMARY PAGE
COMMITTEE NAME (Must be same as on Statement of Organization
Lawpac #6070 FORM
IMPORTANT: Indicate by # type of committee you are reporting for F2 -1 DR-2 DISCLOSURE
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party (Rev . 07/2007) REPORT
( 4 )County Central Committee ( 5 )County Candidate (6 )City Candidate ( 7 )School Board or Other Political
Subdivision Candidate (8 )County PAC (9 )City PAC ( 10 )School Board or Other Political Subdivision PAC For Office Use DAY
11 ) Local Ballot Issue Comm . #
CANDIDATE COMMITTEES ONLY : Logged 1
Candidate Name Political Party (if applicable) Scanned
Computer
Office Sought District (if Senate or House) Audited -. .
Late reports are subject to possible civil and criminal penalties. Pursuant to Iowa Code sections 68B.32A(7) and 68A.401(3), the candidate, for a
lk~_~Ywj ~J
-~~
SIGNATURE F PERSON FILING REPORT TELEPHONE DAT IGNED
7
January 1 through June 30
I AM FILING A REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR.
(report date) Indicate by #
EICHECK IF AMENDMENT TO REPORT DATED
Local Committees, enter Date of Election
El Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 .
County 8 Local Committees, enter County in
(You must continue to file reports until a DR-3 is filed .) which Election is held
STATE COMMITTEES : Submit a reconciled campaign account bank statement in January of each year .
For Instructions, See Back of Form SCHEDULE
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.
NOTE: ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD.
CAUTION: Section 68B.32A(6), 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 .
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 (relatrves by
marriage) . If surname of contributor is the same as candidate, but there is no Page 1 Of 4
familial relationship, enter "not applicable" in the relationship column. (for Schedule A)
For Instructions, See Back of Form SCHEDULE
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 .
NOTE: ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD.
CAUTION : Section 68B.32A(6), 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 .
ID# LloydR.Bergantze
1/25/2007 421 WBroadway, Suite 302 $50.00
CK# Council Bluffs, IA 51503
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 contributoris the same as candidate, but there is no Page 2 of 4
familial relationship, enter "not applicable' in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 07103) RECEIPTS
(Including candidate's personal funds)
FOR CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
IOWA LAWPAC #6070
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 .
NOTE: ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD .
CAUTION : Section 68B .32A(6), 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.
SUB-TOTAL
$ 500.00
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 3 of _4
familial relationship, enter "not applicable' In the relationship column. (for Schedule A)
For Instructions, See Back of Form SCHEDULE
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.
NOTE : ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD.
CAUTION: Section 68B.32A(6), 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-
(MMIDD/YR) AND PAC CHECK (it applicable) RAISER
NUMBER INCOME
ID# Randal J . Giannetto
2/22/2007 25 N . Center St . $ $50 .00
CK# Marshalltown, IA 50158-0557
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
war
C K#
-
ID#
CK#
SUB-TOTAL_-
$ zo0.o~
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 shownto 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 4 of 4
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
MONETARY
EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT
(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 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.
ID#
The Des Moines Embassy Club Committee meeting expenses
03/12/07 801 Grand Avenue 1,237.25
CK#3490
Des Moines, IA 50309
ID# 1114 Hoffiman for Iowa House
05/01/07 616 Parkview Drive 100.00
CK# 3495
Dension, TA 51442 Contribution
ID# 1088
Horbach for House ofReps.
05/01/07 1014 Oakland Drive 100.00
CK#3496
Tama, IA 52339 Contribution
ID# 1397
Friends of Jim Lykam
05/15/07 2906 West 35th Street 100.00
CK# 3491
Contribution
Davenport, IA 52806
ID#
Iowa Senate Majority Fund
05/15/07 200.00
CK# 3492
Contribution
SUB-TOTAL' $ 2,437.25
TOTAL (if last page of this schedule) 1 $
Expenditures to personslentities 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 persontentity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 68A.402(3)(i) .)
Page of 3
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM
SCHEDULE
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B I MONETARY
(Rev . 07103) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEVADE 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
ETHICS & CAMPAIGN DISCLOSURE BOARD. AMENDING FORM
ID# 1114
Hoffman for Iowa House
06/01/07 616 Parkview Drive 100.00
CK#3498
Denison,1A 51442 Contribution
ID# 1338
Danielson for Senate
06/01/07 CK# 3499 3906 Monterey Drive 250.00
Waterloo, 1A 50701-3527 Contribution
ID#
1260 Lensing for House District #78
06/13/07
CK#3503 2408 Mayfield Road 100.00
Iowa City, IA 52245 Contribution
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 2 of 3
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
ID# 1502
Hancock for Senate
06/14/07
CK#3506 310 East Main Street 300 .00
Epworth, IA 52045 Contribution
ID# 957
Taylor for Representative
06/19/07
CK# 3507
1416 A Avenue NW 200.00
Cedar Rapids, IA 52405-4834 Contribution
ID#
1393 Berry for Iowa House of Reps .
06/19/07 241 Madison Street 100.00
C03508
Waterloo, IA 50703 Contribution
ID# 1444
Com . to Elect Wes Whitead
06/19/07
CK#3509
2108 Roosevelt 100.00
Sioux City, IA 51109 Contribution
ID#
1504 Kressig for Iowa House Dist 19
06/19/07
CK#3510
3523 Veralta Drive 100.00
Cedar Falls, IA 50613 Contribution
ID#
1356 Quirmbach for Senate
06/19/07 1002 Jarrett Circle 200 .00
CK#3511
Ames, IA 50014 Contribution
ID#
CK#
SUB-TOTAL
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 personlentity on behalf of the candidate's committee. (Refer to
Schedule G Instructions and Iowa Code 6aA.402(3)(i) .)
Page 3 of 3
(for Schedule B)