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Putney John__1319__scanned

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Published by Zach Edwards
This document is part of the Iowa Ethics & Campaign Disclosure Board set, which was up to date as of 2/20/2011. The documents in this set consist of every pdf posted on the IEC website, but they should not be considered a replacement to searching the official website: http://www.iowa.gov/ethics/ ----- Disclaimer: I am not selling this data or making any money by posting this data. I'm merely trying to find a better way to search the information on the Iowa Ethics & Campaign Disclosure Board website.
This document is part of the Iowa Ethics & Campaign Disclosure Board set, which was up to date as of 2/20/2011. The documents in this set consist of every pdf posted on the IEC website, but they should not be considered a replacement to searching the official website: http://www.iowa.gov/ethics/ ----- Disclaimer: I am not selling this data or making any money by posting this data. I'm merely trying to find a better way to search the information on the Iowa Ethics & Campaign Disclosure Board website.

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Published by: Zach Edwards on Mar 03, 2011
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12/05/2014

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FOR
INSTRUC,,,IONS,
SEE
BACK
OF
°
-
-RM
DISCLOSURE
SUMMARY
PAGE
COMMIT
EE
NAME
(Must
~be
same
ason
Statement
ofOrganization)
hl
4
j
rlef
.
.t
-b
r
S
C
R
C
1
-
C-IMPORTANT
:
Indicate
type
of
committeeyou
are
reporting
for
:
LLI
(
1
)Statewide/Legislative
Candidate
(
2
)Statewide
PAC
(
3
)State
Party
(
4
)County/Local
Candidate
(
5
)County
PAC
(
6
)Ballot
Issue/Franchise
Committee
(
7
)County/City
Central
Committee
(
8
)SupportSlate
of
Candidates
SIGNATURE
OFTREASU
&///-
q73--1a7&
(or
person
filing
this
report)
TELEPHONE
R
Routine
Penalties
Due
For
Late
Filed
Reports
Range
from
$20
to
$800
SEE
INSTRUCTIONS
ON
BACK
AND
COMPLETETHEFOLLOWINGSENTENCE
:
-6
-1,
Z
.
I
AM
FILING
A
&cem
ber
31
Z(~D
1
REPORT
FOR
AN/A
(1)
ELECTION
/(2)NON-ELECTION
YEAR
.
FlCHECK
IF
AMENDMENT
TO
REPORTDATED
(report
date)
Indicate
one
JAN
22
ZuuL
-S
A
I
M
~
06
F~
Check
if
this
is
final
(termination)
report
and
attach
Notice
ofDissolution
Form
DR-3
.
(You
must
continue
to
file
reports
until
a
Notice
ofDissolution
is
filed
.)
STATEMENT
OF
CASH
ON
HAND
CASH
ON
HAND
at
the
beginning
of
the
reporting
period
.
(This
is
the
total
of
all
monies
held
by
the
committee
.
This
amount
MUST
be
the
same
as
the
cash
on
hand
at
the
end
of
the
last
reportingperiod,
or
mustbe
zero
if
this
is
first
report
filed
.)
...........
.
....................
.
.
.
.
.
............
.
..................
.
......
.$
ADD
TOTAL
MONEY
TAKEN
IN
THIS
PERIOD
Schedule
A
:
Cash
Contributions
total
(Attach
ScheduleA)
....
.
.............................................
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
.
.
.
.
..
$
SUBTRACTTOTAL
MONEY
SPENT
THIS
PERIOD
Schedule
B
:
Expenditures
total
(Attach
Schedule
B)
........
.
..................
.
..............
.
.
.
........
.
.....
Schedule
F
:
Loan
Repayments
total
(Attach
Schedule
F)
.
..................
.
..............
.
................
CASH
ON
HAND
at
the
end
of
this
reportingperiod
(if
final
report,
balance
must
be
zero)
(Attach
DR-3)
............
.
.....................................
.
......................
.
.
.
............
.
................
.$
FORM
DR-2
DISCLOSURE
(Rev
.
01/98)
REPORT
For
Office
Use
Only
Comm
.
#
IndexedAudited
Computer
FT
1
/
-
1S-o
,
;?
DATE
SIGNED
Local
Committees,
enter
Date
ofElection
County
&
Local
Committees,
enter
County
in
which
Election
is
held
-
0
--
/
6
.
3
0/0,
nD
-
~~
3
qo
.
oo
4_2
1
L-/
U
1-,,-
J
6
,>
V
UNPAID
BILLS
(From
Schedule
D
-
Attach
Schedule
D)
.......
.
...
.
..................
.
.........................
.
........
.
.$
.3
&'
.~-r
"
Sr
IN
KIND
CONTRIBUTIONS
(From
Schedule
E
-
Attach
Schedule
E)
............
.
.........................
.
........
.
.$
OUTSTANDING
LOANS
(From
Schedule
F
-
Attach
Schedule
F)
.....
.
..................
.
.........................
.
..
.$
3
orD
-
cc)-
,-
CANDIDATECOMMITTEES
ONLY
:
CONSULTANT
BREAKDOWN
(Schedule
G
Attached?)
YES
NO
VALUEOFCAMPAIGNPROPERTY
(From
Schedule
H
-
Attach
Schedule
H)
$
3
35_0
"
CX2
Q
 
For
Instructions,
See
Back
of
Forr
CONTRIBUTIONS
--
MONEY
TAKEN
IN
(Including
candidate's
personal
funds)
COMMITTEE
NAME
(Must
be
same
as
on
Statement
of
Organization)
'r
S
NDIDATES
NO
E
:
IF
A
CONTRIBUTION
IS
RECEIVED
FROM
A
STATE
PAC
(POLITICAL
ACTION
COMMITTEE),
LIST
THEPAC
IDENTIFICATION
NUMBER
AND
THEPAC
CHECKNUMBER
IN
THE
DESIGNATED
COLUMN
.
A
LIST
OF
ID
NUMBERS
IS
AVAILABLE
FROM
THE
IOWA
ETHICS
AND
CAMPAIGNDISCLOSURE
BOARD
.
CAUTION
:
Section
68B
.32A(6),
IowaCode,
prohibits
the
use
of
information
copiedfrom
reports
and
statements
for
soliciting
contributions
or
for
anycommercialpurpose
by
any
person
otherthan
statutory
political
committees
.
SUB-TOTAL
TOTAL
(if
last
page
of
this
schedule)
*
Disclosure
lawrequires
candidate
committees
to
disclose
the
relationship
of
any
relative
making
a
contribution
to
the
committee
.
Relationship
mustbe
shown
to
the
third
degree
of
consanguinity
(blood
relatives)
and
affinity
(relatives
bymarriage)
(See
Page
2
of
forms
packet
.)
.
If
surname
ofcontributor
is
the
same
as
candidate,but
there
is
no
Page
familial
relationship,
enter
"not
applicable"
in
the
relationship
column
.
SCHEDULE
A
MONETARY
(Rev
.
06/97)
I
RECEIPTS
CHECK
THIS
BOX
IF
AMENDING
FORM
$
45b,
oo
Of
(for
Schedule
A)
DATERECEIVED
PAC
ID
NUMBER
(if
applicable)
NAME
AND
ADDRESS
OF
CONTRIBUTOR
RELATIONSHIP
TO
CANDIDATE*
AMOUNT
RECEIVED
I
IF
FOR
FUND-
(MM/DD/YR)
ANDPAC
CHECK
(if
applicable)
RAISER
NUMBER
INCOME
140
1
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For
Instructions,
See
Back
of
Forr
CONTRIBUTIONS
--
MONEY
TAKEN
IN
(Including
candidate'spersonal
funds)
COMMITTEE
NAME
(Must
be
same
as
on
Statement
ofOrganization)
SCHEDULE
A
MONETARY
(Rev
.
06/97)
I
RECEIPTS
CHECK
THIS
BOX
IF
AMENDING
FORM
STATECANDIDATES
NOTE
:
IF
A
CONTRIBUTION
IS
RECEIVED
FROMA
STATEPAC
(POLITICAL
ACTION
COMMITTEE),
LIST
THE
PAC
IDENTIFICATION
NUMBERAND
THE
PAC
CHECKNUMBER
IN
THE
DESIGNATED
COLUMN
.
A
LIST
OF
ID
NUMBERS
IS
AVAILABLE
FROM
THE
IOWA
ETHICS
AND
CAMPAIGNDISCLOSURE
BOARD
.
CAUTION
:
Section
68B
.32A(6),
Iowa
Code,
prohibitsthe
use
of
information
copiedfrom
reports
and
statements
for
soliciting
contributions
or
for
anycommercialpurpose
by
any
person
other
than
statutory
political
committees
.
SUB-TOTAL
TOTAL
(if
last
page
of
this
schedule)
*
Disclosure
law
requires
candidate
committees
to
disclosetherelationship
of
any
relative
makinga
contribution
to
the
committee
.
Relationship
mustbe
shown
to
the
third
degree
of
consanguinity
(blood
relatives)
and
affinity
(relatives
by
marriage)
(See
Page
2of
formspacket
.)
.
If
surname
ofcontributor
is
the
same
as
candidate,butthere
is
no
Page
of,familial
relationship,
enter
"not
applicable"
in
the
relationship
column
.
(for
ScheduleA)
DATERECEIVED
PAC
ID
NUMBER
(if
applicable)
NAME
AND
ADDRESS
OF
CONTRIBUTOR
RELATIONSHIP
AMOUNT
I
IF
FOR
(MM/DD/YR)
AND
PAC
CHECKTO
CANDIDATE*
(if
applicable)
RECEIVED
FUND-RAISER
NUMBER
INCOME
(
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