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  • Quirmbach Herman 1356 Scanned

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    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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    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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    2 views8 pages

    Quirmbach Herman 1356 Scanned

    Uploaded 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.

    Copyright:

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    of 8
    FOR INSTRUCTIONS, SEE BACK OF FORM DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE fRev.08/2002)| REPORT mPORTANT: incest typeof commitee you ae reporting or: []] (+ sttewidetogltva Candidate (2 )Staawide PAC 3 )State Paty (4 CountylLocl Canoe {5 \couny PAC {6 aaa suetranctise Canmaes (7 JCounyrety Cena Conwntee (3 super Slate of Canaates. ‘CANDIDATE COMMITTEES ONLY: Candia Name Patcal Party TE Qu Dire eet ‘tice Sous Distt (Sapa or ouse) —Srete Salers Sst. Pevtencrsft 5/5 2689244 jo/r4Joo ‘SIGNATURE OF TREASURER (or person filingAhis report) TELEPHONE DATESIGNED Routine Penalties Due For Late Filed Reports Range from $20 to $800 ‘SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE: VAMPILING A DE ATO re“ BZIE |, 3-03 REPORT FOR ANIA (1) ELECTION /(2)NON-ELECTION YEAR. ((oport date) Indicate one COCHECK IF AMENDMENT To REPORT DATED Tocal Commies, enter bate of Eedion Hi Checkif this is final (termination) report and altach Notice of Dissolution Form DR-3. | Counly & Local Commies, enter Couiy in (You must continue to file reports unt a Notice of Dissolution i ed) sich Electon is hela STATEMENT OF CASH ON HAND ‘CASH ON HAND at the beginning ofthe reporting period. (This is the toal ofall monies held by the committee. This amount MUST be the same as the cash on hand atthe end (ofthe last reporting period, of must be Zero I this is firs repor fied) eee ADD TOTAL MONEY TAKEN IN THIS PERIOD ‘Schedule A: Cash Contributions total (Attach Schedule A) (also see in-kind below) ‘Schedule F: Loans Received taal (Attach Schedule F) ‘Schedule H: Total Sales of Campaign Property (Attach Schedule H), (Soh ies to Candidates’ Committees On! SUB-TOTAL. ‘SUBTRACT TOTAL MONEY SPENT THIS PERIOD. Schedule B: Expenditures total (Attach Schedule 8) (“also see debis and loans below). Schedule F: Loan Repayments total (Attach Schedule F) CASH ON HAND at the end of this reporting period (if ral report, balance must be zor) (Attach OF-3) ew s ‘UNPAID BILLS (From Schedule D Altach Schedule D)nn $ “W KIND CONTRIBUTIONS (From Schedule E ~Allach Schedule €) s “OUTSTANDING LOANS (From ScneduleF -Atach Scheduie F) s (CANDIDATE COMMITTEES ONL’ CONSULTANT BREAKDOWN (Schedule G Attached?) ves > 92392 Barr Armco | A S00 (2 Priten foit— Bac tube a A s0o\yY Lush thes ot oe eo {fe 500 |= Zino Ketnlaurt Beoy Tess Pee Aaren (A500 /' PDovy tenet Wonde meCoy 5500 D4orr St Arata A 500/44 Hila Teedy ferter— 404 Backré 1 above LDereng Fiz Bd Daw A ia ZoviD SUBTOTAL a $5] 5.029| TOTAL Gitat page of i sched) || + iectceure aw requres canlasta commtaes fo close the rektonshp of any role making a contbuton othe ‘onsnies. Relaorip must bo shou tothe tha degree of consangunty (od reaves) an any atv By ‘marrage (See Page 2 of forms packet). f surname of contbutor ts the Same as candidate, but there is NO Page: _t {anil relatorshp,ertr “hot applcabe" in he relationship column, Tor Scheauis AY For Instructions, See Back of Form CONTRIBUTIONS ~ MONEY TAKEN IN (ehuing canto’ personal fncs) STATE CANDIDATES NOTE: ¥ AcoNTRIOUT (COMMITTEE NAME (iiust bo same as op platemeptof Organization) SCHEDULE A MONETARY, (Rev. 0697) | RECEIPTS CO check THis Box iF [AMENDING FORM IS RECEIVED FROM A STATE PAC [POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTICATION NNUUBER AND THE PAC CHECK NUMBER N THE DESCRATED COLUM, AUST OF 1D MUMBERG IS AVALASLE PROM THE SOWAETHICS AND CAWPAICN DIscLOSURE GORD, CAUTION: Section 688.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for slcting coninbutions ot for any commercial purpose by any person other than slaluory potical eommitees DATE RECEIVED (imaiDDrvR) PACTONUNGER (fappicabie) AND PAC CHECK NUMBER OF oki NAVE AND ADDRESS OF CONTRISUTOR Unthirpited coctrih ork FEATIONSHP | AMOUNT | TIFFOR rocanoioare: | receven | ‘runo- (tappiiable) FRASER INCOME, oF oxi Prtride ¢ Thee tree 3u LG or Svolt oF Kt ba ok - 1b Sen Pie Lore allo PF G0l4 oxi iobgipe Ted Ae erent - PACS B6lA Sw 4G. Dm if 3503) 5° "bb “103% EF FED ENT, Coen TS, 607 14H St AW Suite RO WASIt DE QoooS "6 ¥ om (Ar. oppomaquc psc PAT 1454 goth SulTS D0¥ | id. Deg mojnts pA FOE 6077 “1630 Acy PAC reales SuiTEre a Bp3aa DF GON y 44. SICAL Airy, SH SHiTELOS 1A Fv265" OF 6498 cK foo 1 S515 “Dra TA PAR 1 oe Ww Dam A. 0588 PAS | Pes corn SUITED Spamome jn 50322 1 6375 Gaates [-VeT PRO 549 | Freve DA ‘SUS TOTAL TOTAL (iflest page of this schedule) * Disclosure law requltes cana commits to diclose the relatonship of any rlave making a conten tthe ‘commie. Relationship must bo shown oe tee dogo of consangunt ood lave) ana ate ales by 2. ‘mariage (See Pago 2 o! tama packet) I suname of contour fs the same as candidate, bl there ls no Poge ot fami relationship, enter ‘nt appbcabe” nthe relationship coke, For Instructions, See Back of Form SCHEDULE A MONETARY CONTRIBUTIONS - MONEY TAKEN IN (Rev. 0697) | "RECEIPTS (nui canato's personal funds} CO cueek THis 80x IF [COMMITTEE NAME (ifust be same as on Staement of Organization) [AMENDING FORM Qeicintirch ec Seyret STATE canoioaTes NOTE: hcowrmiuTio's RECeIED FROM A STATE PAC POLTEAL ACTON COMMUTTEE.LIST THE PAC DENTESCATON DNUVBER AND THe PAC CHECK NUMBER I THE DESIGNATED COLUNM. ALIST OF 1 NUMBERS S AVARABLE FROM Tie WA ETHICS AND CAMEAIN CAUTION: ‘Section 688.32A(6),lowa Code, proitits the use of nfarmation coped from reports and statements for soliciting contributions or for any commercial purpose by any person other than statutory palical committees. DATE FACTO NUMBER TAME AND ADORESS OF CONTRIUTOR RELATIONSHIP] AMOUNT] VIFFOR ReceveD | (fappicabie) Tocanpioate: | Receven | “FuND- (muporve) | AND PAC CHECK (¢ applica) RAISER ‘NUMBER. INCOME, Weel PAS {2]93}0 636 Grane AVE. Stobo- 13 )a3}e9 asarse ce Bien 4s Heine Artie oh bloD Soee> Sat op lo Peeer [Pe s85ts [Pad Beat Sore Choma jose Stans boy AT Shean Ons Uf G1 493 Doris Tera [006 Brite Br 22 Sool Jowh cthkoPieenc PAC bos 1+ Prkeng Bivd STE 19° Proleny fr" 5°03) SD! FRC (BE ats. ae Gro DC seve s an ¢ Cornea Fore 1422 Grecye AMer frees “Ar 5S01e SUBTOTAL TOTAL (i last page of this schedule) “bese onan nin corm do nis makin cnn Sone ag sitcom na ges cece ernest 3 eferisretawt sams neue sane Stab Se nove er vom Dt last, onr et opsanewe opce Tacllen FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE B MONETARY EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT pon | ecm STATE PAC COMMITTEES: NOTE: FOR CONTRGUTIONS MADE TO STATEWIDE OR LEGISLATIVE EANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CO check THis Box iF PAG OMECK NUMBER FOR EAGH EXPENDITURE. “LIST OF 1D NUMBERS IS AVAILABLE FROM THE IOWA ‘AMENDING FORM TWIGS & CAMPAIGN DISCLOSURE BOAR. [COMMITTEE NAME (Must be samo as on Statement of Organization) ‘CANDIDATE IDNUMGER (i applicable) ‘AND PAC CHECK NUMBER TRAM AND NODRESS TO WHOM EXPENDITURE (Disbursemen WAS MADE PURPOSE, (DESCRIBE TRANSACTION) 7A_ Pooch PRO Tem sn Ford) 2 bb) FLese OR Dim. iA F333, cP Us sone’ fos Lit A Paps 1 OH BPI Sooner Procad itr 58°/4 Ly [By Dne wee, (SO Aw*f A 5°21) sare! OD SUBTOTAL 54 B14) TOTAL lastpage ofthis schedule) FS ___——_—| [THIS BOX APPLIES TO CANDIDATES’ COMMITTEES ONLY: Purchases of carain campaign propery costing $50 or more must also be ivantoriad cn Schedule H, (Refer to Schedule Hinstructions,) Expenditures to personsfentes providing consulting, advering, und-asing,peting, managing, organizing series must also be deal iteizod on ‘Schedule G by the amount. purpose, and date of e22 be of expencture made bythe persanlenty on Behal ofthe canaiate’s committee. (Refer 0 Schedule G inuctions and loua Code 56.6(3)()) Pope fe fee (for Schedule 8) FOR INSTRUCTIONS, SEE BACK OF FORM [SCHEDULE | : B | moxenaay EXPENDITURES ~ MONEY SPENT FROM COMMITTEE ACCOUNT eaten cee STATE PAC COMMITTEES: NOTE. FOR CONTRIBUTIONS MADE To STATEWIE OR LEISLATWE CANDIDATES. UST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN ANO THE Co CHECK THIS BOX IF PAC CHECK NUMGEA FOM EACH EXPENDITURE. A LIST OF 1D NUMBERS IS AVAIABLE FROM THE IOWA ‘AMENDING FORM | Peers aera (COMATTTEE NAME fit be Sao aso Saiaont of rparlaton) 5 For SD Quran Bac ° EVATE SaNOGATE —] TUE ANG NSORESS TO WH ad ore | Gnome ‘Breworone (DeSCREE TRAREACTION eaPeNCe excenen | apse) (Oso WAS MADE sacar | “ARB ‘ewer a i9 ID eosT MAST EC STAMPS low SrETIoW 5/,,| oxe lvien % s "Foal" 5A | Ames Taseoiy-m) 370.0 oF T $ 19 STAPLES reese (Apa, | OF foe Feet ed ailing label blenks| 2% 66 (3 AS3| Ankeny Ta Seoa) 2 oF : S '9 eee Ry] DeoKettes fler~ 25 |p| CKH 1333 Buckeye Rd ey lo.S oa" aSy | Ame Fe Soro auditor 0. S| A Déioctanic Thom onrord| “hny| SBbI Flee OR od} cKe paG! Fe de = Wal Lag (Ge 5720.05 oF oKe oF owe oF cKe oF one a SETOAL TOTAL Uiiest page ofthis schedule) iS BOX APPLES T6 CANDIOATED COMMITTEES ONLY: Pechaes cara coy spar cnn $50 cr ere mat ao be ric on cece Hero cade eran) ‘Spence psnsintes proving corti, avers, kar, por, marairg, cana serves mt ao be etal tara co SS Gye vou potter onal coh ope ct oachon nee ty te pomtveun an sok ce ccs estmtae” fae Sais Shares pore ae Page > ot (for Schectso 8) FOR INSTRUCTIONS, SEE BACK OF FORM [COMMITTEE NAME (ast bo Samo as on Statement of Organization) DATE RECEIVED (uwDBI¥Ry aj Joa) Quitretsen for Sens [NAME AND ADDRESS: ‘OF CONTRIBUTOR. LOA DEON PM rT Dm 1A 5° 33) RELATIONSHIP ‘CANDIDATE DESHPTON OF IVKND CONTRIBUTION posers < fA Pred SCHEDULE] E IN KIND (Rev 08:97] CONTRIBUTIONS. ID CHECK THis Box IF AMENDING FORM ESTIMATED. FAIR MARKET VALUE TIFFOR. FUNDRAISER CONTRBUTION Faw A Demecenne PARTY Sbbr Frese URL GDM) Dm iA 52°22) [Poses & wane PRdLMoP, Sue tareescerT GSS pserTwose frag if soot ior Peter etree Coens “Disclosure law requires candidates o disclose the relationship ofan relative making ann kind cntbuton tothe Sato TOTAL (ttast page ofthis ‘schedulo) commitee. Relaionshp ust be shown to the rd degree of censanguy ol relatives) av afiaty(elatves bbymariage). (See Page 2 oes packet) sumame of contibutr ke the same ae cancidate ut there fe no fam retatonship,entar ‘nt appcabe”n the relatorship ecu Page| _at__[ ttorScheaule FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE ‘COMMITTEE NAME(Wust be same as on Statement of Organization) i a pce Qiitivirbac foc Sopa ane [ToneoK THis Box [AMENDING FORM NOTE: This schedule repors money lodhad tothe commitee which is deposited inthe committe aczount, ‘TOTAL UNPAID LOANS FROM LAST REPORTING PERIODS _

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