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Randa Gary__1644__scanned

Randa Gary__1644__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
Copyright:Attribution Non-commercial

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03/03/2011

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FOR
INSTRUCTIONS,
SEE
BACK
OF
FORM
DISCLOSURE
SUMMARY
PAGE
COMMITTEE
NAME
(Must
be
same
as
on
Statement
of
Organization)
X-q
.rj
Jq
Fer
5
eNGt(f
IMPORTANT
:
Indicate
by
#
typeof
committee
you
arereporting
for
:
=
(1
)Statewide/Legislative/Judge
Standing
for
Retention
Candidate
(
2
)State
PAC
(
3
)State
Party
(
4
)County
Central
Committee
(
5
)CountyCandidate
(
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
(
11
)
Local
Ballot
Issue
CANDIDATE
COMMITTEES
ONLY
:
Candidate
Name
Cam,
r
Office
Sought
~
ISC
iOSURF
_
~MPA
1,
-uwF
ILED
.
.
?or
t
arty
(if
applicable)
(if
Senate
or
House)
-01,
Late
reports
are
subject
to
possible
civil
and
criminal
penalties
.
Pursuant
to
Iowa
Code
section
68B
.32A(7)
the
candidate,
for
a
candidate's
committee,
and
the
chairperson,
for
any
other
type
of
committee,
is
the
individual
responsible
for
filing
timely
and
accurate
reports
.
I
AM
FILING
A
JZ
;1
Z
N
r
(report
date)
Indicate
by
#
FLI
E]CHECK
IF
AMENDMENTTO
REPORT
DATED
F1
Check
if
this
is
final
(termination)
report
and
attach
Notice
of
Dissolution
FormOR-3
.
(Youmust
continue
to
file
reports
until
a
DR-3
is
filed
.)
&G
S
,
o
Y8
2
.
'e
.1
o
TELEPHONE
DATE
SIGNED
REPORT
FOR
(1)
ELECTION
I(2)NON-ELECTION
YEAR
.
STATEMENT
OF
CASH
ONHAND
CASH
ONHAND
at
thebeginning
of
the
reporting
period
.
(Total
of
all
funds
held
by
the
committee
.
This
amount
MUST
be
the
same
as
the
cashon
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)
.
.
..............
.
..
.
.
.,
.
..............
.
....
.
.
.
......
.
.,.,
.
..
.,
Schedule
H
:
Total
Sales
of
Campaign
Property
(Attach
Schedule
H)
................
.
.........
.
.............
CASH
ON
HAND
at
the
end
ofthis
reporting
period
(if
final
report
balancemust
be
zero)(Attach
DR-3)
..
.
.................................
.
.....
.
..
.
................
.
.....
.
..
.
.
............
.
..................
.
.
.
..
.
...
$
'"'UNPAID
BILLS(From
Schedule
D-Attach
Schedule
D)
..........................
.
.,
.
..
.
............
.
..
.
......
.
....
.
...
.__
$
*IN
KINDCONTRIBUTIONS
(From
Schedule
E
-AttachSchedule
E)
.
.
......
.
..
.
.............
.
.
.
..
.
....
.
.
.,
..
.,
.,
....
.
....
.
$
STATE
COMMITTEES
:
Submit
a
reconciled
campaign
accountbankstatement
in
January
of
each
year
.
FORM
(Rev
.
1212005)
Comm
.
#
Logged
l
Scanned
Computer
Audited
DISCLOSURE
REPORT
Local
Committees,
enter
Date
of
Election
County
&
Local
Committees,
enter
County
in
which
Election
is
held
Itio
.LiS
YES
V
NO
"*OUTSTANDING
LOANS
(From
Schedule
F
-
Attach
Schedule
F)
......................
.
.......
.
........
.
......
.
............
$
CONSULTANT
BREAKDOWN
(Schedule
G
Attached?)
CANDIDATE
COMMITTEES
ONLY
:
VALUE
OF
CAMPAIGN
PROPERTY
(From
Schedule
H
-
Attach
Schedule
H)
$(Schedule
H
applies
to
Candidates'
Committe
es
Only)
SUB-TOTAL
.
.
.
.
..
.
.
.
.
..
$
-
14
1
SUBTRACT
TOTAL
MONEY
SPENT
THIS
PERIOD
Schedule
B
:
Expenditures
total
(Attach
Schedule
B)
(*"also
see
debts
and
loans
below)
...
.
.......
0102
Schedule
F
:
Loan
Repayments
total
(Attach
Schedule
F)
.
.
..................
.
..
.
..................
.
......
.
..
.
.
.
....
 
For
Instructions,
See
Back
of
Form
CONTRIBUTIONS
--
MONEY
TAKEN
IN
(Including
candidate's
personal
funds)
COMMITTEE_NAME(Mustbe
same
asonStatement
ofOrganization)
a
Fd
r
S
eiyrt
T'-e
R
.c'~Ct
~r1rr{1
SCHEDULE
A
I
MONETARY
(Rev
.
07/03)
RECEIPTS
CHECK
THIS
BOX
IF
AMENDING
FORM
STATECANDIDATES
NOTE
:
IF
A
CONTRIBUTION
IS
RECEIVED
FROM
A
STATE
PAC
(POLITICAL
ACTION
COMMITTEE),
LIST
THEPAC
IDENTIFICATION
NUMBER
AND
THEPACCHECK
NUMBER
IN
THE
DESIGNATED
COLUMN
.
A
LIST
OF
ID
NUMBERS
IS
AVAILABLE
FROM
THE
IOWA
ETHICS
AND
CAMPAIGN
DISCLOSURE
BOARD
.
NOTE
:
ANY
PERSON,
OTHER
THANAN
INDIVIDUAL,
THAT
CONTRIBUTES
MORE
THAN
$750
TO
YOUR
CAMPAIGN
MAY
HAVE
FILING
RESPONSIBILITIES
AND
SHOULD
IMMEDIATELY
CONTACTTHE
BOARD
.
CAUTION
:
Section
68B
.32A(6),prohibits
the
use
of
information
copied
from
reports
and
statements
forsoliciting
contributions
or
for
any
commercialpurposebyanyperson
other
than
statutory
political
committees
.
TOTAL
(if
last
page
of
this
schedule)
Disclosure
law
requires
candidate
committees
to
disclose
therelationshipof
any
relative
making
a
contributionto
the
committee
.
Relationship
must
be
shown
tothe
third
degree
of
consanguinity
(blood
relatives)
and
affinity
(relatives
by
marriage)
.
If
surname
of
contributor
is
the
same
as
candidate,
but
there
is
no
familialrelationship,
enter
"notapplicable"
in
the
relationship
column
.
SUB-TOTAL
DATEPAC
ID
NUMBERNAMEANDADDRESS
OF
CONTRIBUTOR
RELATIONSHIP
AMOUNT
J
IF
FOR
RECEIVED
(if
applicable)
TO
CANDIDATE`RECEIVEDFUND-
(MMIDD/YR)
ANDPAC
CHECK
(if
applicable)
RAISER
NUMBER
INCOME
5~~(0~0(o
I
D#
CK#
11311
70
1
3i
1
Fo~
a}~Dr
Nl~-
$
9`t100
0
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N
'F
N
S
O
511
-
7/04,
ID#
7
s
JAllot!
oeh
d
rk
a-v~4
d
y~
as
,v`
N
1000
0
CK#
10
INNS
.
~
~
o~
51)1106
ID#
CK#
rr~
tke_
1(tos
cr+afvv
a~
k
c
2,
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rtide,
tvN
4%/q
.
$b00
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loo
,Np1
-1
l4
S0
-
1
01
."(
slaaloc
,
ID#
c
K#
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~L
03
n
v
z
S
Pa,
;L
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ht
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Q
e~iMQNvtJ
S
SQL
~I
I
D#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
 
THIS
BOX
APPLIES
TO
CANDIDATES'
COMMITTEES
ONLY
:
Purchases
of
certain
campaign
propertycosting
$500
or
more
must
also
be
inventoried
onSchedule
H
.
(Refer
to
Schedule
H
instructions
.)
Expenditures
to
persons/entities
providing
consulting,
advertising,
fund-raising,
polling,
managing,
organizingservices
must
also
be
detail
itemized
onSchedule
G
by
the
amount,
purpose,
and
date
of
each
typeof
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
_-_
(for
Schedule
B)
FOR
INSTRUCTIONS,
SEEBACK
OF
FORM
Reset
Form
SCHEDULE
EXPENDITURES
B
MONETARY
--
MONEY
SPENT
FROM
COMMITTEE
ACCOUNT
(Rev
.
07/03)
EXPENDITURES
STATE
PAC
COMMITTEES
:
NOTE
:
FOR
CONTRIBUTIONS
MADETO
STATEWIDE
OR
LEGISLATIVE
CANDIDATES,
LIST
THECANDIDATE
IDENTIFICATION
NUMBER
IN
THE
DESIGNATED
COLUMN
AND
THE
CHECK
THIS
BOX
IF
PACCHECKNUMBERFOR
EACHEXPENDITURE
.
A
LIST
OF
ID
NUMBERS
IS
AVAILABLE
FROM
THE
IOWA
AMENDING
FORM
ETHICS
8
CAMPAIGN
DISCLOSURE
BOARD
.
COMMITTEE
NA
(Must
be
same
asonStatement
ofOrganization)
c~
N
d
0
1
-
40
r
/Y
a
,
1
C
CANDIDATE
NAME
AND
ADDRESS
TO
WHOM
PURPOSE
AMOUNT
DATE
ID
NUMBER
EXPENDITURE
(DESCRIBE
TRANSACTION)
EXPENDEDEXPENDED
(if
applicable)
(Disbursement)
WAS
MADE
(MM/DD/YR)
AND
PAC
CHECKNUMBER
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