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5'~ 08 ʣ O U : ,',35 Ti ʣFD SPF I hlrS - _5152 13TO1 l' ;0 ʣ0

FOR INSTRUCTIONS, SEE BACK OF F M

CHECK ONE :
e
', ~' r FORM STATEMENT
19 This is on initial Statement of Organization DR-1 OF
O This is an amended Statement of Organizatio (Rev ʣ 01ʣ2000) ORGANIZATION

'An Initial Statement of Oryanfzdtfon musObe bled wititfn 10 ys or t11e cof+tRtiltme'a aooept)ng eonbibuefons, For Office U8e Qnly
malong expenditures, orincumng Indebtedness exadeding S , ʣVpeh,4ntbnrs musf be iled withln 30 days of Commʣ #
a changeʣ Penalties may be imposed for 1p*Ffed Statements rypHihatbn ʣ A cendidolo wIM on open Indexed
committee that exceeds 5750 in octrviy for another ofTico shall F thin 10 days either anew or amended Audited
OR-1 disclosing infomrebbn concerning Ehl campaign for the new oboe soughtʣ Computer

COMMITTEE NAME 4 4 (A Candidate's committee) must include the candidate's last name in the name of the committee ʣ)
Campaign to elet ii Harvey for School Board
IM NT: IndtcaLS type committee you are reporting for :
(t )StabawidelLegislatlvelJudge Standing for Retention Candidate (2 )3tatawlde PAC (3 )State Party (4 )County Certbal Committee
(6 )County Candidate (6 )City Candidate ( 7 }4ehool Board or Other Political Subdivision Candidate (0 )County PAC (9 )City PAC
(10 ),School Board or Other Political 3t4bdvfaion PAC (11) Local Ballot leaue(Ineludlng committee Involved in multiple cttr~ʣcounty ballot h ues)

COMMITTEE TREASURER (mandatortfor all commidiaml ^ COMMITTEE CHAIR mandatory swept for a tandidata's committee)

Harvey
I
N
N and e~-larvey
Mailina
Z"2Lln es nkdW P6fearl R'd W
1 1 Code
26 1 1
~3~ ntll~wa~ 11 CrescentIowa
Phone (712) 545-3010 Phone ( 402 ) 659-1809
sweetemmy06(al~hotmail ʣcom
e_Mai m horvey@hdrincʣco m eMai
INDICATE PURPOSE'OF COMMITT E Check One Box Advocate forʣagalnsl candidale(s) Advocate for ballot isgue(s)
Comment ordescription : 0 Advocateagainst ballot ieue(a)
All Eanddatae Enterʣ CountylLOCal Candidates and Local Ballot Committal Enterʣ
entice Sought Council Bluffs SchoolBoard
County : Pott Co
Political Party (if applicable) (If active in multiple ballot issue elections, attach list of cwrt ti
District: Sept ʣ 12, 2006
Date of Electron :
Year Standing for Election : 2006
f3_unkAccount Name orPe14 f ʣi (1:1 ?PE4tFdil?1CL
Afb(ittlteʣ 4r $ponsgr
NA JJ Harvey
Name of Financial InsdtutioMype of Account L 1 Mailing Addrosc 1 ʣ4

22722 Linden Rd W
Mailing Address 1 4 CRY 4 4 stale 1 d Zip
Crescent Iowa 51526
b 1 State 1 1 Zip
Phone (712 )545-3010

a JA 0,_ C• ʣ

STATEMENT OF AFtRMATION : By filing title document the committee afflrme the following
:
1ʣ The committee and all persons connected with the committee understand that they ere subject to the laws In Iowa Code chapters Wand G11113 and the admlrlstmbve
rotes in Chapter 351 of the Iowa Administrative Code ʣ
2 That town Code aecbon 68Aʣ402 and ring 351-4 ʣ8 require the filing of disclosure reports and that the failure to rile these reports on or boforo the required due dates
wbjec,v the candidate or chairperson (In the case of committees other than a candidate's committee) to the ouwm atic assessment of a civil penalty and the poss,bto
Imposition at other Criminal anti civil sartations ʣ
3 ʣ Thai town Code :ʣec1Jon 68A ʣ405 and ruloc 351-x ʣ38 through 4 ʣ43 require the placement of the wordC 'paid for by' and the name of the committee on ail political
materials except for those items exempted by statute or rule ʣ A cammlttoe that wishes to register a committee name for purposes of using the tortdr'pald for by and
does not Intend to aver, the $750 filing thie ;,hoid shall file the Form DRSFA brm ʣ

4 ʣ That lows Code aedon 68_A ʣ503 and rules 351--4 ʣ44 through 4 ʣ52 prohlbltthe receipt or corporate contributions by all committees except for cbtnwide and local ballot
iacue PACs

S A candidate ann a candidate's cemmitte0 may only expend campaign (uncle Be permitted by Iowa code sections 88A ʣ301 through GbAʣ303 and rule 351--4 ʣ25 ʣ
6 ʣ That the commtnee will continue to rite disclosure reports unct all aar~ity lies ceased ʣ committee tunas spent debts resolved, and a final report and a =ttement of
dissolution (DR-3) has been Fled