Professional Documents
Culture Documents
Reset Form
DISCLOSURE SUMMARY PAGE DR-2 I DISCLOSURE
(Rev. 07/2004) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization)
For Office Use Only
Comm . #
IMPORTANT: Indicate b/# type of committee you are reporting for : Logged In
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party Scanned
(4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or Other
Political Subdivision Candidate ( S )County PAC ( 9 )City PAC ( 10 )School Board or Other Political Computer
Subdivision PAC ( 11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES ONLY :
Candidate Name Political Party (if applicable)
Late reports are subject to
possible civil and criminal
Office Sought District (if Senate or House) penalties .
5-'/a DS
I AM FILING A 0/- /'j- 05-- REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR.
(report date)
1 .-C`r
Indicate by #9
Local Committees, enter Date of Election
CHECK IF AMENDMENT TO REPORT DATE D""
o
Schedule F : Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 8/,
CASH ON HAND at the end of this reporting period (if final report balance must
be zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
a
**OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . $
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
,
&' P_C[l [CO I rh 0, .
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.
CAUTION : Section 68B.32A(6), Iowa Code, 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 J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
e I'=
CK#
t L13q Y
ID#
et-o(/ CK# Tf rr
Itfoku k
rrilc /~,ck~%-y
6,; ZJ ~2- 1006
X-
E:1
ID# ~
par 5~~ keqg P !/
CK# ~1I S ~3'f)St
v L16 aG~z S
I D# 4 n lC
CK# ~ l I< . lrl, l~e17( .Jr
ID# 5.
CK# jl4- --cs ¬ mar,-!
a
5r1'
CK# ,1 J~J
- ,
1.30
1 e, r
1= 5 .~ . s-~, ~~
l~
C, 'A F1 C-
CK# ^~
Ss,~ C~1 171 .3 v
ID# C1 I'/
Sc' 3 3 : ci ~'~
r CK#
`7. U a2
ID# P Lo
CK# Sow
l~ p G- u -5~2 j.2
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 contributor is the same as candidate, but there is no Page of
familial relationship, enter 'not applicable' in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
e6
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.
CAUTION: Section 68B.32A(6), Iowa Code, 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 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
Toe ke' .; Zelh ,
CK# lr) .~ lc ~ y 7-P r r ,
MM 0a
i~Qaw~ sv~ ~ia~
K mm
lo M 0
CK#
ID#
CK#
ID#
CK#
-ID#
CK#
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 contributor is the same as candidate, but there is no
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
Reset Form
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
W l;
CA DIDATE NAME AND ADDRESSTO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
. ~" -
ID# Kx ka d' r ~ ~zz r~~s f ., o , ~ ay
'/O,5 ~~'~?JhrrIJ_A0,I
CK#
O .Z
4
O
49
T7 I t t'r`/< u 1<. .i r b
ID# ^ _ 01
CK#
,
/7 M.
~l~o, yS
D
,.
'314 160
SUB-TOTAL $ a
Purchases of certain campaign property costing 5500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions.)
Expenditures to person slentifes 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) .)
(for Schedule B)
Reset Form
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B
(Rev . 07/03) EXPENDITURES
CK#
ID#
,r
CK#
ID#
TO~lh
CK#
' 1 2,1)
_67; k
ID# 14 o,; l{IrS
CK#
ID# I
CK#
1 ~i D tl - IJ _ a''
.~, r~ -~ -
r
cK#
47 61, 321
SUB-TOTAL $
Purchases of certain campaign property costing 5500 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
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form
SCHEDULE
I it1Yft
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
ID# (~eo . Gabble
CK# 14/05 ~~e D $ C~J
ID# e
CK#
(7 0T
r
ID# dll-
CK# a
(, A Gt .7 L7L)I ~~
ID# Sklll~~r
CK# I L ~~D L)
;~
e)A-qk- 6 ~l
ID#
f I 07 X~L y
,i I5 K -l
ID# 1G.w
Jh~rrv ~ .l
01
CK#
ID#
U ry s ~:
1
T 3
CK#
I/ - lo - ell
ID# C~-li C! l" ~D ~ G L ~J ~`JJ!! /1
SUB-TOTAL $
Purchases of certain campaign property costing S500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
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 person/entity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 68A.402(3)(i) .)
(for Schedule B)
Reset Form
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 07/03) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE CHECK THIS BOX IF
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS 8 CAMPAIGN DISCLOSURE BOARD .
CK# r
ID# y hJ r *'S
F ~ ~;
_ It, -v
CK#
qel e, (I s.
ID#
pcnn, e (L c Lie
CK#
~11 .
n
ut %t? Hrok .1
ID#
dam+ ~ C
3d
l\ t
ID# /
p . ci m c~ /C~cy m ~s
qo
r .
ID# J ~
C
J.
CK#
.-t . 91(55 11
1
`J= -
.30
ID# St-epp
- ' CK# )
--t qn ~, r) kAt
SUB-TOTAL $ c
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions.)
Expenditures to personsientities 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 68A .402(3)(i) .)
Page of
(for Schedule B)
Reset Form
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 07/03) EXPENDITURES
1
COMMITTEE NAME (Must be same as on Statement of Organization)
~6)1)71n,
CAN ATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
I D#
CK# _,
Qc~ ~ ~~ u.k
ID# SyCWrt~'r
~NSSiC-ci
7
CK#
(7
i lr
ID#
CK#
ID#
i-ky ~R~Pr 1
CK# (~
1I1 k
Pi"
ID# OS%
CK# r,
~1 D -T- h l
m
ID#
ti' ~ >~' 11 C' cz
J0 .14
CK#
q 1 3 V
ID# _ VAIN-e- ` [tf-l ty-,oC k
CK# L, ry -
SUB-TOTAL $ O~ dC)
TOTAL (if last page of this schedule) $
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 68A.402(3)(i) .)
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form
SCHEDULE
B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 07/03) EXPENDITURES
ID# et r, 1<-I ti 0 en
~c2
CK# l3 i l 11 ~/ ~.
LL_ 11 _-0-1/ J, I C 16,31
ID#
L7t'c'ryr'
CK# 2$~3 e
q1 Z FM
ID# <i-% k 6,1j
-57 _Ot
CK#
q19 r, . C. Z 7
(
lUi-
f
Nr . ~ I ec rr4
I D#
RIO, - 1,-' r-k I >1 Q,-1 A 111 7 /W 3
CK# 1301/ P e 3
-q f -m . ;6.4 -7 n'fsc CAI/_t~ /,rks
.0
ID# D ca it c. I- Pc. rh%
T-rrr,
CK# y b Z 14,0(c
:-% - ,
i1- Y-a1 k .3- 2 3 ~~ a3
ID#
~/ I'm f- i- r1 r'rJ
V
CK# P 0 . L~nY 77-40-"/
WT i0q,
ID# Rit rfe . 'L' (._ e(-, i! /l
CK# P111 t- 4 (J
11 2 -14-d V1 LZ -1 Weo)< tik 3 ;t- I // I
SUB-TOTAL
-_ll~l7-U_3
THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :
Purchases of certain campaign property costing 5500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to persons/entibes 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) .)
(for Schedule B)