You are on page 1of 4

FORM DR-1: Statement of Organization Form Statement of

ID 6216 DR-1 Organization


Type Iowa PAC Web Reporting System Rev. 09/2003
Status Amended For Office Use Only
Name I.B.E.W. Local 1362 Political Action Fund #6216 Comm. # 6216
Indexed
Filed/Amended 7/15/2007 Audited
Date Computer

Committee Treasurer Committee Chair


Name Michaela L. Parbs Name Thomas M. Tucker
Address 370 Blairs Ferry Rd NE Address 370 Blairs Ferry Rd NE

Cedar Rapids, IA 52402- Cedar Rapids, IA 52402-


Primary Ph. (319) 377-7354 Primary Ph. (319) 377-7354
Secondary Ph. (319) 295-3696 Secondary Ph. (319) 295-6857
e-Mail michaela11781@aol.com e-Mail t.m.tucker@mchsi.com
Purpose
Promote candidates and issues important to Local 1362 and the IBEW.

Office Sought: District:


Party: Year Standing for Election:
County: Linn Date of Election:
Primary Bank Account PAC Parent Entity, Affiliate or Sponsor
Name BankIowa Name I.B.E.W. Local 1362
Address 7045 C Ave. Address 370 Blairs Ferry Rd NE

Cedar Rapids, IA 52402


Account Type Checking Primary Ph. (319) 377-7354
Account Name IBEW LOCAL 1362 POLITICAL ACTION FUND e-Mail

Statement of Affirmation By Treasurer and Candidate; or Political Committees, By Chairperson


STATEMENT OF AFFIRMATION: By filing this document the committee affirms the following:

1. The committee and all persons connected with the committee understand that they are subject to the laws in Iowa Code chapters 68A and 68B
and the administrative rules in Chapter 351 of the Iowa Administrative Code.
2. That Iowa Code section 68A.6 and rule 351-4.9 require the filing of disclosure reports and that the failure to file these reports on or before the
required due dates subjects the candidate or chairperson (in the case of committees other than a candidate’s committee) to the automatic
assessment of a civil penalty and the possible imposition of other criminal and civil sanctions.
3. That Iowa Code section 68A.14 and rules 351-4.38 through 4.43 require the placement of the words “paid for by” and the name of the committee
on all political materials except for those items exempted by statute or rule.
4. That Iowa Code section 68A.15 and rules 351-4.44 through 4.52 prohibit the receipt of corporate contributions by all committees except for
statewide and local ballot issue PACs.
5. A candidate and a candidate’s committee may only expend campaign funds as permitted by Iowa code sections 68A.40 through 68A.42 and rule
351-4.25.
6. That the committee will continue to file disclosure reports until all activity has ceased, committee funds spent, debts resolved, and a final report
and a statement of dissolution (DR-3) has been filed.

________________________________________________________
______________________________________________________
Chair Person: Treasurer:
(signature and date) (signature and date)

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028
Filed/Amended
Committee Accounts 7/15/2007
__________________________________________________________________________________
Default
Checking I.B.E.W. Local 1362 Political Action Fund
1 Firstar Bank
Default Account 1100 Old Marion Rd NE

___________________________________________________________________________________
Checking IBEW LOCAL 1362 POLITICAL ACTION FUND
1 BankIowa
Default Account 7045 C Ave.

___________________________________________________________________________________

___________________________________________________________________________________________________

Page 1 of 1 I.B.E.W. Local 1362 Political Action Fund #6216 8/23/2007 12:16:29 PM
Filed/Amended
Committee Officers 7/15/2007

___________________________________________________________________________________

Role Name and Address

___________________________________________________________________________________________________
Page 1 of 1 I.B.E.W. Local 1362 Political Action Fund #6216 8/23/2007 12:16:29 PM
Filed/Amended
DR-1 Auditors Notes 7/15/2007

___________________________________________________________________________________

___________________________________________________________________________________________________
Page 1 of 1 I.B.E.W. Local 1362 Political Action Fund #6216 8/23/2007 12:16:29 PM