Professional Documents
Culture Documents
Routine Penalties Due For Late Filed Reports Range from $20 to $800
[] Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County 8 Local Committees, enter County in
which Election is held
(You must continue to file reports until a Notice of Dissolution is filed.)
CASH ON HAND at the end of this reporting period (If final report balance must C'~~ ~~
be zero) (Attach DR-3) . .. ... .. . . . . ..... .. ..... .. ..... . . .. .. ....... .. .:. .. .. .. :.. . . . .. .. . . ... .. .. ..... .. .. ..., ....... .: ... .. .$
UNPAID BILLS (From Schedule D - Attach Schedule D) ... . .... .. ..... .. .. .. ... .. .. . ..... .. .. .. 5.~~- . . ~.~....... . $ to V_ __U6 /
IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . ... .. .. .. .. ....... .. .. ... .. .. ..... .... .. .. ... .. .$ _
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) $
IOWA GREEN PARTY
For Instructions, See Back of Form SCHEDULE
P.O . BOX 72
VICTOR, IA 52347 A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 06/97) RECEIPTS
(including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
OWA -? 12 es N -P,4,27- q
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
(if applicable) TO CANDIDATE` RECEIVED FUND-
RECEIVED
AND PAC CHECK (if applicable) RAISER
(MM/DDIYR)
NUMBER INCOME
39 : o' f
ID#
/0
~31
/p
cK# Z ~0
2; g ,Q,t a errt s.y' l .
ID#
i:66
6
C ~Z-57
// ID#
r, Aaley se
fob c, *t
ZZ cK# 3,x -3
/~9Sa x411d .
Z
l Zlo cK# Z q1 Z D ,9w ; C r~ :~ I~¢ sz=~,
ID#
if A
3 ~o l CK# III: ,vt
s:
~,, :h' l, o iAr 5 23l o
ID#
c`a ZS. Sb
(z 3
~01 cK# 0
Gr-,yen
s ~ . SZ ~
/ ID#
alln,
~O l CK#
1A sstz
l) ID#
ID# C*u
I'Zl ZLT s'a
ID#
CK#
SUB-TO IA~
/ $ 2(09.99
<J-C
TOTAL (if last page of this sched~}vie)
$ZIoQ ~q
~l~ icy'. 35
contribution to the
Disclosure law requires candidate committees to disclose the relationship of any relative making a by
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives I of
packet .) . If surname of contributor is the same as candidate, but there is no Page
marriage) (See Page 2 of forms
relationship column . (for Schedule A)
familial relationship, enter "not applicable" in the
IOWA GREEN PARTY
P.O. BOX 72
VICTOR, IA 52347
B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 09/97) EXPENDITURES
I Z Y E . rwaa1 ;n s 4-Y ;
CK# 10 2 a
:tet^jvk 6";47 , - it. SZ Z`fo
P go,( -zy~te
S :~ C1tl +%. h. S Z7.Yo
61oa dt Gw- Gr.,,eKs
SYQ F^*-h+tk..cc 5+ .
ILih s S ~, Cr~7~M :o,C ~A' Y~ z
ca~a~t~
ID# filly N .,i-
RP. aox -Lygp
CK#/0 3 1 Jrwri ash 1 -Dot' 5_7. -&Yf
CK# /03 Z
Sz-zl/
91ty At-,t
p o-6 .y zqVg
Page
(for Schedule B)
IOWA GREEN PARTY
P.O. BOX 72
VICTOR IA 52347
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
.moo WA
CANDIDATE
G, 2e',v Mr- rY
NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER - EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MMIDD/YR) AND PAC
CHECK
NUMBER
G pKhll ~x
ID#
16131 Gl~w~ , fi
Z-
lo b cK#
1036 $
,~ nv A r14, sZZq o
,3 9<
I D# /Vl y
Co A Gh__ C,;
o 'fo u w&a4t.,d 2,
lei cK# p
A(P-) IL 4-1" . /;4 . 's-m-41 r ,3/5 *Z4 . cc
45'
ID#
Ib~~ jlel
Satis~" , +'~to
6,90 , ,. SUB-TOTAL $
1 ~s
TOTAL (iflast page o thhAcUf) $/ ,o ~0 .
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 56 .6(3)(i) .)
(for Schedule B)
IOWA GREEN PARTY
P .O. BOX 72
I
FOR INSTI~UCTJONS, SEE BACK OF FORM VICTOR, IA 5234/ SCHEDULE
D INCURRED
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev. 08198) INDEBTEDNESS
vl s;Ho eo(acatwL $
SUB-TOTAL $
*If actual figure is unknown ; show "estimated" beside the figure . Page of _ /
(for Sc dule D)