FOR INSTRUCTIONS,

SEE BACK OF FORM

CHEGKONE:
El Thisis an Iniflal' Statementof Organhaton f::-l
E tnis is anamended'Statement oi organization I KqgetFory tl
" Mementmusfbefrldwithin l0daysof cr,mmitteewptingantrtbutions, making exrrlAilffi
inanning debts exeading 5750. Amendmentsmu& be frld within30 days of a change.
Effedive January 1, 2010, all statemenb and reports fild by neMrcommftees 6r state offce must be fited
eledronically and eftc{ive January 1,2012, all statemenb and reports ffled by all commltteesbr state offce
must bo filed elecfonlcally.
PACSand State Pailc must be filed
J J (A candldate'soommitieemust lnclude the candldate'slast name ln the name of the commltee.) f amgndlngcommfilee name,
put old name h ( ).
Committee
to electMarkTmmontina
for Woodbury
CountyTreasurer

IUPORTANT: lndlcate type ol commitGo you are ropordng fun

( f lsqtddcrleglsladvelJudge,Standlng for Rstenffon Gandldate ( 2 )Stturlde PAC ( 3lSffi PanV ( a pounty CentrratGommttles
(6fcountyCandldate (6)C!tyCandldab (TlschoolBoardorOtherPollflcalSubdMslonCandldab (SlcountyPAC (glcttyPAC

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Phone 277-3988 Phorc1712| 277-2716
1712y.
sMa' emml 021@cableone.net eMair dmoore@berensteinlarvfirm.oom
- Check One Box E Advocatefrr/againstcandidate(s)[ eovocatebr ballotlssue(s)
INDICATEPURPOSEOF COIUIMITTEE
Comment or description: E Advocaieaoainstballotlssue(s)
#Ftitiffitmftt"""""",t* GountyAocal Gandldds

County:Woodbury
and Ballot lesue Commlfrsss Enton

,Republican (f acti\€lnmultpleballotissueelecfions,
Politcal Party (if appficable) attacfillstofcourdes
tXsticf, rlab ofEredion. G&.2010
for aecdon: 2010
Yearstandlns
BankAccountllams (mustmatchcommiteename) Gandldatename& Addrsscorkmnt Entltv FAGs. if aoolicablel.
JJ J + Affiliato.orsmmor
Committee to elect Mark Tramontina forWoodbury Cg MarkTramontina r\r }j
Name of Finandal lnstitudon/h/poof Accourt J J MamngAddrss J J E.;
CenfralBank- Checking &456 S$awbeny LN ?
*=F
-;?-

MalllngAddress 0 .t sry tJ
2906 Hamilton BLVD tA 511M-1554
Siouxcity -j=
F
C,ty J., StdeJ t zp J J
Phone1712) 252'7871
Sioux City lA 51104
*Ma, mark3456@cableone.net
l\c ril
STATEUENTOF AFFIRHATION:By frllng thlo documert the commlttee afnrms tho followlng:

1. Thecommltteeandallpersonsconnededwiththecommithemder$andtMtheyaresubjecttohelawshto*aCo&cfiapbrs6sAand6sBandtheadminiffiiE
rul€ in Chapter3lil of the lowaAdminisbaliveCode.
2. That toyvaCdte secffon68A.4&l and rute351-.4.9 requirethe fi[ng of dtsclosur€Gportgand thd the failureb file the6ereportgonor b€forethe r€quireddue dd6
subjedsthe candldabor cfiairperson(ln the casad committeesotherthan a candidale'Bcommlttee)to ths aubmaticasessnent d a dvil penaltyand the pedble
impositionot othercrimhal and civil sancfions.
3. That lowaCodesecfion684405 and rul€ 351-4.38 through4.4i1requirethe placementot the wDrds"Fid for hf and the narE of the commltteeon all political
rnaffils exceptfor thce ibms exempGdby #tub or rub. A oommitbothd wish€sb r€glstera committeenamefor purpces of uslngthe shorter"eid for bf and
do6 not Inbnd to crossthe $750fflingthresholdshallfile the Fom DR€FA form In lleu of filingtrusbrm.
a. That lom Cqte secilon68Ag)3 and ruls 351--4.44through4.52 prohblt thg reaElptof corporatecontribuuonsby all commit@ erept fbr htlot lssuePACS.
5. A candidateand a candldale'scsnmitbe mry onlyoe€nd campalgnfundsas permittedby lora €odeseciiqns64A"301through684.303and rule351-4.25.
6. Thd the commltbewil! ondnue to file dlectosurereporbuntilall actvity has ceased,commft@fundsspen! debb rsolved. and a ffnatreportand a #tem€nt of

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