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Disclosure Summary Page 6 DR-2
Disclosure Summary Page 6 DR-2
Disclosure Summary Page 6 DR-2
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DISCLOSURE SUMMARY PAGE DR-2 I DISCLOSURE
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev. 07/2004) REPORT
For Office Use Only
6 4u t Ike !c -U~ Comm. #
IMPORTANT : Indicate by # type of committee you are reporting for : Logged In tiCJ
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party Scanned
(4 )County Central Committee ( 5 )Count)(,, , at#~..f )Cit Candidate ( 7 )School Board or Other
Political Subdivision Candidate ( 8 )Coun ~ard or Other Political Computer ,
Subdivision PAC ( 11 ) Local Ballot Issue 1J#Wf nQ" Audited
CANDIDATE COMMITTEES ONLY :
7 Check if this is final (termination) report and attach Notice of Dissolution Form DR-3. County & Local Committees, enter County in
(You must continue to file reports until a DR-3 is filed.) which Election is held
**UNPAID BILLS (From Schedule D - Attach Schedule D). .. . .. . .. . .. . .. . .. .. . ... .. ... . . . .. . . . .. . .. .. . .. . .. ... .. . .. . . . .. .. $
*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
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)
Q CHECK THIS BOX IF
AMENDING FORM
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE 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
I D#
7
$ old"
CK#
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l
1D#
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ZV
O CK#
ID#
W AA,. ,i
~.
CK#
CK#
7370 s~~ w Ts-
1D#
CK#
I D#
CK#
ID#
C K#
ID#
C K#
ID#
CK#
ID#
C K#
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 Rescc Form SCHEDULE
ID#
psr
CK# .46 0 7
7r lJ~l dQ4-
ID# 051
32. as
00 3
CK# ~.
C4 ~, ~~
I D#
0v
~
l CK#
0# 06s' uo ~".- ~
10(18 l13. ~fo
CK#
ID# GDS
I
~~
l
0,9 CK#
I D#
C K#
ID#
C K#
SUB-TOTAL $.
tit
TOTAL (if last page of this schedule) $
.n
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) .)
Page of
(for Schedule B)
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FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
7w
CANDIDATE NAME AND ADDRESS TO WHO .+a, h, , " - ;' ; ,' a,~ ".. ;, : ?ARP SE AMOUNT
DATE ID NUMBER EXPENDITURE T NSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MA©E
MAE ~ ;~y
(MM/DD/YR) AND PAC zoO f
CHECK
NUMBER
CK# $ ~Y6, fj
ID# ,
cK#
I D#
CK X96
I D#
CK#
ID#
CK#
ID#
C K#
I D#
CK#
ID#
CK#
SUB-TOTAL $
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) .)
Page of
(for Schedule B)