12/14/20041 03 :41 6413243137 400RTHREALTY PAGE 03

FOR INSTRUCT70NS. SEE BACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
(Rev . 0712004) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization)
For OfficaUn4a(Y
MARTIN FOR SHERIFF Comm $
IMPORTANT- Indicate b yatypo of committee you are reporting for 1 1 Logged In
(1 )Statewidel1.eglslative/Judge Standing for Retention Candidate (2 )State PAC (3 )State Party ScannW
(4 )County Central Committee ( 5 )Courrty Candidate (6 )City Candidate (I )School Board or Outer Computer
Political Subdivision Candidate (8 )County PAC (9 )City PAC ( 10 )School Boani or Other Political
.Sahdmidon PAC ( 11 ) Local Sallart Issue Audited
CANDIDATE COMMITTPES ONLY:
Candidate Name Political Party (if applicable)
Late reports are subject to
MARTY MARTIN INDEPENDANT
possible civil and criminal
Office Sought 0
20 1,1District (if Senate or House) penalties.
WOR TH CO . SHERIFF

641/324-1444 12-14-04
SIGNATURE OF PERSON FILING REPORT TELEPHONE DATE SIGNED

I AM FILING A F INAL REPORT REPORT FOR (1) ELECTION IM)NON-ELECTION YEAR .

(report date) Indicate by #

tncal Committees, enter Datw of Election

[]CHECK IF AMENDMENT TO REPORT DATED 11-02-04
0 Check(You
if this is final (termination) report and attach
Notice of Dissolution Form DR-3 .
must continue to file reports until a DR-3 is filed.)
County & Local Commlttrhaa, enter Ceurhty In
which Election Is held
WORTH

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (Total of all funds held by the
comrnittee . This amount MUST be the same as the cash on hand at the end 100 .73
of the last reporting period or must be zero if this is first report filed.) ................ .................. S
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) ('also see in-kind below) .... ...... _,
Schedule F: Loans Received total (Attach Schedule F) ......................... ... ........................... 650 .00,

Schedule H: Total Sales of Campaign Property (Attach Schedule H) ........ . ................. . .......
[Schedule H agplies to Candidates' Co ltllaea_Only)
750-73
SUB-TOTAL ..- .$
SUBTRACT TOTAL MONEY SPEW THIS PERIOD
670 .50
Schedule B: Expendlturtas total (Attach Schedule B) ("also see debts and loans below) ....
Schedule F. Loan Repayments total (Attach Schedule F) ..............., .......................... .......... 80 -23
CASH ON HAND et the end of this reporting period (ti final report balance must
be zero) (Attach DR-3) ................................................ . . . ...... .... . . ....... . . . . .. . .. ...........................$

-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) .... ........... ........ ...... ....... ...... .. . . ..... S
CANDIDATECOWMiTTE ONLY.
CONSULTANT - BREAKDOWN (Schedule G Attached?) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) S
12 :''14/^1134 33 :41 6413243137 )JORTHREALTY PAGE 34

FOR INSTRUCTIONS, SEE BACK OF FORM IZCStiLXL, .~ SCHEDULE

EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY

(Rev . 07i03) EXPENDITURES

STATE PAC COMWTTEES: NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE

CANDIDATES . LIST THE CANDIDATE IOENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN OMCLOSURE BOARD

COMMITTEE NAME (Must be same as on Statement of Organization)

MARTIN FOR SHERIFF
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (tf applnabie) (Discuf"mm) WAS MADE
(MMfDOIYR) AND PAC
CHECK
NUMBER
ID# Northwood Anchor Postage for
801 Central Brochures $ 276 .92
10_15- K# 7 Northwood, Ia . 5045
ID#
11-16- CK# 8 Same as Above Advertising 258 .88

ID# Lake Mills Graphic

204 N . Mill
11-16- 4K# 9
Lake Mills, Ia . 5045 Advertising 124 .20
ID#
Northwood Anchor
801 Central Advertising
12-13- CK# 10 10 .50
Northwood, Ia . 50459 Thank you
ID# Marty Martin
12-14-!4 1tK# 11 1 Shellrock Dr . To Close Account 80 .23
Northwood, Ia . 50459
I DU

CK#

I D#

CK#

1D#

CK#

SU8-TOTAL $

TOTAL (K last page of this schedule) $750 .73

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY:

Purchmses of cerioln campaign property oosring gti00 or more rmrst also be in"nionod on Schedule H. (Rater In Schedule H instructions .)

Expendlturea to pergonalendiles providing oonsulHng, adwrtiging, fund-raising, polling, managing, organizing services must also
be detail itamized on
Schedulo C by the amount, purpose, and dais of,each type of expenditure made by the perwNontity on behalf of the ca ;dale's committee. (Rotor to
uM G In%trucliorr5 and Iowa Credo G&k402(3)(I).)

(for Schedule 6)
FOR INSTRUCTIONS, SEE aACl" OF FORIA SCHEDULE

COMMRTEE NAME(hfusi be same as an SmtemPnt vt O."ganizahwil

F LOANS
(Rev . 07103) RECEIVED
b REPAID
MARTIN FOR SHERIFF
tire oomrnhtee accoun :
CHECK THIS BOX IF
NOTE : This schedule reports mrrney loaned to the comrrdllea which is AEposned in AMENDING FORM
1 2 8 . 81~~
TOTAL UNPAID LOANS FROM LAST REPORTING PERIOD S

PART I - MONETARY LOANS RECEIVED EMS REPORT)NG PERIOD PART G- MONETARY LOAN REPAYMENTS MADE THIS REPORTING PERIOD
(Original source cdkmn, such as a bank, must be shown d a third party is (Loans forgven rmsl be reported on Sahadure E -- ka-tdnd Contributions.)
involved. Include loans from candidate's pnrsanrd funds.)
NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUIJT DATE PAID NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT
DATE
RECEIVED (Include Enciomer's Nerve, If AppScabie) TO CANDIDATE OF LOAN (MMIDaIYR) (Include Endorsees Name, If Applicable) TO CANDIDATE' REPAID
I( A!cabte' If A icable
MMfDDN
S b
12-14-0 Marty Martin
1015-04 Marty Martin
1 Shellrock Dr .
1 Shellrock Dr . ~~
~s
Northwood, Ia . 504r-9
Northwood, Ia . 50459 500 .0

10-17-0 Same as Above 100 .0

10-29-0 Same as Above 50 .0

TOTAL (PART 9
LE S 650 .00 TOTAL CASH REPAYMENTS (PARTIt)

From Schedule E - TOTAL LOANS FORGIVEN

S

S
gl.

c
Z ,f

TOTAL OUTSTANDING LOANS END OF REPORT PERIOD S -

'DiscSosure law requires candidate oommittass to disclose the rela5onWp of any relaVve
making a contrtbut'on lD the oomrMttee . Retatiwrshtp must he shown to the third degree of
consanguinity (blood relatives) end affirJly (rnlaIlves by marriage) It srrrurrne of contribulor is
the cams as candidate. bul there s no familial relal!unship, enter 'not appi!cable' in ths /
Page of
relationship column when it app4es .
(ior Sohedu!e F)