Professional Documents
Culture Documents
Lun-L,,: Disclosure Summary Page 'Zy I 2 DR-2 U
Lun-L,,: Disclosure Summary Page 'Zy I 2 DR-2 U
"UNPAID BILLS (From Schedule D - Attach Schedule D) .. . . . . . . .. . .. ..... .. . .. .. . ... .. .. .. ... .. .. . ... ... ....... .. ... . . S
'IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .. .. ... .. .. . . . . . .. . . . .... .. .. . .. .. .. ... .. .. .. . . $
"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) .. .. .. .. . .... .. . . . . .. .. ..... .. ..... .. .. . . . .. . . ... . $
CANDIDATE GQMMITTEES ONLY:
CONSULTANT BREAKDOWN (Schedule O Attached?) D YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
-Forfi"huetiom,-$" Ieck-offoi n -SOCHEDULf-
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Inducing candidas's personal funds)
a CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement ofOrganization) AMENDING FORM
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 10 NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION : Section SeS .32A(S), Iowa Code, prohibits the use of information copied from reports end statements for soACMng contetXMons or
for any commercial purpose -by any person otherlhan statutory political com"IMeeS .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDDIYR) AND PAC CHECK (If applicable) RAISER
NUMBER INCOME
IDO ) -7 yy ~~
J( .t1P~r- ~-
0 012-9/by ' CK c~
~S
4 (oSOs
I D# P ? tt L ~.%~ r,
°a1
V CKS V
~~w- fur
ID# !'~-1
09
2, 9I614 cK#
-7 pi a
IDS l
r~'Gu v-tL ~.. D~ , av
V44 IL)q CKS
C"
p -I "hd
Ll ~8 I>-
-
Lj
IDI# 1'1 '1L4Z.
. .CK# od
~7
~St~s
~ ~f g ~.ll . -
~
qZ
~~7t2'Ilsll<iT_
IDS ) - b7
ld
CK# .sus r -),j
G1 7 9 =4
it
1D#
Li
s
IDO
CA1MON : Sedlon se8 .32A(tl), Iowa Coda, prohibits the use of Information copied from reports end staternents for so"np oonMbudons or
for any comrnerdel purpose by any person other than statutory poldcal commttteas .
till
1 05' CK
Ct~ ., -°~G
IDS
CK0
100
CKit
100
cwK
ADO
CK#
ID1t
CK#
ID#
CKA
CKA
ADO
cKO
ADO
CKia
SUB-TOTAL
Disclosure law requires candidwts committees to disclose the relMlon*hlp of any relative msidnp a contribution to the
cemmfs Relationship must be shown to the third degree of consmguinity (blood relatives) and alifnity (relatives by
marriage) . It surname of oontrlbutor in the some as candidate, but there is no
Nmillol relationship, enter 'not applicable' in the relationship column . Papa - 2-- _ of
(for ScheduleA)
.F_QRIWSSIRL1C.TaDb1a .SEEB4CKAFFDR)1I
sCUF9DULE
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY
(Rev, 07M) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE I~ CHECK THIS BOX IF
PAC OHEeK1Jt71kt3ER FOR £Ae" fXPENDITURE. A-0ST OF iD ftUMBERS iS AVAtLABL£ fROM THE IOWA AMENDWG fORM
ETHICS A CAMPAIGN DISCLOSURE BOARD
(O 3s P-+ ,,- .L 5 .
6u?$ c~
IDO
CK#
14141 .
&q qy ` -- _(2j,4
C>0
/ S ~ ,cJ
C K# ~~ o
/ ~
~ll CK# 0 ,~
~OS
ID#
(~le CK# 11-3 N
ID#
It 105- CK#
SUB-TOTAL $
{tor SrAeduk-IE 4
pi. 1!5'Y
., ..
a r6%. O ri 40Y
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (If applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
I D# 177142- rn
II 0
oo/
ID# 9.~~ a
u rl-L -&,
/65 cK#
/00 o~.euCc Yv-Ij'n ~~I-
ID#
CK#
I D#
CK#
I D#
C K#
ID#
C K#
ID#
C K#
ID#
C K#
SUB-TOTAL $
Purchases of certain campaign property costing S500 or more must also be inventoried on Schedule H (Refer to Schedule H instructions .)
Expenditures to personslenti0es providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail Itemized on
Schedule G by the amount, purpose, ane date of each type of expenditure made by the Dersonlentity on behalf of the candidate'$ committee (Refer to
Schedule G instructions and Iowa Code 88A.402(3)(t) )
Page
(for Schedule B)