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2005-03-22 DR2 Summary
2005-03-22 DR2 Summary
22 2005 11 :48Pf1 P1
7 ;
FOR INSTRUCTIONS, SEE BACK OF FORM
FORM
DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev. 07/2004) REPORT
SUB-TOTAL . . . . . $ 5 .19
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B : Expenditures total (Attach Schedule B) ("also see debts and loans below) . . . .
Schedule F : Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . .. . . . .. . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . 5 .19
CASH ON HAND at the end of this reporting period (if final report balance must
be zero Attach DR-3 -U-
NOTE ; This schedule reports money loaned to the committee which Is deposited In the commIltea accounl.
I CHECK THIS BOX IF
AMENDING FORM
TOTAL UNPAID LOANS FROM LAST REPORTING PERIOD $ 200.00 _-___---~--
PART I- MONETARY LOANS RECEIVED _THIS REPORTING PERIOD PART 11 - MONETARY LOAN REPAYMENTS MADE THIS REPORTING PERIOD
(Odglnal source olfoan, such as a bank, must be shown If a third party is (Loans forgiven must bo reported can Sehadula E - M,kfnd Conl4b0bns.)
Involved . Include loans from cendkfato's personal funds.)
DATE NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT DATE PAID NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT
RECEIVED (Include Endorser's Name, 11 Apptirabla) TO CANDIDATE OF LOAN (Mh11DDlYR) (Include Endorser's Name, it Applicable) TO CANDIDATE' EPAID
Mh11DD/YR If A Ilcable' It A licah;a
S S
Judy Church
1699 140th Avenue
211 1/05 Murray, 1A 50174 Self 5,19
TOTAL (FART0 $ 5. 1 9
S TOTAL_ CASH REPAYMENTS (PART 11)
'Disclosure law requires candidate commlttses to dlscbose the relationship of any rotative
making a contribution to the oommlttee. Retallonshlp musl be shown to the Third degree of
consangutnlty (blood relatives) and affnlty (relatives by marriage). If surname of contributor Is
the same as candidate, but there Is no famllIal relationship, enter "not applicable" In the
retationshlp column when It applies . Page 1 of )
(for Schedule F)
COPJT I HUE FROM PREVIOUS PAGE 001
'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page t of
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule E)
by marriage) . (See Page 2 of forms packet .) If surname of contributor is the same as candidate, but there is no
familial relationship, enter "not appficeble' in the relationship column .