FOR INSTRUCTIONS, SEE BACK OF FOR

CHECK ONE :
7 Tni, is an initial' Statement of Organization FORM STATE%lE'J T

nJ This is 3n amended' Statement of Organization DR-1

(Rev. 0112006)
OF
OPGANIZ,4,TION
'An init , uf Statement of organization must oe Sled within 10 days sf the commtttt : c ring c tnhuftons, For O _ ice Use Only
rr,ak;ng cxpero'r!.ure . or incurring indenfedne .ss exceeding :7~0. Amen~7menfs
must , in 30 days of Gomm. 4~
a change . Per,a16"a may ba rrttposed fcrlate-fi/ed Statements of Orgsnizstion . A candidate tnMIJ an open
comnuaeo Mir Exceeds 5750 in activity far anctnar oli shat; filer »thin 10 days either a new cramonded Index.a d
D.R-1 disclosing inform,3lion conceming the campaign for the now olca sought Audited -
Pain Sprague for Taylor Coun ty Treasurer Committee
ComPtiter

COMMITTEE NAME 1 :, (A candidate's committee mu&t Include the candidate's last name in the name of the committee.)

IMPORTANT : Indicatetype of committee you are reporting for,

( 1 )St atowide/Legislative/Judge Standing for Retention Candidate ( 2 )Statewide PAC ( 3 )State Party (4 )County Central Committee
j S )County Candidate ( 6 )City Candidate ( 7 )School Board or Other Political Subdivision Candidate ( 8 )County PAC ( 9 )City PAC
( 10 )School Board or Other Political Subdivision PAC ( 11 ) Local Ballot Issue (including committee involved In multiple clty1co unty ballot issue:
:)
COMMITTEE TREASURER (mandatory for all committees
.) COMMITTEE CHAIR (mandatory except tar a candidate's committee)
"dame Name . .
L~a~r ;_ a Herry
i P:lailing Adoress 1 J.

City ; State- L' r Z Code City, Slats - ' Zip Code L :.

Fe4l: ord IA. 5U,533
Phone (712, ) 52 ,1- 1 131 Phone

F-ti1ail __ &-Moil
INDICATE ROSE OF COMMITTEE - Check On3 Box Advorab3 forragainst candidates) Advocate for ballet issue(s)
Comment or description :
All Candidmos Enter:
0
Advpcole aaain,l ballot issud(s)
County/Local Candidates and Local Ballot Committee-4 Enter:
OfireScugnt:C ount-y Treasurer _-
Countv:
,
Ta r l o r
Politir~l P9r; ( f ,opli :;ablej Repll b-11 C sn - - (If active m multiple ballet i, :ue elections, attach hst of ca:ntir:~

Date of Election : --L1.0- j}

District :
) 1n
Y~tar Stan7in~7 for Ele_lion : _ 2006
Bank Account NamF ! 1 ;_andatename lx Addre,s cr,earnt Entity [PA;c .lf ap -~ Ip1
L ! AM liate, gt_Sponsor
Pam Sprague
Name of Financial ln';Iitution/type of Account J . I. Mailing Addre~ l .,
407 Grant Street
Voiling AddrFSS city ! State ! L Zip

Bedford IA 50333
City
t state J. ! '7i p
Phone (1 12 1 --5-2-4 , ,

&-Moil

STA7EMENT OF AFFIRMATION: By filing this document the committee affirms the following :

1 . TI- e corrlmittee and all persons connectco with'.he committee understand that they are :utacct to the laws in Iowa Code chapters 68A and 656 aria the ai c
-ul,>4 r, Cnspter ;~51 of the Iowa Aomini t atr,e Code .
2 That Iowa 5oce ,eel on 6FA.402 and rule 351 -4 9 require In) filing of disclosure rep.lrt5 ano Trial the failure ;o flit tne,e repom, on cr before :he requirr>c c,~., 7'_oi~
SuCr>rls Te c3nic,,1Jle Jr rhairper .,o .'" (,in the C35e of Committees Mar lhan .1 CandIcatr)'S committee) to the out~mam 85:SesSment of 3 Ck,ll penalty era the r
impn,,ticn ;rf orr,er :rimlnal and ,,i :il sanctlon~ .
' . That IoYn C :de Becton e8A.405 ano rules 251---4 .38 thrai 4 43 require the placement or the words'paid for by' and the nartiC of the ccmmLteF on all po .,c:
malenic exGi :pl fir tna,e items vxempted by s6'[ute or rule A ccrrlmifaa that ".vlShf^; to regi5tor a committee name for purpoa .), of using the 4noncf 'poid for r;' it
CIO" no! intend to cross the $760 fillnq Ihre held shall file the Form OR-SF.A form .
.503 anJ rule : 351 -.t .44 through n.52 prchib .tthe receipt of cerparate conirioutlons by 311 commlt;ees (-rcpt for :tate"Wice -'no loci =3 : o :
a. Tirit iov.7 'o...^'e :crion 69A
,sue cAc-

5 A carnllrat . and a candld0in` committee may only expend campaign (une:: 8s permitted by lo%ra code Sections e8A,301 inrougn 68A ?73 snd nJlo 351-1 ;5
". That
lee nom- will crnlinur to file drerlosure rnports until all act~ . "Iq, had reared . r_ommirW9 funds &pent, debts ro :onrwd, enr9 a linai mpoA and c. 5t .1temont ci

a c i nu