DC T-100F 10 :4r SEf=UPITY HH(!

f 7112 '277 655S

FOR INSTRUCTIONS, SEE BACK OF FO M

CHECK ONE : FORM STATEMEI ,il

This is an initial' Statement of Organization DR-1 OF

[] This is an amended' Statement of Organization (Rtv 0112003) ORGAN Z-ATIVtI

"/an initial Statement of Org9nizstlon must be filed wdhin t0 daysvfftts.4gmm r'~`tee s accepting cc Epr quite 1~y e_Ony
making cxpendi:ures, or incurring inoebteoness e.<ceeernq 37 ., Comet . '
a change . Penalties rr3y De imposeo for lilt-files Statements of Organization A candidate tvith an open In;e'ed
cornmtttL, e !natexceeds : "7-50 in activity for another al shat! file u-nhl,n 10 days either i ne :v or amenoea Audited
pF-i crsc;esing infomlatron concerning 'he c3mpa,gn for the nt." ~^: office sought. CCMP`tar

COMMITTEE NAME , (A candidates conin11rree n;u 1 include the candidates list home in the 11,311 -10 11' the

League of Women voters Ballot Issue

reporting-for
IMPbRTANT Indicate type of committee you arc
1 )StatewidelLogislativo!Judgo Standing for Retention Candidate ( 2 )Statewide PAC ( 3 )State Party (4 )County Central Committee
( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or Other Political Subdivision Candidate ( 8 )County PAC ( 9 )City PAC
( 10 )School Board or Other Pol itical Subdivision PAC (11 ) Local Ballot Issus(Including committee involved in multiple city)county ballot jS~uet~l

COMMITTEE TREASURER (mandatory for all committee;) COMMITTEE CHAIR (mandatory except for a candidate 's com mittee )
P salt - ri . me ,
16teve come ~ Sire Miethke
4- i
~U ta VS23 r nUft 4 I 1~~ Ead ow Lane
.7
~N
16 Sit 5,1,9 6R1 t~~ Sta ' 'p de ,
SIOUX ~Ity, IA ~f ~~

Phone (712 )27 Phone l 712 ) 2 39-4437

e-rnaa scorrit_,tr55)snbonline .com I I o4.9a11

INDICATEPURPOSE OF COMMITTEE - ChcCk One Box Advocate for/against candidate (s) P,dvoca e for ballot i:,SuuR,)
_ Comment or de-,criptton : Against direct election of Mayor Pdvo eat e ai3ain.;t ballot Issuo( :~)
All Candidates Enter : County/Local Candidates andLocal Ballot Committees Enter :
Office sought :
County Wo_od bury
Foillical Party (if applicable) (If active ill multiple ballot tSSuu CICctiorv; att :l "'.ri list of rta :rlu: :i

Distncl Dote of Saeuon Nov 7 . 2006

Year Standing for Ele:::ion
j3nnk Account Namo
Candidate name K Addre ~,!-, or Parr~ilt- Entity- trAG ; . it : epi L90 le
Affiliate,  . or Saon~ or

League of 'homer Voters Ballot Issue

Nam? of Financial InsftutioNtype of Account 1 1 malllng Af,di'es5

Security Natio n a l Bank ! checking account

f .1ailing Addrc,- City . . is tLl1,: . .. ap
601 Pier ce Street

City Stale Zip ..

Phone^
Sioux City Iowa 51101

e-Mail _

STATEMENT OF AFFIRMATION : By filing this document the committee affirm

; the following :

The cemmitfrc .3ri : all persons connected witn tilt cornmMee undersl3nd !tai they a2 sUOICr,I to ti law ; it I :wa Code ctapler; GFra 1 n,J Qe uri ; J

rules in Cnapter 351 of Inc I,iwa Adminirtrafive Code

That lo".va Code section 68A .402 and rule-24.1-4 9 Fe-'are the faun; of disc :csure reports ano tnat the r3uui : to file ',like reams on or cefore me no,q .rir,`d a .,a a ~iw .
°ublC~t ; thn r_3ndidale or chairperson (in thr, ,_.isc o! comrr ;ttees ether !r1Jil B :..1nUiilatc"'s :ommillee ; to the aulorlalic VrSe;Pn1Nr l Cf a civil penalty ano
mpcsaion of pine: cr m riW and civil sanctions

That Code sr:teem f raA_a05 and rule ; 351 --4 38 throw .1h e 42 requirene placement cr inc woros paid for by" and the name cr th,, comniacc on all poi t . :a'
rr]1l :rNIS except ic - Inot.e Items Cxurripled by st3tvte 3r rule A rnmm.itl4-" ih .A wisnes to reoister a c9mmi namC f^,f purposes :f using the s .nor'er - pairl fir b",' 1117
does not ~rter l tc _r ,am ii-, c ;7 ;rj filing thre;nald Srmii flE- the Form DR-CFA term

4 Tnx i]v " a Co7n ~e , 'rn E,tiA =0' and r ;lca 35" -1 -1 4 1 4 = r .rnbitU.i r" n:-cipl of corpcril? conlribu?ion°. hi ill cxr._ l for ,ate :v'" . an'
. . ",ue PACs .

A :dn-`.dale an .l 0 :-an,;ilate'S Cnm111it',r?<' ill .]f ,irt :( uxocr' :. canr~a .3r aS fti'Mitir.- d by I::.vJ ccda section ; 6FA -101 ii.iA .30? 3r : ru .2
Thdt !Iv : =miaee v:ili cr_nunue to r,lc, i1, ; .:l,^.,ore spins unit uii i!, ccmm-nee tuna°_ s eer i ; :.,,olvi;o orv: a final ra= .on :r :j a
rri xotuli, :n tDR-is has Been %ed

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