FPOI •t : F I PST BAPTIST CHURCH-CL I t 1TOt 1 PHOrIE HO . : 3192424773 JIUN .

12 -1007 09 :O'SA,M P1

FOR INSTRUCTIONS, SEE BACK OF FORM

© ( am filing this form to use the shorter 'paid for by' attribution, The committee well
I I Rese t Form

not be
FORM
DR-SFA
(Rev . 01/2006)
Statement of
Organization
crossing the $750 threshold .' "Paid For By"

"If the committee crosses the threshold, an initial DR-1 Statement of Organization must be filed within 10 days For Office Utte Only
of The committee's accepting contributions, making expenditures, or incurring indebtedness exceeding $750. In Comm . s
addition, the committee will be required to file campaign disclosure reports Indexed
Audited
Computer

J COMMITTEE NAME 1 .L (A candidate's committee must include the candidate's last name In the name of the committee .)
Citizens for Joshua Meyer
IMPORTANT: Indicate type of committee you are registering for 1 c
( 1 )StatewidelleglalativelJudge Standing for Retention Candidate (2 )Sfatewide PAC (3 )Slat . Party (4 )County Central Committee
(5 )County Candidate (S )City Candidate ( 7 )School Board or Other Political Subdivision Candidate (C )County PAC (9 )CIty PAC
I (10]SchoolBoard or Other Political SubdivisionPAC(111 Local Ballot Issue (Including committee involved Inmultiplecity/countyballot Issues)

COMMITTEE TREASURER (mandatory for all committees) CANDIDATE or COMMITTEE CHAIR (mandatory except for a
candidate's committee)
Name 1 4 Name 1 J.
Jocelyn Meyer Joshua Mcycr
Mailing Addres .4 1 1 Mailing Address 1 1

6512 2nd Ave . S. 6531,12 2nd Ave • 5,
Gty, State 1 1 Zip Code 1 1 City, State 1 1 Zip Code 1 1
Clinton . L4 5273 2 C1toil LA 52732

Phone ( ;03 ) .4 .-5vu

Phone (563 ) 242-5912

e Mail J~lynschsdaneyer(a) yattoo .com ,Mail riscspyouth otmail ..xtm

INDICATE PURPOSE OF COMMITTEE - Check One Box 10 Advocate for/against candidate(s) D Advocate for ballot issues)
Comment or description : [a Advocate against ballot issue(s)

All Candidates E1dar. County/Local Candidates and Local Ballot CommlUseo Enter
Office Sought Mayor of Clinton, IA
County _ Clinton
Political Party (Y applicable) (If active in multiple ballot issue elections, attach list of counties
Diwwia:
Date of Election : November 6, 2007
i Year Standing for Election : tan

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

persons connected with Ire committee undemtand that they are subject to the laws in Iowa Coda chapters 6815 and 680 and the administrative
1 . The committee and all
rues in Chapter 351 of Me Iowa Administrative Code.
2. That Iowa Code section 68A.405 and rules 351 -4 .38 through 443 require the placement of the words *paid for by and the name of the committee on all p iiticai
materials except for those items exempted by swtute or rule .
3 That Iowa Code section 68A 503 and rules 351-4 .44 through 4 .52 prohibit the receipt of corporate conbibutions by all committees except for statewide and tocai oaliot
,-we PACs
4 That i' me committee excooda $750 in campaign activity, a DR-1 Stst merit of OrganIzaUon must be filed within 10 days and the committee is required to file campaign
dWdoeure reports .

bate Iprwd

odt Signed

:9 RV Z I Nflf tool
9 I

0 g 38nSo Sa1N H IVdWVO