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Berryhill Mel - 1691 - Scanned
Berryhill Mel - 1691 - Scanned
712 - 338-9733 p .4
I
FOR INSTRUCTIONS, SEE BACK OF FORM FORM
DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
(Rev. D720D4) REPORT
COMMITTEE NAME (Must be same as on Statement of Orgraniza5o,!L e
2,4 ~- /?c,~
~ For Office Use Only
Comm .
Looned In
IMPORTANT.' Indicate by it type of committee you are reporting for. C7_J
( . .kludge Standing for Retention Candidate (
1 )StatewidelLegislativ- 2 )State PAC ( 3 )State Party scanned
{ 4 )County Central Committee-( 5 )CountyrZandidate ( 6 )City Candidate ( 7 )School Board or Other Political Computer
Subdivision Candidate ( e )County PAC, (9w PAC ( 10 )School Board or Other Political Subdivision PAC
11 ) Local Ballot Issue Audited
[] Check if this is final (termination) report and attach Notice of Dissolution Form DR-3- County a Local CommitLes, enter County in
which Election is held
(You must continue to file reports until a DR-3 is filed .)
1bq1
For Ornee Use Only
Comm . R _
Looped In
1tJPOnoi2tc try type o1 committee you am reporting fo-
( I )StatevadefLegislatrvraJudge Standing for RetLntion Candidate ( 1 ) tate PAC 1 3 )State Party
( 4 )County C--ntrat Committee-( 5 )County Candidate ( 6 )City Candidate (7 )S&ool Board or Other Politica) Computer
Sabdivision Candidate ( 9 )County PAC ( 9 )City PAC ( 10 )Srhoo[Soard or Other Political Subdivision PAC
i 7? ) Loc21 Ba llot Issue Audited
CH C2 Sought
I-
Late reports are subject to possib)
Cher-k it this is final (termination) report and attach Notice of Dissolution Form DR-3
(You must continue to file reports until a DR-3 is filed )
0
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
NOTE ANY PERSON, OTHER THAN AN INDMDUAL, THAT CONTRIBUTES MORE THAN 3750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBIUTIES AND SHOULD IMMEDIATELY CONTACT THE BOARD.
CAUTION: Section 68B.32A(6), prohibits the use of information copied from reports and stalements for soliciting contributions or for any
Commercial purpose by any person other than statutory political Committees.
DATE PAC ID NUMBER NAME AND ACDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND
(MM/DD/YR) AND PAC CHECK (if applicable) RAISE=R
NUMBER INCOME
ID#
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CK#
ID#
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Cr U Pert l
CleY
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ID#
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J SUB-TOTAL
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLTTICAL ACT10N COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THF PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF IO NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD .
NOTF- ANY PERSON, OTHER THAN AN INDNIDUAL THAT CONTRIBUTES MORE THAN $150 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBIUT IES AND SHOULD IMMEDIATELY CONTACT THE BOARD.
CAUTION: Section 68B .32A(6), prohibits the use of information copied from reports and statements for soliciting contributions or for any
commercial purpose by any person other than statutory political committees.
DATE I PACID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RPIATIONSHIP AMOUNT q IF FOR '
RECEIVED (if applicable) TO CANDIDATE' RECENED FUND-
(MM/DD/YR) ! AND PAC CHECK Cifapplicable) RAISER
NUMBER INCOME
ID#
CK#
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' Disclosure law requires candidate committees to disclose the relabonstsp of arty relative makhtg a contribution to the
mmmittc±e Relationship must be shown to the third degree of consanguinity (blood relatives) and amity (relatives by ~
marriage) . If surname of contributor is the same as candidate, but there is no Page -11f
familial relationship, enter'not applicable' in the relationship Column_ (for Schedule
A)
Oct 31 06 08 :52p Mel Berr~jhill 712-338-9733 p .4
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SUB-TOTAL
Purchases of certain campaign property costing $50C or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to personstenGUes providing corsulling, adverbsinc, fund-raising, polling managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the persoNentity on behalf of the candidate's cummittee. (Refer to
Schedule G instructions and Iowa Code 68A .402(3)(i) .) _
(for Schedule B)
Oct 31 06 08 :53p Mel Herryhill 712 - 338-9733 p.
MONETARY
EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT (Rev,,0
07Jn3) FXPFNDrTURES I
STATE PAC COMMITTEES : NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATFVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH FXPFNDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
LIHICS & CAMPAIGN DISCLOSURE BOARD
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OIL.
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SUB-TOTAL
Purchases of certain campaign property cosLng $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
E-xpendilures to personslentities providing consulting, adverbsmg, fund-raising, polling_, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date ofeach type of expenditure made by the persoNentity on behalf of the candidate's committee (Refer to
Schedule G instructions and Iowa Code 68A.402(3)(i) .) - -
(for Schedule B)
Cl c:t, 31 (1E; (18 :93P MPl Herryhill
712 - 338-9733
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SUB-TOTAI-
573 ?/ 7,41
53 Y7 ~/5
l ?ao!~, of _/--
- It actual fICLTE is unknown, show'esiimated' besidathe ` .U,E
(for Schedule D)
D t- 'c t' S
'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page / 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 sumarne of contributor is the same as candidate, but there is no
familial relationship, enter "not applicable" in the relationship column .