Disclosure Summary Pa: T%Cler'
Disclosure Summary Pa: T%Cler'
Disclosure Summary Pa: T%Cler'
DISCLOSURE SUMMARY PA
Routine Penalties Due For Late Filed Reports Range from $20 to $800
I AM FILING A t%CLer' 4 or, 3 Il ZC10> REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR.
(report date) Indicate one
0 Check if this is final (termination) report and attach Notice of Dissolution Form DR-3. County & Local Committees, enter County in
which Election is held
(You must continue to file reports until a Notice of Dissolution is filed.)
CASH ON HAND at the end of this reporting period (if final report, balance must ti t 8,oq . i -zr
be zero) (Attach DR-3) . . . . . . .. . . . . . ... .. . . . .. . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . . . . . . .. . . . . . .. . .. . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . .$.
ors 4C-4c-4
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 66B.32A(6), Iowa Code, 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 PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT +1 IF FOR
RECEIVED (ifapplicable) TO CANDIDATE' RECEIVED FUND-
(MMIDDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
cK#,2yg3
41 .32 .6? sw r1 ~ ;-t om
D e3 wt- o, vtr-s . 31'3
ID# M Lcen
C,- U.eh I , n~ .
27of tL-w"'er".i
CK#
_ I?~(o l ~? p5 ~,,,, ~3 t U
n e~ t ZS~ .vc)
CK# .3 Z4 /tc~ilt ~.
7
/v . t V . cal
ID# Dry n k c
CK# D C~J~s w~ ~~uv n cJY+-c .Z S, U,:1
y ~h G
ID#
/0 . lL " tv t
CK# l36~i f,34y/ r!/(fir /l~r~-t ~,S~ . Uv
Q~ ~Y! c'/ r, is
&-u
ID# ~I I w, .vA Si ever5
I Of AVI
CK#
0 07 , TO,
ID , L - vl
ID# Jet H eW I- a-a )~ AceQ'rVV
/ 7l E
cK#
Mvl 4~e i:-.c SID3r7
0.s- 5
ID#
Oe,br4- r J ..erc," Phll/~Ps
7j4 C :4,--J s v3 i y
ID#
CK# ~
30 jLl-e- o ~-
arlov-li , r
ID# FAed
X
lv " 7., vl
CK# It z-d -y s
1J-" h-up wti .L fi~ 3 I
SUB-TOTAL
/74 It-4
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL . ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, 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 PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
RECEIVED (ifapplicable) TO CANDIDATE' RECEIVED FUND-
(MMIDD/YR) AND PAC CHECK (If applicable) RAISER
NUMBER INCOME
ID* r6/
~Lt v/
$ 'r
CK#
u4 <-,
ID#
e-
CK# er l c
c~ ..e5 h-t t71 KAd ,
CK# l5g75
.
~~
tiw ILS~
atc) ~. -c /001
,
J H-a,LrR _
wI
CK# U! Sw
r ID#
I n4 pl a330'
!) ~ ~ . r'i1
CK#
~ S la'V1. v ~ viJ S
SUB-TOTAL
Disclosure law requires candidate committees to disclose the relationship or anyrelative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms packet .). If surname of conhibutor is the same as candidate, but there is no Page
familial relationship, enter 'not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Foam SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN
(Rev. W97) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Sta)ement of Organization) AMENDING FORM
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . ALIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements forsoliciting contributions or
forany commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
t,v
ID#
?v 1-~'~ n0ot. -e
CK#
/1~ i~-~-ov~ ;a3 f y
ID#
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, butthere is no Page Of
familial relationship, enter 'not applicable' in the relationship column. (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev- 06197) RECEIPTS
(Including candidate's personal funds)
a CHECK THIS BOX IF
COMMITT E NAME (Must be same n Statement of Organization) AMENDING FORM
JfiC s
v
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION : Section 66B.32A(6), Iowa Code, 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 PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
w
ID#
, "f. SZ~Li
ID# e4r~ c IIG 4,!leti
ll~a Lv .v i CK# ~ ZZ ~~ h o .~ -c loo, v~
ID#
~bb e1eS-h-e>^
!l 2 U( ~'O 'SOCK , w
CK#
L~o wc-S, o 5-D U)
ID#
pa-G ;71le-lk Gfi~ 4 ewl
&G t r1 ~S . ok
ID#
4~97/
11-11
Y~V,4 14
n -e
CK#
1L 57,E 3 i
ID# J,
ID# ztn t
To a n'
SUB-TOTAL
Disclosure law requires candidate comma to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page __4 of
familial relationship, enter'not applicable' in the relationship column . (for uIs A)
For Instructions, See Back of Form SCHEDULE
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEES LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, 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 PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT +1 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
11- ~
,u ID#
ae4/jA ?- Aju. ,irjt2 K~sIvfv
CK# i-7 16'
t" .v- r I
ID# r _
CK#
q lvl ~
ID#
S -7~`l -~ N't"vv k-c3 ri
CK#
ID# any h
.u +
3~tk fr> r v,-c1
CK#
1~ 'li t SD3 t
SUB-TOTAL
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page of
familial relationship, enter 'not applicable' in the relationship column. (for Schedule A)
For Instructions, See Back of Fonn SCHEDULE
STATE CANDIDII
- Td NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEES LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECKNUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, 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 PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID# "yZti I ~~.~ hC'
J l -~ 1
L5 /~doGo+c'S ~ 5ti3!
ID#
Re- n
O -C
,e lit v f it. r_ S _ L(
ID# 1v ~lh~r f-,43~f,~/ J~ " w-lox
6 711 t/
01 CK# , _ I 4 D~'1-2
lh
ID#
~v Joss L 4 ~l
0/ CK#
ID#
Yrti
ID# U.r~ CtceA k, a h ~' l3 f 7-
Disclosure lawrequires candidate comma to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to thethird degree of consanguinity (blood relatives) and affinfly (relatives 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 applicable' in the relationship column .
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 06/97) RECEIPTS
(Including candidate's personal funds)
Q/ CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
STATE CANDIDATES NOTE: IF ACONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECKNUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B .32A(6), Iowa Code, 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 PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
CKS
2- 2- ZU
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL
Disclosure lawrequires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forma packet .). If surname of contributor is the same as candidate, but there is no
familial relationship, enter 'not applicable' In the relationship column .
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
1 ` -C--c
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (ifapplicable) (Disbursement) WAS MADE
(MMIDDIYR) AND PAC
CHECK
NUMBER
ID# oc~ S-(u =~n S
at 3S4 i
.=r .5~rs~~l $ 2)1=Oe-)
CK# Vkl
I ID . a"` 5'7~ 5 r L
CK#
D~
S t 1 t .c .. . 10 "'
DjS ~` ;~rt5
I D# L ?L. v
. tJ r ; n .1
I L rz
CK# pJ~ t,~
a rti . S~3rf
ID#
~, it .
Lt"" v" s rtn ad
cK#Ses
. cum ~ercr^
ID# A4, td WX1 f{-°- S V CSI (,0
. c1u
J~d ;Lf .Ul
CK# ~i
L ~a o
CK# I-D 5
SUB-TOTAL $ /3~SZ p d
/I l, kt
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (If applicable) (Disbursement) WAS MADE
(MM/DDIYR) AND PAC
CHECK _ _
NUMBER
14 lt e. S
3 i ~-
1D#
-(ZC
~J~LS "ars~~f
CK#
ID#
io, 160-,
CK# ~-~-
Sv3 +~
ID# i1u&c vt1
(,ut c, v. xv,S
cK# S'Z '~ rk~ o3t(
. ID#
t 1 L .U
1 j,(~ cc -~c f clS C.& rc~. .- t+~
CPW
la , 5v3~ y s - L
WP"--t 0 17-0
TOTAL (N last page of this schedule) $
Page - 2- of :2 41
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
B MONETARY
EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT (Rev. =97) EXPENDITURES
STATE PAC COMMITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE 01 CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.
CK#
01 ID#
L
cK# 2
0..s 4y7a rn "S .
ID# pvgynS Tcv p~'~7uS~- o
Lln I v.~rs ~
CK# 53(6
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL
(for Schedule B)
FOR INSTRUCTIONS, SEE B&4CK OF FORM SCHEDULE
B MONETARY
EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . =97) EXPENDITURES
STATE PAC COMMITTEES: NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE 0 CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.
COMMITTA.g NAME
_(Must be asatement of Organi ion)
7A0 I
b<- 0 b
iovi t~wl
ID#
CK#
I D#
CK#
I D#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL
Purchases of certain campaign property costing 5500 or more must also be inventoried on Schedule H. (Refer to Schedule H Instructions.)
Expenditures to persons/entities providing consulting, advertising, fund-raising, polfing, 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 person/entity on behalf of the candidate's committee . (Refer to
Schedule G Instructions and Iowa Code 58.8(3)(1).)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
D INCURRED
coM~ NAME (Must be saw as an nWWon) (Rev . 08198 INDEBTEDNESS
C r P .~, KA-, ~
~2 - 3 - U~
I? 39 CJ ra-, cY .7
DI-4:3 K40 1 wA 4 ' ~ S13)6
SUB-TOTAL $
'If actual figure is unknown, show "estimated' beside the figure. par. / of
(for Schedule D)