Professional Documents
Culture Documents
r DR-2 DISCLOSURE
DISCLOSURE SUiviMARY PAGE (Rev. 01/98) REPORT
-z -~ a
SIGNATURE OF T EASURER (or person filing this report) TELEPHONE DATE SIGNED
Routine Penalties Due For Late Filed Reports Range from $20 to $800
CASH ON HAND at the end of this reporting period (if final report, balance must ,
be zero) (Attach DR-3) . ..... .. ... .. ..... .. .. ......... ..... . .... . . ....... ..... .. .. .. .. ..................... .. ..... ......... .. . . ..$ 1-7
UNPAID BILLS (From Schedule D - Attach Schedule D) .. .. .. ... .. ..... .. .. .. .. .. .. .......... ..... .. .. .... .....---.----- ..$
IN KIND CONTRIBUTIONS (From Schedule E . Attach Schedule E) .. . . .. .. .. .. ... .. ... .. ... .. .. .. .. .. ...... .... .. ..! $ ~3
OUTSTANDING LOANS (From Schedule F - Attach Schedule F) .. .. . . .. .. .. .. .. ... ..... ....... .. .. .. .. .. .. .. .. .. .. ..$
CANDIDATE COMMITTEES ONLY:
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
1~
Patq 4 0 k-rA C mP I9
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 . 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 .
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 For- SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 02/96) RECEIPTS
(Including candidate's personal funds)
011 CHECK THIS BOX IF
COMMITTF,) NAME (Must be same as on Statement of Organization) ,L AMENDING FORM
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 .
u /V To 1~ z73
ID#
PhCNARD K Qk 0AW-V Ms'o135R
I CK# '7~~R Al 1
~~
?H 5T
6-7- 7
11VIA PqP-, x
me vl5 ks r1 4&
ID#
,e .9,
~) II Woo di-AIV ~tl T
o . C
CK# -
A
ID#
.~ . 0 R 00 90M q - . PP, f lT
DI CK# $o~ P ~IN~ ai-vo A11A
QL)/V ro JA 5,
ID#
AAIN 1Y)5y9P\
'D 6Ld0 NIA
h CK# x,110 02 Pb'k6Nlll1&
Q~
GLlN'o ~A ev273a
ID# gd eq~Orri&AL WO-AK
A kS~i~1 PIE
CK# /7W ~;V'0 AVM ~T~ All#
oLl N L )L Z012&5
ID# o P T'oM&Tie) e A,,ndiA Ww
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)
v . . . . .r, . . .. .. . . .. . . .rr v .. .. .. .. . . .. v . . v . . .r J\rrlCUV6C
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN
(Rev . O6M7) RECEIPTS
( r~nridstb's poo" hinds)
O CHECK THIS BOX IF
COMMITTEE NAME (Must be wale as on Statement of Organization) AMENDING FORM
Pal, M r GAm'PA1~
STATE CANDIDATES NOTE: IF A CONTR19UTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE. UST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A UST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD .
CAUTION : Section 688 .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 10 NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (H applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (it applicable) RAISER
NUMBER
INCOME
ID#
MRs H . J . PRATr .
Q/ CK# 6o(o P&Pls' rn~ &L~D $ 0 G'D
n l~J~
r:-i-1 To Z'y3
ID# ~l 144 WfdkAr XrrWRK
i~ 3
41 CK# poi 7,717 N. CAP, r0L -~, i AID ,--4 ti)Tc4l0
I~W To Dd . ~ 40),
62
PAC
hAe
ID#
ID# &0& ,7
rcw'p y]5Air>1 PAL K
CK# (0/7-150 wt sr© v~ ~J ~ v~ y
W~i' D~~ IYIo~ ' ~A
ro~~
IV)~ '
ID#
1eVfAgN F~vND r
rA D5rnockA I PAQTy
MA aQ?
I" PV
CK#
5t 1 Ibilk
uk w~
a .krol _ ifs 50 ~2 I
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
O
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE 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 .
D~ 1VOIA~A
t
cK# ~4
G lO'T~
~z7/a
ID# rNi~~ ~ com~~~r P
I
r w ~-
_4 . LD()1) ,~- r :5; r - o v~c~~' ~2 mle5
CK#
C4*1c~71 Die, -_e~ mcvn'l,6~7
/- /A ~M-A uv A~~R ss
ID#
A/1 16, /
n1 /1 V
A DV PkTI I'LL
CK#
I
~clr7 kj1VroA' 1A 5z
ID# C' LLt1 LA12
01 /,7 . G~ ~1.L~ ~~lG~l'
P D. ~ ~o~'y1
CK#
G : IoI
ID# o, ,!, liLGC
'~' r Jl9 Of
P. o oi )~
CK# o
jo q
ID# j,!~G~.tkL0
CK#
01tw
,~ ID# go 31o A6 aAll -r !!~, -r Cl ft R~
TG Vo ~, k~
1 '
cK# 6kvr r 6M)
cu n, ~aA~A
ID# . e15_uVL,AR
V,4
LpI,z/©1 cep- p~/orc-~~
CK# P.o . OCR -A IG&
SUB-TOTAL $
'? tick
C ~~ S Yl
TOTAL (if last page of this schedule) $
Expenditures to persons/entities providing consulting, advertising, 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 person/entity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(i).)
Page
~~~~(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
IoM U
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
CK# 0 . ~~ )C6177
$. 1~
~ - 6r__ ,0A )Z
IT
3&16111 ID#
ol~', s ZD ~ti~ ~7)S)4C
CK#
o -
G l.) l\r-rO lU IA
ID#
l I ~, y , ~ Zl-1,~LA k C2~LZ- ft~A'25
CK# P .(-). J??0~4- 10647
C ~~IQ 'R~ i~~ I
`~ 11110_1 ID#
av4A
olp_pAp -R~PioI7 iA
#
ID#
i6~l6l01 0,y,CVZ~VVAR
R 0 10 ~~
A
ID# ~Wp
~1Wc p AT 1L Q 0,x,4 1
I Dl C 7/4/1,
r, ID
K# !~
m
~I -F ~o
10
*
11
l
l ID#
-boo aj(~ "
I
NuAOa+,)
11\, ~l f) ~II~ 5
SUB-TOTAL $ ~~
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to persons/entities providing consulting, advertising, 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 person/entity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(1).)
Page
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
CK#
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL $
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to persons/entities providing consulting, advertising, 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 person/entity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 56.6(3)(i).)
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E I IN KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev . 02/96) CONTRIBUTIONS
~ ~ *A aAW1611
PaN -~--q 17t,7"
p CHECK THIS BOX IF
AMENDING FORM
.4 . ~ z?
0
SUB-TOTAL $
PART I - MONETARY LOANS RECEIVED THIS REPORTING PERIOD PART II - MONETARY LOAN REPAYMENTS MADE_ THIS REPORTING PERIOD
(Original source of loan, such as a bank, must be shown if a third party is (Loans forgiven must be reported on Schedule E -- In-kind Contributions .)
involved. Include loans from candidate's personal funds .)
RELATIONSHIP AMOUNT DATE PAID NAME AND ADDRESS OF LENDER RELATIONSHIP ' AMOUNT
DATE NAME AND ADDRESS OF LENDER
RECEIVED (include Endorser's Name, If Applicable) TO CANDIDATE OF LOAN (MM/DDIYR) (Include Endorser's Name, If Applicable) TO CANDIDATE' REPAID
(If Applicable") (If Applicable)
(MM/DD/YR) $
Po~Ly VKTA $
~~ sr
&o4
41 &D N'TolV A
'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 familial
relationship, enter "not applicable" in the relationship column when it applies .
Page ) of
(for Schedule F)