You are on page 1of 1

File with:

Iowa Ethics and Campaign


Disclosure Board IIA ETHICS AND
510 E. 1r, Ste.1A CAMPAICH Mw"?_C5 1JRE
Des Moines, Iowa 50319 FOR INSTRUCTIONS, SEE BACK OF FORM
Fax 515-281-4073 DISCLOSURPPUNVIARYIPAGM,
COMMITTEE NAME (Must be same as on Statement of Organization)
FORM .
vcb DR-2 DISCLOSURE
IMPORTANT: Indicate by # typo of committee you are reporting for: L-2mi (Rev . 12/2005) REPORT
( t )Statewide/LogislativeiJudge Standing for Retention Candidate ( 2, )State PAC ( 3 )State Party
( a )County Control Cornmthoo ( 6 )County Candidate ( 8 )City Candidate (7 )School Board Of Other For Office Uso OnN
Political Subdivision Candidete ( $ )County PAC ( 9 )City PAC ( 10 )School Board or Other Political
Corm, #
Logged In GfiT
Candidate Name Political Party (If applicable)
Scanned
Computer -
Office Sought District (If Senate or House)
Audited
,rrnw~ -
Late reports am subject to possible civil and criminal penalties. Pursuant to Iowa Code section 68B.32A(7) the candidate, for a candidate's committee,
and the qWrpe",,C any other type of committee, Is the individual responsible for filing timely and accurate reports.

n 4Flo'. 2-V(/.
TELEPHONE gk DATE SIONF.A

OaHEcK IF AmeimwTo RF- .PmDATED Local Committee&, enter Data of Election

0 Chad If this Is final (termination) report and attach Notice of Dissolution Forth OR-3 .
County 3 Local Committees, enter County In
(You must continue to file reports until a DR-3 is filed.)
which Election In held

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period, (Total of all funds held by the
committee . This amount MUST be the same as-the cash on hand at the end
of the last reporting period or must be zero Nthis is first report filed .) . . . ., . ., . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....$

ADDTOTAL MONEY TAKEN IN THIS PERIOD

Schedule A: Cash Contributions total (Attach Schedule A) ('also see in-kind below), . . ., . . .  . ., . . . . . .

Schedule F: Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . ..... . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,

Schedule H: Total Sale$ of Campaign Property (Attach Schedule H) .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . ., . .

SUB-TOTAt, . . . . . . . . . . . . . . . .. . .. . . .5
SUBTRACT TOTAL MONEY SPENTTHIS PERIOD

Schedule B: Expenditures total (Attach Schedule B) ("aloe see debts and loans below) . . . . . . . . . . . . . . . . . .

Schedule F: Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . ., . . ... .. . . .. . . ., ., ., . . . . . ., . . . . . ., . . . . . . . . .

CASH ON HAND at the end of this reporting perlod (If final report batanog muAbo zero). ...... . . . ... . . . . . . . . . . . . . . . . . . . . . .$ Z- IND
"UNPAID BILLS (From Schedule D - Attach Schedule D) . ... . . . . . ... . . . . . . . . ., . . ., . . . .  , . . . . . . . . ... . .. . . ..... .. . . . . . . . ., . ., ., . . . ., . . .$ 0
'1N KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) ., . . . . . . . . . . . . . . ., . . . . . . . . . . . .. . ., . . ., . . . .. ... . . . . . . . . . . . . . . . . . . . . . . .$
"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . ., .... . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

CONSULTANT BREAKDOWN (Schedule G Attached?) -YES _ZNO


CA AN CMIMMQNLY:

VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $


STATE COMAIUTTEES: Submit 2 reconciled campaign account bank statement In January of each your .

You might also like