Beruflich Dokumente
Kultur Dokumente
~ e V-
Late reports are subject to
e aV'_ VVI , possible civil and criminal
OfficeSought wesf4v'~ Cn District (if Senate or House) penalties .
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SIGNATURE OF PERSON FILING REPOR TELEPHONE DATE SIGNED
/0_"~/
I AM FILING A - REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate by # e
Local Committees, enter Date of Election
CHECK IF AMENDMENT TO REPORT DATED
STATE CANDIDATE 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 .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT v IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK
~,
(if applicable) RAISER
NUMBER INCOME
pa stD 3 y
$
ID#
~lglo y ~..
CK# eAri de(lP, r4 -J-Ot/l ° 0
CA Ti't ,
f l1 t
L~4a - et c q,1A Of _
br ab
0-ft
DD SS &`re~ LOW "ct
<<~ ~~ cK#
c.e air t .f d~ ~~.Y p;~- x'16
, ID#
vG
Inif
~~,-~ CK# ) )pQ
- 0-- --t s v ( % ( e %,j '535- 31,
ID#
9130%0 ant F,-t{
CK# P~ 3 -3 ~7 3-C) ~~
e~svlt (e ~~ ~zC
ID#
CK#
I D#
C K#
_
I D#
CK#
I D#
CK#
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) . If surname of contributor is the same as candidate, but there is no Page -L- of _j
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
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- I jSC HEDULE
!)WPrit bJ4 tJQ Ini if LFw) °FG r C 6Pj 7`D P fPC~" beo-., tk'xerI9f ~-
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DDfYR) AND PAC
CHECK
NUMBER
ID# rlQav,_ k~PLef ~~. P~ ~'Ne
I D#
CK#
F C K#
C K#
1D#
CK#
ID#
C K#
1D# --
CK#
ID#
CK#
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 68A.402(3)(i) .)
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM
SCHEDULE
D INCURRED
COMMITTEE NAME (Must be same as on Statement of Organization)
(Rev . 08/98) INDEBTEDNESS
GUP)>
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CHECK THIS BOX
NOTE : Debts previously reported that remain unpaid must be included on this AMENDING
Schedule, as well as any new obligations incurred in this period . Reset Form FORM
(art C1f~ave SE
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ao
.
e rj a V44...Q V t t-A e I,-
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~o s~ r )P .J X u .~ r h
P rSVI IIN r 4)4 Sa 0V6 = ?,c,v
er or ,reKitI"c
P . ~d . S
Svl/~0 rl rt
SUB-TOTAL $
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'If actual figure is unknown, show "estimated" beside the figure . Page / of
(for Schedule D)
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7/1 f6 De- 0_-
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IjPl,tvi 00 r L,+
1
711at t34 k,-Tr ev- ev ,16tl3PV' P1,
6( 4-1-L QvP S'E
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f"l o r i ~- ~r~ ~.1
(7JarsV, 1 let 2'/~L 5aUYo
71
1 I t a F i1 aYo SE " ~il/ley~t~s
- uy, (~a-,.~p~ Sy y~I
t e w~ - I li', X~- S', -V 1/ 1-1 Fv r^ ~a rtvQ,~
oar (rartA-At)
SUB-TOTAL $
'If actual figure is unknown, show estimated' beside the figure . Page / of -3
(for Schedule D)
SE .
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/3Ct ~(~-G`Cl~re
S~yr..
r 1k+ re~it`~
t (t L/o
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( -31( of Lard C ff'frJ
1%; 1 11 e, -r,4 5~x vv o
0
qlaq
,j ~ t.~ ; K . a-7
sE s
(~ (!-~Svi t le t TA S~ .O~lU
SUB-TOTAL $
s6I D- r7
TOTAL DEBTS OWED BY COMMITTEE AT THE END OF THIS REPORTING PERIOD $
PS~ern t +r.~ot~Q ~~"~d"t N:.cd ~txr- l'"a ~o e IQc lJe«~ CHECK THIS BOX
AMENDING
NOTE : Debts previously reported that remain unpaid must be included on this
Schedule, as well as any new obligations incurred in this period .
~sReset:Fonrt FORM
k~),,) .e rs t~ ~ ~ ~ t . ~4 r ya
`l~l~4'~
r cr~~ Q~e S c
l ~ 3
SUB-TOTAL $
3f .~G
TOTAL DEBTS OWED BY COMMITTEE AT THE END OF THIS REPORTING PERIOD $
n I ~ ~~ l
57
'If actual figure is unknown, show'estimated' beside the figure . Page - '3 - of -3
(for Schedule D)