Sie sind auf Seite 1von 1

FOR INSTRUCTIONS, SEE BACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 I DISCLOSURE


COMMITTEE NAME (MUst be same a$ do Stat6MQnf of Organlzadon) (Rev . 11242005) REPORT

for Oflh Use Only

Fo, L~,, .,  t II Comm .


IMPORTANT : Indicate by tt type of committee you are reporting for :
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate (2 Pate PAC ( 3 )Stale Party
( d )County Central Committee ( 5 )Countk .Coadidate ( B )City Candidate (7 )School Board or Other Scanned ----------------------
Political Subdivision Candidate ( a idouhty PAC, ~-4 YI Z
4 . . ', ~ chool Board or Other Political Computer --___--___--____-___

Audited -----------------------

Candidate Nerve ) r 2001 Political Party (I(applicable) File with :


Iowa Ethics and Campaign
men6cr (~T.J
( . .77 Dociosure Board
Office Sought District (If Senate or House) 510 E.12*, Ste, 1 A
Des Molnss, Iowa 50319
.
Fax : 515-281-3701
Late reports are subject to possible civil and crimUtal penalties . Pursuant to Iowa Code section 68B .32A(7)
the candidate, for a candidate's committee, and the chairperson, for any other type of committee, Is the
individy4 responsi¢le for filing timely and accurate reports .

.X2 14 1I)_-1,41. -2-q'?-- 6cJf Ii,x00


FLM REPORT 7BI91i10NE DATE MOM

I AM FILING A oc~,L, 11 . REPORT FOR (1) ELECTION I(z)I~WELECTION YEAR.


(report date) Indicate by #
CHECK IF AMENDMENT TO REPORT DATED, Local Committees, enter Date to Elootlon

[] Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 .
County 8 Looel Committees, enter County in
(You must continue to file reports until a DR-3 Is filed .) which Election is 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 if this is first report Aled,) . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,$ 0 53Y,a5
'

ADD TOTAL 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 Sales of Campaign Property (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., .

1Schadule H applies to Candldatos' Committees Only)


St186TOTAL .... . .... . . . ..... . . .. . . S IV 53-465
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B : Expenditures total (Attach Schedule B) ("also see debts and loans below), . .  . . . . . . . . . . . . .
Schedule F : Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .
CASH ON HAND at the end of this reporting period (If final report balance must
6 S3~L/ oS
be zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . .  . . .  . .  . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . ., . . ., . . . ., . . .  . . . .3

"UNPAID BILLS (From Schedule D - Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .-S


'IN IOND CONTRE'IUTIONS (From Schedule E - Attach Schedule E) . . . . . . . . ., . . ., . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . .  . . . .$
"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . .. . . . . . . . . . . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

CONSULTANT BAEAKDOMIN (Schedule t3 Attached?) - YES -, NO


QhWIDATESroMMITfm ONLY,
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)

STATE COMMITTEES: Submit a reconciled campaign account bank statement in January of each year,

ZO 39Vd QNI a32WVH3 N3HS 95b8-9VZ-ZTL 8T :8O 9OOZ/6T/OT