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FOR INSTRUCTIONS, SEE BACK OFF n FORM

DR-2 I DISCLOSURE
DISCLOSURE SUMMARY PAGE (Rev . 01/98) REPORT

For Office Use Oniv


COMM~I EE NAME (Must ~be same as on Statement of Organization) Comm . #
Of
-t7 c~lU iJ~lY-l~ . V Indexed _
Audited
IMPORTANT: Indicate type of committee you are reporting for: Computer
( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate
( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee
( 8 )Support SI to of Candidates
J,~j CZ~ AtMe~j" 7(--2- 2z~ -3 - 0(`7 l O
SI NATURE OF TREASURE (r person filing this r ort) TELEPHONE DATE SIGNED

Routine Penalties Due For Late Filed Reports Range from $20 to $600

SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE : AUG 1 5 2001

I AM FILING A / l1_)1i'G- REPORT FOR AN/A (1) ELECTION /(2)NbN-ELECTION YEAR.


06
(report date) u t
A,rWI ; na ` Indicate one

EICHE IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election

heck 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.)

STATEMENT OF CASH ON HAND


CASH ON HAND at the beginning of the reporting period . (This is the total
of all monies 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 filed.) .................... ............. ........................... ........... .....$
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) ......... .. ......... .. ....... ....................
Schedule F: Loans Received total (Attach Schedule F) .. ................. .. ........... ....... .. .. .. ... .. .....
Schedule H: Total Sales of Campaign Property (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL......$
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ........ .. .. .. .. .. ....... ........... ........... .. .. . .. .. .. .
Schedule F: Loan Repayments total (Attach Schedule F) .. .. .............................................. .

CASH ON HAND at the end of this reporting period (if final report, balance must
be zero) (Attach DR-3) .......... .. .. ..... .. .. .. ........... ....... .. .. .. . .. ..... .. ............... .. .. .. .. ... .. ........... ....... .$

UNPAID BILLS (From Schedule D - Attach Schedule D) .... ....... .. ............... ... .. .. .. .. .. . .. .. ... .. . .... .$ s3
a 7,Y0
f v
. .. . .. . . .$ /0
IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .... .. .. :
OUTSTANDING LOANS (From Schedule F - Attach Schedule F) ............ . .. ..... .... .... ..... .. .. ......... .. .....$ m

,NDIDATE COMMITTEES ONLY :


CONSULTANT BREAKDOWN (Schedule G Attached?) YES X NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $ t-15
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 06/97) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
DMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

0, W_ I e /J 1~-o r,-- 5 ,; a +-e 5- e ti la- f~ CO.Kin


.

STATE CANDIDATES NOTE: IF A CONTRIBUTION 1S 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 1D 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
I D#

CK#

ID#

CK#

I D#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

I D#

CK#

SUB-TOTAL

TOTAL (if last page of this


schedule)
>ciosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
-nmittee . 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)
~,' S)-C e ~e, f(zf e ra m m scti R
^jA n O ` gr i
Contribution List cc'-7 1,'xAc t n~

M~o ( Harold and Lorah Swanson $25


210 E. Florence
Glenwood, IA 51534

Mills County Democratic Committee $100


9 Diane Van Tersch
25333 St. Hwy. 949
Glenwood, IA 51534

Phil Hascall $30


35504 Galveston Rd
Atlantic, IA 50022
tj
Don Sonntag $100 N
58979 Maine Rd
Atlantic, IA 50022
pU o ~j E-
Cass Co. Democratic Committee $350
Helen Pigg Treasurer
'0 602 E. 8th St.
Atlantic, IA 50022

Rodney D. and Katherine Camerson $25


3 Summit Circle
Council Bluffs, IA 51503

Lyle and Helen Pigg $20


602 E. 8th St.
Atlantic, IA 50022
to 6tiE--
Viola Myers $20
505 Olive St.
Atlantic, IA 50022

Ron and Marlene Feilmeyer $150


305 E. 21st St.
Atlantic, IA 50022

Russell and Linda Joyce $40


67239 Troublsome Creek
Atlantic, IA 50022

0,,j -A'eVJ T - O ° 0"


~&
0" A, ieYl 4r' S-j ~fe ~Prna1e ~om m~ e~ --
o~c~ey~te A
f'-'j4" r)
Phil and Mary Jo Thielen $250
4209 N. 134th St.
Omaha, NE 68164
IUONL
Dr. Ron Pearbolte $50
408 Poplar St.
Atlantic, IA 50022

Jim and Monica Hughes $100


25312 State Hwy. 949
Glenwood, IA 51534

Steve and Donna Green $30


1409 Lincoln Dr.
Atlantic, IA 50022

Richard L. Delashmutt $100


416 Fust St.
Glenwood, IA 51534

Don Henningsen $25


1703 Bryn Mawr Blvd
Atlantic, IA 50022

Larry Harris $50


Denise O'Brien
59624 Chicago Rd
Atlantic, IA 50022

Tony Dvorak $50


Mary Pat Gregersen
69324 730th St .
Massena, IA 50853

(Jeanne F. Howorth $20


411-00 201-1/2 Crombie PI
Atlantic, IA 50022

Edith R Shank $20


201-1/2 Crombie PI
Atlantic, IA 50022
s $ 20 ti a N -er.
20 4qs, s. , 0N .
$1595

2 fff -I-
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B


(Rev . 09/97)
MONETARY
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
AMENDING FORM
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA
ETHICS & CAMPAIGN DISCLOSURE BOARD .

COMMITTEE NAME (Must be same as on Statement of Organization)

,1©14~j 0, alvi c N ¢orc


CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
DATE
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
1D#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL $

TOTAL (if last page of this schedule) $

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY:


instructions .)
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H
must also be detail itemized on
)enditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services committee . (Refer to
ochedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's
Schedule G instructions and Iowa Code 56 .6(3)(i) .)

Page of
John O'Brien
105 West 14th St
Atlantic, IA 50022
Council Bluffs Nonpareil Ad $69 .80

Barry Long
2169 Hickory Ave.
Red Oak, IA 51566
Red Oak Newspaper Ad -

Total $109.80

Expenses
~ Bank Service Charges $0.11
Bank Service Charges $1 .17
Anita Printing ° = $266.00
Meredith Community rad c 6 $151.20
The Opinion Tribune 38.32
Malvern Leader/ Beacon K-cf U~- _ ,
6/ - 3 Sidney Argus Herald $-31 .60
Co/g KMA Radio Station $264.00
( 3 KJAN Radio Station Q co I ,

Hamburg Reporter 30.00


Postmaster $68 .00
f Anita Tribune 00
News Telegraph Lever $ 90.8
Vl o Villisca Review 36.80
7(~o John O'Brien Mileage 342.92
i V4o(? t 9-0

Total Expenses $1595.00

Ending Balance $0
OCT 9 2001
In Kind Contribution
1
,b Aj

John O'Brien
CaIv4~~e
105 West 14th St
Atlantic, IA 50022
Council Bluffs Nonpareil Ad --~~ $ 69.80

Barry Long Iv 0
2169 Hickory Ave.
Red Oak, IA 51566
Red Oak Newspaper Ad $40.00

Total $109.80

Expenses

"~lV,,,c r

--- Bank Service Charges $0


.11
Bank Service Charges $1 .17
,_
4, 13 Anita Printing $266.00 4 ;U -cc ( )~ - ;
3 Meredith Community A25
" C oc $151.20 >
The Opinion Tribune 38.32
Malvern Leader/ Beacon vs~, ~5
hj U
28.001 et-~- ) -

6/' 3 Sidney Argus Herald ` S 3160


.
W9 KMA Radio Station
((3 KJAN Radio Station $156.00 ~d~e-u-~ `-,
fe F1 Hamburg Reporter 0.00
Postmaster ~~c~ ~'
_$ 68.00
Anita Tribune $ 901. 00 -4-yo~--1 ~`
News Telegraph _ o f $ 90.8
ff/o Villisca Review . ~ 36.80
7(c John O'Brien Mileage rVb / f ~~ 342 .92 ¢a o I o
G &4oQ , ~-d

Total Expenses $1595.00

Ending Balance $0

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