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R-l Statementof anization €F$

Commlftee Name: BakerFor Treasurer
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Gommittee Type: GountyCandidate- Treasurer CommifteeCode:
County: Lucas PollticalParty: Republican
Distrlct: 0 Date of Electlon:
YearStanding for Electlon: 2O1O Office Sought: CountyTreasurer
Status: Filed Date: 5l1Ot201O
Purpose
is for DR-SFAthiscommiftewill not be crossingthe $750.00threshold.

Treasurer
LastName: Baker Flrst Name: Phyllis Ml: J
Address: 12309542nd St
Giff: Lucas State: lA lZip Gode: 50151 lPhone: 641-266-661S
E-Mall:

Candidate
Last Name: Baker Flrst Name: Phyllis Ml: J
Address: 12303542nd St
Ct'ty: Lucas State: lA lZip Gode: 50151 lPhone: 641-7666615
E-Mail:

Statementof AffirmatlonBy Treasurerand Candldate;or PolitlcalGommlttees,By Ghalrperson

STATEMENTOF AFFIRMATION:By flllngthls documentthe commltteeafirms the bllowlng

1. The commltee and all p€rsons connected wfth the commftteeunderstandthat they are subJectto the laws In lowa Code chapteE 68A and 688
and the adminlsbatlve rules In Chapter 351 of the lowa Adminlstrative Code.
2. That lowa Code secdon684.6 and rule 351.4.9requlrethe frlingof dlsclosurereportsand that failureto file these reportson or beforethe
requlred due dates subjects the candldate or chalrperson (ln the case of commlttees other lhan a candldate's commiftee) to the automatlc
assessmEntof a cMl penaltyand the possiblelmpositlonof other crlmlnaland cMl sancllons.
3. That lowa Code secton 68A.14and rules 351-4.38through4.43 requlrethe placementof the words 'pald for bf and the name of the
committee on all polltical materlals except for those ftems exempted by statute or rute.
4. That lowa Code secffon68A.15and rules 351-4.44thmugh4.52 prohlbltthe recelptof corporatecontsibutonsby all committeesexceptfor
etatewlde and local ballot lssue PACs,
5. A candldate and a candidate's committee may only expend campalgn funds as permltted by lowa code sec{ons 68A.40 through 68A.42 and
rule 351-4.25.
6. That the commltteewlll contlnue to flle dlsclosure reports untll all actlvlty has ceased, commlttee funds spent, debts resolved, and a final report
and a statementofdlssoluton (DR-3)has been frled. E
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Candidate: (signatureand date) Treasuren (signatureand date) ,n

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rowA ETHlcs AND CAMPAIGNDISCLOSUREBOARD| 510 EAST 12th,SUTTE1A I DES MO|NES,tA 50319 | (515) 2814028 -r o f 1
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