Professional Documents
Culture Documents
Comm. # _ --
IMPORTANT: Indicate type of committee you are reporting for: 11-1
Indexed~O_
( 1 )Statewide/Legislative Candidate ( 2 )StateWkj i,3~)State Party ( 4 )Oou !Local Candidate Audited
( 5 )County PAC ( 6 )Ballot Issue/Franchise Cor%lMgRif 7 )County/City Central C' mmittee
( B )Support Slate of Candidates Computer
SIGNATURE OF TREASURER (or person filing this report) TELEPHONE DATE SIGNED
Routine Penalties Due For Late Filed Reports Range from $20 to $800
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :
[] Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County & Local Committees, enter County in
(You must continue to file reports until a Notice of Dissolution is filed .) which Election is held
SUB-TOTAL . .. . . . $ X2-126 . 81
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
a1
be zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .$ 21726,
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICAT10N
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 6i3B .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 10 NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOI
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/oD/YR) AND PAC CHECK (if applicable) RAISEF
NUMBER INCOME
ID# 10 kcGor e $ 00
?75 Morni»i,iJe A V( 30.
07/I S/01 CK#
L0g i 1 t(s 51S03
ID# Pat 61 1 o
ob/1l /o `/ CK# a03 Sie+wss Ave . ' its, -
Co, .c;l 151,46=A SIS03
ID#
T''" G<<55
C K#
ID#
CK#
ID#
CK#
ID#
' CK#
ID#
CK# '
SUB-TOTAL 213 c~