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    Polk County Farm Bureau - 09-20-04 - Contribution

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    Zach Edwards
    This document is part of the Iowa Ethics & Campaign Disclosure Board set, which was up to date as of 2/20/2011. The documents in this set consist of every pdf posted on the IEC website, but they should not be considered a replacement to searching the official website: http://www.iowa.gov/ethics/ ----- Disclaimer: I am not selling this data or making any money by posting this data. I'm merely trying to find a better way to search the information on the Iowa Ethics & Campaign Disclosure Board website.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Polk County Farm Bureau - 09-20-04 - Contribution

    Uploaded by

    Zach Edwards
    11 views1 page
    This document is part of the Iowa Ethics & Campaign Disclosure Board set, which was up to date as of 2/20/2011. The documents in this set consist of every pdf posted on the IEC website, but they should not be considered a replacement to searching the official website: http://www.iowa.gov/ethics/ ----- Disclaimer: I am not selling this data or making any money by posting this data. I'm merely trying to find a better way to search the information on the Iowa Ethics & Campaign Disclosure Board website.

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    Polk County Farm Bureau_09-20-04_Contribution

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    © Attribution Non-Commercial (BY-NC)

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    This document is part of the Iowa Ethics & Campaign Disclosure Board set, which was up to date as of 2/20/2011. The documents in this set consist of every pdf posted on the IEC website, but they should not be considered a replacement to searching the official website: http://www.iowa.gov/ethics/ ----- Disclaimer: I am not selling this data or making any money by posting this data. I'm merely trying to find a better way to search the information on the Iowa Ethics & Campaign Disclosure Board website.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    11 views1 page

    Polk County Farm Bureau - 09-20-04 - Contribution

    Uploaded by

    Zach Edwards
    This document is part of the Iowa Ethics & Campaign Disclosure Board set, which was up to date as of 2/20/2011. The documents in this set consist of every pdf posted on the IEC website, but they should not be considered a replacement to searching the official website: http://www.iowa.gov/ethics/ ----- Disclaimer: I am not selling this data or making any money by posting this data. I'm merely trying to find a better way to search the information on the Iowa Ethics & Campaign Disclosure Board website.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    Sep-23-04 10 :04am From- 515 225 4686 T-881 P .

    001/001 F-768

    Form DR-OTC
    ND CAMPAIGN DISCLOSURE BOARD
    510 EAST 12T " , SUITE 1A ONE-TIME CONTRIBUTION IN
    DES MOINES, IIA 50319 ~i2 , EXCESS OF $750 BY A
    j'i_1141i PERMANENT ORGANIZATION
    Fax: (515)281-3701
    www.iowa .gov/ethics For officeuseonly
    Indexed_,
    WE CONTRIBUTION IN EXCESS OF $750 Audited
    BY A PERMANENT ORGANIZATION Checked -
    Computer
    Iowa Code section 68A.402(9) requires a permanent organization that contributes in excess of
    $750 to register and file reports as a PAC . This form is intended to serve those purposes . The
    form must be filed withthh Board onor before the tenth day of the date the check was issued
    ORGANIZATION MAKING CONTRIBUTION :'

    PolK County farm Bureau


    SE Delaware Ankeny, Iowa 50021
    Mailing Address City, State . Zip Code
    515 .964 .5354
    Email Address (Optional) Area Code & Telephone No .

    CONTACT PERSON FOR THE ORGANIZATION :

    Dave Harman
    Njf35 NW 16th St Ankeny, Iowa 50021
    Mailing Address City . State, Zip
    515.964 .0857
    Email Address (Optional) Area Code &Telephone Number

    CANDIDATE OR COMMITTEE RECEIVING THE CONTRIBUTION :

    Vote No Merger Committee


    Name of Candidate or Committee
    2913 Southern Hills Circle Des Moines, IA 50321
    Mailing Address City, State, Zip Code 20 Septernber 2004 $ 8,000.00
    515.229.9188 Date of Contribution Amount
    2 November 2004 Polk
    Emad Address (if available) Area Code & Telephone Number
    Date of Election County (if Applicable)

    If contribution to candidate, disclose source of original funds used to make


    such contribution (attach additional pages if necessary) . If In-Kind Contribution. Describe

    Criteria to use this form:

    t. One campaign contribution In excess of $750 was made to a state or local candidate . party, political committee (PAC) for either a
    candidate or a ballot issue, or any other organization that advocates the election or defeat of a candidate or ballot issue.
    2. Must be a permanent organization not established for election purposes.
    3. No person gave money to the organization for the purpose of the organization then using the money to make the contribution .
    4. If the contribution was made to a candidate, no funds from a corporation or other prohibited contributor under Iowa Code section
    68A.503 were used to make the contribution (this does not apply to a contribution made to a ballot Issue committee) .
    5. Only one contribution to any campaign committee except for a ballot Issue committee was made In a calendar year. No more than one
    contribution may be made to any one ballot Issue committee during a ballot issue election. If more than one contribution and the total
    amount of the contributions exceed 5750, the organization must register with the Board as a political committee (PAC) within 10 days of
    crossing the 5750 threshold .

    affirm that the contribution reported above is accurate. I further affirm that the information concerning the organization is
    e best of my knowledge. I understand that by fling this form, I am subject to the laws found in Iowa Code chapter 68A and
    ound in chapter 351 . 1 also understand that the fallure to timely file this form leads to the imposition of civil penalties and the
    y lead to additional civil and criminal sanctions .

    ' 'Contribution' includes goods or services that are provided for free or otherwise less tnan fair market value.

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