,S Jperyi - Sor - As: Disclosure Summary Page DR-2
,S Jperyi - Sor - As: Disclosure Summary Page DR-2
,S Jperyi - Sor - As: Disclosure Summary Page DR-2
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ARy l 2011
Ebr Office Use Only
Comm . tR
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71
IMPORTANT: Indicate by # type of committee you are reporting for.
(1 )Statewide/LegislativelJudge Standing for Retention Candidate (2 )State PAGt-3 )State Party, Scanned
( 4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )Sch-gQI_Board or Other ,
Political Subdivision Candidate (8 )County PAC (9 )City PAC (10 )School Boerd or Other Political Computer
Subdivision PAC ( 11 ) Local Ballot Issue - _ Audited
CANDIDATE COMMITTEES ONLY:
Can (date Name Political Party (if applicable)
,~ L v C Late reports are subject to
_t9 Qel-) possible civil and criminal
Office Sought District (if Senate or House) penalties.
""UNPAID BILLS (From Schedule D -Attach Schedule D) ..... ....... ................. ... ... ....... .... ...: ... ... ....... ...$
`IN KIND CONTRIBUTIONS (From Schedule E -Attach Schedule E) ........... ............. ....... ... . ....... ...$
"OUTSTANDING LOANS (From Schedule F -Attach Schedule F) .. . ... ... ... ....... ... ... ... . ... ... ...... ., ........ $
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?) 1:1YES 71 NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
May 18 05 11 :05a Pete Crawford 712-623-5819 p,2
s
nr r/ S r
STATE CANDIDATES NOTE: IF ACONTRIBUTION IS 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 ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibf the use of infomlation copied from reports and statements for sokAing contributions or
for any corrvnercial purpose by any person other than statutory political committees-
W ID#
CK#
ID# -
C
- -
q 711
:gee- cc
l 0, ".x
r i4
p
u .v~S/n
~UU
S S(v ro
lmi~
5 ~
_
CK#
ID#
i o 7,v 4
CK# b ;o E- GORNu1G .
CK#
ID# ,
CK#
ID#
CK#
ID# o
ID#
SUB-TOTAL
$ .~
TOTAL (rf last page of this schedule) x;
C
' Disdosure law requires candidate committees to disclose the relationship dany relative making acontribution to the
committee_ Relationship must be shown to thethird degree dconsanguinity (blood relatives) and affinity (relatives by
marriage)
of . If surname of contributor is the same as candidate, but there is no Page 1 _- :;I-
familial relationship, enter 'not applicable' in the relationship column. (for Schedule A)
Mad 18 05 11 :06a Pete Crawford 712-623-5819 p .4
D
STATE PAC COMMITTEES: NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES. LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.
(for Schedule B)
May 18 05 11 :06a Pete Crawford 712-623-5819 p .5
r--o R s VxIcavl-so R
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MMIDDNR) AND PAC
CHECK
NUMBER
ID#
RE y p,0 a je r~ 0 rJ Ta
s/1 Vos' Clue t
ID#
CKO
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
1D#
CK#
__
ID#,
i
CK#
` SUB-TOTAL $ 0l
TOTAL (ff last page of this schedule) $ 149 Li
E
THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY:
Purchases of certain campaign property costing $500 of more must also be inventoried on Sdledule, H. (Refer to Schedule H instructions)
Expenditures to personslentities providing consulting, advertising, fund-raising, poling, managing, organizing services must also be detail itemized on
Schedule G by the amount,purpose, and date of each type of expenditure made by the personlentfty on behalf of the candidates committee. (Refer to
Schedule GinstrrxxionS and Iowa Code 6aA_402(3xi).)
Page :A - of --3-
(for Schedule B)