chambers royd__1333__scanned
TRANSCRIPT
8/7/2019 Chambers Royd__1333__scanned
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P r i n t e d u s i n g t h e I ECDB Web R e p o r t i n g Sy s t e m o n 0 3 / 2 9 / 2 0 0 2 1 0 : 5 0 : 2 2
FORM DR- 2 : D i s c l o s u r e Summa r y P a g eS t a t u s : F i l e d
I D # 1 3 3 3
Co mmi t t e e Ch a mb e r s f o r I o wa H o u s e
CommT y p e : St a t e H o u s e
Da t e Du e : 0 1 / 1 9 / 2 0 0 2
Re p o r t Y e a r : 2 0 0 1
Tr e as u r e r : Ho wa r d T i e me n s
Pr i ma r y Ph . ( 7 1 2 ) 3 2 4 - 4 3 6 0 S e co n d a r y Ph . ( ) -
Ch a i r : R o y d E Ch amb e r s
Pr i ma r y Ph . ( 7 1 2 ) 3 2 4 - 2 6 9 4 S e co n da r y Ph . ( ) -
Co u n t y : NA
Amen ded :
S t a t e me n t o f C a s h o n Han d
A d d i t i o n a l As s e t s a n d L i a b i l i t i e s
FORM DR- 2 : Chamb e r s f o r I o wa Ho u s e
P r i n t e d u s i n g t h e I ECDB Web R e p o r t i n g Sy s t e m o n 0 3 / 2 9 / 2 00 2 1 0 : 5 0 : 2 3 P a g e 1 O f 1I OWA ETHI CS AND CAMPAI GN DI SCLOSURE BOARD 1 5 1 4 EAST LOCUST STREET, S UI T E 1 0 4 1 DES MOI NES, I A 5 0 3 0 9 ( 5 1 5 ) 2 8 1 - 4 0 2 8
Ca s h o n Hand a t S t a r t o f P e r i o d $ 0 . 0 0S c he d u l e A : Ca sh c o n t r i b u t i o n s T o t a l $ 4 , 2 2 0 . 0 0
S c he d u l e F : L o a n s Re c e i v e d T o t a l $ 0 . 0 0
S c he d u l e H : Camp a i g n P r o p e r t y Sa l e s $ 0 . 0 0
SUB- TOTAL $ 4 , 2 2 0 . 0 0
S c he d u l e B : E x p e n d i t u r e T o t a l $ 5 2 5 . 0 3
S c he d u l e F : Ca sh L o a n Re p a y me n t s
( Ca s h o n Hand A t En d o f P e r i o d 3 , 6 9 4 . 9 7
L o a n s i n P l a c e a t S t a r t o f P e r i o d $ 0 . 0 0
S c he d u l e D: Un P a i d B i l l s $ 0 . 0 0
S c he d u l e E : I n - K i n d C o n t r i b u t i o n s $ 0 . 0 0
S c he d u l e F : F o r g i v e n L o a n s
S c he d u l e F : Ou t s t a n di n g L o a n s $ 0 . 0 0
S c he d u l e G : Co n s u l t a n t Br e a k d o w n ? No
( S c h e d u l e H: Camp a i g n P r o p e r t y Va l u e $ 0 . 0 0
S t a t u t o r y Du e Da t e 0 1/ 1 9 / 2 0 0 2
A d j u s t e d Due Da t e / /
Re ce i v e d Da t e 0 1 / 2 2/ 2 00 2
Po s t ma r k Da t e 0 1 / 1 8 / 2 00 2
Amen de d / /
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Fo r I n s t r u c t i o ns , See Back o f Fo r m
CONTRIBUTI ONS- - MONEYTAKENI N
( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )
I COMMI TTEENAME( Mu s t b e s ame a s o n S t a t eme n t o f Or gam2 l
TOTAL ( i f l as t page o f t h i s s c h e du l e )
STATE CANDI DATES NOTE : I F ACONTRI BUTI ON I S RECEI VED FROMA STATE PAC( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PACI DENTI F I CATI ONNUMBER ANDTHEPACCHECK NUMBER I N THE DESI GNATED COLUMN . AL I S T OF I D NUMBERS I S AVAI LABLEFROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .
CAUTI ON : Se ct i o n 68B. 3 2 A ( 6 ) , I o wa Code, p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s an d s t a t e me nt s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r an y c omme r c i a l p u r p o s e by an y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e es
D i s c l o s u r e l aw r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f an y r e l a t i v e mak i n g a c o n t r i b u t i o n t o t h e
c ommi t t e e . R e l a t i o n s h i p mus t b e s h ow n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s } an d a f f i n i t y ( s e 4 a t i v e s b y
ma r r i a g e ) ( S e e Page 2 o f f o r ms p a c k e t . ) . I f s u r n ame o f c o n t r i b u t o r i s t h e same as c a n d i d a t e , b u t t h e r e i s n o Page ~ o f +
f a mi l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l umn . ( f o r Sc h e d ul e A)
SCHEDULE
A MONETARY
( Re v . 0 6 / 9 7 ) RECEI PTS
CHECK THI S BOX I F
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DATE PAC I D NUMBER NAMEANDADDRESSOF CONTRI BUTOR RELATI ONSHI P AMOUNT i I F FORRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE RECEI VED FUND-( MMI DDI YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SER
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Fo r I n s t r u c t i on s , Se e Back o f Fo r m
CONTRI BUTI ONS - - MONEYTAKEN I N
( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )
COMMI TTEE NAME ( Mu s t b e sa me a s o n St a t e me n t o f Or g a n i z a t i on )
STATECANDI DATES NOTE I F A CONTRI BUT I ON I S RECEI VED FROM ASTATE PAC ( P OL I T I C A L ACT I ON COMMI TTEE ) L I S T T HE PAC I DE NT I F I CA TI ONNUMBERAND T HE PAC CHECK NUMBER I N THEDESI GNATED COL UMN_ A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CSAND CAMPAI GNDI SCLOSURE BOARD.
CAUTI ON: Sec t i o n 68B . 3 2 A ( 6 ) , I o wa Code , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s an d s t a t eme n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o mme r c i a l p u r p o s e by a n y p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e es .
TOTAL ( i f f a s t page o f t h i s s c h e d u l e )
' D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c ommi t t e es t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e
c ommi t t e e R e l a t i o n s h i p mus t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y
ma r r i a g e ) ( S e e Pa g e 2 o f f o r m s p a c k e t . ) I f s u r n a me o f c o n t r i b u t o r i s t h e s ame a s c a n di d at e . b u t t h e r e i s n o
f a mi l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn
SUB- TOTAL
SCHEDULE
A MONETARY
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DATE PAC I D NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT i I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE" RECEI VED FUND-( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SER
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Fo r I n s t r u c t i o n s , Se e Back o f F o r m
CONTRI BUTI ONS - - MONEYTAKEN I N( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )
COMMT f EE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f O r g a n i z a t i o n )
C6' w' " - ( Z- -. ~~t " v A
STATE CANDI DATES NOTE : I F A C ON T R I B U T I O N I S R E CE I V E D FROMA S T A T E PAC ( P O L I T I C A L A CT I O N C OMM I T T EE ) , L I S T T HE PA C I D EN T I F I C AT I O NNUMBER AND TH E P A C CHECK NUMBER I N T H E D ES I G NA T E D COL UMN . A L I S T OF I D NUMBERS I S A VA I L A B L E FROM T HE I O WA E T HI C S AND C A MP A I G ND I S C L O SU R E BOARD .
CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 8 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o mme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s .
SUB- TOTAL
TOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e )
D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . Re t a t i o mh i p mu s t b e s h o w n t o t h e t h l s d d e g r e e o f c o r s s a n g u t n l t y ( b l o o d r e l a t i v e s ) a n d Wmt t y ( r e l a t i v e s b Vm a r r i a g e ) ( S e e P a g e 2 o f f o r ms p a c k e t . ) I f s u r n a m e o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o P a g e o ff a m i l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e " I n t h e r e l a t i o n s h i p c o l u mn . ( f o r S c h e d u l e A )
SCHEDULE
A MONETARY
( Re v 0 6 / 9 7 ) RECEI PTS
CHECK THI S BOX I FAMEND I NGFORM
DATE PA C I D NUMBER NAMEAND ADDRESS OF CONTR I BUTOR REL A T I ON SH I P AMOUNT I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECE I VED FUND-( MM/ D D/ YR) AND P A C CHECK ( i f a p p l i c a b l e ) RA I SER
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Fo r I n s t r u c t i o n s , Se e Ba c k o f F o r m
CONTRI BUTI ONS - - MONEYTAKEN I N
( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )
COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f O r g a n i z a t i o n )
a . w . ( o e r s r g v - - Lov i A j 4
S TA TE CANDI DATES NOTE : I F A C ON T R I B U T I O N I S R E CE I V E D FROMA S T AT E P AC ( P O L I T I C A L A CT I O N C OM MI T T E E ) , L I S T T HE P AC I D E NT I F I C A T I ONNUMBER AND T HE P AC CHECK NUMBER I N T HE D E S I G NA T E D COL UMN . A L I S T OF I D NUMBERS I S A VA I L A B L E FROMT HE I O WA E T H I C S AND C A MP A I G N
D I S C L O SU R E BOARD .
CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Code, p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s an d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o mme r c i a l p u r p o s e b y an y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c ommi t t e es .
TOTAL ( i f f a s t p a g e o f t h i s s c h ed u l e )
' D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . Re l a t i o n s h i p mu s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) ( S e e P a g e 2 o f f o r m s p a c k e t . ) . I f s u r n ame o f c o n t r i b u t o r i s t h e same a s c a n d i d a t e , b u t t h e r e i s n of a m i l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l umn .
Page__o f( f o r S c h e d u l e A ) -
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Fo r I n s t r u c t i o n s , SeeBack o f Fo r m
CONTRI BUTI ONS- - MONEYTAKENI N
( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )
COMMX17EENAME( Mu s t be same a s o n St a t e me n t o f Or g a ni z a t i o n)
u<--
STATECANDI DATES NOTE: I F ACONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I CA L ACT I ON COMMI TTEE) , L I S T THEPACI DENT I F I CATI ONNUMBER AND THE PACCHECK NUMBER I N THEDESI GNATED COLUMN. A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.
CAUTI ON : Se c t i o n 68B. 3 2 A ( 6 ) , I o wa Code , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o pi e d f r o m r e p o r t s an d s t a t e me nt s f o r s o l i c i t i n g c o n t r i b u t i o ns o rf o r an y c omme r c i a l p u r p o s e b y an y p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e e s .
SUB- TOTAL 1
6
100-0
TOTA L ( i f l as t page o f t h i s s c hedu l e )
r $* D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e commi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f an y r e l a t i v e mak i n g a c o n t r i b u t i o n t o t h ec ommi t t e e. R e t a t i o n s h i p mus t b e s h o v m t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r " b y e s ) a n d a t t h y ( r e l a t i v e s b ym a r r i a g e ) ( S e e Page 2 o f f o rms p a c k e t . ) . I f s u r n ame o f c o n t r i b u t o r i s t h e same a s c a n d i d a t e , b ut t h e r e i s no Page_~_o ff a mi l i a l r e l a t i o n s h i p , e nt e r ' n ot a p p l i c a b l e * I n t h e r e l a t i o n s h i p c o l u mn . ( f o r Sc h e d ul e A)
SCHEDULE
A MONETARY
( Re v . 0 6 / 9 7 ) RECEI PTS
7 / CHECK THI S BOX I F
AMENDI NG FORM
DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT t i l I F F ORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-( MM/ DDI YR) AND PA C CHECK ( i f a p p l i c a b l e ) RAI SER
NUMBER I NCOME
# - 7 1 7 7 ) ~_
$
l a ` I S~. ( 6 r O( 6 r O r ,r,~72ot / ( f 2 5 - r 1 0I D
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Fo r I n s t r u c t i o n s , Se e Back o f Fo ,
CONTRI BUTI ONS - - MONEYTAKEN I N
( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )
COMMI TTEENAME( Mu s t b e s ame a s o n St a t e me n t o f Or g a n i z a t i o n )
`~1 r ` -- r , ! w, , , t 4 I 1 S~
STATECANDI DATES NOTE: I F ACONTRI BUT I ON I S RECE I VED FROM ASTATE PAC ( P OL I T I C A L ACT I ON COMMI TTEE) , L I S T THE PACI DENT I F I CATI ONNUMBERAND THEPACCHECKNUMBER I N THEDESI GNATED COLUMN A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .
CAUTI ON: Se c t i o n 68B . 3 2 A ( 6 ) , I o wa Code , p r o h i b i t s t h e u s e o f i n f o r mat i o n c o p i e d f r o m r e p o r t s an d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r an y c o mme r c i a l p u r p o s e by any p er s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e es
D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c ommi t t e es t o d i s c l o s e t h e r e l a t i o n s h i p o f an y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p mus t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) an d a f f i n i t y ( r e l a t i v e s b y ~/_ /
m a r r i a g e ) ( S ee Page 2 o f f o r ms p a c k e t . ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s ame as c a n d i d a t e , b u t t h er e i s n o P a g e ~ o f
f a mi l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn . ( f o r Sc h e du l e A)
SCHEDULE
A MONETARY
( Re v . 0 6 / 9 7 ) RECEI PTS
CHECKT HI S BOX I F
AMENDI NG FORM
DATE PAC I D NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT t i i I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MMI DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SER
NUMBER I NCOME
a , ~ ) $1 _ 2
a )CK# Po 1 3 t n - 7 / s
A' ~ k 4 1, . , /P?7 - s c s z s s 9 4 , I V% l - a , C 2 S , a -
l a a ~/of
CK# - 7 2 + M2 t i , r 4 - ~ t
1 1 /1 14 ~D- 02 - -s c ~ c ~ r t i . qs i z d 1
AZ, , / 0 / CK# 3 0 - 7 OVA-
S' t " , 4 / 1A. ~ l
1S
y
I D#c y - : F 47 V- 1 t h ~) o y r e e -
5 0
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7 / CK# 2 ~o qw- < Y>
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l a a~~ ,
CK#
I D#
CK#
I D#
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SUB- TOTAL
TOTAL ( i f l a s t page o f t h i s s c h e du l e)ZZf 7
$
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THI S BOXAPPLI ES TOCANDI DATES' COMMI TTEES ONLY :P ur c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mus t a l s o b e i n v e n t o r i e d o n Sc h e d u l e H. ( R e f e r t o Sc h e d u l e H i n s t r u c t i o n s . )
E x pe nd i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e mi z e d o nSc h e d u l e Gb y t h e amo u n t , p u r p o s e , a n d d at e o f e a c h t y p e o f e x p en d i t u r e mad e b y t h e p e r s o n / e n t i t y o n b eh a l f o f t h e c a n d i d at e ' s c o mmi t t e e . ( R e f e r t oSc h e d u l e Gi n s t r u c t i o n s a n d I o wa Cod e 5 6 . 6 ( 3 ) ( 1 ) . )
( f o r Sc h e d u l e B)
= ~ + a _ y c "
FOR I NSTRUCTI ONS, SEE BACK OF FORM JAN 2 2 ZOOZ SCHEDUL E
EXPENDI TURES - - MONEYSPENT FRO COMMI TTE E ACCOUN B MONETARY
" 0( Re v . 0 9 / 9 7 ) EXPENDI TURES
STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MAD 'CANDI DATES, L I ST THE CANDI DATE I D ENT I F I CATI ON NUMBER I N THE DESI G ATED COLUMNANDTHE 0CHECKTHI S BOXI FPAC CHECKNUMBER FOR EACHEXPENDI TURE A L I ST OF I D NUMBERS I S AVA I L A B L E FROMTHE I OWA AMENDI NG FORMETHI CS & CAMPAI GN DI SCL OSURE BOARD
COM I TTEENAME ( Mu s t_ .
b e s am e a s o n St a t e me n t o f O r g a n i z a t i o n )
U~w 4~1 _ ~vI l k I - 1 1 uS, 2 _
CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED
EXPENDED ( i f a p p l i c a b l e ) ( Di s b u r s e me n t ) WASMADE( MM/ DDNR) AND PAC
CHECKNUMBER
I D # > 3 ~ 3 h" oy , 4 ~a y n yC y
, d , s 6 ,CK#
~ d lO a t Al 2_0 - o ,
~
y
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l ~ n , y a - 5 / ?~ l e 7 n .
1 D# 1333 SL . e I i ` a 5 . f i 0 4 t z _ e _
I D# 1 3 , 3 3 PL, *Z"s" p c . 7 h , V+ -
j > 0 , 1 3 c x I Z v
l d ~~01
CK#/ e 3
you khan - S ' f iT ' . Q a
ID# / 3 3 3
CK# ~D l /I mo . c , t 2~n
CK#' 7 wu~~> , S
~d ZL 1 1 1l r J
l ' ~ r ~ , ~ L r l - 5i 23 / 1 1 Z ~ . v ' S S C - r i 7 S ' b l " ~ / l I h Di :
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SUB- TOTAL
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T HI S BOX A PP L I E S TO CANDI DATES ' COMMI TTEE S ONL Y :
P u r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mus t a l s o b e i n v e n t o r i e d o n S c he d ul e H. ( R e f e r t o S c he d u l e H i n s t r u c t i o n s . )
E x pe nd i t u r e s t o p e r s o n s / e n t i c e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e mi z e d o nS c h ed u l e G b y t h e amou n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x pe nd i t u r e mad e b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e r t o
S c h ed u l e G i n s t r u c t i o n s a n d I o wa C o d e 5 6 . 6 ( 3 ) ( 1 ) . )
P a g e
( f o r S c he d u l e B)
FOR I N STRUCT I ONS , SEE BACK OF FORM SCHEDUL E
EXPENDI TURES B MONET ARY- - MONEY SPENT FROMCOMMI TTEE ACCOUNT
( Re v . 0 9 / 9 7 ) EXPENDI TURES
STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUT I ONS MADE TO STATEWI DE OR L E GI S L A TI V ECANDI DATES , L I S T THE CANDI DATE I D EN TI F I C AT I ON NUMBER I N THE DESI GNATED COLUMN AND THE CHECK THI S BOX I FPAC CHECK NUMBER FOR EACH EXPEND I TURE A L I ST OF I D NUMBERS I S A VA I L A B L E FROMTHE I OWA AMEND I NG FORMETHI CS &CAMPAI GN D I SC LOSURE BOARD .
COMM EE NAME ( Mu s t b e s ame a s on S t a t e me n t o f O r g a n i z a t i o n )
a s ' ' -
Z~~
~ 4 u _ I c e _
CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED
EXPENDED ( i f a p p l i c a b l e ) ( Di s b u r s e me n t ) WASMADE
( MM/ DD/ YR) AND PACCHECK
NUMBER
1 1 42 0 ,CK# ~~~ o y G S y o y G ~s " Gt ~
~~>
QscPVl ~ ~- ~az~~
1 1 p z D l 11D#D
~
~uSv l QwS ~ p s C~
CK# 1 1 18 5 1
~ - T - . , ~ s C ~ c ~ 't
~~, Sl 3 . sI D# ~ '
CK#
1D#pzmf
l ~ ~ n / a 1CK#
/ / 3
I D# w' dv . ) F , ' w b t 'c
~ ~ I g rCK# /A
/A. k i , r r v % - ~ S7 . ? S Pw- / a , 0 - 2 1
I D # ~v , , t l e y L - 1 x " ~ s C G , . $
~ ~9 / p
1 CK#l ~ S ~ , ~
1 - , a , C l l rI D#
S~ . P. - S T 046' "
~ . 2 / l ~ l d lCK# ~/ ( v
G. a l d ~~ , . ~ 51336 S s3Lj ,
SUB- TOTAL $17~ 4 - 2 t -
TOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) $
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T HI S BOX APPL I ES TOCANDI DATES ' COMMI TTEES ONLY :
Pu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mus t a l s o b e i n v e n t o r i e d o n Sc h e d ul e H ( R e f e r t o S c he d u l e H i n s t r u c t i o n s . )
Ex p e nd i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e m i z e d o nS c he d u l e Gb y t h e amou n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x pe nd i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n di d a t e ' s c o mmi t t e e . ( R e f e r t o
Sc h e d ul e G i n s t r u c t i o n s a n d I o wa Code 5 6 . 6 ( 3 ) ( i ) . )
( f o r Sc h e d ul e B)
FOR I NSTRUCT I ONS , SEE BACK OF FORM SCHEDULE
EXPENDI TURES B MONET ARY- - MONEY SPENT FROM COMMI TTEE ACCOUNT
( Re v . 0 9 / 9 7 ) EXPENDI TURES
STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE T O STATEWI DE OR L EGI S L AT I V ECANDI DATES, L I ST THECANDI DATE I DE NT I F I CA TI ON NUMBER I N THEDESI GNATED COLUMN AND THE 0 CHECK T HI S BOX I FPAC CHECK NUMBER FOREACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI L ABLE FROM THE I OWA AMENDI NGFORME THI CS &CAMPAI GN DI SCLOSURE BOARD.
COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t eme n t o f O r g a n i z a t i o n )
C~ . b C - : 3-2 0 VJA 4 VCANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNT
DATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED
EXPENDED ( i f a p p l i c a b l e ) ( Di s b u r s e me n t ) WASMADE
( MM/ DDYR) AND PAC
CHECK
NUMBER
I r v i e , <
l a l 3D~
CK#/ / 7
57, 14. t: 14 5 l 2 - a l` T . ~
Y ar ^ $ / d , y e tI N We s f , N , ` I l s A f t
CK# ; ~
1 D#b
1 . 2 1 3 1c K#
/ 19
I N ? wwel pe 11 4 o - f 4- 1 1 - L
/ ; Z / 3 fCK# / I m
5kai o e_ ~ T- P S ; , 12~ f s~ yyv 0 1D
I D#
CK#
I D#
CK#
I N
CK#
I D#
CK#
SUB- TOTAL $r 3s~~
o -y
TOTAL ( I f l a s t p a g e o f t h i s s c h e du l e ) $ . 5- D