iowa federation of animal owners9724scanned

8/7/2019 Iowa Federation of Animal Owners__9724__scanned

1/4

FOR I NSTRUCTI ONS,SEE BACKOF FORM

DI SCL OSURE SUMMARY PAGE

COMMI TT EENAME ( M u s tb e s a me a s o n S t a t e me n to fOr g a n i z a t i o n )

I OWA FEDERATI ON OF ANEVI ALOWNE RS

I MPORTANT: I n d i c a t eb y# t y p eo f c o mmi t t e ey o ua r er e p o r t i n gf o r:( 1) S t a t e w i d e / L e g i s l a t i v e / J u d g eS t a n d i n gf o rR e t e n t i o nCa nd i d a t e( 2 ) S t a t ePAC(3 ) S t a t eP a r t y(4 ) C o u n t yC e n t r a lC o mmi t t e e(5 ) C o u n t yCa nd i d a t e(6 ) C i t yCa n d i d a t e(7 ) S c h o o lB o a r do rO t h e rP o l i t i c a lS u b d i v i s i o nCa nd i d a t e(8 ) C o u n t yPAC ( 9 ) C i t yPAC ( 1 0) S c h o o lB o a r do rO t h e rP o l i t i c a lS u b d i v i s i o nPAC ( 1 1) L o c a lB a l l o tI s s u e

CANDI DATECOMMI TT EESONLY:Ca n d i d a t eName P o l i t i c a lP a r t y( i fa p p l i c a b l e )

O f f i c eS o u g h t \ 0 / I I D i s t r i c t( i fS en a t eo rHou s e )

WCLI LTNK #SI GNATUREOF PERSON F I L I NGREPORT

IAM F I L I N GAJULY1 9 t h' 2 0 0 5

( r e p o r td a t e )

EI CHECKI FAMENDMENT TO REPORT DATED

0 Che c ki ft h i si s f i n a l( t e r mi n at i o n )r e p o r ta n da t t a c h No t i c eo fD i s s o l u t i o nF o r mDR- 3.( Yo umus tc o n t i n uet of i l er e p o r t su n t i la DR- 3 i s f i l e d. )

Re s e tFo r m

REPORT FOR ( 1 )ELECTI ON/ ( 2 ) NON- ELECT I ONYEAR.I n d i c a t eb y#

STATEMENT OF CASH ON HAND

5 / 5 - 9 ' 8 9 - 11 -1 5 5 I ` 1 1 - 8 - 0 5-TEL EPHONE DATESI GNED

CASHON HAND a t t h eb e g i n n i n go ft h er e p o r t i n gp e r i o d. ( T o t a l o fa l lf u n d sh e l db yt h ec o mmi t t e e. T h i samountMUSTb e t h esame a s t h ec a s h o nh a n da t t h ee n do f t h el a s tr e p o r t i n gp e r i o do rmu s t b ez e r oi ft h i si sf i r s tr e p o r tf i l e d. ) . . .. . .. . .. .. ... . .. . . . . . . .. . .. . . . ..$ 3 0 2 5. 0 0

ADD TOTALMONEY TAKENI NTHI SPERI ODSc h e d u l eA : Ca sh Co n t r i b u t i o n st o t a l( A t t a c hS c h e d u l eA ) ( * a l s os e e i n - k i n db e l o w ).. . .. . . . .. $ 5 6 2 5. 0 0

S c h e d u l eF : L o a n sR e c e i v e dt o t a l( A t t a c hS c h e d u l eF ). . .. . .. .. . .. . . . .. . .. . . . .. . .. . .. .. .. . . .. . .. . . . .. . .. . . . ..

Sc h e d u l eH : To t a lSa l e so fCamp a i g nP r o p e r t y( A t t a c hSc h e d u l eH). . . . . .. . . . .. .. .. .. . .. . . . .. . .. . . . ..

( Sc h ed u l eH a pp l i e s_t oCa n di d a t e s 'Co mmi t t e e s n l

SUB- TOTAL. .. ..$ 8 6 5 0. 0 0SUBTRACT TOTALMONEY SPENTTHI SPERI ODSc h e d u l eB: E xp e nd i t u r e st o t a l( A t t a c hS c h e d u l eB )( * * a l s os e ed e b t sa n dl o a nsb e l o w ).. . . $ 6 0 5 5. 1 0

S c h e d u l eF : L o a nRep a ymen t st o t a l( A t t a c hS c h e d u l eF ). . .. .. . .. . . . . . . .. . .. . . . .. ... .. .. . . . . . .. . . . .. . .. . . . ..

CASHON HANDa t t h ee n do ft h i sr e p o r t i n gp e r i o d( i ff i n a lr e p o r tb a l a n c emust2 5 9 4. 9 0b ez e r o )( A t t a c hDR- 3 ). . .. . .. . . . .. . .. . . . .. . .. .. . .. . .. .. . .. . . . .. . . . . .. . .. .. . .. . .. .. . .. . . . .. . .. . . . .. . .. . . . .. ... . .. . . . .. . .. . . . . . . . .$

* ' UNPAI D BI L LS( F r o mS c h e d u l eD - A t t a c hS c h e d u l eD). .. .. ... ... . .. . .. .. ... . .. .. . .. .. ... . .. . .. .. ... .. .. .. . .. .. . .. . .. ..$

* I NKI NDCONTRI BUTI ONS( F r o mS c h e d u l eE - A t t a c hS c h e d u l eE ) . . .. . .. . . . .. . .. . . . .. .. .. . .. .. . . . .. . .. . . . .. . .. . .$

" OUTSTANDI NGL OANS ( F r o mS c h e d u l eF - A t t a c hS c h e d u l eF ). .. . . . . . . .. . . . .. . .. . . . .. ... . .. . .. .. . .. . .. . . . .. . . . . .$CANDI DATECOMMI TTEES ONLY:CONSULTANTBREAKDOWN ( S c h e d u l eG A t t a c h e d ? )VALUE OF CAMPAI GNPROPERTY ( F r o mS c h e d u l eH - A t t a c hS c h e d u l eH) $

FORM

DR- 2 I DI SCLOSURE( R e v. 0 7 / 2 0 0 4 ) REPORT

F o rO f f i c eUs e On N

Comm. #L o g g e dI n

S c a n n e dC o mp u t e rA ud i t e d

L a t er e p o r t sa r es u b j e c tt op o s s i b l ec i v i la n d c r i mi n a lp e n a l t i e s.

L o c a lC ommi t t e e s ,e n t e rD a t eo f E l e c t i o n

C o u n t y&L o c a lC ommi t t e e s ,e n t e rC o u n t yi nw h i c hE l e c t i o ni sh e l d

YES NO


2/4

Fo r I n s t r u c t i on s , Se e Back o f Fo r m

CONTRI BUTI ONS - - MONEY TAKEN I N( I n c l u d i n gc a n d i d a t e ' s p e r s o n a lf u n d s )

COMMI TT EE NAME ( Mu s t b e s a me a s o n S t a t e me n t o f Or g a n i z a t i o n)

= -0W0- VPC) f l r ab' Un 0S- h1) i n~a1 OLA) 1 -1 - PY' 5

Re s e t Fo r m

STATE CANDI DATES NOTE : I FA CONTRI BUTI ONI SRECEI VEDFROMA STATE PAC ( P OL I T I CALACTI ONCOMMI TTEE) ,L I S TTHE PAC I DENT I F I CATI ONNUMBERAND THE PAC CHECK NUMBER I NTHE DESI GNATEDCOLUMN . A L I STOF I DNUMBERS I SAVAI LABLEFROM THE I OWAETHI CSAND CAMPAI GNDI SCLOSUREBOARD .

CAUTI ON : Se c t i o n 6 8B . 3 2 A ( 6 ) ,I o wa Code , p r o h i b i t st h e u s e o f i n f o r ma t i onc o p i e d f r o m r e p or t s a n d s t a t e me n t s f o r s ol i c i t i n gc o nt r i b ut i o nso rf o ran y c omme 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 yp o l i t i c a lc o mmi t t e es .

SUB- TOTAL

TOTAL ( i fl a s t p a g e o f t h i s s c h e d u l e )

Di s c l o s u r el awr e q u i r e sc a nd i d a t ec ommi t t e es t o d i s c l o s et h er e l a t i o n sh i p o fa n y r e l a t i v ema k i n g a c on t r i b u t i o n t ot h ec ommi t t e e. Re l a t i o n s h i pmus t b e s h ow n t o t h e t h i r dd e g r e eo f c o n s a n g u i n i t y( b l o o dr 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 sb yma r r i a g e ). I fs u r n a me o f c o n t r i b u t o ri s t h es ame a s c an di d a t e , b ut t h e r ei s n o Page ~- o f _ 1 2f a mi l i a lr e l a t i o n s h i p ,e n t e r" n o t a pp l i c a b l e "i nt h e r e l a t i o n s h i pc o l umn. ( f o rSc h e d u l e A)

SCHEDUL E

A MONETARY( Rev . 0 7 / 0 3 ) RECEI PTS

CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I DNUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i fa p p l i c a b l e ) TO CANDI DATE` RECEI VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i fa p p l i c a b l e ) RAI SER

NUMBER I NCOME

ID#

Rr i a n ~ , D a r r c ~ c ~ - ~

CK# I C ) s3 s s s h a L 0 t ,C ).m a 2 6aZO .

I D#~j c k y r , ~M a h a n

- a3 - CS c K# A 0 1 L30 x > UoZ ~5

oD 0

I D# CUI ` t - I ' S L r r"

CK#-* 1 1 3 i y c t r , 0 t , _ s c L j-

1 ' 6 ~ 0 '1 t v . / S.A b 3 -

I D# CI J a r e ~Ce w e t l j e t _- y - o 5 CK#

I D# Gec a I d l - a u ( - aBoneCK# 1 3 s c l Bl a c k h c t wkRd

O P~ UL wc ~ s a S0 - . X1 0 0I D# R. G. Be u. Ke i ma n

3 CK# ? y y ( U. PY ) a i nRUC'

SUU .f > LUGL ~ : 5 vI D# k a n C1 Ruby

-

z - - 1 ( g- ~5 CK# a5l c 'St

~_J a ~ r ~ l . l ~JI D# Ph i l l i

T1 30 G-

BG1~~C ' Y

0CK#r t - - S-0138 -

I D# Ff anC i 5 Ct x ( -, j

c K#e( - - c6 C*L L A -r r ~ 1.k ?a zUw~cc . 5 ~50Ido v c

I D# j -oe C ; - e r s t

3 - 1 ( a O5 CK#1j ' 7 0 C? j - i n o - J -G h t ) S U r - )

O -ma t 1 c c - ~ c r t.u 5 a 3


3/4

Fo r I n s t r u c t i o n s ,Se e Back o f Fo r m

CONTRI BUTI ONS - - MONEY TAKEN I N( I n c l u d i n gc a n d i d a t e ' sp 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 eme n t o f O r g a n i z a t i o n )

I OWA FEDERATI ON OF ANI MAL OWNERS

STATE CANDI DATESNOTE: I FACONTRI BUTI ONI SRECEI VEDFROMASTATEPAC( P OL I T I C A LACTI ONCOMMI T T E E ) ,L I S TTHEPAC I D EN TI F I C AT I ONNUMBER ANDTHE PACCHECKNUMBERI NTHEDESI GNATEDCOLUMN. AL I S TOF I DNUMBERSI SAVAI L A B L EFROMTHEI OWAETHI CSANDCAMPAI GNDI SCLOSUREBOARD.

CAUT I ON: S e c t i o n6 8B. 3 2 A ( 6 ) ,I o wa Co d e,p r o h i b i t st h eu s e o f i n f o r ma t i o nc o p i e df r o mr e p o r t san d s t a t e m e n t sf o rs o l i c i t i n gc o n t r i b u t i o n so rf o ra n y c omme r c i a lp u r p o s eb y an y p e r s o no t h e rt h a ns t a t u t o r yp o l i t i c a lc o mmi t t e e s.

SUB- TOTALI $ a ~9 C? S ".

` L

TOTAL ( i fl a s tp a g e o f t h i ss c h ed u l e ) I$5 , 4, d6-

_

*D i s c l o s u r el a wr e q u i r e sc a n d i d a t ec o mmi t t e e st od i s c l o s et h er e l a t i o n s h i po fa n yr e l a t i v ema k i n ga c o n t r i b u t i o n t ot h ec o m m i t t e e. R e l a t i o n s h i pm u s tb e s h o wnt ot h et h i r dd e g r e eo fc o n s a n g u i n i t y( b l o o dr e l a t i v e s )a n da f f i n i t y( r e l a t i v e sb yma r r i a g e ). i fs u r n ame o fc o n t r i b u t o ri st h es ame a s c a n d i d a t e ,b u tt h e r ei sn o Page _~ o f_5Zf a m i l i a lr e l a t i o n s h i p ,e n t e r" n o ta p p l i c a b l e "i nt h er e l a t i o n s h i pc o l umn. ( f o rS c h e d u l eA )

SCHEDULE

A MONETARY( Re v. 0 7 / 0 3 ) RECEI PTS

Q CHECK THI SBOXI FAMENDI NGFORM

DATERECEI VED

PACI DNUMBER( i fa p p l i c a b l e )

NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I FFOR( MM/ DD/ YR) AND PACCHECK

TO CANDI DATE*( i fa p p l i c a b l e )

RECEI VED FUND-RAI SER

NUMBER I NCOMI D# 7a r ba r c & ~CGC' C7r l

3 - - I I C-G 5 CK# I G oCA- Dt % I ( . ~3 y $

I D# Ba l l- b c t r c lE . G ~ r c JCK# I IH I F Cc C o c . ~r ~ t y Rd, ' 034 E: 1,.

i & , p I, V C d L -%Ijm 0 ( 0 ( 0 1

I D# Bo b I h tBox - ~5

h s3 - 1 ( Q-U5CK# P, 0. 3 y

L t - )h v o r j + - c 3 v - )mL . ( 0 4 I C JI D# L~ c = d I t i l c , ~ Cl Gl i l

- , A C , CK# u cx 3 31

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1 1 0

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I D#

CK#

Dt , t CW le l l .: >ccuoci e~r wood

1 1 er

Rut .

Ch F6 C ; z a5 C%&1 SI D# R i c h a r dK I u b er t a v lz

3 c K # J - 4 1 t ,K " f f q s1 - Y n r ~I C IS t C 7a eh G'1 1 u ~= s 3 : ~~ ~ ~

I D# S- r euen Kr use

3 - X7 - b 5 c K# a 3 ~I S > - i i ~n wc t yI h

ID# tJ ; t 700 J i nn - - To

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I D## k ar i ~ x Wi ese

c K# 3asU N~ 9 6 t l" - =. . ~ , aaoI D#

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35- 0ma na r d - TH 5c ) t o ~5


4/4

THI SBOX APPLI ESTO CANDI DATES'COMMI TTEES ONLY :

P u r c h a s e so fc e r t a i nc amp a i g np r o p e r t yc o s t i n g$ 5 0 0o r mo r emusta l s ob e i n v e n t o r i e do n S c he d u l eH. ( R e f e rt o S c he d u l eH i n s t r u c t i o n s. )

E x p e n d i t u r e st o p er s on s / e n t i t i e s p r o v i d i n g c on su l t i n g ,a dv 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 gs e r v i c e smusta l s ob e d e t a i li t e mi z e do nSc h e d u l eG b yt h ea mo u n t ,p u r p o s e ,a n dd a t eo fe a c ht y p eo fe x pe n d i t u r emade b y t h ep e r s o n / e n t i t yo nb e ha l fo f t h e c an d i d a t e ' sc o mmi t t e e. ( R e f e rt oSc h e d u l eG i n s t r u c t i o n sa n d I o w aCo d e 6 8 A. 4 0 2 ( 3 ) ( i ). )

( f o rSc h e d u l eB )

FOR I NSTRUCTI ONS,SEE BACK OF FORM R e s e tFo r m SCHEDUL E

EXPENDI TURES B MONETARY- - MONEY SPENT FROM COMMI TTEE ACCOUNT ( R e v. 0 7 / 0 3 ) EXPENDI TURESSTATEPACCOMMI TT EES: NOTE: FORCONTRI BUTI ONSMADETOSTATEWI DEOR LEGI SLAT I VECANDI DATES,L I S TTHECANDI DATEI DENT I F I CAT IONNUMBERI NTHEDESI GNATEDCOLUMN ANDTHE CHECK THI S BOX I FPACCHECK NUMBERFOREACHEXPENDI TURE. A L I S TOF I DNUMBERSI SAVAI LABLEFROMTHE I OWA AMENDI NG FORMETHI CS&CAMPAI GNDI SCLOSUREBOARD.

COMMI TT EENAME( Mu s t b es ame a s o n S t a t e me n to f O r g a n i z a t i o n )

I OWA FEDERATI ON OF ANI MAL OWNERS

CANDI DATE NAME ANDADDRESSTOWHOM PURPOSE AMOUNTDATE I DNUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED

EXPENDED ( i fa p p l i c a b l e ) ( D i s b u r s e me n t )WAS MADE( MM/ DDI YR) AND PAC

CHECKNUMBER

I D# 0 i 1 / Kl l r i 1 1 Pr i n i k i t t l Pa r ant - f o r3- 8 - 05 - CK# . I 0 t 1

/ U( O Pr a y r 1 ' ~ Cr y / v b b ~r t a c d ~~ $ ~ ,c. . a s

C a r l ' mPS ~ ' ~ SOl l lI D# g i l l V I '- Fi n a l t a m p , - 7 t7 F o r -CK# / OGl 1 0 A - 1t ULO p r a i r i eC r t ? t ? Kr , l o bby e o r , f r a c t - dUD5

3000CC)

Gf - i n -? &5

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I D# L ' (0 00 GI ` f u f L l. ~ - F S I e r oBank C i I l ( ' C I ~ S: . . a CK# o f d s P.C3. gox 9 q . l e a

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~P ' I ~ s l ~CK#~~~~` . a . bo x

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C ja r 1 SPA 5017I D# '

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SUB- TOTAL $

TOTAL ( i fl a s tp a g e o f t h i ss c h e du l e )I

iowa federation of animal owners__9724__scanned

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iowa federation of animal owners9724scanned