mcroberts pete1621scanned

8/7/2019 McRoberts Pete__1621__scanned

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FOR I NSTRUCT I ONS, SEE BACK OF FORM

DI SCLOSURE SUMMARY PAGE

COMMI TT EE NAME ( M u s t b e same 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

McR. o b e r t s f o r I o wa

I MPORTANT I n d i c a t e b y # t y p e o f c o m m i t t e e y o u a r e r e p o r t i n g f o r : L l( 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 e S t a n d i n g f o r R e t e n t i o n C a n d i d a t e ( 2 ) S t a t e PAC ( 3 ) S t a t e P a r t y( 4 ) C o u n t y C e n t r a l C o mm i t t e e ( 5 1 C c i t r n t y - C a n d a t e ( 6 ) C i t y C a n d i d a t e ( 7 ) S c h o o l B o a r d o r O t h e rP o l i t i c a l S u b d i v i s i o n C a n d i d a t e ( $ ) CDg n t y PA q : ( , PA G r - { 1 Q; ) S c h o o l B o a r d o r O t h e r P o l i t i c a l

S u b d i v i s i o n PAC ( 1 1 ) L o c a l B a l l o t l u c r e

CANDI DATE COMMI TT EES ON Y :C a n d i d a t e Name

P e t e Mc Ro b e r t s

P o l i t i c a l P a r t y ( i f a p p l i c a b l e )

Demo c r a t

L a t e r e p o r t s a r e s u b j e c t t o p o s s i b l e c i v i l a n d c r i mi n a l p e n a l t i e s . P u r s u a n t t o I o wa Code s e c t i o n 6 8 B . 3 2 A ( 7 )

t h e c a n d i d a t e , f o r a c a n d i d a t e ' s c o mm i t t e e , a n d t h e c h a i r p e r s o n , f o r a n y o t h e r t y p e o f c o mmi t t e e , i s t h e

i n d i v i d g a ~ r e s p p n s i b l e f o r ~ f i l i n g " y a n d a c c u r a t e r e p o r t s .i

S I ( MATURE OF PERSON F I L I N G REPORT TELEPHONE

I AM F I L I N G A1 0 / 3 1 / 0 6

/ 1 - 3 - 0 Co

( r e p o r t d a t e ) I n d i c a t e b y #

CHECK I F AMENDMENTTO REPORT DATED

Ch e c k i f t h i s i s f i n a l ( t e r mi n a t i o n) r e p o r t a n d a t t a c h N o t i c e o f D i s s o l u t i o n F or m DR - 3 .( Y o u m u s t c o n t i n u e t o f i l e r e p o r t s u n t i l a DR- 3 i s f i l e d . )

SUBTRACT TOTAL MONEY SPENT T HI S PERI OD

r e s e t Fo r m

REPORT FOR ( 1 ) ELECT I ON / ( 2 ) NON- ELECT I ON YEAR

( Sc h ed u l e H a p p l i e s t o Ca nd i d a t e s ' Commi t t e e s On l y )

SUB - TOTAL . . . . . . . . . . . . . . . . . . . . . . . $ 2 7 , 1 9 0 . 7 7

Sc h e d u l e B : E x p e n d i t u r e s t o t a l ( A t t a c h Sc h e d u l e B ) ( * * a l s o s e e d e b t s a n d l o a n s b e l o w ) . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n Re pa y men t s t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ONHAND a t t h e e n d o f t h i s r e p o r t i n g p e r i o d ( i f f i n a l r e p o r t b a l a n c e mu s t

b e z e r o ) ( A t t a c h D R- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $

FORM

DR- 2( R e v . 1 2 / 2 0 0 5 )

F o r Of f i c e Us e On l y

Comm . #

L o g g e d I n

Scanned

C o mp u t e r -

A u d i t e d

F i l e w i t h :I o w a E t h i c s a n d Campa i gn

D i s c l o s u r e B o a r d5 1 0 E . 1 2 " ' , S t e . 1 ADes Mo i n e s , I o w a 5 0 3 1 9

F a x : 5 1 5 - 2 8 1 - 3 7 0 1

DATE SI GNED

L o c a l C o mmi t t e e s , e n t e r D a t e o f E l e c t i o n

C o u n t y 8 L o c a l C omm i t t e e s , e n t e r C o u n t y i n

w h i c h E l e c t i o n i s h e l d

1 9 , 8 9 3 . 7 1

7 , 2 9 7 . 0 6

DI SCLOSURE

REPORT

' * UNPAI D BI L LS ( F r o m S c h e d u l e D - A t t a c h Sc h e d u l e D $ 00 . 00

* I N KI ND CONTRI BUT I ONS ( F r o m S c h e d u l e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

* * OUTSTANDI NG LOANS ( F r o m S c h e d u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) - YES - NO

CANDI DATE COMMI TT EES ONLY:

VALUEOF CAMPAI GN PROPERTY ( F r o m S c h e d u l e H - A t t a c h Sc h e d u l e H ) $

STATE COMMI TT EES : S u b m i t a r e c o n c i l e d c a mp a i g n a c c o u n t b a n k s t a t e m e n t i n J a n u a r y o f e a c h y e a r .

STATEMENT OF CASH ON HAND

CASH ON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d . ( T o t a l o f a l l f u n d s h e l d b y t h e

c o mm i t t e e T h i s amount MUST b e t h e same a s t h e c as h o n h a n d a t t h e e n d2 0 , 1 0 0 . 7 7

o f t h e l a s t r e p o r t i n g p e r i o d o r mu s t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADD TOTAL MONEY TAKEN I N T HI S PERI OD7 , 0 9 0 . 0 0

Sc h e d u l e A : Cash C o n t r i b u t i o n s t o t a l ( A t t a c h S c he d u l e A ) ( * a l s o s e e i n - k i n d b e l o w ) . . . . . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n s R e c e i v e d t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e H : T o t a l S a l e s o f Campa i g n P r o p e r t y ( A t t a c h S c h e d u l e H ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .



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

CONTRI BUTI ONS - - MONEY TAKEN 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 St a t e me n t o f O r g a n i z a t i o n )

Mc R o b e r t s f o r I o w a

R e s a t Fomn

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECE I VED FROM A STATE PAC ( P O L I T I C A L ACT I ON COMMI TTEE) , L I S T THE PAC I DE NT I F I CA TI ONNUMBERAND T HE PA C CHECK NUMBER I N THE DES I GNATED COLUMN A L I S T OF I D NUMBERS I S AVA I L AB LE FROM T HE I OWA ETHI CS ANDCAMPA I GNDI SCLOSURE BOARD.

NOTE : ANY PERSON, OTHER THAN AN I N D I V I D U A L , THAT CONTRI BUTES MORE THAN $ 7 5 0 T O YOUR CAMPAI GN MAY HAVE F I L I N GRE SPONS I BI L I T I E S AND SHOULD I MMEDI A TE L Y CONTACT T HE BOARD.

CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , 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 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 r f o r a n yc o mme r c i a l p u r p o s e b y a n y 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 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 m m i 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 m a k i n g a c o n t r i b u t i o n t o t h e

c o m m i t t e e R e l a t i o n s h i p m u 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 y 1 4m a r r i a g e ) . 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 a m e a s c a n d i d a t e , b u t t h e r e i s n o Pa ge o f -f 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 Sc h e d u l e A )

SCHEDULE

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

FI CHECK T HI S BOX I F

AMENDI NG FORM

DATE PA C I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT J I F FORRECE I VED ( i f a p p l i c a b l e ) T O CANDI DATE* RECEI V ED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RA I S ER

NUMBER I NCOME

I D#I o w a D e mo c r a t i c P a r t y $ 1 2 0 0

1 0 / 1 6 / 0 6CK# 5 6 6 1 F l e u r Dr D e s M o i n e s I A 5 0 3 2 1

I D#

J u d y H a r l a n d2 51 0 / 1 7 / 0 6 CK# 3 1 9 l 3 t h Av e NE I n d e p e n d e n c e I A 5 0 6 4 4

I D#

J u l i e S m i t h 2 5 01 0 / 1 7 / 0 6

CK# 3 9 1 7 H i l l c r e s t Dr D e s Mo i n e s I A 5 0 3 1 0

I D#

Pa m H o g a n 5 01 0 / 1 7 / 0 6 CK# 5 4 4 E a s y S t . , Wi n t h r o p , I A , 5 0 6 8 2

I D#

Ed Ga l l a g h e r 1 5 01 0 / 1 8 / 0 6 CK# 8 0 0 P r o s p e c t B l v d , Wa t e r l o o , I A , 5 0 7 0 1

I D#

Mi k e G a l l i g a n 2 0 01 0 / 1 8 / 0 6CK# 2 4 2 5 J o r d a n T r a i l , W D e s Mo i n e s , I A , 5 0 2 6 5

I D#Ro n C u r r y 7 5

1 0 / 2 0 / 0 6CK# 4 0 3 5 t h Av e S E , I n d e p e n d e n c e , I A , 5 0 6 4 4

I D#D a r r e l l W e n z e l 1 0 0

1 0 / 2 0 / 0 6CK# 1 0 1 1 7 t h S t NE , I n d e p e n d e n c e , I A , 5 0 6 4 4

I D#P h i l J a m e s 5 0

1 0 1 2 3 / 0 6CK# 1 1 5 2 2 1 s t S t # 1 , De s Mo i n e s , I A , 5 0 3 1 1

I D#

Da n C o h e n 2 51 0 / 2 3 / 0 6CK# 4 0 6 Wo o d l a n d D r , H a z l e t o n , 1 A , 5 0 6 4 1



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



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 )


RE SP ONS I B I L I T I E S AND SHOULD I MMEDI AT E L Y CONTACT THE BOARD .

R e s e t F o r m

STATE CANDI DAT E S NOT E : I F A CONTR I B UT I O N I S RECE I VED FROM A S T AT E P AC ( P OL I T I C A L ACT I ON COMMI T TEE ) , L I S T THEPAC I DE NT I F I CAT I ONNUMBER AND T HE PACCHECKNUMBER I N THE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD

NOTE : ANY PERSON , OTHER T HAN AN I N DI V I D U AL , THAT CONTR I BUT ES MORE THAN $ 7 5 0 TOYOUR CAMPAI GN MAYHAVE F I L I N G

CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , 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 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 r f o r an 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 e s .

SUB - T O T AL

TO TA L ( 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 mm i 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 m a k i n g a c o n t r i b u t i o n t o t h e

c o mm i t t e e . R e 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 y 2 4ma r r i a g e ) 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 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 Pa ge o f

f 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 7 / 0 3 ) R ECE I P T S

CHECK T HI S B OX I F

AMEND I NG FORM

DATE PAC I D NUMBER NAMEAND ADDRESS O F CONT R I B UT O R RE L AT I ONSHI P AMOUNT J I F FORRECE I V ED ( i f a p p l i c a b l e ) T O CANDI DATE* RECE I V ED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI S E R

NUMBER I NCOME

I D#Cor y H a i g h t $ 1 0

1 0 / 2 3 / 0 6CK# 4 0 8 5 t h S t W, I n d e p e n d e n c e , I A , 5 0 6 4 4

I D#J a n e R i e s s e n 5 0

1 0 / 2 3 / 0 6 CK# 3 1 6 K i mb e r l y Dr ,WB u r l i n g t o n , I A , 5 2 6 5 5

I D#B r e n d a n Gr e i n e r 2 5

1 0 / 2 3 / 0 6CK# 4 2 1 N P l e a s a n t H i l l B l v d , P l e a s a n t H i l l , I A , 5 0 3 2 7

I D#

A n n e N o l t e 5 01 0 / 2 3 / 0 6 CK# 6 2 0 4 t h S t S E , I n d e p e n d e n c e , I A , 5 0 6 4 4

I D#C y n t h i a Wa t e r s 3 0

1 0 / 2 3 / 0 6CK# 1 5 8 6 2 6 0 t h S t SW, I n d e p e n d e n c e , I A , 5 0 6 4 4

I D#

Ro n G i d d i n g s 1 0 01 0 / 2 4 / 0 6CK# 2 1 2 3 d Av e S E , I n d e p e n d e n c e , I A , 5 0 6 4 4

I D#J o h n K l o t z b a c h 1 0 01 0 / 2 4 / 0 6

CK# PO Box 3 7 1 , I n d e p e n d e n c e , I A , 5 0 6 4 4

D#UFCW I n t e r n a t i o n a l U n i o n 5 0 0

1 0 ? 2 4 / 0 6CK# 1 7 7 5 K S t . , Wa s h i n g t o n , D C , 2 0 0 0 6

0 0 3 7 5 2 3 7

I D #J e r r y C r a w f o r d 2 5 0

1 0 / 2 4 / 0 6 CK# 1 7 0 1 R u a n C e n t e r , D e s Mo i n e s , I A , 5 0 3 0 9

I D#

Mi k e S t a r c e v i c h 5 01 0 / 2 4 / 0 6CK# 6 4 0 1 K i r k w o o d B l v d , C e d a r R a p i d s , I A , 5 2 4 0 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 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 as on S t a t e me n t o f O r g a n i z a t i o n )


R e s e t F a r m

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THEPAC I DENTI F I CATI ONNUMBER AND THE PACCHECKNUMBER I N THEDESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD

NOTE : ANY PERSON, OTHERTHAN AN I N DI V I D U A L , THAT CONTRI BUTES MORE THAN $ 7 5 0 TO YOUR CAMPAI GN MAY HAVE F I L I N GRESPONSI B I L I T I ES AND SHOULD I MMEDI ATELY CONTACT THE BOARD .

CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , 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 r f o r a n yc 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 o mmi t t e e s .

SUB- TOTAL



c o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o wn 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 ) . I f s u mame 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 Page

f 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 .

3o f

4

( f o r Sc h e d u l e A )

SCHEDULE

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

CHECK THI S BOX I F

AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FORRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

I D#S t e v e O v e l $ 5 0

1 0 / 2 4 / 0 6CK# 2 2 5 9 Wa s h i n g t o n Av e . , C e d a r R a p i d s , I A , 5 2 4 0 3

I D#

D a v e M i z e 7 51 0 / 2 5 / 0 6 CK# 1 2 4 0WA j o W a y , T u c s o n , A Z , 8 5 7 1 3

I D#P h i l J a m e s 2 0 01 0 , / 2 5 / 0 6

CK# 1 1 5 2 2 1 s t S t # 1 , D e s Mo i n e s , I A , 5 0 3 1 1

I D#6 4 1 4 H a w k e y e L a b o r C o u n c i l P o t . Ed . A c t i o n Cmt e 1 0 0 01 0 / 2 5 / 0 6 CK# 1 2 1 1 Wi l e y B l v d , C e d a r R a p i d s , I A , 5 2 4 0 41 0 2 7

I D#C h r i s S a l i n a s 5 0

1 0 / 2 5 / 0 6 CK# 3 4 5 P u r d y S t . , J e s u p , I A , 5 0 6 4 8

I D#

S a l l y B r o wn e 2 5 01 0 / 2 5 / 0 6CK# 8 0 1 0 J e s u p Rd . , J e s u p , I A , 5 0 6 4 8

I D#C y n d i S mi t h 1 0 0

1 0 ' 2 6 / 0 6CK# 3 8 3 7 B o s t o n Av e . , D e s Mo i n e s , I A , 5 0 3 1 0

I D#C y n d i S mi t h 1 0 0

1 0 / 2 6 / 0 6CK# 3 8 3 7 B o s t o n Av e . , D e s Mo i n e s , I A , 5 0 3 1 0

I D#S c o t t T e n l e y 2 5

1 0 ,1 2 6 / 0 6 CK# 1 5 3 C h i s w i c k Rd . , B r i g h t o n , MA, 0 2 1 3 5

I D#

I s a a c Oh 5 01 0 / 2 6 / 0 6CK# 4 5 7 1 K a t e s Rd . , N i c e v i l l e , F L , 3 2 5 7 8



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



COMMI TTEE NAME ( Mu s t b e s ame 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 )


R ES PONS I B I L I T I E S AND SHOULD I MME DI A T E L Y CONT ACT T HE BOARD.

SCHEDULE

A MONETARY( R e v . 0 7 / 0 3 ) RECE I P T S

CHECK T HI S BOX I F

AME NDI NG FORM

STATE CANDI DA T ES N OT E : I F A CONTR I BU T I ON I S RECE I V ED FROM A S TATE PAC( P OL I T I C A L ACT I ON COMMI T TEE ) , L I S T T HE PACI DE NT I F I CA T I O NNUMBERAND T HE P AC CHECK NUMBER I N T H E DE S I GN AT E D COLUMN A L I S T OF I D NUMBERS I S AVA I L A B L E FROM T HE I OWA E TH I CS AND CAMPAI GND I SCLOSURE BOARD

NOTE ANY PERSON , OTHER T HA N A N I N D I V I D U A L , T H AT CONT R I B UT E S MORE THAN $ 7 5 0 TOYOUR CAMPA I GN MAY HAVE F I L I N G

CAUT I O N : S e c t i o n 6 8 B . 3 2 A( 6 ) , 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 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 r f o r a n y

c omme r c i a l p ur p o s e b y a ny 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 - T O T A L



c o m m i t t e e R e l a t i o n s h i p m u s t b e s h o wn 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

m a r r i a g e ) . I f s u m ame o f c o n t r i b u t o r i s t h e s a m e 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

f 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 .4

o f4

( f o r S c h e d u l e A )

DATE PAC I D NUMBER NAMEAND ADDR E S S OF CONTR I BU TOR R EL A T I ON SHI P AMOUNT J I F FORRECE I V ED ( i f a p p l i c a b l e ) T O CANDI DAT E * RECE I V ED FUND-( MM/ DDI YR) AND P AC CHECK ( i f a p p l i c a b l e ) R AI S E R

NUMBER I NCOME

I D#Pa m H o g a n $ 5 0

1 0 / 2 6 / 0 6CK# 5 4 4 E a s y S t . , Wi n t h r o p , I A , 5 0 6 8 2 , 5 0 6 8 2

I D#

UFCW I n t e r n a t i o n a l U n i o n1 0 0 01 0 ! 2 7 / 0 6 CK# 1 7 7 5 K S t . , Wa s h i n g t o n , D C , 2 0 0 0 6

0 0 3 7 5 3 4 0

I D#

J o h n H e d g e c o t h 5 01 0 / 2 8 / 0 6CK# 3 5 0 0 F Av e NW, C e d a r R a p i d s , I A , 5 2 4 0 5

I D#9 7 2 5 B l a c k Hawk U n i o n C o u n c i l P o l i t i c a l Ed F u nd 5 0 0

1 0 / 2 8 / 0 6 CK# 1 6 9 5 B u r t o n Av e . , Wa t e r l o o , I A , 5 0 7 0 32 0 1 7

I D#B i l l K n a p p 1 0 0

1 0 / 3 0 / 0 6 CK# 4 9 4 9 We s t o w n P k w y , WD e s Mo i n e s , I A , 5 0 2 6 6

I D#

G e r a r d N e u g e n t 1 0 01 0 / 3 0 / 0 6CK# 4 9 4 9 We s t o w n P k w y , WD e s Mo i n e s , I A , 5 0 2 6 6

I D#Ma r k H a l v e r s o n 1 0 0

1 0 / 3 1 / 0 6CK# 1 6 7 3 C o l u m b i a Rd . , No 7 0 3 , Wa s h i n g t o n , DC ,

2 0 0 0 9I D#

CK#

I D#

CK#

I D#

CK#



T HI S BOX APPL I ES TO CANDI DATES' COMMI TTEES ONLY :

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 mu s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H . ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )

E x p e n d 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 mu s t a l s o b e d e t a i l i t e m i z e d o n

S c h e d u l e G b y t h e a mo u 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 p e n d 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 d i d a t e ' s c o mmi t t e e . ( R e f e r t o

S c h e d u l e G i n s t r u c t i o n s a n d I o w a Code 6 8 A . 4 0 2 ( 3 ) ( i ) . )

( f o r S c h e d u l e B )

FOR I NSTRUCTI ONS, SEE BACK OF FORM ' R e s e t Fo r m ISCHEDULE

EXPENDI TURES B MONETARY- - MONEY SPENT FROMCOMMI T T EE ACCOUNT

( Re v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E GI S L AT I V ECANDI DATES, L I S T THE CANDI DATE I D ENT I F I CA T I O N NUMBER I N THE DESI GNATED COL UMN AND THE CHECK T HI S BOX I F

PAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NG FORM

ETHI CS & CAMPAI GN DI SCLOSURE BOARD

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 )


CANDI DATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE I D NUMBER EXPENDI TURE ( DESCR I BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE

( MM/ DD/ YR) AND PACCHECK

NUMBER

I D#Wa l M a r t Of f i c e S u p p l i e s

1 0 / 1 8 / 0 6 3 0 2 E n t e r p r i s e Dr . , I n d e p e n d e n c e , I A , 3 5 . 2 8CK# $5 0 6 4 4

I D#US P o s t a l S v c S t a mp s

1 0 / 1 9 / 0 6 I n d e p e n d e n c e , I A , 5 0 6 4 4 7 2 . 0 0CK#

I D #S t r a t e g i c Me d i a , L t d Ma i l P i e c e s

1 0 / 2 3 / 0 6 1 1 0 7 W S a n M a r n a n Dr . 1 9 7 3 9 _ 9 2CK#Wa t e r l o o , I A , 5 0 7 0 1

I D #C l i f f K u e h n R e i mb u r s e me n t f o r c o s t s o f c o f f e e

1 0 / 2 3 / 0 6 3 1 4 6 t h Av e . SW, I n d e p e n d e n c e , I A e v e n t i n o f f i c e 1 3 . 0 0CK#5 0 6 4 4

I D # P a y p a l D e d u c t i o n P e r i o d o f 1 0 / 1 4 / 0 6 t o 1 0 / ' 3 1 / 0 6

1 0 / 3 1 / 0 6 CK# 3 3 . 5 1

1 D #

CK#

D#

C K#

D#

CK#

SUB- TOTAL $ 1 9 8 9 3 . 7 1TOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) $ 1 9 8 9 3 . 7 1



FOR I NSTRUCT I ONS, SEE BACK OF FORM

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

M c R o b e r t s f o r I o w a

NOTE : D e b t s p r e v i o u s l y r e p o r t e d t h a t r e ma i n u n p a i d mu s t b e i n c l u d e d o n t h i sS c h e d u l e , a s w e l l a s a n y n e w o b l i g a t i o n s i n c u r r e d i n t h i s p e r i o d .

DEBTS / OBL I GAT I ONS REMA I N I NG T HI S REPORT I NG PER I OD

( DO NOT I NCLUDE LOANS - - S HOW LOANSON

SCHEDULE F )

R c s c i D o r m

SCHEDULE

D I NCURRED

( R e v . 0 8 / 9 8 ) I NDEBTEDNESS

CHECK T HI S BOXI F AMENDI NGFORM

An " i n c u r r e d d e b t " i s a d e b t f o rg o o d s o r s e r v i c e s o r d e r e d o rr e c e i v e d , b u t n o t p a i d f o r b y t h e

e n d o f t h e r e p o r t i n g p e r i o d . ,

r e g a r d l e s s o f w h e t h e r a n i n v o i c e

h a s b e e n r e c e i v e d

' I f a c t u a l f i g u r e i s u n k n o w n , s h o w " e s t i m a t e d " b e s i d e t h e f i g u r e . Page 1 o f _1( f o r S c h e d u l e D)

CAND I DATE COMMI TT EES NOTE :` I n c u r r e d i n d e b t e d n e s s a l s o i n c l u d e s e a c h p e r s o n / e n t i t y w i t h whom t h e c a n d i d a t e ' s c o mm i t t e e h a s e n t e r e d i n t o a c o n t r a c t d u r i n g t h e r e p o r t i n g p e r i o d f o r f u t u r e

o r c o n t i n u i n g p e r f o r m a n c e . E n t e r t h e name o f t h e c o n s u l t a n t wh o p r o v i d e s o r p r o c u r e s s e r v i c e s f o r i t e m s s u c h a s 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

o r g a n i z i n g s e r v i c e s . R e p o r t o n S c h e d u l e G t h e n a t u r e o f p e r f o r m a n c e a n d t h e e s t i m a t e d p e r f o r m a n c e r e a s o n a b l y e x p e c t e d o f t h e c o n s u l t a n t .

DATEI NCURRED( MMI DD/ YR )

NAME AN D ADDRESS OF PERSONT O WHOM DEBT OR OBL I GA T I ON I S OWED

DESCRI PT I ON OF GOODS ORSERV I CES PROVI DED OR

PURCHASED

BALANCE OWED ATC L OSE OFREPORT I NG

PERI OD'

Op i n i o n F a c t o r , 9 1 3 3 Mo n r o e P l a z a Way , S u i t e BS a n d y , UT 8 4 0 7 0

T e l e p h o n e S e r v i c e s( E s t i m a t e ) 2 , 5 0 0 . 0 0

SUB- TOTAL $

2 , 5 0 0 . 0 0

TOT A L DEB T S OWED B Y COMMI T T EE A T T H E ENDOF T HI S REPORT I NG PER I OD $

2 , 5 0 0 . 0 0

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