ragan amanda__1336__scanned

Download Ragan Amanda__1336__scanned

Post on 08-Apr-2018

218 views

Category:

Documents

0 download

Embed Size (px)

TRANSCRIPT

  • 8/7/2019 Ragan Amanda__1336__scanned

    1/17

    FORi NSTRUCTi ONS, SEEBACK OF FORM

    DI SCLOSURE SUMMARY PAGEC . MI TT. EE NAM~ j Mu s t b e s ame aJ s o n St a t e me n t o f O r g a n i z a b v o r . ;

    I ; . a c, 4 a4uL . a c t , ~I c c . . .I MPORTANT : I n d i c a t e t y p e o f c o mmi t t e e y ou a r e r e po r t i n g f o r :( 1 ) S t a t e w i d e / L e g i s l a t i v e Ca n d i d a t e ( 2 ) S t a t e wi d e PAC ( 3 ) S t a t e P a r t y ( 4 ) Co u n t y / L oc a l Ca n d i d a t e( 5 ) Co t y PAC ( 6 ) B a l l o t I s s u e / F r a nc h i s e mmi t t e e ( 7 ) C o u n t y / C i t y Ce n t r a l Commi t t e e

    I ( 8 u p p r t f t o o f Can d t e s. l - d am -

    GNATURE OF TREASURER ( o r p e r s o n f i l i n g t h i s r e p o r t ) TEL EPHONE DATE S I GNEDRo u t i n e Pe n a l t i e s Du e F o r L a t e F i l e d Re p or t s R a n g e f r om $ 20 t o $ 8 0 0

    SEE I NSTRUCTI ONS ONBACK AND COMPL ETE THE F OL LOWI NGSENTENCE :r J - , , ~ . , " c 5 ~ n . ~.I AM F I L I NG A l . 1 1 1 I BC c f " i / L REPORT FORAN/ A ( 1 ) ELECTI ON / ( 2 ) NON- EL ECT I ON YEAR .

    ( r e p o r t d a t e ) I n d i c a t e o n enCHECK I F AMENDMENT TO REPORT DATED MAR 1 1 2 0 0 2

    h ) - 3 . _ ~F ~ C h 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 o r m DR- 3 .

    C{ o u mus t c o n t i n u e t o r i l e r e p o r t s u n t i l a N o t i c e o f D i s s o l u t i o n i s B l e d . )

    STATEMENTOFCASHONHANDCASH 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 h i s i s t h e t o t a lo f a l l mon i e s h e l d b y t h e c o mmi t t e e . T h i s amoun t MUST b e t h es ame a s t h e c a s h o n h a n d a t t h e e n d o f t h e l a s t r e p o r t i n g p e r i o d , 3

    o r mus 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 r i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ADD TOTAL MONEY TAKEN I N THI S PER I ODSc h e d u l e A : Ca s h C o n t r i b u t i o n s t o t a l ( A t t a c h Sc h e d ul e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d u l e F : L o a n s Re c e i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d u l e H : T o t a l Sa l e s o f Campa i g n P r o p e r t y ( A t t a c h Sc h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    ( S c h ed u l e H a a p l i e s t o Ca n d i d a t e s ' Commi t t e e s On l y )PPR. TOTAL . . . . . . 5

    SUBTRACT TOTAL MONEY SPENT THI S PER I ODSc 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . , . , . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d u l e F : L o an Re p a y me n t s t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    CASH ON HAND 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 m u s t , , ~ Q a p * , - Ib e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . $UNPAaD Bi L LS : ( F r o m Sc h e d u l e i 7 - A t t a c h Sc h e d u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $I N KI ND CONTRI BUT I ONS ( F r o m Sc h e d u l e E - A t t a c h Sc h e d ul e E ) . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ,OUTSTANDI NG LOANS ( F r o m Sc h e d u l e F - A t t a c h Sc h e du l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATEC- OAAMI TTEES ONLY :CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? )VALUE OF CAMPAI GN PROPERTY ( F r o mSc h e d u l e H - A t t a c h Sc h e d u l e H) $

    L o c a l Commi t t e e s , e n t e r Da t e o f ! E t e c t i o n

    Co u n t y & L o c a l Commi t t e e s , e n t e r Co u n t y i nwh i c h El e c t i o n i s h e l d

    ~,I ~I~II ' "1111~~~"I I I 11 1c t 4

    I a . I V

  • 8/7/2019 Ragan Amanda__1336__scanned

    2/17

    Fo r I n s t r u c t i o n s , Se e Back o f Fo r mCONTRI 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 )I COMMI TTEENAME( Mu s t b e same a s o n St a t e me n t o f Or g a n i z a t i o n)

    SCHEDULEA MONETARY( R ev . 0 6 / 9 7 ) I RECEI PTS

    CHECK T HI S BOX I FiAMENDI NG FORM

    STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECE I VED FROMA STATE PAC ( P OL I T I CA L ACT I ON COMMI TTEE) L I S T THE PAC I DENT I F I CATI ONNUMBER ANDTHEPACCHECKNUMBER I N THEDESI GNATED COLUMN A L I S T OF I D NUMBERS I S AVA I L A BL E FROM THE 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 use o f i n f o r ma t i on c o pi ed f r o m r ep or t s a n 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 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 .

    SUB- TOTAL

    TOTAL ( i f l a s t page o f t h i s s c h ed u l e )

    Di s d os u r e l a w r e q u i r e s c a nd i d a t e c ommi 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 R e l a t i o n s h i p must 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 ee Page 2 o f f o r ms p a c k et . ) 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 er e i s n o P a g e I - o f _f a m i l i a l r e l a t i o n s h i p e nt er ' 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 u l e A)

    DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT " . I F FORECEI VED ! i f a p p l i c a b l e ) TO CANDI DATE - RECEI VED FUND-( I v 1 M/ DD%YR ) AND PACCHECK ( i f a p p l i c a b l e ) RAI S ER

    I NUMBER I I NCOME'~ ~ a l a s l D P I D#cK#

    __- D f - Q t b e ( fA. 10X~~VUl 4~nC~~VA+L ) CL. a+ N~~i l k w y ~ lI D# 1 e I e v l KI uSSrnar I

    3a $ 1 ' - I t i t S~~ cK# V ~l a s w t Cf , I t ~ 1 - 5 ~- l 0 II D# + " I G Q W~

    AOL

  • 8/7/2019 Ragan Amanda__1336__scanned

    3/17

    Fo r I n s t r u c t i on s , Se e Back o f Fo r mCONTRI 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 St a t e me n t o f Or g an i z at i o n )

    SUB- TOTAL

    SCHEDULE

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

    A MONETARY( R ev . 0 6 / 9 7 ) I RECEI PTS

    CHECKT HI S BOX I FAMENDI NG FORM

    STATE CANDI DATES NOTE : ' I F A CON- r R I BUTI ON I S RECEI VED FROMASTATE PAC( P OL I T I CA L ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ONNUMBER ANDTHE PAC CHECKNUMBER 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 se o f i n f o r mat 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 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 ns o rf o r an y c omme r c i a l p u r p os e by an y p er 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 .

    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 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 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 must 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 ) 1ma r r i a g e ) ( Se e 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 nd i d at e b u t t h e r e i s n o P a g e-A- _ 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 Sc h ed u l e A)

    DATE PAC I D NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT I F FORECEI 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 SERNUMBER I NCOME

    I D# -n a~ V ,2 12 U ) 02 - CK# s r S $ _j UN i t z~~LO~

    I D# ( z u s ~ e I ~ ~ V -Mg 0 , 4 u _ 00 ~ + . j C l t T 1 \CK#I D# Q. ~ c t r ~ ~ f d 1 5 + ~ ~

    Z I Z u ) 0 Z CK# 1` 1 5_ ~ ` 6 l - t ~ ~ t E e I - c ~ r ( , ~ m : a d 1C , c s c ~ ID r 1 SI D# ( ~ c r + 0V Or ~ , / L12 G ,H

    Ic . G 1 , ,: l a y ~o z CK#

    I D# KCl

    E+ - < < ` ~oSVt E Vv l r yt ~ ' d L 7 ~ d l - 6 Of ] bCK#e t c - , L C 1U ~ - f 1A J Z c . ~ t . eo

    ,1 D# j ( a C I 7 4 ~ C, 11' I Cl l

    J l ; ~ c ~ I oL _ 5 ~/ s 6 2wc i sStCK# l q ~ t c f e , I~ ~zvc; z - V,I D# ~ ( i c L l a k l Nc v w l a r t ! /

    ~ ~ I ZU' i 1Z S 2CK# ~ l c - s e V%C' ' r + - ' . 1 5~g01I D# Ui c k -

    U 10 Z4 1 e VCK# AaSc x , C o; I x ~y

    I D# L t ' y ) r I E CEC" f c r 4 -2 / 2U~~Z S~x 4 v~ s i - St : -CK# ~~~ I _ T

    I D# C t 7 ) 1 YIJ C ~