FORM DR-2: Disclosure Summary Page DRe2 | disclosure ICFRS 4/98 |___REPORT Ce For Office Use Only (County: ‘Type: State Senate Comm. # a Treas:Ralph Watts (515) 993-4850 Indexed Std Name: Johnson For Senate Audited Computer Report Due Date: 05/19/2002 Committee Chair: Jim VanWerden ( ) - Status: Orig Notice of Dissolution: N/A Statement of Cash On Hand Cash On Hand at Start of Period $816.09 ‘Schedule A: Cash Contributions Total ‘$1,050.00 ‘Schedule F: Loans Received Total $0.00 ‘Schedule H: Campaign Property Sales $0.00 ‘SUB-TOTAL $1,866.09 Schedule B: Expenditures Total $1,866.09 ‘Schedule F: Loan Repayments Total ‘$0.00 Cash on Hand At End of Period $0.00 Additional Assets and Liabilities Loans in Place at Start of Period $0.00 ‘Schedule D: UnPaid Bills $0.00 ‘Schedule E: In-Kind Contributions $0.00 ‘Schedule F: Outstanding Loans $0.00 ‘Schdule G: Consultant Breakdown? No ‘Schedule H: Campaign Property Value ‘$0.00 Forgiven Loans (From Schedule E) $0.00 Orig This Report Was Printed With The ICFRS Software on 01/20/2003 11:59:02 AMA: Contributions - Money Taken In sore MONETARY RECEIPTS Name: Johnson For Senate ie ORIGINAL Type: State Senate Committee 1D Date Relationship ‘Amount Received | _ Check # Name and Address of Contributor To Candidate Received fovosrz002 ID; 6484 |lowa Sociely of Anesthesiologists PAC 3500.00 Dept of Anesthesia U. of IA Hospitals & Clinics Chk: 1836 Iowa City 1A 52242 eres inane Towa Optometric ASSO6. No Relation "$550.00 9721 Aurora Ave. Des Moines 1A 50322 i085) ORIGINAL Page Total $1,050.00 Report Total $1,050.00 This Report Was Printed With The ICFRS Software on 01/20/2003 11:59:14 AM Page 1 of 1 (for schedule A)‘SCHEDULE SCHEDULE B: Expenditures - Money Spent From Committee Account MONETARY, 1D:849 B EXPENDITURES . ICERS 12/09 Name:Johnson For Senate ORIGINAL Type: State Senate Date [Committee ID | Name and Address To Whom Expenditure “Amount Expended| Expended |Check # (Disbursement) Was Made "71472002 |ID; o161 [Republican Party of iowa and lis Eisenhower Club 350.00) chit: 1618 [521 €. Locust st. Des Moines 1A 60300 leisso [POLITICAL CONTRIBUTION |ov72zr2002 |ID: 9161 [Republican Party of iowa and is Eisenhower Club $500.00 Ichi: 1617 [521 E. Locust st Des Moines 1A 50300 lr1e4q) | POLITICAL CONTRIBUTION: lowstr2002 [Walls Fargo Bank $2.10 laael_1A fetess) [BANK CHARGES: jozosr2002 [US Cetuiar $55.07 Ichi: 1619 8475 Hickman Road lurbandale 1A 50322 |e1es1) | OFFICE HOLDER EXPENSES: Cal Phone Expones | 02/28/2002 |Unitemized Expenditure - No contact required. $2.10) frtes6) BANK CHARGES: losrasrz002 Walls Fargo Bank $2.10 ladel_1A Jeresr) BANK CHARGES: 04/09/2002 Riada $250.00) |Chk#: 1620 ® Jetesay [OTHER EXPENDITURE, centon fo community fg pies jo4/1 1/2002 \Treasurer of State $20.00) |Chk#t: 1621 Des Moines 1A letess) _|GIETS ORMEALS FOR VOLUNTEERS: fag ORIGINAL, Page Total|___‘$881.37] This Report Was Printed With The ICFRS Software on 01/20/2003 11: Page 1 of 2 (for schedule B)‘SCHEDULE B: Expenditures - Money Spent From Committee Account SCHEDULE | MONETARY 10-849 B _lexPenpiTures ICFRS 12/09 Name: Johnson For Senate ORIGINAL ‘Type: State Senate Date [Commiffes 1D | Name and Address To Whom Expenditure “Amount Expended] Expended|Check # (Disbursement) Was Made loarsorz002 [Walls Fargo Bank $2.10 [Adel 1A Jetose; _[BANKCCHARGES: losvstr2002 [Walls Fargo Bank $3.15 ladel_1¢ |rresay [BANK CHARGES: loeraar2002 [Walls Fargo Bank $3.15 [adel 1A frioeq) [BANK CHARGES: lovratr20c2 [Unitomized Expenditure - No contact required $3.15 fetes) | BANK CHARGES: losrstr2002 [Unitemized Expenditure - No contact required $3.15 ricco) [BANK CHARGES: fosrs072002, [Walls Fargo Bank $3.15 ladel ta feiess) | BANK CHARGES: jrorss72002 |ID: 6049 Dallas County Republican Central Committes $966.87 Icnk#: 1622 |P. 0. Box22 [Datias Center 1A 0063 Jv1004) | DISSOLUTION DISTRIBUTION. Donat raining funds my acoant tothe Daim Couny Repblican Coal Common, ORIGINAL Page Total ote Report Total[ $1,866.09 Page 2 of 2 This Report Was Printed With The ICFRS Software on 01/20/2003 11:59:24 AM (for schedule 8)SCHEDULE H: Campaign Property Inventory ‘SCHEDULE | CAMPAIGN Heat | PROPERTY 10-849 ICFRS 4/98 _ [INVENTORY Name: Johnson For Senate ORIGINAL ‘Type: State Senate PART | - On Going Inventory of Campaign Property foATE PuRcHaseD| (Schedule 8) DATE RECENVE! (Schedule E) PURCHASE PRICE | CURRENT ESTIMATED ESTIMATED VALUE | FAIR MARKET VALUE DESCRIPTION OF PROPERTY WHEN ACQUIRED THIS REPORT [Computer, Campaign finance records, Org, purchd. i 2000, now value Harstv2001 js zero $1,500. s0.09 #1646 (Estimated) Page Total] $0.00 ORIGINAL Report Total $0.00 ‘This Re Pye tof 1 port Was Printed With The ICFRS Software on 01/20/2003 11:59:50 AM (or schedule H Pat 1)FORM FORM DR-3: Notice of Dissolution DISSOLUTION : DR-3 NOTICE ICFRS 7/98, Cee For Office Use Oniy Type State Senate Ea Indexed = Audited Computer Ceritied Date of Dissolution COMMITTEE NAME [Official Name of Committee Johnson For Senate “Address 1405 Court Ave City State Zip Adel 1A 50003. Phone (S15) 993-1954 (515) 975-4546 Effective Date of dissolution..................... 01/18/2003 Ralph C. Watts 01/18/2003 ‘Signature of Treasurer Date Signed ifs BOX APPLIES TO CANDIDATE COMMITTEES ONLY: |. the candidate, certify that my candidate committee's cash balance is zero, all debts, oblications and loans have been paid or satisfied in accordance with law as shown on my committee's final report and all campaign property and leftover funds have n distributed in accordance with my committee's last filed Statement of Organization. JoAnn M. Johnson 01/18/2003 Signature of Candidate Date Signed Every committee continues to have a disclosure filing obligation until it 1) has paid or transferred all of its debts or ‘obligations, (2) reduced its cash balance to zero, (3) (if a candidate committee, sold or transferred its campaign property. ‘AND (4) filed a final report showing these transactions and a Notice of Dissolution form ‘The Notice of Dissolution must be filed within thirty (30) days of the committee's dissolution, with a copy, of the final bank statement attached, Leftover funds (including, for candidate's committees, receipts from the sale of campaign property) must be distributed according to the statement of intent on the most recently filed Statement of Organization.