Академический Документы
Профессиональный Документы
Культура Документы
Routine Penalties Due For Late F!Ied Reports Range from $20 to $W0
SEE INSTRUCTIONS ON HACK ARID COMPLETE_THEFOLLOWING SENTENCE :
I AM FILING A .._ ..__ .J ;__-1,___2001 TO DEC . 31, 2001 REPORT FOR AN,rA (~) ELECT'ON (2)NON-ELECTION YEAR .
(report date) Indicate one
OCHECK IF AMENDMENT TO REPORT DATED _ Local Committees, enter Date of Election
Check if this .1s final (termination) report and attach Notice of Dissolution Form DR-3 . County & Local Committees, enter County in
(You must continue to file reports until a Notice of Dissolution is filed .) which Election is held
**UNPAID BILLS (From Schedule D -Attach Schedule D) . . ... ... .. .. ...... ....... .. .. .. . .. ....... . . . ..... . . ... .. ... . . . ..$ 563 .64
*'IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .... ........ . .. .. . . . .. .. ... .... .. .... .. .. .. .. ..$ ---- .70 .05
"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) .... .... ......... .. .. .. . .... .... .. ......... .. .. .. ..$ 2,0 0 .00
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?) YES _X__ NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)
For Instructions, See Sack of Form SCHEDULE
MONETARY
CONTRIBUTIONS -- INIONEY TAKEN IN (Rev. 0&/97) RECEIPTS
(including candidate's personal funds)
Q CHECK THIS BOX IF
CC) MMII"SEE NAME (Must be same as on Statement of Organization) AMENDING- FORM
STATE CANDIDATES NOTE. IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT -1 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
08-08-01 BRIAN H . PHILLIPS $ 25 .00
CK# 4500 WESTOWN PARKWAY, STE 150
- W . DES MOINES, IA 50266
ID# WILLIAM C . COX 50 .00
08-08-01
CK# 317 SOUTH WALNUT,'PO BOX 220
SHELL ROCK, IA 50670-0220
ID#
08-08-01 KENNETH W. SHARP 100 .00
CK# 16417 JONES CIRCLE
OMAHA, NE 68118
ID#
08-08-01 YVONNE WENTE 500 .00
CK# 2013 180th STREET
WAVERLY IA 50677
ID# DANIEL STADTMULLER 250 .00
08-08-01
CK# 23913 COUNTY ROAD E 16
MONTICELLO, IA 52310
ID#
08-08-01 KAREN M . HOTZE 25 .00
CK# 44639 HIGHWAY 92
CARSON, IA 51525-4197
ID# 500 .00
X08-08-01 JIM HUGHES REAL ESTATE
CK# 410 S . LOCUST PO BOX 111
GLENWOOD, IA 51534
iD# 100 .00
08-08-01 JOHN RUAN
CK# 3200 RUEN CENTER
DES MOINES IA 50309
08_08_01 ID# ROBERT M. ESDEN 50 .00
PO BOX 148
CK#
THURMAN, IA 51654-0148
ID# LAURA JENSSEN 150 .00
08-08-01
7623 J AVENUE
CK#
ARLINGTON, IA 50606-8223
SUB-TOTAL
$ 1750 .00
STATE CANDIDATES NOTE. IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATION
VUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE ICWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION : Section 686 .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees.
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
1D#
08-08-01 ROBERT P . ABBOTT $ 25 .00
CK# PO BOX 447
TABOR, IA 51653
ID#
08-08-01 JULIE DERBY 50 .00
CK# 20302 ALLIS ROAD
PACIFIC JUNCTION, IA 51561
ID#
08-08-01 NORMA TROXEL 100 .00
CK# 3737 270th STREET
FARRAGUT, IA 51639
08-08-01 ID# CANDACE-GOTSCHALL 100 .00
PO BOX 271 -
CK#
GLENWOOD, IA 51534-0271
ID# ELIZABETH B. WEBSTER 25 .00
08-08-01
405 37th STREET APT. 203
CK#
DES MOINES, IA 50312-4349
ID# R. D . CLAUSE 25 .00
08-08-01
CK# 2485 210th STREET
GRAND JUNCTION, IA 50107-8541
ID# 50 .00
08-08-01 ROSS SILCOCK
CK# PO BOX 57
TABOR, IA 51653
ID# 50 .00
08-08-01 LARRY GAYLORD
CK# RR 1 BOX 159
TABOR, IA 51653
ID#
08-08-01 JACK BRANDT 100 .00
CK# 20 WESTLAKE VILLAGE
COUNCIL BLUFFS, IA 51501-8275
d8-08-01 ID#
LOUIS C . BECKER 25 .00
CK# 104 FOX CIRCLE
HAMBURG, IA 51640
SUB-TOTAL
550 .001
TOTAL (rf last page of this
schedule) ~$
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms packet). If surname of contributor is the same as candidate, but there is no Page 2 of -1 1-
familial relationship, enter "not applicable" in the relationship column. (for Schedule A)
For Instructions, See Back oi Form SCHEDULE
MONE-ARY
CONTRIBUTIONS -- IINIONEY TAKEN IN (Rev. 06/97) RECEIPTS
(including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING- FORM
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD .
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees.
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 1 IF FCR
RECEIVED (if applicable) - TO CANDIDATE' RECEIVED g
FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
STATE CANDIDATES NOTE_ IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATION
NUMBER AND THE PAC CHECX NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person otherthan statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT .l IF FOR s
RECEIVED (if applicable) I TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER G
NUMBER INCOME
08-17-01 1D# LINDA LaRUE $ 25 .00
CK# 212 N . CHESTNUT
GLENWOOD, IA 51534
E
08-1Z-01 1D# HENRY C . BRANDT 100 .00
CK# RFD 1
COUNCIL BLUFFS, IA 51501
'
08-17-01 1D#
CHERRI SPURLOCK 25 .00
CK# 2152 220th STREET
PERCIVAL, IA 51648
ID#
08-17-01 RANDY BALDERSTON 25 .00
CK# _ 3978 SUTTON ROAD
CENTRAL CITY, IA 52214
08-17-01 ID# DAN BROWN 50 .00
1311 SCENIC VIEW DRIVE _
CK# IOWA FALLS, IA 50126-1068
E~
08-22-01 ID# MARK BOUSKA 300 .00
4200 E DUNKERTON ROAD
CK#
WATERLOO, IA 50703
I I -
SUB-TOTAL
850 .00
TOTAL (if last page of this
schedule) $
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood ielatives) and affinity (relatives by
marriage) (See Page 2 of forms packet). If surname of contributor is the same as candidate, but there is no Page 4 of 1 1
familial relationship, enter "not applicable* in the relationship column. (for Schedule A)
For Instructicris, See Back oi Form SCHEDULE
MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN
(Rev. 06197) RECEIPTS
(Inducting candidate's personal funds)
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), [.ISTTHE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LISTOF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT -l IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDDNR) AND PAC CHECK (if applicable) RAISER
NUMBER
INCOME
08-22-01 ID# MICHAEL L . LILJEDAHL $ 50 .00
2232 AUSTIN AVENUE
CK#
MONDAMIN, IA 51557-4011
08-22-01 ID# R . W . HAGIE 100 .00
CK# 2418 HAMILTON DRIVE
AMES, IA 50014-8202
ID#
08-22-01 WILLIAM TALSMA 500 .00
CK# 913 W 18th ST . S
NEWTON, IA 50208
ID#
08-22-01 w. E. AGAN 50 .00
CK# 57204 240th STREET
GLENWOOD, IA 51534
08-22-01 ID# BEN HOWE 100 .00
1632 BLUFF ROAD .
CK#
THURMAN, IA 51654
08-22-01 ID# IRENE M. WAGNER 500 .00
5766 STATE HWY. 175
CK#
IDA GROVE, IA 51445
MONEiARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 06/97) RECEIPTS
(Including candidate's personal funds)
STATE CANDIDATES NOTE. IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LSTTHE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LSTOF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT d IF FOR
RECEIVED fif applicable) TO CANDIDATE' RECE?VED FUND-
(MMlDD/YR) AN PAC (ifapplicable) RAISER
NUMBERECK
INCOME
08-31-01 ID# CRAIG HILL 50 .00
1160 210th AVENUE
CK#
MILO, IA 50166
STATE CANDIDATES NOTE IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A UST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 688.324(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 1 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECE?VED
(MMIDDIYR) FUND-
AND PAC CHECK (if applicable) RAISER
NUMBER INCOME )
09-18-01 ID# GLORIA DITTBERNER $ 25 .00
CK# PO BOX 203
HAMBURG, IA 51640
ID#
09-18-01 COLEEN VANDELUNE 100 .00
CK# 12982 S . 88th AVENUE W
PRAIRIE CITY, IA 50228
ID#
09-18-01 MARINE HAMILTON 50 .00
CK# 1137 210th STREET
RED OAK, IA 51566
E,
ID#
09-28-01 LONNIE HOUCHIN 500 .00
CK# 2793 200th STREET
SIDNEY IA 51652
09-29-01 ID# HELEN FRIEST 50 .00
14263 CO HWY . D-65
CK#
RADCLIFFE, IA 50230-8053
ID#
1
STATE CANDIDATES NOTE. IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A UST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 688.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees.
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT -l IF FOR
RECEIVED (if applicable) TO CANDIDATE* RECEIVED FUNC-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
10-19-01 KRIS BRUNKHORST $ 50 .00
CK# 419 3rd AVENUE SW
WAVERLY IA 50677
10-19-01 ID# JAMES F. HAHN 50 .00
CK# 805 WEST 4th STREET
MUSCATINE, IA 52761
10-19-01 ID# CATHERINE HUGGINS SISTER 25 .00
1226 MOKAPU BLVD .
cx#
KAILUA, HI 96734
M-
10-31-01 ID# TRACEY FRAZEE 100 .00
CK# 22675 FORRESTER LANE
GLENWOOD, IA 51534
11-08-01 ID#
NANCY LINCOLN 100 .00
CK# BOX 210 -
GLENWOOD, IA 51534
ID#
11-15-01 DENISE FOUTS 25-00 HOUSE
CK# 250 ROBINWOOD DRIVE PARTY
ROBINS, IA 52328
11-15-01 ID# JEFFERY ELGIN 250 .00 HOUSE
6940 BOWMAN LANE NE PARTY
CK#
CEDAR RAPIDS, IA 52402
STATE CANDIDATES NOTE. IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC
IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND
CAMPAIGN
DISCLOSURE BOARD .
CAUTION: Section 688.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting
contributions or
for any commercial purpose by any person other than statutory political committees.
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT -1 IF FOR -
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DDNR) AND PAC CHECK (if applicable) RAISER
NUMBER
INCOME
11-15-01 ID# WILLIAM GOODWIN 100 .00
1515 LINDEN ST .,STE . 210
CK#
DES MOINES, IA 50309-3197
MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 06/97) RECEIPTS
(Inc:uding candidate's personal funds)
STATE CANDIDATES NOTE. IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION CO :VIIVi1TTE`), LISTTHE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
far any commercial purpose by any person otherthan statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER
INCOME
12-11-01 1D# JOHN LACOCK 25 .00
11806 HWY 64
CK#
WYOMING, IA 52362
12-11-01 ID# DEBRA RYUN 25 .00
RR 3 BOX 339A
CK#
CHARITON, IA 50049
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC
IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A UST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for
soliciting contributions or
for any commercial purpose by any person other than statutory political committees.
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) - TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER
INCOME )
ID#
12-13-01 NANCY THOMPSON $ 40 .00
CK# 7015 OAK BROOK DRIVE
URBANDALE, IA 50322
12-13-01 1D# MARVIN DUSANEK 100 .00
18782 190th AVENUE
CK#
MONTICELLO, IA 52310
12-13-01 ID# GREGORY NORLIN 100 .00
12762 BUFFALO ROAD PO BOX 195
CK#
ANAMOSA, IA 52205
CK#
ID#
CK#
SUB-TOTAL
$ 345 .00
TOTAL (if lastpage of this
schedule) $10425- .00
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page 1 1 of 1 1
familial relationship, enter "not applicable* in the relationship column. (for Schedule A)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
ID#
09-21-01 POSTMASTER STAMPS FOR TREASURER
PERCIVAL, IA 51648
CK#
505 6 .80
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions.)
Expenditures to personslentities providing consulting, advertising, fund-raising, poiling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 56.6(3)(i) .) - -- '-
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
ID#
09-28-01 REPUBLICAN PARTY OF IOWA TABLE OF 10 FOR TRIBUTE TO
521 E LOCUST ST RONALD REAGAN DINNER
CK#
508 DES MOINES, IA 50309 250 .00
09-30-01 1D# PRO SIGN DESIGN & GRAPHICS 4 x 6 CAMPAIGN BANNER
2519 FALLS AVENUE
CK# 509 WATERLOO, IA 50701 154 .08
ID#
10-02-01 REPUBLICAN PARTY OF IOWA OCT . OFFICE RENT
521 E LOCUST ST .
CK#
511 DES MOINES, IA 50309 300 .00
SUB-TOTAL $ 2425,99
TOTAL (if last page of this schedule) $
1 n
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions.)
Expenditures to personslentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the personientity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 56.6(3)(i) .) '
Page 2 of 6
(for Schedule B)
t-Ut-r 1IVJ ilYUC; i 1Onls, &L-.E: BACK OF FORM
SCHEDULE
10-18-01 ID#
MCLEOD USA OFFICE PHONE BILL
P .O . BOX 3243
CK#
514 MILWAUKEE, WI 53201-3243 45 .25
1D#
CHECKVOIDED AND SENT TO
Cr<# AND SENT TO IA ETHICS
515 CAMPAING BOARF -0-
10-27-01 ID# LARSON ENTERPRISES BOOTH EXHIBIT AT IFBF 2001
909 50th STREET ANNUAL MEETING
CK# 516 WEST DES MOINES, IA 50265 325 .00
ID#
11-01-01 CHRISTIAN PRINTER, INC. INVITATIONS, OUTER & REPLY
1411 21st STREET ENVELOPES FOR HOUSE PARTIES
CK#
518 DES MOINES, IA 50309 782,28
ID#
11-01-01 L VICTORY STORE .COM REORDER DONATION MAILERS,
CK# 1612 ROCKINGHAM RD SHIPPING/HANDLING & TAX
519 DAVENPORT, IA 52802 262,77
SUB-TOTAL $
1618 .38
TOTAL (if last page of this schedule) $
i
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions.)
Expenditures to personslentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the personlentity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 56.6(3)(i) .) '
Page 3 of -6
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
ID#
MILEAGE 260 @ .34 PER .MILE
CK# 522 235 .73
ID#
11-18-01 REPUBLICAN PARTY OF IOWA NOV . OFFICE RENT
521 EAST LOCUST ST . 672 COPIES @ .03
CK#
525 DES MOINES, IA 50309 320 .16
ID#
11-19-01 POSTMASTER STAMPS FOR TREASURER
CK# PERCIVAL, IA
rs
526 6 .80
SUB-TOTAL $
-141 61;
TOTAL (iflastpage of this schedule)
-
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 56.6(3)(1).)
Page 4 of 6
(for Schedule B)
O INSTRUCTIONS, SE'c BACrC OF FORiVI
SCHEDULE
ID#
MILEAGE 155 '@ .25 PER MILE
CK#
527 897 .81
ID#
12-18-01 REPUBLICAN PARTY OF IOWA DEC. OFFICE RENT
521 EAST LOCUST STREET 2557 COPIES @ .03-
CK#
528 DES MOINES, IA 50309 376 .71
12-19-01 ID# KELLY THOMPSON STAMPS & POSTAGE FOR MAILINGS
508 ROOSEVELT ST . & THANK_YOU"S,STAFF CELL
CK# POLK CITY, IA 50226 PHONE BILL, TABLE DECORATIONS
"f9rTf~ul91D1
ID#
FOOD FOR ASKEW FOR AG ADVISC Y
BOARD MEETING .
CK# 529
231 .76
ID#
12-31-01 YVONNE WENTE REIMBURS FOR EXPENSES - GAS
2013 180th STREET -LEADER VISITS, INVITES,
CK#
WAVERLY, IA 50677 ENVELOPES,POSTAGE FOR AUG .1
_.-ri ,
tfeP .
ID#
CALLS,FAXES TO MEDIA,POSTAG ,
CK# LODGING & PARKING FEES FOR
FARM BUREAU TRADE SHOW
ID# MILEAGE 815 @ .34
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)
Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(i).) '
Page 5 of 6
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B
(Rev. 09/97) EXPENDITURES
STATE PAC COMMITTEES : NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CI CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF 10 NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM f
ETHICS & CAMPAIGN DISCLOSURE BOARD .
CK#
1D#
CK#
1D#
CK#
ID#
CK#
ID#
CK#
1D#
CK#
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)
Expenditures to personstentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the personlentity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 56.6(3)(i).)
Page 6 of 6
(for Schedule B)
"OR INSTRUCTIONS. SE= BACK OF F-OAA
' INCURRED
COMMITTEE NAME (Must be same as on Statement of Crganizatran) i (Rev .
i
i
SUB-TOTAL $
563 .64
"f actual flgure is unknown, show "estimated" beside the figure . Page 1 of
(for Schedule D)
IN KIND
COMMITTEE NAME ;Must oe same as cn Statement of Organization) (Rev . 06197)1CONTRIBU'IONC
ASKEW FOR AGRICULTURE 2002
CHECK THIS BOX IF
AMENDING FORM
FOOD/BEVERAGE
08-01-0. 1 YVONNE WENTE X0 .05
DESSERT/
2013 180th STREET
DISCUSSION
WA
EVENT 08-01-01
@ COUNTRY KITCHEN
I
I
I
- I
page of this
schedule)
Page 1 of
`Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Schedule E)
ccrnmittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and amity (relatives
(far
is no
by marriage) . (See Page 2 of forms packet.) if surname of contributor is the same as candidate, but there
iarrialiai relationship, enter 'not applicable" in the relationship column .
0%,f iCUULZ
NOTE : This schedule reports money loaned to the committee which Is deposited in the committee account . 0 CHECK THIS IF Box
AMENDING FORM
TOTAL UNPAID LOANS FROM LAST REPORTING PERIOD $
PART 1- MONETARY LOANS RECEIVED TL j;i: REPORTING PERIOD PART It - MONETARY LOAN REPAYMENTS MADE TIM REPORTING PERIOD
(Original sourca of loan, such as a bank, must be shown If a third party is (Loans forgiven must be reported on Schedule E - In-kind Contributions .)
involved, Include loans from candidate's personal funds,)
DATE NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT DATE PAID NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT
RECEIVED (include Endorser's Name, If Applicable) TO CANDIDATE OF LOAN (MM/DD/YR) (Include Endorser's Name, If Applicable) TO CANDIDATE' REPAID
MM/DD/YR If icable.* if A Ilcabie
'Disclosure law requires candidate committees to disclose the relationship of any relative
making a contribution to the committee. Relationship must be shown to the third degree of
consanguinity (blood relatives) and affinity (relatives by marriage) . (See Page 2 of forms
packet .) If surname of contributor is the same as candidate, but there is no familial
relationship, enter "not applicable" In the relationship column when It appllas . ___, page-1 _ Of,
(far Schedule F)