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For Office Use Only
Clute for State House Committee' Comm . #
IMPORTANT: Indicate by # type of committee you are reporting for: ( 1 Logged In
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party Scanned
(4 )County Central Committee( 5 )County Candidate ( 6 )City Candidate (7 )School Board or Other
Political Subdivision Candidate ( 8 )Co _L9- C PAC ( 10 )School Board or Other Political Computer
Subdivision PAC 11 Local Ballot Iss ar1 --~~ 1' "-
Audited
File with :
Iowa Ethics and Campaign
Disclosure Board
510 E . 1201 , Ste . 1A
Des Moines, Iowa 50319
Fax : 515-281-3701
ct to possible 'vil and criminal penalties. Pursuant to Iowa Code section 68B .32A(7)
a candidate' ee, and the chairperson, for any other type of committee, is the
risible fg~ and accurate reports .
TELEPHONE
- 01,7 6 -- i -,4,5j DACE srAED
0 Check if this is 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 DR-3 is filed .) which Election is held
CASH ON HAND at the end of this reporting period (if final report balance must 16,188.00
be zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . .$
STATE COMMITTEES: Submit a reconciled campaign account bank statement in January of each year .
For Instructions, See Back of Form Reset Form SCHEDULE
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.
NOTE : ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD .
CAUTION : Section 68B .32A(6), 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 .
ID#
9742 All Children Matter - Iowa PAC, 951 Iowa St, 500 .00
10/22/06 CK# Dubuque, IA 52001
1094
ID#
Chuck Celsi, 7700 E Gainey Ranch Rd, Scottsdale, 200 .00
10/22/06 CK# AZ 85258
ID#
Dennis & Diane Young, 521 Champagne Rd, 250 .00
10/30/06 CK# Waukee, IA 50263
ID#
6066 IFDA PAC, 2400 86th St, Ste 22, Clive, IA 50325 250 .00
10/30/06 CK#
2036
ID#
David & Jennifer Lock Oman, 743 53rd St, Des 100 .00
10/31/06 CK# Moines, IA 50312-1820
ID#
9698 IAAMB, 4949 Westown Pkwy, Ste 165-111, West 250 .00
10/31/06 CK# Des Moines, IA 50266-6702
560
ID#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL
ID# Dan Clute, 1671 NW 122nd Ct, Clive, Reimbursement for Des Moines
10/18/06 IA 50325 Register Ads 4760 .00
CK#
ID#
Polk County Republican Party, 621 E Contribution to the Party
10/23/06 CK# Ninth St, Des Moines, IA 50309 1000.00
ID#
Dan Clute, 1671 NW 122nd Ct, Clive, Reimbursement for Postage
10/30/06 CK# IA 50325 39 .00
1D#
CK#
ID#
CK#
SUB-TOTAL $
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 68A.402(3)(i) .)
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN-KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev . 06/97) CONTRIBUTIONS
Clute for State House Committee
Q CHECK THIS BOX IF
AMENDING FORM
Reset Form
Republican Party of Iowa, 621 E Ninth St, Direct mail, design 2,227.26
10/19/06 Des Moines IA 50309 & postage
F1 -
71
E:1
F~
F1 -
F 1-
E:1
F 1-
SUB-TOTAL
`Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page 1 of 1
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule E)
by marriage). (See Page 2 of forms packet.) If sumame of contributor is the same as candidate, but there is no
familial relationship, enter "not applicable" in the relationship column .