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8/7/2019 Fiegen Tom__1285__scanned

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FORM DR- 2 D i s c l o s u r e Summa r y E . . g e. I D 1 2 8 5

C o u n t yT y p e Sl a t e c ommi t t e e

T r e a s Maur een Bowi e ( 3 1 9 ) 8 86 - 6 3 4 7Na me F r i e nd s and Ne i g hb or s of To m F i e ge n

R e p o r t Du e D a t e 0 1 / 1 9 / 2 00 2Commi t t e e C h a i r ( ) -

S t a t u s Or i g

N o t i c e o f D i s s o l u t i o n N/ A

S t a t e me n t o f C a s h On Hand

Add i t i ona l A s s e t s and L i a b i l i t i e s

7 0 0 / 1 90 066 /W579

Or i g

J AN 2 2 2 0 0 21 hi I - 1 ~

FORMDR-2 DI SCLOSURI CF RS 4 / 9 8 REPORT

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

I n d e x e dA u d i t e dCompu t e r

T h i s Re po r t Was P r i n t e d Wi t h T he I C FRS Sof t wa r e on 0 1 1 1 8 1 2 0 0 2 0 2 : 3 3 : 2 1 PM

Cash On Hand a t S t a r t o f P e r i o d $ 7 0 3 . 2 1Sc h e du l e A C a s h C o n t r i b u t i o n s T o t a l 5 4 , 1 5 0 . 0 0

S c he d ul e F L o a n s Re c e i v e d T o t a l 5 1 , 5 2 5 . 0 0Sc h e du l e H Camp a i g n P r o p e r t y S a l e s $ 0 . 0 0

SUB- TOT A L S 6 , 3 7 8 . 2 1Sc h e du l e B E x p e n d i t u r e s T o t a l 5 5 , 9 7 1 . 7 2

Sc h e du l e F L o a n Re p a yme n t s T o t a l $ 0 . 0 0C a s h on Ha n d A t En d o f P e r i o d $ 4 06 . 4 9L o a n s i n P l a c e a t S t a r t o f P e r i o d $ 0 . 0 0

Sc h e du l e D Un Pa i d B i l l s $ 0 . 0 0S c h e d u l e E I n - K i n d C o n t r i b u t i o n s $ 0 . 0 0Sc h e du l e F O u t s t a n d i n g L o a n s 5 1 , 5 2 5 . 0 0

S c h d u l e G C o n s u l t a n t Br e a k d o wn ? NoS c he du l e H : Camp a i g n P r o p e r t y V a l u e $ 4 0 0 . 0 0

F o r g i v e n L o a n s ( F r o m S c he d ul e E ) $ 0 . 0 0


2/9

ORI GI NAL

T h i s Re p o r t Wa s P r i n t e d Wi t h Th e I CF RS S o f t w a r e o n 0 1 1 1 8 1 2 0 0 2 0 2 : 3 3 : 2 7 PM

P a g e T o t a l $ 3 , 0 0 0 .

Pag e 1 o f( f o r s c h e d u l e A

SCHEDULE A C o n t r i b u t i o n s - Mon e ~ T a k e n i n SCHEDULEI D 1 2 8 5 A MONETARYRECE I PTS

Name : Fr i e n d s and Ne i g h b o r s o f Tom Fi e g e n I CFRS 1 2 / 9 9ORI GI NAL

_ T y p e Sl a t e c o mmi t t e eCommi t t e e I DDa t e R e l a t i o n s h i p Amoun tRe c e i v e d Chec k # Name a n d Ad d r e s s o f Co n t r i b u t o r To Ca n d i d a t e Re c e i v e

! 0 1 / 0 4 / 2 0 0 1 I D 6 0 4 6 J u s t i c e F o r A l l P a c 6 0 4 6 No R e l a t i o n $ 2 0 0 .V Chk # 3 3 5 5 218 6 t h A v e n u e S u i t e 526De s Mo i n e s I A 5 0 3 0 9[ # 4 8 4 ]

; 0 1 / 0 4 / 2 0 0 1 I D 6 0 9 6 Ma n u f a c t u r e d Ho u s i n g PAC $ 4 0 0 .Chk # : 1 3 9 8 1 4 0 0 De a n A v e n u eDe s Mo i n e s I A 5 0 3 1 6

[ # 4 8 5 ]X 0 1 / 0 5 / 2 0 0 1 I D 8 1 9 6 Ame r i c a n I n s u r a n c e A s s o c PAC / S t a t e I n d i v i d u a l $ 2 0 0 .

Chk # 1 5 4 1 1130 C o n n e c t i c u t Av e . , NW S u i t e 1 0 0 0Wa s h i n g t o n DC 2 0 0 3 6[ # 4 8 6 ]0 1 / 0 5 / 2 0 0 1 I D 6 0 5 6 Ba n k e r s U n i t e I n L e g i s l a t i v e D e c i s i o n s ( AKA : BUI L D) $ 2) 0 .

Chk # 2 4 91 4 18 S i x t h Av e S u i t e # 4 3 0De s Mo i n e s I A 5 0 3 0 9 2 4 3 8[ # 4 8 7 ]0 1 / 0 5 / 2 0 0 1 I D 6 1 6 2 I o wa A g r i b u s i n e s s Emp l o y e e s ' P o l i t i c a l A c t i o n $ 2 0 0 .

Chk # 1229 9 0 0 De s Mo i n e s S t S u i t e 1 5 0De s Mo i n e s I A 5 0 3 0 9[ # 4 8 2 ]0 7 / 2 6 / 2 0 0 1 I D 6 0 7 0 I o wa L a w Pa c $ 1 . 5 0 0 .

Chk # 1 0 0 0 5 2 1 E L o c u s tDe s Mo i n e s I A 5 0 3 0 9[ # 4 8 8 ]0 9 / 2 4 / 2 0 0 1 N e i l s e n , C r a i g H No R e l a t i o n $ 2 0 0 .

Chk # 6 7 2 2 8620 T i t l e i s t C i r c l eL a s V e g a s NV 89117

0 9 / 2 4 / 2 0 0 1 I D 6 2 7 7 SMCI PAC No R e l a t i o n $ 1 0 0 .Chk # 1153 1454 3 0 t h S t r e e t S t e 2 0 1We s t De s Mo i n e s I A 5 0 2 6 5

i [ # 4 9 0 ]


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ORI GI NAL

T h i s R e p o r t Wa s P r i n t e d Wi t h T h e I CFRS S o f t w a r e o n 0 1 1 1 8 1 2 0 0 2 0 2 : 3 3 : 2 7 PM

P a g e T o t a l $ 1 , 1 0 0 .

P a g e 2 o f( f o r s c h e d u l e

SCHEDULE A Co n t r i b u t i o n s - Mone T a k e n I n SCHEDULEI D 1 2 8 5 A MONETARYRECE I PTS

Name F r i e n d s a n d N e i g h b o r s o f To m F i e g e n I C FRS 1 2 / 9 9y ORI GI NAL

T y p e S l a t e c o mmi t t e eCo mmi t t e e I DD a t e R e l a t i o n s h i p Amount

L Re c e i v e d C h e c k # Name a n d Ad d r e s s o f C o n t r i b u t o r To Ca n d i d a t e Re c e i v e1 09 / 2 6 / 2 0 0 1 F r i e d ma n n , Ed w a r d J r No R e l a t i o n $ 1 0 0 .

Ch k # 4 1 7 9 Ro u t e # 2 Bo x 152AR e d f i e l d I A 5023 3# 4 9 1

! 1 0 / 0 2 / 2 0 0 1 B a u e r , P a t r i c k B No R e l a t i o n $250 .Ch k # 4 3 9 5 3 3 8 K o s e r A v e n u eI o wa C i t y I A 52246

r # 4 9 9 ]. / 0 2 / 2 0 0 1 I D 6 0 2 1 C r e d i t Un i o n PAC $ 1 0 0 .

Ch k # : 1 4 4 0P . O Bo x 10 4 0 9De s Mo i n e s I A 5 0 3 0 6 0 4 0 9

[ # 4 9 8 11 0 / 0 2 / 2 0 0 1 I D 6 0 7 0 I o wa L aw Pa c $ 1 0 0 .

Ch k # 2525 5 2 1 E L o c u s tDe s Mo i n e s I A 5 0 3 0 9# 4 9 5 1

1 0 / 0 2 / 2 0 0 1 I D 6118 I o wa O p t o m e t r i c A s s o c i a t i o n P o l i t i c a l A c t i o n $150 .Ch k # 1 7 3 3 9 7 2 1 A u r o r a A v e n u eUr b a nd a l e I A 50322

[ # 4 9 7 ]1 0 / 0 2 / 2 0 0 1 I D 6 0 4 6 J u s t i c e F o r A l l Pa c 6 0 4 6 No R e l a t i o n $ 2 0 0 .218 6 t h A v e n u e S u i t e 526Ch k # 3 3 8 8 De s Mo i n e s I A 5 0 3 0 9i # 4 92 1; 1 0 / 0 2 / 2 0 0 1 I D 6 4 1 1 MCI I OWA PAC $ 1 0 0 .

I Ch k # 1 1 3 8 1 9 2 5 Bo y r u m S tI o w a C i t y I A 52240[ # 4 9 6 11 0 / 0 2 / 2 0 0 1 P a l me r , Da v i d No R e l a t i o n $ 1 0 0 .

Ch k # 5759 213 SW F l y n n D r i v eAnk en y I A 50021[ # 4 9 4 1


4/9

ORI GI NAL P a g e T o t a lR e p o r t T o t a l

T h i s Re p o r t Was P r i n t e d Wi t h T h e I CF RS So f t wa r e o n 0 1 1 1 8 / 2 0 0 2 0 2 : 3 3 : 2 7 PM

$ 5 0 .$ 4 , 1 5 0 .

P a g e 3 o f( f o r s c h e d u l e

SCHEDULE A C o n t r i b u t i o n s - M o n e " a k e n I n SCHEDULEI D 1 2 8 5 A MONETARYR ECE I P T SNa me Fr i e nd s a n d Ne i g h b o r s o f Tom Fi e g e n I CF RS 1 2 / 9 9ORI GI NAL

T y p e Sl a t e c o mmi t t e ei Co mmi t t e e I DDa t e R e l a t i o n s h i p A mo u n t

Re c e i v e d C h e c k # Name a n d Ad d r e s s o f C o n t r i b u t o r T o Ca n d i d a t e Re c ei v e1 0 / 0 2 / 2 0 0 1 Wa t s o n , M e l i s s a No R e l a t i o n $ 5 0 .

C h k # 2 5 8 7 6 83 3 2e d S t r e e tDe s Mo i n e s I A 5 0 3 1 3[ # 4 9 3 ]


5/9

ORI GI NAL P a g e T o t a l C $ 3 , 2 9 9 .P a g e 1 o f 3T h i s Re p o r t Wa s P r i n t e d Wi t h The I CFRS S o f t w a r e o n 0 1 1 1 8 1 2 0 0 2 0 2 : 3 3 : 3 4 PM ( f o r S c h e d u l e

SCHEDULE B Ex p en d i t u r e s - - Monp S p e n t F r o m Co mmi t t e e A c c o u n t SCHEDULE MONETARYI D 1 2 8 5 B EXPENDI TURESFr i e n d s and I CFRS 1 2 / 9 9Name : Ne i g hb o r s o f To m F i e g en ORI GI NAL

T y p e S l a t e c o mmi t t e e`YDa t e Commi t t e e I D Name a n d Ad d r e s s To Whom E x p e n d i t u r e Amou r t E x p e n d eE x p e n d e d Che c k # ( D i s b u r s e me n t ) Was Made0 1 / 0 8 / 2 0 0 1 C a r t e r P r i n t i n g $ 7 2 .

Chk# 1 0 5 6 1 7 3 9 E a s t G r a n d Av e n u eDe s Mo i n e s I A 5 0 3 1 6# 5 0 3 ] P R I N T I N G & REPRODUCTI ON r e c e p t i o n f l y e r s0 2 / 0 5 / 2 0 0 1 B o w i e , M a u r e e n $ 6 0 0 .Chk# 1 0 5 8 1 5 9 5 L o g a n A v e n u eT i p t o n I A 5 2 7 7 2# 5 0 5 ] SALARY & GRATU I T Y T r e a s u r e r d u t i e s0 4 / 2 0 / 2 0 0 1 U n i t e d S t a t e s P o s t O f f i c e S2 7 .

Chk# 1 0 5 9T i p t o n I A 5 2 7 7 2# 5 0 7 ] OF F I C E S U P P L I E S 6 mo n t h s p o s t o f f i c e b o x r e n t

0 7 1 1 3 / 2 0 0 1 F i e g e n , To m $ 3 4 0 .Chk# 1 0 6 0 9 3 L o mb a r d S t r e e tC l a r e n c e I A 5 2 2 1 6

# r 0 3 ] CAMPAI GN MERCHANDI SE T - s h i r t s & c a n d y $ 3 1 3 . 3 2 , m i l e a g e 8 4 m i l e s x . 3 2 5 = 2 7 . 3 00 7 / 2 6 / 2 0 0 1 F i e g e n La w F i r m P . C $ 1 , 1 0 0 .

Chk# 1 0 6 2 PO B o x 2 8 4 9C e d a r R a p i d s I A 5 2 4 0 6# 5 2 1 ]

_ -OTHER EXPEND I TURE p h o n e c a l l s 1 1 0 0 . 0 0

0 7 / 2 6 / 2 0 0 1 F i e g e n , To m $ 5 8 , 8Chk# 1 0 6 2 9 3 L o mb a r d S t r e e tC l a r e n c e I A 5 2 2 1 6

# S C ' 7 ] CAMPAI GN MERCHANDI SE c a n d y 3 9 . 3 8 , m i l e a g e 6 0 m i l e s x . 3 2 5 = 1 9 . 5 0

0 8 / 0 8 / 2 0 0 1 Q u a l i t y Co mp u t e r S e r v i c e I n c $ 7 ' 7 1 .Chk# 1 0 5 7 6 1 1 C e n t e r P o i n t R o a d NEC e d a r R a p i d s I A 5 2 4 0 2

# 5 0 4 ] OF F I C E EQUI PMENT A c e r P I I s y s t e m , O k i d a t a l a s e r p r i n t e r a n d N e c m o n i t o r0 8 / 1 3 / 2 0 0 1 B e s t W e s t e r n S t a r l i t e $ 3 2 8 .

Chk# 1 0 6 8 9 2 9 3 r d S t r e e tDe s Mo i n e s I A 5 0 3 0 9t # f : , ~ ] F U N D - R A I S E R ( H OL D I N G) r o o m a n d f o o d f o r f u n d r a i s e r


6/9

ORI GI NAL P a g e T o t a lC $ 1 , 2 3 4 .P a g e 2 o fT h i s Re p o r t Wa s P r i n t e d Wi t h T h e I CFRS S o f t w a r e o n 0 1 1 1 8 1 2 0 0 2 0 2 : 3 3 : 3 4 PM ( f o r s c h e d i l e

SCHEDULE B : Ex p en d i t u r e s - - Mon( S p e n t F r o m Co mmi t t e e Ac c o u n t SCHEDULE MONETARYI D 1 2 8 5 B EXPE NDI TURESI C FRS 1 2 / 9 9Name F r i e n d s and Ne i g hb o r s o f Tom F i e g e n ORI GI NALr y p e S l a t e c ommi t t ee

Commi t t e e I D Name a n d Ad d r e s s To Whom E x p e n d i t u r e Amoun t E x p e n d eE x p e n d e dE x p e n d e d Che c k # ( D i s b u r s e me n t ) Was Made0 8 / 1 5 / 2 0 0 1 D e Wi t t O b s e r v e r $ 3 5 .

Chk# 1 0 6 4 PO B o x 4 9De Wi t t I A 5 2 7 4 2# 5 1 1 ] OTHER EXPEND I TURE 1 y e a r s u b s c r i p t i o n1 0 8 / 1 5 / 2 0 0 1 N o r t h S c o t t P r e s s 5 3 0 .

Chk# 1 0 6 6 PO B o x 2 0 0E l d r i d g e I A 5 2 7 4 8# 5 1 3 ] OTHER EXPEND I TURE 1 y e a r s u b s c r i p t i o n0 8 / 1 5 / 2 0 0 1 T i p t o n C o n s e r v a t i v e S2 7 .

Chk# 1 0 6 3 PO Bo x 2 7 1T i p t o n I A 5 2 7 7 2# 5 1 0 ] OTHER EXPEND I TURE 1 y e a r s u b s c r i p t i o n1 0 8 / 1 5 / 2 0 0 1 U n i t e d S t a t e s P o s t O f f i c e $ 6 .

Chk# 1 0 6 7 T i p t o n I A 5 2 7 7 2# 5 1 5 ] P O S T A G E , S H I P P I N G, D E L I V E RY 2 0 s t a mp s

1 0 8 / 1 5 / 2 0 0 1 We s t B r a n c h T i me s S2 7 .Chk# 1 0 6 5 PO Bo x 3 6 8We s t B r a n c h I A 5 2 3 5 8

t # 5 ' 2 ] OTHER EXPENDI TURE 1 y e a r s u b s c r i p t i o

1 1 0 / 0 1 / 2 0 0 1 C a r t e r P r i n t i n g 5 2 3 .Chk# 1 0 7 0 1 7 3 9 E a s t G r a n d A v e n u eDe s Mo i n e s I A 5 0 3 1 6

# 5 1 8 ] P RI N T I N G & REPRODUCTI ON i n v i t a t i o n s1 1 0 / 0 1 / 2 0 0 1 F i e g e n La w F i r m P . C $ 4 0 0 .

Chk# 1 0 7 1 PO Bo x 2 8 4 9C e d a r R a p i d s I A 5 2 4 0 6# 5 2 3 ] POSTAGE , S H I P P I N G, D E L I V E RY 4 0 0 . 0 0 p o s t a g e1 0 / 0 1 / 2 0 0 1 F i e g e n , To m $ 6 8 5 .

i Ch k # 1 0 6 9 9 3 L o mb a r d S t r e e tC l a r e n c e I A 5 2 2 1 6# 5 1 7 ] MI L E A G E m i l e a g e 1 3 8 6 m i l e s x . 3 2 5 = 4 5 0 . 4 5 , c a n d y 2 3 5 . 0 3


7/9


8/9

I D - 1 2 8 5Name F r i e nd s a n d Ne i g hb o r s o f Tom F i e ge n

vT y p e S l a t e c o mmi t t e e

T o t a l Un p a i d L o a n s F r o m L a s t R e p o r t i n g P e r i o d $ 0 . 0 0PART - MONETARY LOANS RECEI VED T HI S REPORT I NG PERI OD

SCHEDULEFI CFRS 1 2 / 9 9

ORI GI NAL

LOANSRECEI VED. & REFA I D

Page 1 o fORI GI NAL ( f o r s c h e d u l e FT h i s Re p o r t Was Pr i n t e d Wi t h T h e I CF RS So f t wa r e o n 0 1 1 1 8 1 2 0 0 2 0 2 : 3 3 : 5 2 PM

Da t eRe c e i v e d Name a n d Ad d r e s s o f L e n d a e r( I n c l u d e E n d o r s e r ' s Name , I f A p p l i c a b l e ) R e l a t i o n s h i p T oCa n d i d a t e Amount oL o a nF i e g e n , Tom S e l f $ 0 00 8 / 3 1 / 2 0 0 1 9 3 L omba r d S t r e e tC l a r e n c e I A 52216# 5 0 1L F i e g e n , Tom S e l f $ 1 4 251 2 / 3 1 / 2 0 0 1 9 3 L omb a r d S t r e e tC l a r e n c e I A 52216# 5 2 5

tSCHEDULE F L o a n s Re c e i v e d & Re p a i d TOTAL LOANS RECEI VED T HI S PERI OD ( P a r t I ) $ 1 , 5 2 5

F r o m S ch ed u l e E - TOTAL LOANS FORGI VEN $ 0TOTAL OUTSTANDI NG LOANS END OF REPORT PERI OD : ! $ 1 , 5 2 5


9/9

T y p e : S l a t e c o mmi t t e ePART I - On Go i n g I n v e n t o r y o f Camp a i g n Pr o pe r t y

P a g e T o t a lORI GI NAL Re p o r t T o t a l

T h i s Re p o r t Was Pr i n t e d Wi t h Th e I CFRS So f t wa r e o n 0 1 1 1 8 1 2 0 0 2 0 2 : 3 4 : 0 1 PM

ORI GI NAL

$ 4 0 0 .$ 4 0 0 .

Page 1 o f 1( f o r s c h e d u l e H P a r t

DATE PURCHASED PURCHASE PRI CE CURRENT ESTI MATE( S c h e d u l e B ) R EST I MATED VALUE FAI R MARKET VALUDESCR I PT I ON OF PROPERTY WHEN ACQUI RED T HI S REPORT( S c h e d u l e E )

A c e r P I I s y s t e m , I k i d a t a L a s e r P e i r n t e r & Ne c mo n i t o r0 1 / 0 8 / 2 0 0 1 $ 7 7 1 . 7 5 $ 4 0 0 .

# 5 0 5

SCHEDULE H Campa i gn P r o p e r t y . v e n t o r y SCHEDULE CAMPAI GNI D : 1 2 8 5 ( P a r t I )I CFRS 4 / 9 8 PROPERTYI NVENTORY

Name : F r i e n d s an d Ne i g hb o r s o f Tom Fi e ge n

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