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8/7/2019 Linn Area Biz PAC__9749__scanned

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F i l e w i t h :I o w a E t h i c s a n d Ca mp a i g nD i s c l o s u r e B o a r d5 1 0 E 1 2 ' " , S t e . 1 ADe s Mo i n e s , I o w a 5 0 3 1 9F a x : 5 1 5 - 2 8 1 - 4 0 7 3 FOR I NSTRUCT I ONS, SEE BACK OF FORMDI SCLOSURE SUMMARY PAGECOMMI TTEE NAME ( Mu s t b e s a m e a s o n St a t e me n t o f O r g a n i z a t i o n )L i n n AReq 3 i z h ACI MPORTANT : I n d i c a t e b y # t y p e o f c o mm i t t e e y o u a r e r e p o r t i n g f o r .m( 1 ) S t a t e w i d e / L e g i s l a t i v e / J u d g e S t a n d i n g f o r R e t e n t i o n C a n d i d a t e ( 2 ) S t a t e PAC ( 3 ) S t a t e P a r t y( 4 ) C o u n t y C e n t r a l C o mm i t t e e ( 5 ) C o u n t y C a n d i d a t e ( 6 ) C i t y C a n d i d a t e ( 7 ) S c h o o l B o a r d o r O t h e r P o l i t i c a lS u b d i v i s i o n C a n d i d a t e ( 8 ) C o u n t y PAC ( 9 ) C i t y PAC ( 1 0 ) S c h o o l B o a r d o r O t h e r P o l i t i c a l S u b d i v i s i o n PA C1 1 ) L o c a l B a l l o t I s s u eCANDI DATE COMMI TTEES ONLY :Ca n d i d a t e Name P o l i t i c a l P a r t y ( i f a p p l i c a b l e )

Of f i c e So u g h t D i s t r i c t ( i f Se n a t e o r H o u s e )

L a t e r e p o r t s a r e s u b j e c t t o p o s s i b l e c i v i l a n d c r i mi n a l p e n a l t i e s . P u r s u a n t t o I o w a C o d e s e c t i o n s 6 8 B . 3 2 A ( 7 ) a n d 6 8 A . 4 0 1 ( 3 ) , t h e c a n d i d a t e , f o r a

3 1 Q 3a - 4 0 4 , ' 7 - 12 - d7S I GN R F PERSON FI L I NG REPORT TELEPHONE DATE S I GNED

I AM FI L I NG A J 4 1 1 / - 1 U l l e . 3 0 , 2 0 0 7( r e p o r t d a t e )

OCHECK I F AMENDMENT TO REPORT DATEDOC 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 Fo r m DR- 3( Yo u mu s t c o n t i n u e t o f i l e r e p o r t s u n t i l a DR- 3 i s f i l e d . )

STATEMENT OF CASH ON HAND

. ~ F 4 '

FORMDR- 2( R e v . 0 7 / 2 0 0 7 )

DI SCLOSUREREPORT

F o r O f f i c e Us e d lComm . #L o g g e d I nS c a n n e dC o mp u t e rA u d i t e d

REPORT FOR ( 1 ) ELECT I ON / ( 2 ) NON- EL EC TI ON YEAR .I n d i c a t e b y # 1 0 - 1

CASH 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 o t a l o f a l l f u n d s h e l d b y t h ec o mmi t t e e . T h i s amoun t MUST b e t h e s a m e a s t h e c a s h o n h a n d a t t h e e n do f t h e l a s t r e p o r t i n g p e r i o d 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 f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ADD TOTAL MONEY TAKEN I N T HI S PERI ODSc h e d ul e A : C a 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 ) ( * a l s o s e e i n - k i n d b e l o w ) . . . . . . . . . . . . . . . . . .Sc h e d ul e F : L oa n s Re c ei v e d t o t a l ( A t t a c h Sc h e d ul e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d ul e H : T o t a l S a l e s o f Ca mp a i g n P r o p e r t y ( A t t a c h Sc h e d ul e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h e du l e H a p p l i e s t o Ca n di d a t e s ' Co mmi t t e e s O n l y )SUB- TOTAL . . . . . . . . . . . . . . . . $

SUBTRACT TOTAL MONEY SPENT T HI S PERI 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 ) ( * * a l s o s e e d e b t s a n d l o a n s b e l o w ) . . . . . . . . . . . .Sc h e d ul e F : L o a n Re p a y me n t s t o t a l ( A t t a c h Sc h e d ul e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r ^ .J J

L o c a l C o mmi t t e e s , e n t e r D a t e o f E l e c t i o nC o u n t y & L o c a l C ommi t t e e s , e n t e r C o u n t y i nw h i c h E l e c t i o n i s h e l d

? 1 6 . LJ2 3 , ~ 3

2 , 5 q 5 , q 229 . 3 9

CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) - YES XNOCAND I DATE COMMI TTEES ONLY :VALUE OF CAMPAI GN PROPERTY ( Fr o m Sc h ed u l e H - A t t a c h Sc h e d ul e H) $STATE COMMI TTEES : S u b mi t a r e c o n c i l e d c a mp a i g n a c c o u n t b a n k s t a t e me n t i n J a n u a r y o f e a c h y e a r .

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 mus t b e z e r o ) . . . . . . . . . . . . . . . . . . . . . . . . . $ 2 1 5 7 / ' 03* * UNPA I D BI L LS ( F r o m Sc h e d ul e D - A t t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* I N K I 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 2 . 3* * OUTST AND I NG LOANS ( Fr o m Sc h e d ul e F - A t t a c h Sc h e d ul e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $


2/4

Fo r I n s t r u c t i o n s , Se e B a c k o f F or mCONTRI BUTI ONS - - MONEY TAKEN 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 TT EE NAME ( Mu s t b e s ame a s o n St a t eme n t o f O r g a n i z a t i o n )

, L i h n Aeeq B ; z 1 2 4 c( 7 1S T A T E C A N D I D A T E S N O T E I F A C O N T R I B U T I O N I S R E C E I V E D F R O M A S T A T E P A C ( P O L I T I C A L A C T I O N C O M M I T T E E ) , L I S T T H E P A C I D E N T I F I C A T I O NN U M B E R A N D T H E P A C C H E C K N U M B E R I N T H E D E S I G N A T E D C O L U M N A L I S T O F I D N U M B E R S I S A V A I L A B L E F R O M T H E I O W A E T H I C S A N D C A M P A I G ND I S C L O S U R E B O A R DNOTE : ANY PERSON, OTHER T HAN AN I N DI V I D U A L , THAT CONTRI BUTES MORE THAN $ 7 5 0 TO YOUR CAMPA I GN MAY HAVE F I L I N GRESPONSI B I L I T I ES AND SHOULD I MMEDI ATELY CONTACT THE BOARD .CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e 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 r f o r a n yc o mme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c ommi t t e e s .

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e ) $ 2' 78 ?3

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 o mm i 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 m a k i n g a c o n t r i b u t i o n t o t h ec o mm i t t e e . R e l a t i o n s h i p m u s t 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 ) . I f s u r n ame 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 d i d a t e , b u t t h e r e i s n o Page 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 S c he d u l eA)

SCHEDULEA MONETARY( Re v . 0 7 / 0 3 ) RECEI PTSCHECK THI S BOX I FAMENDI NG FORM

DATE PA C I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR REL AT I ONSHI P AMOUNT I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE ' RECEI VED FUND-( MM/ DD / YR) AND PA C CHECK ( i f a p p l i c a b l e ) RA I SERNUMBER I NCOMEI D# Ra l p h 7 i L L a s e ( f $ . 0 ,l - q - 07 9 9 1 5 $equek 0 0 1 1 0 1 0 SE 200CK# Qed 4 R F a i ' c t s TA 52 903I D# IB, e . * Adt Ws 7 l 4 I eet Y6 Fa-5-0? CK# 3 / 4 A s h k h d SD . a oRq i c d TAr 52 03I D# 'CK# ~ , 0 2I D#

2 - 2 8 - O ~ I CK#I D#

3 - 3 1 - 0 7 CK# 9 . 9 8I D#

y - 3 o - a ~ CK# x . 92I D#5 - 3 1 - 0 7 CK# ~~ I . 9 - fI D#

G ' 3 ~ ' Oq CK# 9 , G3I D#CK#I D#CK#


3/4

T HI S BOX APPL I ES TO CANDI DATES' COMMI TTEES ONLY :P u r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H . ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , m a n a g i n g , o r g a n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l i t e m i z e d o nS c h e d u l e G b y t h e a m o u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mm i t t e e . ( R e f e r t oS c h e d u l e G i n s t r u c t i o n s a n d I o w a Co d e 6 8 A . 4 0 2 ( 3 ) ( i ) . )

( f o r S c he d u l e B )

FOR I NSTRUCT I ONS , SEE BACKOF FORM Rese t F o r m SCHEDULEEXPENDI TURES B MONETARY- - MONEY SPENT FROM COMMI TTEE ACCOUNT ( R e v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI DATES, L I S T THE CANDI DATE I D ENT I F I CA T I O N NUMBER I N T HE DESI GNATED COLUMN AND THE CHECK T HI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NG FORMETHI CS & CAMPAI GN DI SCLOSURE BOARD.COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n )

l , A A ARe 4 B i z ~ C 'CANDI DATE NAME ANDADDRESS TO WHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( MM/ DD/ YR) AND PACCHECKNUMBER

1 2 - 3 h o 1 -I D# Ct n P4 1 2 ' ' ! L s } e4 ChQr h J 7 eCe n + b e ~ Pa5 f 4~~o . ' F ' Co e a e ~ I v E 1 1 . 3 (CK#

90 - - e d gy -I T/ ~ S2 D I Qgt 4 i A 2467) $I D# 4h~ sh t Ppe~ s ~} ss oG Qt t ' a u3 - $ - o l ) PO BDX 71882

i Ppt A~, Cd1QQ~~~ '. S~ b ~CK# Cedes R4 dJ Z ' f l 52107

I D#CK#1 D#CK#1 D#CK#

I D#CK#I D#CK#1 D#CK#

SUB- TOTAL $TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) $ r L 9 , 34


4/4

F OR I N S T R U C T I O N S , S E E B A C K OF F O R MC OMMI T T E E N AM E ( M u s t b e s a m e a s o n S t a t e m e n t o f O r g a n i z a t i o n )

k i n n AReqSCHEDULE

E I N- K I ND( R e v . 0 6 / 9 7 ) 1 CONTR I BUT I ONS

E3 CHECK THI S BOX I FAMENDI NG FORM

" 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 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 n i n k i n d c o n t r i b u t i o n t o t h e P a g e~-o f L -c o mm i t t e e . R e l a t i o n s h i p mu s t 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 ( f o r S c he d u l e E )b y m a r r i a g e ) . ( Se e P a g e 2 o f f o r m s p a c k e t . ) I f s uma 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 d i d a t e , b u t t h e r e i s n of 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 .

DATE RELAT I ONSHI P DESCRI PTI ON ESTI MATED 4 I F FORRECEI VED NAME ANDADDRESS TO CANDI DATE OF I N K I ND F AI RMARKET FUND- RAI SER( MM/ DD/ YR) OF CONTR I BUTOR ' ( i f a p p l i c a b l e ) CONTRI BUTI ON VALUE CONTRI BUTI ON, Sg R. 4 Al av l i x eRL - 3 o - o 7 d R ARe4 CMmbe/ Z s -F4q 4 ; n t e 9 0 5 . 7 14 . ' t 9 / _ - 9 + r 4HC

-e R 0 , 1 2 1 4, 1 5 I N 5 2 9 o /- 3 0 - 0

1 . e e CQAL l e( } s a me q . 5 a o v e ) _ ' 0 q- W 41 ~ me 23 F- 1

6 - 3 0 - o ? / 2 t t QMe l z f , 4 ~i ~. . . 7 f 4 " t ' ~ " + ' i ~ ' N L ' Z ~ 7 TQ I EJ(5Qf c 43 a b o v e )6 - 3 0 - 0 1 Ty q n n 4 , SF e P h e v t , s o h~Sa~+e Qs 4bove~ 4 i * m e 12 , 3 - f FL ' 3 0 - o f f To y N~eh o L s oN( s qme qs a b o v e ) Si g - Y - P 4 1 " m e g l , g D F

3 0- 1 7~eQhnt 1 3RQ~ c r P e s J t " 4 " t i v n e , 5 . 5 1 Fc s q me q s Qbove )

F- 1F- 1F- 1F- 1

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