sievers bryan1224scanned

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R e p o r t Du e Da t e 0 1 / 1 9 / 2 0 0 2

Co mmi t t e e C h a i r J o Anne Hammes

S t a t u s Or i g

Co u n t y : Sc o t t

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

St a t e me n t o f Cash On Hand

Ad d i t i o n al Asse t s and L i a b i l i t i e s

O r i g

( 3 1 9 ) 2 8 5 - 9 7 1 6

T h i s Re p o r t Was P r i n t e d Wi t h T he I CF RS So f t war e o n 0 1 1 1 9 / 2 0 0 2 1 0 : 3 3 : 5 0 AM

Cash On Hand a t S t a r t o f P e r i o d $ 3 9 4 . 9 9

S c h e d u l e A Cash C o n t r i b u t i o n s T o t a l $ 2 , 1 0 0 . 0 0

Sc h e du l e F L o a n s Re c e i v e d T o t a l $ 1 , 7 5 0 . 0 0

Sc h e du l e H C amp a i g n P r o p e r t y S a l e s $ 0 . 0 0

SUB- TOTAL $ 4 , 2 4 4 . 9 9

S c h e d u l e B E x p e n d i t u r e s T o t a l $ 2 , 3 8 5 . 3 8

S c h e d u l e F L o a n Re p a y me n t s T o t a l $ 1 , 7 5 0 . 0 0

Cash o n Ha n d At En d o f P e r i o d $ 1 0 9 . 6 1

L 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 : UnPa i d B i l l s $ 0 . 0 0

S 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 0

Sc h e du l e F O u t s t a n d i n g L o a n s $ 0 . 0 0

Sc h d ul e G C o n s u l t a n t Br e a k d o w n ? No

S c h e d u l e H : Campa i g n P r o p e r t y V a l u e $ 0 . 0 0

F o r g i v e n L o a n s ( F r o m Sc h e du l e E )$ 0 . 0 0

FORM DR- 2 : D i s c l o s u r e Summa r y r a g e

I D : 1 2 2 4

ORM

DR- 2 DI SCL OSU

I CF RS 4 / 9 8 REPORT

F o r O f f i c e Us e On l y' , o u n t y : Sc o t t

T y p e : St a t e Hou se Comm. # " " ' 1 2 2 4

T r e a s Mi c h a e l He i n ( 3 1 9 ) 2 8 4 - 6 7 2 6 I n d e x e d

Name Si e v e r s Fo r St a t e Hou se A u d i t e d

Comp u t e r Co ~ -



ORI GI NAL

T h i s Re p o r t Was Pr i n t e d Wi t h Th e I CF RS So f t wa r e o n 0 1 1 1 9 12 0 02 1 0 : 3 4 : 5 9 AM

P a g e T o t a l $ 8 5 0 .

P a g e 1 o f

( f o r s c h ed u l e

SCHEDULE A Co n t r i b u t i o n s - Mono - T a k e n I n SCHEDULE

I D 1 2 2 4MONETARY

RECE I PTSName Si e v e r s Fo r S t a t e H o u s e I CFRS 1 2 / 9 9

ORI GI NAL

T y p e S t a t e H o u s e

Co mmi t t e e I D

Da t e R e l a t i o n s h i p Amo u n t

Re c e i v e d Ch 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 e0 1 / 0 5 / 2 0 0 1 I D 6 1 0 1 Mo t o r C a r r i e r s PAC: $ 2 5 0 .

Ch : 2 1 0 97 1 7 E . Co u r tDes Mo i n e s I A 5 0 3 0 9 4 9 0 1

[ # 7 5 7 ] A0 6 / 0 4 / 2 0 0 1 I D : 6 1 0 1 Mo t o r C a r r i e r s PAC: $ 1 0 0 .

C h k # 10 9 17 E . Co u r tDe s Mo i n e s I A 5 0 3 0 9 4 9 0 1

EXPLANAT I ON : PAC F u n d r a i s e r

[ # 7 8 5 ]

0 6 / 0 5 / 2 0 0 1 I D : 6 2 9 1 I o wa H o s p i t a l As s oc i a t i o n P o l i t c a l Ac t i o n Co mmi t t e e No Re l a t i o n $ 1 0 0 .

C h k # : 1 7 6 0 10 0 E . Gr a n d Su i t e 1 0 0De s Mo i n e s I A 5 0 3 0 9

EXPL ANATI ON : PAC F u n d r a i s e r

[ # 7 7 6 ]

0 6 7 / 2 0 0 1 I D : 6 0 7 3 I o wa Me d i c a l P o l i t i c a l A c t i o n Co mmi t t e e $ 1 0 0 .

C h k # : 3 5 01 0 0 1 Gr a n d Av e n u e

We s t De s Mo i n e s I A 5 0 2 6 5 3 5 0 2


[ # 7 7 4 ]

0 6 / 0 8 / 2 0 0 1 Wi l s o n , Geor geA. No R e l a t i o n $ 5 0 .

C h k # : 1413 03 1 7 S i x t h A v e n u e Su i t e 7 4 0

De s Mo i n e s I A 5 0 3 0 9 4 1 1 4

EXPL ANATI ON : PAC F u n d r a i s e r[ # 7 7 1 ]

0 6 / 1 0 / 2 0 0 1 mod , Mona R. No R e l a t i o n $ 1 0 0 .

C h k # : 5 7 6 3 2 8 1 8W. 1 s t S t r e e t

A n k e n y I A 5 0 0 2 1


[ # 7 7 2 ]

0 6 / 1 1 / 2 0 0 1 I D : 6 0 2 1 Cr e d i t Un i o n PAC $ 1 0 0 .

C h k # : 1417P . O . Bo x 1 0 4 0 9De s Mo i n e s I A 5 0 3 0 6 0 4 0 9


[ # 7 7 5 ]

0 6 / 1 1 / 2 0 0 1 I D : 6 0 3 4 En g i n e e r sC $ 5 0 .

C h k # : 14391 0 0 0 Wa l n u t S t r e e t , S u i t e 1 0 2

Des Mo i n e s I A 5 0 3 0 9


[ # 7 6 9 ]



ORI GI NAL

T h i s Re p o r t Was Pr i n t e d Wi t h T h e I CFRS So f t wa r e o n 0 1 1 1 9 1 2 0 0 2 1 0 : 3 5 : 0 0 AM

Page T o t a l $ 8 0 0 . 0 0

Pa g e 2 o f 3

( 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 - Mone- T a k e n I n SCHEDULE

I D - 1 2 2 4 A MONET ARYRECEI PTS

Name : S i e v e r s F o r S t a t e H o u s e I CFRS 1 2 / 9 9

ORI GI NAL

T y p e : S t a t e House

C o mmi t t e e I DD a t e R e l a t i o n s h i p Amount

R e c e i v e d Chec k # Name a n d A d d r e s s o f C o n t r i b u t o r T o C a n d i d a t e R e c e i v e d

2 0 01 I D : 6 1 1 8 I o w a 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 $ 1 5 0 . 0 0

Chk# : 1 7 0 0 9 7 2 1 A u r o r a A v e n u eU r b a n d a l e I A 5 0 3 2 2

EXPLANATI ON : PAC F u n d r a i s e r[ # 7 7 9 ]

2 0 01 I D : 6 1 2 5 I o w a R e a l t o r s P o l i t i c a l A c t i o n C o mm i t t e e $ 1 0 0 . 0 0

Chk# : 1 8 2 7 7 0 2 3 D e l M a t r o A v e n u eDes Mo i n e s I A 5 0 3 1 1


6 1 1 / 2 0 01 I D : 6 1 6 3 I o w a S o f t D r i n k PAC $ 5 0 . 0 0

Chk# : 2 8 6 0 P . O.Box 1 7 7 8C e d a r R a p i d s I A 5 2 4 0 6


2 0 01R o b e r t s , S t e v e n W. No R e l a t i o n $ 5 0 . 0 0

Chk# : 6 5 7 1 6 6 6 Wa l n u t S t . S u i t e 2 5 0 0Des Mo i n e s I A 5 0 3 0 9


6 / 1 1 / 2 00 1 I D : 6 1 5 5 T a x p a y e r s U n i t e d $ 1 0 0 . 0 0

Chk# : 3 8 4 4 P . O. Box 2 0 9Mu s c a t i n e I A 5 2 7 6 1


2 0 01 M u r p h y , L a r r y No R e l a t i o n $ 5 0 . 0 0

Chk# : 1 7 4 1 5 3 1 - 6 t h S t . N .O e l w e i n I A 5 0 6 6 2


2 0 01 I D : 6 0 8 2 M i d A me r i c a n E n e r g y Company E f f e c t i v e G o v e r n m e n t $ 2 0 0 . 0 0

Chk# : 6 7 56 6 6 Gr a n d A v e n u e P . O . Box 6 5 7De s Mo i n e s I A 5 0 3 0 3 0 6 5 7

EXPLANATI ON: PAC F u n d r a i s e r[ # 7 8 4 ]

6 / 2 0 0 1 I D : 6 0 5 6 B a n k e r sU 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

: B UI L P ) $ 1 0 0 . 0 0Chk# : 2 5 0 0

4 1 8 S i x t h Av e . S u i t e # 4 3 0Des Mo i n e s I A 5 0 3 0 9 2 4 3 8

EXPLANATI ON: PAC F u n d r a i s e r

[ # 7 8 0 ]



ORI GI NAL Pag e T o t a l 1 $ 4 5 0 .

R e p o r t T o t a l 1 $ 2 , 1 0 0 .

Pag e 3 o f

T h i s Re p o r t Was P r i n t e d Wi t h Th e I CF RS So f t wa r e o n 0 1 1 1 9 1 2 0 0 2 1 0 : 3 5 : 0 0 AM ( 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 T a k e n I n SCHEDULE

I D 1 2 2 4MONETARY

RECE I PTSName : Si e v e r s Fo r S t a t e H o u s e I CFRS 1 2 / 9 9

ORI GI NAL

T y p e : S t a t e H o u s e

Commi t t e e I D

Da t e R e l a t i o n s h i p Amount

Re c e i v e d Chec 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 e6 / 1 8 / 2 0 0 1 I D : 6 0 6 9 I o w a i n d u s t r y P o l i t i c a l A c t i o n Commi t t e e ( I I I F FAG) - -$50

Chk# 1 8 0 0 9 0 4 Wa l n u t - S u i t e 1 0 0

De s Mo i n e s I A 5 0 3 0 9 3 5 0 3

EXPLANATI ON : PAC F u n d r a i s e r[ # 7 78 ]

0 6/ 2 9/ 2 0 01 I D : 6 0 2 7 De e r e PAC I o wa No R e l a t i o n $ 2 0 0 .

Chk# : 1 8 2 26 6 6 Gr a n d A v e n u e S u i t e 1 7 0 7

De s Mo i n e s I A 5 0 3 0 9 2 5 0 7

EXPLANATI ON PAC F u n d r a i s e r[ # 7 8 6 ]

0 9/ 1 3 / 2 0 0 1 I D 6 4 1 1 MCI I OWA PAC $ 1 0 0 .

Chk# : 1 1 4 7 1 9 2 5 Bo y r u m S tI o wa C i t y I A 5 2 2 4 0

EXPLANATI ON C o n t r i b u t i o n

[ # 7 9 4 ]

0 / 2 0 01 I D 0 g?) WL a f a r g e PAC No R e l a t i o n $ 1 0 0 .

Chk# 1 4 1 81 1 1 3 0 S u n r i s e V a l l e y Dr . S t e 2 0 6

R e s t o n , VA 2 2 0 9 1

EXPLANATI ON : C o n t r i b u t i o n

[ # 7 9 5 ]



ORI GI NALPage T ot a l $ 1, 9 76 . 4

Page 1 o f 2

T h i s Re p o r t Was Pr i n t e d Wi t h T h e I CFRS So f t wa r e o n 0 1 11 91 2 0 0 2 1 0 : 3 5 : 1 3 AM ( f o r s c h e du l e B

SCHEDULE B : Ex p en d i t u r es -- - Mo r - Spe n t F r o m Co mmi t t e e A c c o u n t D I V

BMONETARY

0: 1 2 2 4 EXPENDI TURES

Name Si ev e r s F o r S t a t e Ho u s eI CFRS 1 2 / 9 9

ORI GI NAL

T y p e S t a t e Ho u s e

Da t e Commi t t e e Name a n Ad d r e s s o Whom E x p e n d i t u r e mo wn x p e n . eE x p e n d e d Check # ( D i s b u r s e m e n t ) Was Made

0 1/ 0 7/ 2 0 0 1 Kn o t t P r i n t e r s $ 4 8 1 . 3

Chk# : 1108

Mu s c at i n e I A 5 2 7 6 1

# 7 5 9 ] PRI NT I NG & REPRODUCTI ON : P r i n t i n g Campa i g n M a t e r i a l

0 1/ 0 7/ 2 0 0 1 V i c t o r y En t e r p r i s es $860 . 0

Chk# : 1109

Da v e n p o r t I A 5 2 8 0 2

# 7 5 8 ] HOEXPENSES : Web S i t e d e s i g n a n d h o s t i n g

0 1/ 2 8 / 2 0 0 1 Po s t ma s t e r $32 . 0

Chk# : 1110 New L i b e r t y P o s t O f f i c e

New L i b e r t y I A 5 2 7 6 5

# 7 6 0 ] POSTAGE, SHI PP I NG, DEL I VERY : P . O . Bo x R e n t a l

0 7/ 0 3 / 2 0 0 1 I D : 1224 B r y a n Si e v er s $74 . 1

Chk# : 1112 27135 1 s t Av en ue

New L i b e r t y I A 5 2 7 6 5

# 7 6 8 ] I N TEREST ON LOAN : I n t e r e s t o n L o a n f r o m C a n d i d i a t e ' s Own Fu n d s

0 7/ 1 7/ 2 0 0 1 I D : 1224 Br y a n Si e v er s $35 9 . 0

Chk# : 1114 27135 1 s t Av en ue

New L i b e r t y I A 5 2 7 6 5

# 7 8 8 ] OTHER EXPENDI TURE : Re i mbu r semen t f o r We b s i t e Fees $ 1 5 0 . 0 0 , N o r t h S c o t t P r e s s $ 1 4 0 . 0 0 a n d D1 $6 9 . 0 0 .

0 7/ 1 7/ 2 0 0 1 V i c t o r y En t e r p r i s es $30 . 0

Chk# : 1113Da v e n p o r t I A 5 2 8 0 2

# 7 8 9 ] OTHER EXPENDI TURE: We b s i t e m o n t h l y f e e

0 8 / 1 2 / 2 00 1 V i c t o r y En t e r p r i s es $ 3 0 . 0

Chk# : 1115

Da v e n p o r t I A 5 2 8 0 2

# 7 9 0 ] OTHER EXPENDI TURE : M o n t h l y We b s i t e Fees

0 9/ 1 4/ 2 0 01 I D : 1224 B r y a n Si e v er s $109 . 9

Chk# : 1116 27135 1 s t Av en ue

New L i b e r t y I A 5 2 7 6 5

# 7 9 3 ] MEALS REI MBURSEMENT : 2 0 Mea l s f o r R i v e r Re n a i s s a n c e Me e t i n g



ORI GI NAL Page T o t a l

Re p o r t T o t a l

$ 4 0 8 . 9 0

$ 2 , 3 85 . 3 8

Page 2 o f 2

T h i s Re p o r t Was Pr i n t e d Wi t h Th e I CF RS So f t war e o n 0 1 1 1 9 1 2 0 0 2 1 0 : 3 5 : 1 3 AM ( f o r s c h ed u l e B )

SCHEDULE B Ex p en d i t u r e s - - Monev Sp e n t Fr o m Co mmi t t e e A c c o u n t SCHELL LE-- MONETARY

BI D 1 2 2 4 EXPENDI TURESI CFRS 1 2 / 9 9

Name S i e v e r s Fo r S t a t e H o u s eORI GI NAL

T y p e : S t a t e H o u s e

Da t e Commi t t e e 1 0 Name an d Ad d r e s s 1 5 Whom E x p e n d i t u r e Amou n t E x p e n d e e iE x p e n d e d Che c k # ( D i s b u r s e m e n t ) Wa s Mad e

V i c t o r y E n t e r p r i s e s $ 3 0 . 0 0

Chk# 1 1 1 7D a v e n p o r t I A 5 2 8 0 2

OTHER EXPENDI TURE : Mo n t h l y Web S i t e H o s t i n g

1 2 / 2 0 01 V i c t o r y En t e r p r i s es $30 . 00

Chk # : 1 1 1 8

Da v e n p o r t I A 5 2 8 0 2

OTHER EXPENDI TURE: Web S i t Fees

1 9 / 2 00 1 Y 4 0 St o r a ge $2 8 8 . 9 0

Chk # : 1 1 1 9 Bo x 2 6 1

Wa l c o t t I A 5 2 7 7 3

OTHER EXPENDI TURE : R e n t a l U n i t f o r Y a r d S i g n s

1 2 / 2 0 01 I D : 1 2 2 4 Br y a n S i e v e r s $ 3 0 . 0 0

C h k # : 1 1 2 0 2 7 1 3 5 1 s t A v e n u e

New L i b e r t y I A 5 2 7 6 5

OTHER EXPENDI TURE: Rei mb u r s eme n t f o r Mo n t h l y Web S i t e Fees

1 4/ 2 00 1 V i c t o r y En t e r p r i s es $30 . 00

Chk # : 1 1 2 1Da v e n p o r t I A 5 2 8 0 2

OTHER EXPENDI TURE : Mo n t h y We b S i t e f e e s



I D : 1 2 2 4Name Si e v e r s Fo r St a t e House

T y p e St a t e House

SCHEDULE

FI CFRS 1 2 / 9 9

LOANS

RECEI VED& REPAI D

ORI GI NAL

T o t a l Un p ai d L oan s F r om L a s t R e p o r t i n g P e r i o d $ 0 . 0 0

PART - MONETARY LOANS RECEI VED T HI S REPORTI NG PERI OD

SCHEDULE F L o a n s Re c e i v e d & Re p ai dTOTAL LOANS RECEI VED T HI S PERI OD ( P a r t I ) : $ 1 , 7 5 0 .

PART I I - MONETARY LOAN REPAYMENTS MADE T HI S REPORTI NG PERI OD

SCHEDULE F L o a n s Re c e i v e d & Re p a i dTOTAL L OAN REPAYMENTS T HI S PERI OD ( P a r t I I ) $ 1 , 7 5 0 .

Fr o m Sc h e d u l e E - TOTAL LOANS FORGI VEN

TOTAL OUTSTANDI NG LOANS END OF REPORT PERI OD

$ 0 .

$ 0 .

ORI GI NAL

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 S o f t w a r e o n 0 1 1 1 9 1 2 0 0 2 1 0 : 3 5 : 2 5 AM

Page 1 o f

( f o r s c h e d u l e F )

Da t e Name an d Ad d r e s s o f L e n d ae r R e l a t i o n s h i p To Amou n t o fRe c e i v e d ( 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 ) Ca n d i d a t e L o a n

Ca n d i d a t e s P e r s o n a l F u n d s$ 1 , 7 5 0 .

0 1 / 0 5 / 2 0 0 1

# 7 6 1 ENDORSER : B r y a n S i e v e r s P e r s o n a l Che c k # 1 4 2 3 6 e n d or s e d b y Re p . B r y a n S i e v e r s

Da t e

P a i d

Name a n d Ad d r e s s o f L e n d ae 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 o

C a n d i d a t eAmount

Re p ai d

0 4 / 0 7 / 2 0 0 1

C a n d i d a t e ' s P e r s o n a l F u n d s$ 7 5 0 .

# 7 6 4 ENDORSER : B r y a n S i e v e r s - Ch ec k # 1 03 3

0 7 / 0 3 / 2 0 0 1C a n d i d a t e ' s P e r s o n a l F u n d s

$ 1 , 0 0 0 .

# 7 6 7 ENDORSER : B r y a n S i e v e r s - Check # 1 1 1 1

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