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Seymour James - 1411 - Scanned
Seymour James - 1411 - Scanned
React F=m
DISCLOSURE SUMMARY PAGE DR-Z DISCLOSURE
S~~ , I
HIPORTAMd Indrate-by # type of corrrvillee youwe reporngfor:: --
(1)Stalewiden egislstive/Judge StandiM for Retention Candidala (2 )State PAC (3)State Party
(4)Courky Certraai Corrrr~ILee (S )Comity Candidate (6 )City Candidate (7 )School Board or Other
Political Subdivision Candkide (S )County PAC (S)CityPAC (1D)School Board or Outer Po§6cal
Subdivision PAC (11 ) Local Ballot Issue
CANDIDATE COMMITTEES ONLY:
Candidate Na P i cal P jif applicable)
vlcs 4 d CV4 i 04,r,; Late reports are subject to
possible civil and criminal
District (if Senate or House) penalties .
l
I AM FILING a 0~: X' 706 ORT FOR (1) ELE O~Ic LECTION YEAR.
(report date) tridwate by 0
Check if this is final (termination) report and attach of Dial F&m DR=3. County & Local Convnittees, enter County in
which; Election is held
(You must continue to file reports until a DR-3 is fled.)
"UNPAID BILLS (From Schedule D -Attach Schedule D) ._ . . . .. . . . .. . ._ . . . . . . ._ . ._ . . . . . . ._ .__ .. . . . ..__ . . . . . . . .._ . . .. . . ._.$
"IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
CANDIDATE COMMITTEES ONLY:
CONSULTANT BREAKDOWN (Schedule G Attached?) YES
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)
For Instructions, See Back of Form Keset }'ortn SCHEDULE
STATE CANDIDAIMS 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 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER
_ INCOME
z O
ID# -L'!7-
(pi 77777
^~-'7 getATZ ;v~ iYiTt`
l 3 r'ic~ N, w r ' l 1'f ST: s7~ 1 ~4~
Q
I D# (, 0 5 tf -'* 44rSS ~~2~~ Jt'! I
o
CK#
ItI I _b, 0 , .. -
L7 i
.
CK#
ID#
CK#
I D#
CK#
1D#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL
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) . If surname of contributor is the same as candidate, but there is no Page of
familial relationship, enter "not applicable" in the relationship column . (fo Schedule A)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form SCHEDULE
B MONETARY
EXPENMTURES - MONEY SPENT FROM COMMITTEE ACCOUNT
(Rev . 07/03) EXPENDITURES
STATE PAC COMMITTEES: NOTE: FOR CONTRIBUTK)NS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.
CK# .s
IO ;rB CK#
ID#
CK#
ID#
CK#
1D#
CK#
I D#
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 persoNentity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 68A.402(3)().)
(for Schedule B)