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Disclosure Summary Page DR-2: (Must Be Same As On Statem T of Orga Nation) - Tinm, - R& !
Disclosure Summary Page DR-2: (Must Be Same As On Statem T of Orga Nation) - Tinm, - R& !
02i06
PEOPLES NATL BANK 333BDb.IY
SEP-18- 2003 05 : 19
I
FORM
DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
COM TTEE NAME (Must be same as on Statem t of Orga~nation) (Rev. 07/2003) REPORT
- tinm , -r& !:- - eD tl4nfl
For Office Use One!`
44~_ ,
IMPORTANT: Indicate type of committee you are reporting for: Comm . # _
13
Logged In
( 1 )Statewide/Legielative Candidate ( 2 )Statewide PAC ( 3 )State Party (4 )CountyLocal Candidate
( 5 )County PAC ( 5 )Ballot Issue/Franchise Committee ( 7 )CountyiClty Central Committee Scanned I , __L_~_ 3
( 8 )Support Slate of Candidates Computer
CANDIDATE COMMITTEES ONLY : Audited _
Cand to Nam~'' Political Party
Late filed reports are subject to possible civil and criminal penalties.
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE:
I AM FILING A , 9 -19 - J 3 REPORT FOR ANIA (1) ELECTION /(2)NON-ELECTION YEAR .
(report date)
Indicate one
Local Committees, enter Date of Election
QCHECK IF AMENDMENT TO REPORT DATED .03
9-9
County & Local Committees, enter County in
Check if this is final (termination) report and attach Notice of Dissolution Form DR-3. which Elpptlon is held
(You must continue to file reports until a Notice of Dissolution is filed.) TAW- ~E
CASH ON HAND at the beginning of the reporting period . (This is the total of all monies held
by the committee. This amount MUST be the same as the cash on hand at the end /
of the last reporting period, or must be zero if this is first report filed.) .. ... ... .. ...... ... ..... .. ... .. .. $ __ ..-
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) ('also see in-kind below) . ...... .. .
Schedule F: Loans Received total (Attach Schedule F) . ..... ... .. . ... .... . . ... ..... .. ... ,. , ... .
Schedule H: Total Sales of Campaign Property (Attach Schedule H) .. ... ..... ... ... .. ... .. ... ... .. ...
(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL .....$
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B : Expenditures total (Attach Schedule B) ("also see debts and loans below) ....
Schedule F: Loan Repayments total (Attach Schedule F), .. ... ... .. . .. .. .. ... . . ... . . . . .. ....., . .. .
CASH ON HAND at the end of this reporting period (if final report, balance must
be zero) (Attach DR-3) .. . . ... . . . .. ..... ... . .. ..... . . ... .. ..... .. ... .. . . ... .. ... . .. .. ... . .. . ... .. .. . ..... ... .. ... ..... ... . ..... . S
"UNPAID BILLS (From Schedule D - Attach Schedule D) .. . .. .. . .. .. ... . .. . . . ... . . .. . ...... ... ... .. .... .. ... . $ _.-.
'IN KIND CONTRIBUTIONS (From Schedule E -Attach Schedule E) . ... . . . .. . ..... . .... . ... .. ... .. ... ..... . .. ..... $ -_,-_ i~a,aq~
-OUTSTANDING LOANS (From Schedule F - Attach Schedule F) ...... .. ... ... ..... . ... ..... ...... .. ... . . $
CANDIDATE COMMITTEES ONLY:
CONSULTANT BREAKDOWN (Schedule G Attached?)
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
712 325 5141 P-1213/015
05 :10 PEOPLES NATL BANK 333BDLJY
SEP-18 - 2003
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
CAUTION : Section 68B.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 10 NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (If applicable) TO CANDIDATE - RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
s 0
4-t1-o3 CK# uN ITze-mlzsz)
C - ~s
s Is~ a~
ID#
I D#
_8 03 CK#
ID#
CK#
1D#
CK#
ID#
CK#
ID*
Co
ID#
CK#
CK#
SUB-TOTAL
° Disclosure law requires candidate committees to dlaclose 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 sumame of contributor Is the same as candidate. but (hero is no Page - -I- Of __L_
familial relationship, enter - not applicable" in the relationship column . for Schedule A)
712 325 5141 P- 0 4/05
PEOPLES NATL BPNK 333BDIA)Y
SEP-18 - 2003 05 :13
4-9
.o3 ~sr
CK#
l~ " +ynR~><~wr - u s . PaY lls,~-x~ . ~ Sag $ 6S.a5
ID#
q_Q-P3 CK#
S As: O'tC -%
a-3 CK#
(U PA,Nr7i16
3"13 .ld 1
ID#
( C.aL~-+niS
I D# ~'
~,rn IGC .n~S /
y .> ,SIBS
bY. 18
CK# g f
vIC;m Srd z~ .C :~ "n
ID#
~c4:tIJ~
~ItcYrnc JG' ~~sA~
Q -`}a3
'~
CK# - r
~NJ,-IN
CK#
CK#
SUB-TOTAL
at 130
TOTAL (if last page of this schedule) S
a-I 30 '
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)
Expenditures to person slentltles 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/enthy on behalf of the candidate's committee. (Refer to
Schedule G Instructions and Iowa Code 68A .6(3)(i) )
Page _I _ of
(for Schedule 8)
712 325 5141 P . 05i05
SEP-18-2003 05 : 19 PEOPLES NATL BANK, 333BDIWY
P/)M CaCLJ,8
O CHECK THIS BOX IF
AMENDING FORM
ZINI
F7
(MMIDDIYR) OF CONTRIBUTOR ' (If a pricable) CONTRIBUTION VALUE CONTRIBUTION
F-1 I
1,9 . .)3 -noc rjLV2j-0
sti "'O3
F7
F7
a
0
F7
0
TOTAL (if last
page of this
schedule)
'Disclosure law requires candidates to disclose the relationship of any relative making an In kind contribution to the Page I of
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 surname of contributor to the same as candidate, but there is no
famlllal relationship, enter 'not applicable' in the relationship column .