cole bob__1511__scanned

Upload: zach-edwards

Post on 08-Apr-2018

223 views

Category:

Documents


0 download

TRANSCRIPT

  • 8/7/2019 Cole Bob__1511__scanned

    1/4

    J A N- 1 8 - 2 0 0 6 1 6 : 4 3 FROM COMMUNI TY NRTI ONRL SRNKFCR I N STRUCT I ONS, SEE BACK OF FORM

    DI SCLOSURE SUMMARY PAGECOMMI TT EE NAME ( M u s t b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )

    CANDI DATE COMMI TT EES ONLY :Ca d i d a t e Na 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 )i g me

    O f f i c e S o u g h t / I D i s t r i c t ( i t S e n a t e o r H o u s e )ZOWA f f ause a

    NATURE OF PERSON F I L I

    I AM F I L I N G A / 9 -( r e p o r t d a t e )

    MCHECK I F AMENDMENT TO REPORT DATED J A I V 18 20 0 6* Check i t t h i s i s f i n a l ( t e r m i 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( Y o 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

    TO 1 5 1 5 2 8 1 3 7 0 1

    I MPORTANT: I n d i c a t e b y # t y p e o f c o m m i t t e e y o u a r e r e p o r t i n g f o r ,"( I ) S t a t e w i d i N t 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 o 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 l 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 PAC( 1 1 ) L o c a l B a l l o t I r s u e

    P 0 2 / 0 6FORMDR- 2 DI SCLOSURE( R e v 1 2 / 2 0 0 5 ) 1 REPORT

    F o r O f f i c e Us e O n l y J rComm .L o g g e d I WS c a n n e dC o mp u t e rA u d i t e d - - - -

    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 m i 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 6 8 8 , 3 2 A ( 7 ) t h e c a n d i d a t e , f o r a c a n d i d a t e ' s c o mm i t t e e ,a n d # i e c h a i r p e r s o n , f o r a n y o t h e r t y p e o f c o mm i t t e e , i s t h e i n d Md u a l r e s p o n s i b l e f o r f i l i n g t i m e l y a n d a c c u r a t e r e p o r t s ./ - ~ ; ~ / - ~ ' . 1-18-04TELEPHONE DATE SI GNED

    REPORT FOR 0 ) ELECT I ON / ( 2 ) NON- ELECT I ON YEAR,I n d i c a t e b y # I s

    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 m m i t t e e . T h i s amoun t MUST b e t h e same 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 m u s 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 MONEYTAKEN I N THI S PEMODS c h e d u l e A : Cas 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 S c h e d u l e A ) ( * a l s o s e e I n - k i n d b e l o w ) . . . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n s R e c e i v e d t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l 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 S c h e d u l e H ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    ( S c h a d u i g H a p p i l e r , WC a n d i d a t o i s ' C o r n i r n i f t 0 s O n l y )SUB- TOTAL . . . . . . . . . . . . . S

    SU13TRACT TOTAL MONEYSPENT T HI S PERI ODS 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 ( A t t a c h S c h e d u l e S ) ( " 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) . . . . . . . . . . .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 ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    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 mu s tb e z e r o ) ( A t t a c h D R - 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $- UNPA I D BI L L S ( F r o m S c h e d u l e D - A t t a c h S c h e d u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 . 11 . . . . . . . . . . . . . . . . . . . . I . . . . . . $' I N K I ND CONTRI BUT I ONS ( F r o m S c h e d u l e E - A t t a c h S c h e d u l e E ) . . . . . . I " . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . .. . $" OU T ST ANDI NG LO ANS ( F r o m S c h e d u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

    L o c a l C o mm i 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 o mm i 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 o l d

    0

    CONSULTANT BREAKDOWN ( S c h e d u l e GA t t a c h e d ? ) -YES_NO; _ A _ N D I D A T E COMMI MES ONLY :VALUE OF CAMPAI GN PROPERTY ( F r o m S c h e d u l e H - A t t a c h S c h e d u l e H ) $S I AT E COMMI TT EES : S u b mi t a r e c o n c i l e d c a m p a i g n a c c o u n t b a n k s t a t e m e n t i n J a n u a r y o f e a c h y e a r

  • 8/7/2019 Cole Bob__1511__scanned

    2/4

    JAN- 18 - 2 006 1 6 : 4 3 FROM COMMUNI TY NATI ONAL BANKFo ~ I n s t r u c t i o n s , Se e B a c k o f Fo r mCONTRI BUTI ONS - - MONEYTAKENI 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 TTEE NAME ( Mu s t b e s ame a s on St a t e me n t o f Or g a n I z a t i o n )8 o b 6o l e , - Cwy t h e - 00- e c p r / e C o wi x t 17 t e j

    TO 15152813701

    TOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e )

    P . 04 / 06

    STATE CANDI DATES NOTE , I F A CONTRI BUTI ON I S RECEI VED FROMA STATF: PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DEN11F I CATI ONNUM13ERAND THE PAC CHECKNUMBER I N THE DESI GNATED COLUMN, A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON : Se c t i o n 6 88 . 3 2 A ( 6 ) , I o wa Cod e , 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 on c o p i e d f r o m r e p o r t s and s t a t e me n t s f o r s o l i c i f i n g c on t r i b ut i on s o rf o r a ny c omme r c i a l p u r p os e b y a ny p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

    ' D i s c l o s u r e l a w r e q u i r e s c a n di d a t e c o mmf t e e s t o d i s d o %@ 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 c o n t r i b u t i o n t o t h eG=Ml t We , r % 0 1 a u 0 n $ r 1 1 p mu s t besh own t o t h e t h r d g r e e o f c o n s a n g u i n i t y k o 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 y e G b y 6AJ6o f 6 ) A) ,ma r r i a g e ) . I f su r name o f c o n t r i b u t o r i s t h e s am e a s c a n d i d a t e , b ut t h e r e i s n o P a g ef 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 ot 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 Sc h e d ul e A)

    SCHEDULEA MONETARY( Re v . 0 7 / 0 3 ) RECEI PTS

    FN- 1 CHECK THI S BOX I F !AMENDI NG FORM

    DATE PACI DNUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND( MWDDf YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SE

    NUMBER I NCOMa 1 ) YY 7AL ' ? ) I A f a ~ l e - - ) , t e 4CKONJ A S a l l e 100 . E 0 q - - Sr S- - r A- - r e: 0A/ , E

    I D# A S C-CK# - 4l D#CK#I D#GK#I D#CK*I D#CK#I D#CK#I D#CKOI D#CK#I D#CK#

  • 8/7/2019 Cole Bob__1511__scanned

    3/4

    J AN- 1 8 - 2 0 0 6 16 : 4 3 FROM COMMUNI TY NATI ONAL BANK

    T HI S BOX APPL I ES TOCANDI DATEWCOMMI TTEES ONLY :

    TO 1 5 1 5 2 8 1 3 7 0 1 P . 0 3 / 0 6

    P u r c h a s e s Of 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 f i n g $ 5 0 0 o r Mo r e mu s t 9 1 SO b e I n v e n t o r i e d o n S c he d u l e H . ( R e f e r t o Sc h e d u l e H i n s t r u o 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 f 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 , ma n a g i n g , o r g 2 nWn g s e r v i c e s mu s t a l s o b e d e t a i l i t e m i z e d o nSc h e d u l e G b y t h e a mo 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 m a d e b y t h e p e mo 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 mmi t t e e . ( R e f e r t oSc h e d u l e G i n s t r u c t i o n s a nd I o wa Code 88A . 4 0 2 ( 3 ) ( i ) . )

    Pa g e ~~ o f e ) A) C-

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

    FORI NSTRUCTI ONS, SEEBACK OF FORM r r M S C H E D U L EEXPENDI TURES B MONETARY- MONEY SPENT FROMCOMMI TTEE ACCOUNT ( Re v . 0 7 1 0 3 ) EXPENDI TURES

    STATE PAC COMMI T TEES : NOTE . FOR CONTRI BUTI ONS MADE TO STATEWI DE OR I FGI SLAT I VECANDI DATES, L I S T THE CANDI DATE I DENTI FI CATI ON NUMBER I N THE 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 A CAMPAI GN DI SCLOSURE BOARD.COMMI TTEE NAME ( M u s t b e s ame a s o n S t a t e me n t o f O r g a n i z a t i o n )

    0 l e e p l th. e - , Pe o eCANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI PE TRANSACTI ON) EXPENDEDEXPENDED ( ; f a p p l i c a b l e ) ( D i s b u r s a me n t ) WAS MADE( MMI DD/ YR) AND PACCHECKNUMBERI D# C- p - d - 4 1A l r ~a~ v v e L h o s - t l ,

    0 ,7 CKO1083 $30C61V. Mb, AI D#CK#

    9 c l e m+ n lCK#I D#CK#I D#CK#I D#CK#I D#CK#I D#CK#

    SVS- TOTAL $TOTAL ( f f l a s t p a g e o f t h i s s c h e d u l e ) $ 4 1 ?A, t 1 6

  • 8/7/2019 Cole Bob__1511__scanned

    4/4

    J A N- 1 8 - 2 0 0 6 1 6 : 4 4 FROM COMMUNI TY NRT I ONRL &W TO 1 5 1 5 2 8 1 3 7 0 1 P . 0 5 / 0 6

    No t i c e o f D i s s o l u t i o n

    COMMI TT EE NAME

    FORM ( Re v . 0 7 / 0 3 )DR- 3

    NOTI CEOFDI SSOLUTI ON

    WHEN TO F I L E :Th e N o t i c e o f D i s s o l u t i o n mu s t b e f i l e d w i t h i n t h i r t y ( 3 0 ) d a y s o f c o m p l e t i o n o f a l l t h e f o l l o w i n g1 A l l d e b t s , l o a n s a n d o b l i g a t i o n s h a v e b e e n p a i d o r t r a n s f e r r e d ;2 A l l c a mp a i g n f u n d s h a v e b e e n s p e n t ;3 A l l c a mp a i g n p r o p e r t y s o l d o r t r a n s f e r r e d ( c a n d i d a t e s o n l y ) ; a n d4 A f i n a l r e p o r t d i s c l o s i n g a l l t r a n s a c t i o n s c l o s i n g t h e c o mm i t t e e

    F o r s t a t e c a n d i d a t e s a n d s t a t e P A C s , a f i n a l b a n k s t a t e m e n t mus t b e f i l e d w i t h t h e N o t i c e o f D i s s o l u t i o n o r a s s o o n a sp o s s i b l e i f t h e b a n k s t a t e m e n t i s n o t a v a i l a b l e a t t h e t i m e t h e N o t i c e o f D i s s o l u t i o n i s f i l e d

    FOR I N ST RUC T I ONS, SEE BACK OF FORMT h i s f o r m i s n o t a pp l i c a b l e t o s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

    c a r_' . , t d i d a t e ' s c o mmi t t e e ) / S i g n a t u r e o f C h a i r o r T r e a s u r e r ( i f PAC)-/ ~f 04: ~D a t e S i g n e d

    & .e 0 0eoel e ( f 1 7 A-- ? e- )O f f i c i a l Name o f Co mmi t t e e

    e-t" 4 ; - = A -

    C i t y , S t a t e , Z i p Co d e

    Y / ) L / - ; L - 3 - 0 Y' 3 6 ,A r e a T e l e p h o n eCo d e

    Ma i l t o -TECDH5 1 0 E a s t 1 2 0 ' , S u i t e I A F o r Qf f l r e Us o On l yDe s Mo i n e s , I o wa 5 0 3 1 9

    2 0 9 6Comm . 9I n d e x e dA u d i t e dC o mp u t e rC e r t i f i e d Da t e o f D i s s o l u t i o n