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COMMI TT EE NAME ( M u s t b e s ame a s
POWELL FOR HOUSE
I MPORTANT: I n d i c a t e 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 :
F OR 1 1 1 . - T T R U C T I O N S , S E E B A C K O F F (
DI SCLOSURESUMMARYPAGE
( r e p o r t d a t e )
nCHECK I F AMENDMENT TO REPORT DATED
( 1 ) S t a t e w i d e / L e g i s l a t i v e C a n d i d a t e ( 2 ) S t a t e w i d e PAC ( 3 . ) S t a t e P a r t y ( 4 ) C o u n t y / L o c a l C a n d i d a t e( 5 ) C o u n t y P A C ( 6 ) B a l l o t I s s u e / F r a n c h i s e C o m m i t t e e ( 7 ) C o u n t y / C i t y C e n t r a l C o m m i t t e e( 8 ) S u
o r t S l a t e o f C a n d i d a t e s
S I GNA
RE OF
EASURER ( o r p e r s o n f i l i n g t h i s r e p o r t )
p C h e c k i f 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 s o l u t i o n F o r m D R- 3 .( Y o u m u 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 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 . )
STATEMENT OF CASH ON HAND
FORM
DR- 2 DI SCLOSURE
( R e v . 0 1 / 9 8 ) ' REPORT
F o r O f f i c e Us e On l y
Comm #
I n d e x
A u d i t e d
C o m p u t e r
1 A i 1 C _ ~
5 1 5 / 4 6 5 - 4 4 0 7 0 1 / 2 0 / 0 2
TELEPHONE
DATE SI GNED
Ro u t i n e Pe na l t i e s Du e Fo r L a t e F i l e d Re p or t s R a n g e f r o m $ 20 t o $
SEE I NSTRUCT I ONS ON BACK AND COMPL ETE THE FOLLOWI NG SENTENCE :
AM F I L I N G A
0 1/ 2 2/ 0 2
REPORT FOR A N/ A ( 1 ) ELECTI ON / ( 2 ) N O N
C o u n t y & L o c a l Co 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 e l d
I n d i c a t e o n e
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 h i s i s t h e t o t a l
o f a l l m o n i e s h e l d b y t h e c o m m i t t e e T h i s a m o u n t MUST b e t h es 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 d o 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 . )
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
9 8 . 2 7
ADD TOTAL MONEY TAKEN I N T HI S PERI OD
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Fo r I n 6 t r u c t l o n s , Se e Back o f Fo r m
CONTRI BUTI ONS - MONEYTAKEN I N
( i n c l u d i n g c a n d l d a t e ' s p e r s o n a l f u n ds )
COMMI TTEENAME ( Mu s t b e s am e 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 )
POWEL L FOR HOUSE
STATE CANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROM ASTATEPAC ( POL I T I CAL ACTI ON COMMI TTEE) . L I S T THE PAC I DENT I F I CAT I ONNUMBER ANDTHE PACCHECKNUMBER I N THEDESI GNATED COLUMN . AL I S T OF I D NUMBERS I S A VAI L ABLE FROMTHE I OWA ETHI CS AND CAMPA I GNDI SCLOSURE BOARD.
CAUTI ON : Se c t i o n 6 8 8 . 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 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 me n t s f o r s o l i c i t i n g c on t r i b u t i o n s o rf o r an y c 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 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 .
SCHEDULE
A MONETARY
( Re v . 0 8 1 9 7 ) RECEI PTS
CHECK T HI S BOX I F
AMENDI NG FORM
DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE' RECEI VED FUND-
( MWDD/ YR) ANDPACCHECK ( i f a p p l i c a b l e )RAI SERNUMBER I NCOME
I D# I o wa Democ r a t i c Pa r t y .$ 5 , 9 6 0 . 0
0 2 / 1 2 / 0 1 CK#5 6 6 1 F l e u r Dr i v e
De s Mo i n e s , I A 5 0 3 2 1
I D # Da ws o n Po s t ma s t e r 6 1 . 00 3/ 1 0 / 0 1 CK# 1 * 4 4D aw s o n , I A 5 0 0 6 6
I D#
CK#
I D#
CK#
I D#
CK#
I D#
CK#
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FOR I NSTRUCTI ONS . SEE BACKC ' ' ARM SCHEDULE
EXPENDI TURES B- MONEY SPENT FROMCOMMI TTEE ACCOUNT MONETARY( R e v . 0 9 / 9 7 ) EXPENDI TURES
STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E G I S L A T I V ECANDI DATES, L I S T THE CANDI DATE I D E N T I F I C A T I O N NUMBER I N THE DESI GNATED COLUMN AND THE D CHECK T HI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S A VA I L A B L E FROMTHE I OWA AMENDI NG FORME T HI C S t i 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 )
POWEL L FOR HOUSE
CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED
EXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADE( MMI DD/ YR) AND PAC
CHECKNUMBER
0 2 / 12 / 0 1 I D* Pe r r y Ch i e f Ad s 17 9 . 6 01 3 2 3 Se c o n d S t r e e t
CK# 3 0 6 P e r r y , I A 5 0 2 2 0 $
0 2 / 12 / 0 1I D# Wi n t e r s e t Mad i s o n i a n Ad s 1 , 1 4 4 . 9 2
3 0 71 12 Wes t Cou r t S t r e e t
CK# Wi n t e r s e t , I A 5 0 2 7 3
0 2 / 12 / 0 1I D# T h e S h o p p e r Ad s 9 8 1 . 0 0
CK# 3 0 8 P"0
"Bo x 2 8
Wi n t e r s e t , I A 50 2 7 3- 0 0 2
0 2 / 12 / 0 1I D# Da l l a s Co u n t y News Ad s 52 4 . 7 0
CK# 3 0 9p , 0 , Bo x 1 9 0Ad e l , I A 5 0 00 3 - 0 1 90
0 2 / 12 / 0 1I D# Ea r l h a m Ad v o c a t e Ad s 14 8 . 0 5CK#310
p , p , Bo x 3 2 7
Ea r l h a m, I A 5 0 0 7 2 - 0 3 2 7
0 2 / 12 / 0 1I D#
Wi n t e r s e t Ci t y L i mi t s Ad s 2 8 1 . 48CK# 3 11 P . 0 " Bo x 5 3 9
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FOR I NSTRUCTI ONS, SEE BACKC ' ' ARM SCHEDULE
EXPENDI TURES B- MONEY SPENT FROMCOMMI TTEE ACCOUNT MONETARY
( Re v . 0 9 / 9 7 ) EXPENDI TURES
STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONSMADE TO STATEWI DE ORLEGI SLATI VECANDI DATES . L I S T THE CANDI DATE I DENTI F I 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 FORM
ETHI CS & CAMPAI GN DI SCLOSUREBOARD
.
COMMI TTEE NAME ( Mu s t b e s a m e 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 )
POWELL FOR HOUSE
CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNT
DATE I D NUMBER EXPENDI TURE ( DESCR I BE TRANSACTI ON) EXPENDED
EXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADE
( MM/ DDNR) AND PAC
CHECK
NUMBER_ . . . , _
0 3 / 1 2 / 0 1 I D # J o a n A . Ki e r n a n e i mb u r s e me n t 388 . 5 5839 - 4 1 s t St r e e t
CK# 313 De s Mo i n e s , I A 50312 $
I N
CK#
I N
CK#
CK#
'. i
CK#i
CK#
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FOR I NSTRUCTI ONS, SEE BACK t - ORM SCHEDULE
EXPENDI TURES B MONETARY- MONEY SPENT FROM COMMI TTEE ACCOUNT
( Re v . 0 9 t 9 7 ) EXPENDI TURES
STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLATI VECHECK T HI S BOX I F
CANDI DATES, L I S T THE CANDI DATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THE
PAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NGFORM
ETHI CS t i CAMPAI GN DI SCLOSURE BOARD .'COMMI 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 )
POWELL FOR HOUSE
CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNT
DATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED
EXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADE
( MM/ DD/ YR) AND PAC
CHECK
NUMBER
0 3 / 1 2 / 0 1I D # J o a n A . Ki e r n a n r e i mb u r s eme n t f o r d o o r
8 39 - 4 1 s t St r e e t f l y e r s d i s t r i b u t e d i nCK#313 De s Mo n i e s , I A 5 0 3 1 2 l a s t mon t h o f c amp a i g n $ 3 8 8 . 5 5
I D #
CK#
,~ I !
9
2 p u c IR
j
CK#
I D #
CK#
I D #
CK#
I D#
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FOR I NS TRUCT I ONS , SEE BACK OF FORM
COMMI TTEE NAME( Mus t b e same a s o n S t a t eme n t o f O r g a n i z a t i o n )
POWELL FOR HOUSE
NOTE : T h i s s c h e d u l e r e p o r t s money l o a ne d t o t h e c o mmi t t e e wh i c h I s d e po s i t e d i n t h e c o mmi t t e e a c c o u n t .
TOTAL UNPAI D LOANS FROM LAST REPORTI NGPERI OD $
PART I - MONETARY LOANS RECEI VED T HI S REPORTI NGPERI OD( O r i g i n a l s o u r c e o f b an , s uc h a s a b a n k , mu s t b e s h o w n i f a t h i r d p a r t y i s
i n v o l v e d i n c l u d e l o a ns f r o m c a n d i d a t e ' s p e r s o n a l f u n d s . )
4 1 , goa G G
TOTAL ( PAR T I )
' 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 ommi 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 an 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 e c o mmi t t e e . R e l a t i o n s h i p must 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 ) an d a f f i n i t y ( r e l a t i v e s b y m a r r i a g e ) . ( S ee Page 2 o f f o r m s
p a c k e t . ) 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 same a s c a n d i d a t e , b u t t h e r e I s n o f 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 umn when i t a p p l i e s .
PART 1 1 - MONETARY LOAN REPAYMENTS MADE I MREPOR T I N G PER I OD( L o a n s f o r g i v e n must b e r e p o r t e d o n S c h ed u l e E - - I n - k i n d C o n t r i b u t i o n s . )
TOTAL CASH REPAYMENTS ( PAR T / 1 1)
F r o m S c h ed u l e E - - TOTAL LOANS FORGI VEN
$
TOTAL OUTSTANDI NG LOANS END OF REPORT PERI OD $2 , 9 00 . 0 0 - -
Page _ - - _ __ - o f( f r n S , 1 1 f l ' l u l , F%
$2 , 0 00 . 0 0
SCHEDULE
F LOANS
( R e v . 0 8 / 9 6 ) RECENED
REPAI D
pCHECK T HI S BOX I F
AMENDI NG FORM
DATE
RECEI VED( MM/ DDNR)
NAME AND ADDRESS OF LENDER
( 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 )RELAT I O NSHI PTO CANDI DATE
( I f l i k a b l e '
AMOUNTOF LOAN
S
DATE PAI D
( MMI DDI YR )
NAME ANDADDRESS OF LENDER
( I n c l u d e En d o r s e r s Name, I f A p p l i c a b l e )
RELAT I ONSHI P
TO CANDI DATE'( i f A p p l i c a b l e )
AMOUNT
REPAI D
0 2/ 1 6 / 0 1 Ka t h y Powe l l
P . 0 . Box 2 1Pe r r y , I A 5 0 2 2 0 - 0 0 2 1
Se l f
S
2 , 0 00 . 0 0