forinstructions, rm form … · 31-jul-01 burtwin day, p.o. box293, norway,ia 52318 25.0 x...

FOR INSTRUCTIONS, SEEBACK OF,

RMDISCLOSURE SUMMARY PAGE

COM I

E NAME (Mu

esam

or1SPtement of Organization, C

1 6 2~~2ens r-

nT

P 1'~

UIMPORTANT: Indicate type of committee you are reporting for: FTI

( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee( 8 )Support Slate of Candidates

-

CANDIDATECOMMITTEES ONLY:

Candidate NameD, &

Qught

Routine Penalties Due For Late Filed Reports Range from $20 to $800

(report date)

CHECK IF AMENDMENT TO REPORT DATED

Poll '

f Parte

v~Distr t (if Senate or House)

Check if this is final (termination) report and attach Notice of Dissolution Form DR-3.(You must continue to file reports until a Notice of Dissolution is filed.)

STATEMENT OF CASH ON HAND

FORM

DR-2 DISCLOSURE(Rev. 0512002)

I

REPORT

For Office

s

OnlComm. # __Indexed -_Audited --~!Computer ___W_'l~

i

S%3 oZ7~-/ ~JoZ.

/~

A aLTELEPHONE

DOESIGN#_D

SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE:1 AM FILING A

REPORT FORAN/A (1) ELECTION /(2)NON-ELECTION YEAR .

Indicate oneaLocal Committees, enter Date of Election

County & Local Committees, enter County inwhich Election is held

CASH ON HAND at the beginning of the reporting period . (This is the total of all monies heldby the committee. This amount MUST be the same as the cash on hand at the endof the last reporting period, or must be zero if this is first report filed .

ADDTOTAL MONEYTAKEN 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(ScheduleH applies to Candidates' Committees Only)

SUB-TOTAL. . .. . .$ o~CJt ~9 7, 6

SUBTRACT TOTAL MONEYSPENTTHIS 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

jg&

gbezero) (Attach DR-3) . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . ...$

1

I

**UNPAID BILLS (From Schedule D- Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

----

--------

*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

~~0

0a,"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .$

"-'-

CANDIDATECOMMITTEES ONLY:

CONSULTANT BREAKDOWN (Schedule G Attached?)

VALUEOF CAMPAIGN PROPERTY (From Schedule H- Attach Schedule H)

YES

v NO

$ __

L_

FORINSTRUCTIONS,~SEEHACK OF FORM

COY

ENAME (Must be Somas

dOrga~Hon)

70, l Z~°71-5

~W~( a -C

SCHEDULE

roar . oswE

IN KINDCONTRIBUTIONS

0 CHECKTHIS BOX IF .AMENDING FORM

'Disclosure law requires candidates to disclose themlstionsMp ofany relate making an in kind conkibutlonto the

pap.

I_of-Icommittee. RelaBomhip must be show to the third degree of consanguMlly (blood relatives) anda" (rslatkes

(for Schedule E)by marriage) . (See Page2 ofform packet .) If surname ofconhibutor is the same as candidate, but there is nofamilial relationship, enter -notapplicable' in the relationship coiurnn .

DATERECEIVEDMMIDDNR

NAMEANDADDRESSOF CONTRIBUTOR

RELATIONSHIPTO CANDIDATE' A

DESCRIPTIONOF IN KIND

CONiRBUTKNd

ESTIMATED-FAIR MARKET

VALUE

IF FORFUND4WSERCONTRIBUTION

JulPdtIt A6-44'1~4g:4

/4`101

mrf4A.p/O file d ~ G1 C,f,

a. -~B'A~,l

v.00

rte. . ...~.

.

Pin

of 4

FOR INSTRUCTIONS . SEE BACK C

DRM

1 AM FILING A

DISCLOSURE SUMMARY PAGE

CO

TT E NAME (Must

same as o Stat ment of Organization)01-` r

e7i%S

r

G~dIMPORTANT: Indicate type of committee you are reporting for: FLI( 1 )Statewide/Legislative Candidate (2

tatewide PAC ( 3 )State Party ( 4 )County/Local Candidate( 5 )Coun

AC

)Ballot Issue/

c se Committee ( 7 )County/City Central Committee(8

e e a '

f

E$SURER (or person filing this report)

Routine Penalties Due For Late Filed Reports Range from $20 to $800

SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE:

/'5 j 76TELEPHONE

[]CHECK IF AMENDMENT TO REPORT DATED

Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 .(You must continue to file reports until a Notice of Dissolution is filed.)

REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR.

STATEMENT OF CASH ON HANDCASH ON HAND at the beginning of the reporting period . (This is the total

of all monies held by the committee . This amount MUST be thesame as the cash on hand at the end of the last reporting period,or must be zero if this is first report filed.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

SUBTRACT TOTAL MONEY SPENT THIS PERIOD

SUB-TOTAL. . . . . . S

Schedule B : Expenditures total (Attach Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Schedule F : Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

UNPAID BILLS (From Schedule D - Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S

OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S

CANDIDATE COMMITTEES ONLY :

CONSULTANT BREAKDOWN (Schedule G Attached?)

VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)

6 0, S-1A,, -2 1J

ADD TOTAL MONEY TAKEN IN THIS PERIODSchedule A: Cash Contributions total (Attach Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

/3,

9Schedule F : Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Schedule H : Total Sales of Campaign Property (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(Schedule H applies to Candidates' Committees Only)

f

O a-DA SIGNED

Local Committees, enter Date of Election

County & Local Committees, enter County inwhich Election is held

,~O, 497. f G

CASH ON HAND at the end of this reporting period (if final report, balance must

5be zero) (Attach DR-3) ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

/- /

°1..Q' &'

YES

#-*NO/~$ 9~ t;

For Instruc3ions, See Back of Forr

CONTRIBUTIONS -- MONEY TAKEN IN(Including candidate's personal funds)

COMMITTEE NAME (Mustbe

me as on Statement of Organization)

~!1f)117.-fo7u S

/'

/& 4" 1(0-;t-

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE) . LIST THEPAC IDENTIFICATIONNUMBER AND THE PACCHECKNUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

CAUTION : Section 688.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor anycommercial purpose by any person other than statutory political committees .

SUB-TOTAL

TOTAL (if last page of thisschedule)

' Disclosure iaw requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no

Page ~- ofJ__familial relationship, enter "not applicable" in the relationship column .

(for Scnedule A)

SCHEDULE

A MONETARY(Rev . 06/97) RECEIPTS

CHECK THIS BOX IFAMENDING FORM

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT v IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUNO-(MM/DD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOME

ID#

CK# r~ r~5ID# -

CK# a-vID#-

1CK# S¢i

. ill ~jr

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

I D#

CK#

Contributions - Money Taken In

Citizens for Maddox

Schedule A [Attachment]

Prepared 1/18/02

A 4F~S'Vo

Page 1 of 8

tPAC t0fA'PAC

CSI and Address ofCM*bJtDrPtebbms*to Arnow

CW40191110 Red"x If t:1,a-

'~ 05-Jan-0 ~~ ransp . Pol . Ed . League PAC #8025, 14600 Detroit Av, Cleveland, OH 44107 500 .00

18-May-01 John & Judy Carlson, 9754 Sunset Ter, Clive, IA 50325 1 20 .00

I Homebuilders Association PAC #6146, 9001 Hickman Rd, Suite 210, Urbandale, IA j30-Jun-01'_ 50322 200 .00

24-Jul-01Ii

6070/2506I

Iowa Law PAC #6070, 521 E Locust, FI . 3rd, Des Moines, IA 50309-1939s i

250 .0

31-Jul-01i

David Brown, 803 Fleming Bldg, Des Moines, IA 50309-T 100 .00

. .X _

31-Jul-01 Burtwin Day, P.O . Box 293, Norway, IA 52318 25 .0 X31-Jul-011

_~Andrew C hristenson, 6454 Merle Rd, Johnston, IA 50131-1229 50.00 X

31-Jul-01 David 0 . or Norma Creighton, 9547 University, No 16, Clive, IA 50325 25.001 X I

02-Aug-01 Debi & Sarah Kleckner, 1709 NW 101st St, Clive, IA 50325 j 50.00 X

02-Aug-01 ` Wendell R. & Carol J. Dickey, 4308 64th St, Urbandale, IA 50322 -^ 25 .00 X

02-Aug-01 Clifford & Patricia Walsh, 6881 NW 54th Ct, Johnston, IA 50131 100 .00 ~X

02-Aug-01 Walt & Judy Tomenga, 7250 Hyperion Pointe, Johnston, IA 50131 25 .00 X

02-Aug-01' ' Porter & Beverly Williams, 5380 NW 71st PL, Johnston, IA 50131 50 .00 X02-Aug-01 Michael Carver, 4417 96th Ct, Urbandale, IA 50322

_25 .00_ X

02-Aug-01 John & Wanda Lewis, 2019 Crown Flair Dr, West Des Moines, IA 50 265 25 .00{ X

1 02-Aug-01 Ronald A . & Melba M . Fulton, 8804 Sunflower Cir, Urbandale, IA 50322 50.00 X .R 02-Aug-01 Charles Gabus, 3910 72nd St, Des Moines, IA 50322-2602 250.00 X

02-Aug-01 Richard Pope, 2905 Sherry Ln, Urban dale, IA 50322_ 25.00 XF~02-Aug-01 John & Pam Wharton, 13331 Hickory Av, Clive, IA 50325 50 .00 X

02-Aug-01 Jerry & Darlene Stanto n, 1835 NW 1 04th St, Clive, IA 50325 250 .00 X

02-Aug-01 Barb Beatty &John IA. Merriman, 13850 Lakeshore Dr ., Clive, 50325 50 .00 XI

02-Aug-01 David C or lone E Wilkens, 16 0 1 Buffalo Rd, West Des Moines, IA 5026 50 .00 X02-Aug-01 ~ ~

_John Pappajohn, 24 Foster Dr, Des Moines, IA 50312 100 .00

~^

~^X.

02-Aug-01 Laura & Conrad Githens, 8 211 Twana Dr, Urbandale, IA 50322 10.10_ XM

02-Aug-01 Dave Palmer, 213 SW Flynn Dr, Ankeny, IA 50021 100.00 X02-Aug-01 Ronald E . Cross, 4104 72nd St, Urbandale, IA 50322 50 .00 X

I~ 02-Aug-01 Richard Preston, 700 4 Jefferson, Windsor Hts ., IA 50322 100 .00 X

02-Aug-01 Jon F . & Patricia Crose, 4304 98th St, Urbandale, IA 50322i

_X._^._

02-Aug-011 Adam & Denise Obrecht, 1609 70th PI, Urbandale, IA 50322 50 .00 X


Citizens for Maddox


Prepared 1/18/02 Page 2 of 8

PAC tt*&PAC to Amowd x if Fun4l-Dam Receiued Ch" NameepdAd*89adCow' c RecWred MW tpcof

02-Aug-01 Ray & Betty Collins, 2061 NW 80th Ct, Clive, ]A , 50325~~w

50.00 X..._.... _.~

i 04-Aug-01 Russ & Dae Underwood, 8111 Wellington Blvd ., Johnston, IA 50313 100.00 X

04-Aug-011S

Sally & Lel a n d Vanderlinden, 300 Walnut, #1903, De s Moines, IA 50309 (i

j 100.00~ r

X

08-Aug-01 Vicki and Ray Davis, 12926 Timberline Dr, Urbandale, IA 50323 50.00 X I

08-Aug-01 Robert & Marilyn Kollmorgen, 3208 Melanie Dr, Urbandale, IA 50322 50.00 X s

08-Aug-01 , Robert Hand, 6076 Terrace Dr, Johnston, IA 50131 I I 50.00 X !

08-Aug-01 Margaret & Leo Hough, 7027 Oak Brook Dr, Urbandale, IA 50322 I 25.00 X08-Aug-01 Jeff Plummer, 14 99 98th St, Clive, IA 50325 + 25

i 08-A ug-01 Ken Petersen, 109 N Jacob St, Grimes, IA 50111 25 .00 X

t08-Aug-01

IMark Feldmann, 300 Walnut Street #59, Des Moines, IA 5 0309 100 .00 X

I

08-Aug-01 Nancy & Virgil Deering, 9890 Clark St, Clive, IA 50325 50 .00 X

08-Aug-01..... ........... ._ . ._.._.... ._ ..__Orville & Nancy Bunker, 1 911 69th St, W indsor Heights, IA 50322 ~ 25 .00

t

X E

I 08-Aug-01 Mary & Eugene Weber, 4035 Green View Dr, Urbandale, IA 5032 25 .00 X j

08-Aug-01___

Derek Holmes, 1806 NW 104th St, Clive, IA 50325_25 .00 X r

08-Aug-01 Lloyd & Sh aron Klinzman, 6142 Terrace Dr, J ohnston, IA 50131 __ 25 .00 X~

08-Aug-01 John & Theresa Taylor, 2012 40th PI, Des Moines, IA 50310-3832Ii 25 .001 X

08-Aug-01 G . Dean & Judith A. Dymond, 15676 Sheridan Av, Cliv e, IA 50325 _ 1 50.00 X s

08-Aug-01 Harold & Trudie Higgs, 2024 NW 92nd Ct, Clive, IA 50325 50.00 X

08-Aug-01 Charles & Ellen Larson, 434 Tonawanda Dr, Apt #103, Des Manes, IA 50312 50.00 X

08-Aug-01 Kenneth C Stroud, 4123 Timberwood Dr, West Des Moines, IA 50265 100 .!f, X

08-Aug-01 Barbara Vogen, 8118 Hardwicke Dr, Johnston, IA 50131 50 .00 X

08-Aug-01 ~ Willard & Coryene Classen, 13832 Lakeshore Dr, Clive, IA 50325 50 .00i

X

08-Aug-01 ~_

Lucille & Art Nelson, 1709 Walnut St, Dallas Center, IA 500 6 50 .00 u X_

08-Aug-01 Les & Lu Rhodes, 7300 NW 107th St, Grimes, IA 50111-_

50.00 X ,

08-Aug-01 Donald & Louise Running, 2909 88th Ct, Urbandale, IA 50322 25 .00----._._.______ .__.X 1

08-Aug-01 Charles & Katherine Safis, 4107 Greenview Dr, Urbandale, IA 50322 50.00 X_-

__ _08-Aug-01 Wayne Rand, 9917 Winston Av, Urbandale, IA 50322 25.00 X l

08-Aug-01I Shirley Allen, 9205 Willard Ct, Urbandle, IA 50322 25.00


Citizens for Maddox


08-Aug-01

108-Aug-O1

08-Aug-01

Kurt & Jan Johnson, 3412 Eula Dr, Urbandale, IA 50322

08-Aug-011

Stan Thompson, 5523 Grand Av, Des Moines, IA 50312

11-Aug-01

11-Aug-01

11-Aug-01

1 1-Aug-O1

11-Aug-01

11-Aug-01

11-Aug-01

11-Aug-01

Prepared 1/18/02

Now

606311438

Iowa Dental PAC #6063, 505 5th Av, Suite 333, Des Moines, IA 50309-2379

Norval & Mary Edwards, 150 Thompson Dr, SE, #306, Cedar Rapids, IA 52403-1740

Allen & Barbara Munsterman, 8107 Plum Dr, Urbandale, IA 50322

Pat & Mary Knueven, 8509 Prairie Av, Urbandale, IA 50322

Lawre nce & Wanda Katz, 2700 Lind a Dr, U rban da le, IA 50322

Russ & Lucile Johnson, 12918 Timberline Dr, Des Moines, IA 50323

Gerald & Barbara Newbrough, 13172 Pinecrest Ln, Clive, IA 50325

Philip & JoAnn Thomas, 2144 NW 80th PI, Clive, IA 50325

Paul & Judy Bissinger, 14822 Lakeview Dr., Clive, IA 50325

Phyllis Kelly, 126 Cedar Circle, Charles City, IA 50616

Robert Landess, 2111 NW 135th St, Clive, IA 50325

Dona Henderson, 5500 Fortunes Ridge Dr 89-13, Durham, NC 27713

Governor Terry Branstad, 3108 SW 39th St, Des Moines, IA 50321

Keith Luchtel, 10521 Sunset Ter, Clive, IA 50325~~ -

P Dennis Arthur, 2729 Lakeland Dr, Urbandale, IA 50322

Julie A & Robert Fleming, 1063 45th St, Des Moines, IA 50311

John & Barbara McDonald, 100613th St, #209, Dallas Center, IA 50063

James & Alice Van Lew, 13086 Cedarcrest Ln, Clive, IA 50325

Sue Reed, 907 Ashworth Rd, West Des Moines, IA 50265

Bruce & Jeanne Roone- Graves, 105 S 32nd St, West Des Moines, IA 50265

Dr. Larry

&Kathy Betty, 2901 72nd St, Urbandale, IA, IA 50322

Jim & Judith Zahnd, 1592 NW 102nd St, Clive, IA 50325-6722

Paul & Betty Woodard, 4521 73rd St, Urbandale, IA 50322

Marilyn Lantz, 4617 Beavercrest Dr, Des Moines, IA 50310

Beth & Daniel Dittemore, 2727 Glenwood Dr, Des Moines, IA 50321-1533

Tom & Dottie Carpenter, 1100 24th St, West Des Moines, IA 50265

25 .001

25 .001

25.00

50.00

25.00

50 .00

X

X

100 .00 X

25 .00

100 .00

25 .00

10.00

X

X

50.0 X)~ ~loS" Ov

Page 3 of 8


Citizens for Maddox


17-A ug-01

17-Aug-01

17-Aug-01

17-Aug-01!

I Betty & Michael McDaniel, 10274 Sunset Ter, Clive, IA 50325

17-Aug-01

_

(Jacob & Dan Nissly, 1201. N. Francis Av,-Grimes, IA 50111 -_

17-Aug-01

17-Aug-0 1

17-Aug-01

Jame s & Carol Roland Hughes, 13553 Villag e Ct, Clive, IA 50325

Brice Oakley, 418 38th PI, Des Manes, IA 50312

Gene Shepard, 3312 Eula Dr, Urbandale, IA 50322-6824

Rusty & Charlotte Laird, 13577 Village Ct, Clive, IA 50325

Bob Gilley, 940 9 Hammontree Dr, Urbandale, IA 50322-1338

Paul and Bev Leighton, 13982 Lakeview Dr, Clive, IA 50325

William Kimball, 6917 Capitol View Ct, Johnston, IA 50131

17-Aug-01

17-Aug-01

17-Aug-01

18-Aug-01

18-Aug-01

2 0-Aug-01

~20-Aug-01

20-Aug-01

20-Aug-01

21-Aug-01

21-Aug-01

21-Aug-01

21-Aug-01

Cal Hultman, 1200 57th St, Des Moines, IA 50266

Dean & Salty Fisher, 9603 Elmcrest Dr, Clive, IA 50325-6307

Dennis Groenenboom, 1134 38th St, Des Moines, IA 50311

William C & Janet A Lawson, 6810 Roseland Dr, Urbandale, IA 50322-3460

10 .00

50 .00

25 .00

25 .00

_XX

Joey Bishop, 2909 Patricia Dr, Urbandale, IA 50322

Pau l & Mic hell e Dupey, 2720 Mary Lynn Dr, Urbandale, IA 50322

Len & Shirley Daib, 205 N . Circle Dr ., Grimes, IA 50111-1022

W.T . & Edna Dahl, 1 SW 56th St, Des Moines, IA 50312

Barbara Smith, 3725 RiverOaks Dr, Ste 301C, Des Moines, IA 50312

Craig D Walter, 14862 Lakeview Dr, Clive, lA 50325

James & Karen Pittman, 4408 74th St, Des Manes, IA, IA 50322-1126

Virginia Soelberg, 5979 Dogwood Circle, Johnston, IA 50131

Joe Van Winkle, 6507 Northwest Dr, Des Moines, IA 50322

Michael Wolnerman, 422 Glenview Dr, Des Moines, IA 50312

Robert & Kay Eggers, M.D., 12350 Hickman Rd, Clive, IA 50325

Hal & Marabel Manders, 1707 Laurel, Dallas Center, IA 50063

Jacklyn Fleming, 6046 Terrace Dr, Johnston, IA 50131

Wayne & Lois Menzel, 1920 Elm Cr, West Des Moines, IA 50265

Caries Schamp & Josette Daum, 4712 71st St, Urbandale, IA 50322

Hartsook, 1134 38th St, Des Moines, IA 50311

X

50 .00 X

20.001 X

50.00 X

30.00 X25.00 X

11 ySO-00

Prepared 1/18/02

Page 4 of 8


Citizens for Maddox


21-Aug-01

Robert & Karen Andeweg, 4719 93rd St, Urbandale, IA 50322

2t-Aug-01'~_

'~LaVon Cooper, 1430 55th St, Des Moines, IA 50311

21-Aug-011

Kathy Stavneak, 1 6 29 NW 102nd St, Cl ive, IA 50325

21-Aug-01

David Walker, 1922 80th St, Clive, IA 50322

21-Aug-01

21-Aug-01

21-Aug-01

2 1-Aug-01_21-Au g-01

21-Aug-01

2 1-Aug-01

23-Aug-01

23-Aug-01

23-Aug-01

27-Aug-01

27-Aug-01

27-Aug-01

609813156

603311695

John Gilliland, 5853 Medow Valley Ct, West Des Moines, IA 50265

Patricia S Ward, 2092 NW 13 4th St, C live, IA 50325

4

Hobie & Dawn Bannister, 10639 Ridgeview Dr, Clive, IA 50325

Charles & Beatrice Moench, 8931 New York, Urbandale, IA 50322

Caroline V. & John Barzen, 3300 Crestmoor PI, Des Moines, IA 50310

E.J . Giovannetti, 3004 Melanie Dr, Urbandale, IA 50322t-_-_

Daryl & Karyl Henze, 4325 75th St, Urbandale, IA 50322

I owa Bev PAC #6098, 321 E. Walnut St, Ste 310, Des Moines, IA 50309

EMC Co. PAC #6033, 717 Mulberry St, Des Moines, IA 50309

Gus [R .L.F.] & Karen Skovgard, 4421 Bdnkwood Rd, Des Manes, IA 50310

Linda Shanks, 1680 NW 81st St, Clive, IA 50325

Bill & Marilyn C orwin, 10989 Hawthorne Drive, Clive, IA 50325-7040

Les & Sharon Aasheim, 8011 Northwest Dr., Clive, IA 50325

David & Sara Hawkins, 13193 Cedar Crest Ln, Clive, IA 50325-8751

Edene Veverka, 403 North Marshall, Prairie City, IA 50228

Bob Hamilton, 7730 Harbach, Clive, IA 50325

Jim & Susan Staudenmaier, 8709 Horton Cir, Urbandale, IA 50322

Timot hy D. Peterson, 9581 Lincoln Av, Clive, IA 50355

Arlo & Madeline McDowell, 181174th St, Windsor Heights, IA 50322

50.0

2 5.00

100 .00

75 .001 X

400 .00 X25 .oot:: X

_50 .00. ~_X25 .00 X

X

25.00 X50.00 X

50.00 X

25.00

25.001 X

100.0 X50 .001 X

50 .00 X

f, 7-) 0.00

Prepared 1/18/02

Page 5 of 8

Kim Schmett, 10141 Lincoln, Clive, IA 50325 25 .00 X

Joe Ellen Hill & Ted Sporer, 1475 NW 92nd St, Clive, IA 50325 50 .001 XMichael Carver, 4417 96th Ct, Urbandale, IA 50322 25 .00 X

Lind a Goeldner, 4038 Kingman Blvd, Des Moines, IA 50311 30 .00 X~.Dick & Pat Christian, 3509 82nd St, Urbandale, IA 50322 250.00 X

t

James D & Janet M Henter, 2182 NW 80th Ct, Clive, IA 50325 25.00 X


Citizens for Maddox


Prepared 1/18/02 Page 6 of 8

PACMW Raiiardtlpr10 x N FrxK-Date Recoived Chm NM SWAd*Wof Co or G*XkWe Reaetwd raiser lrorwie

04-Sep-01 Robert' Sharon Meisenheimer, 4208 74th St, Urbandale, IA 50322 50 .00 X _

10Seep-01 . Jon & Joyce Schneider, 3208 Mary Lynn Dr, Urbandale, IA 50322 T_~ - - 25 .00 .. ^Xd

I10-Sep-01 ArthurA & Judith A Andersen, 701 52nd St, West Des Moines, IA 50265 25 .00 X12-Sep-01 ' Diane Kutzko, 2026 5th Av, SE, Cedar Rapids, IA 52403 200 .00 X

23-Sep-01 ' Jane & James Clark, 9871 Lincoln Av, Clive, IA 50325 j 100.0 X(~ Q So Bankers Unite In Leg . Decision 6430, 418 6th Av, Ste 430, Des Moines, IA 50309- I

25-Sep-0143012517e2420 150 .00 X

j Independent Ins . Agents of Iowa PAC #6052, 4000 Westown Pkwy, West Des25-Sep-01 6052/2520 Moines, IA 50265 100 .0 X

! 1Meredith Corporation EE Fund PAC #6099, 1716 Locust St, Des Moines, IA 50309- j

25-Sep-0160991580 3023 150 .001 X

25-Sep-01 6070/2524 I ow a Law PAC #6070, 521 E Locust, FI 3rd, Des Manes, IA 50309 j 150 .00 X

I -~ ~ Iowa Certified Public Acc'tants PAC #6062, 950 Office Park Rd, Ste 300, West Des ~ I-~ j 25-Sep-01 6062/1315 Manes, IA 50265-2548 150 .00 ^_

Iowa Committee of Auto Retailer PAC #6059, 1111 Office Park Rd, West Des 1,

25-Sep-01 6059/2105 Moines, IA 50265 150 . X

{ 25-Sep-01 1 I Iowa Independent Bankers PAC #6160, 1623 22nd St, West Des Moines, IA 50266 250 .00 X

I ~ I PIowaTelecommunications Assoc . PAC #6087, 1601 22nd St, Suite 209, West Des25-Sep-01 6087/1120 Moines, IA 5026 6 250 .00 X

Iowa Optometric Association PAC #6118, 1454 30th St, Suite 204, West Des Manes,25-Sep-01 611811732 IA 50266 250.00 X

25-Sep-01 Carlos Jayne, 3523 SW 37th St, Des Moines, IA 50321 25.00 X

25-Sep-01 6077/1544 Iowa Pharmacy PAC #6077, 8515 Douglas, Ste 16, Des Moine s, IA 50322 150.00( X

25-Sep-01 6486/1050 Iowa Telecom PAC #6486,115 S 2nd Av, Newton, IA 50208 100.0 X

25-Sep-01 8025/1467 Transp. Pol . Ed . League PAC #80 25, 14600 Detroit Av, Clevel a nd, OH 44107 1 50 .00 X

26-Sep-01 6069/1836 Iowa Indus try PAC #6069, 904 Walnut, Suite 100, Des Moines, IA 50309-3503 {~ 100 .00 X

26-Sep-01 Joh n Shors, 2923 Fox Ru n, Des Moines, IA 50321 150.E ~- X _

{

26-Sep-01 635 1/1065 Petroleum Marketers of Iowa PAC #6351, 1303 50th St, West Des Moines, IA 50266 150 .0 X


Citizens for Maddox


6101/2131

6411/1130

i17-Oct-01

ITeresa A. Weis Preston, 7021 Sheridan Cir, Urbandale, IA 50322

50.00,17-Oct-0116107/3222

10west PAC #6107, 925 High St, 9S9, Des Moines, IA 50309

I

1

100 .00

623711386

29-Nov-0116038/0028

1Verizon Iowa State Good Govt CI PAC #6038, 111 1th Av, Grinnell, IA 50112

1

1

100.00

30-Sep-01

Steve & Dawn Roberts, 666 Walnut St, St 2500, Des Moines, IA 50309-3993

j

100.00

30-Sep-01

Susan Cameron, 2202 NW 140th St, Clive, IA 5 0325

10000'

X

01-Oct-01

06-Oct-01

18-Oct-01

23-Oct-011

IWarren Riekenberg, 3209 Melanie Dr, Urbandale, IA 50322

13-Nov-011

1Michelle Wood, 10055 Lincoln Av, Clive, IA 50325

1 3- Nov-6323/2482

Master Builders of Iowa PAC #6323, 221 Park St, Des Moines, IA 50303 .

14-Nov-011

Sandra Wilson, 10985 Lincoln Av, Clive, IA 50325

27-Nov-01

James Fox, 1707 Walnut St, P.O. Box 514, Dallas Center, IA 50063-0514

25.00

02-Dec-01

ILu A Cag in, 1 5 93 NW 103rd St, Clive, IA 50325

(

;

25.00'

02-Dec-011

+( Drew & Karla Tillotson, 1250 71st St, Windsor Heights, IA 5031102-Dec-011

1Jim & Judith Zahnd, 1592 NW 102nd St, Clive, IA 50325-6722

08-Dec-011

Craig N eilsen, 8620 Titleist Cir, Las Vegas, Nev 89117

17-Dec-01

28-Dec-01182511865

Motor Carriers PAC #6101, P .O. Box 6121, East Station, Des Moines, IA 50309

150.001

MCI Iowa PAC 6411, 70717th St, Ste 3600, Denver, CO 80202-3436

1

1

100 .00

ABATE PAC #6237, 3118 Eastern Av. NE, Cedar Rapids, IA 52402

Iowa Committee of Auto Retailer PAC #6059, 1111 Office Park Rd, West Des6059/2116

1 Manes, IA 50265

Serge H . & Caryl J. Garrison, 6812 Northwest Dr, Windsor Heights, IA 50322

Ron Langston,3330 1 Kingman Blvd ., Des Moines, IA 50311

200 .00

100 .001

100 .00

25.00150.00

1 00.00100.00

250 .00

xifrwnd-

a a3 0,00

Townsend, 2425 Hubbell, Des Moines, IA 50317

Principal Life Inusrance Comp . PAC #8251, 711 Hight St, Des Moines, IA 50392-0220

25 .00

Prepared 1/18/02

Page 7 of 8

02-Dec-01 Laurie Bruner, 6782 Sunset Ter, Windsor Heights, IA 50311 I 30.00

02-Dec-01 Kathy Stavneak, 1629 NW 102nd St, Clive, IA 50325 40.00

02-Dec-01 Will Worthington, 1365 NW 93rd St, Clive, IA 50325 60.00

08-Dec-01 J .J . Fetty, 15722 Sheridan Av, Clive, IA 50325 50.00


Citizens for Maddox


Prepared 1/18/02

~7~"~cTG>

Total

13,795.00

Page 8 of 8

PAC 09 &PAC p io MM* X rfFwnd-Dato awed Nomad`Addreaailfifia utoc 'C RWeVed raiWlnc"

28-Dec-01 6113/2519 AFSCME/Iowa Council 61 PAC #6113, 4320 NW 2nd Av, Des Moines, IA 50313 250.00

28-Dec-01 Dale & Mary Belknap, 6819 Oakwood Dr, Des Moines, IA 50322 25 .00

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Purchases of certain campaign property costing 5500 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 person/en'ity on behalf of the candidate's committee . (Refer to

Schedule G instructions and Iowa Code 56 .6(3)(i) .)

Page - of _L__ __

(for Schedule B)

rUH INSTHUCTIONS, SEEBACK OF FORM SCHEDULE

EXPENDITURES B-- MONEY SPENT FROM COMMITTEE ACCOUNT MONETARY(Rev . 09/97) EXPENDITURES

STATE PAC COMMITTEES : NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE [j CHECK THIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD .

COMMITTEE NAME (Must be same as on Statement of Organization)

CANDIDATECANDIDATE NAMENAME ANDAND ADDRESSADDRESS TOTO WHOMWHOM PURPOSEPURPOSE AMOUNTAMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED

EXPENDED (if applicable) (Disbursement) WAS MADE(MM/DD/YR) AND PAC

CHECKNUMBER

ID#

CK# tea.- h~cka $ 46; 195: Sof

Sf3~

ID# ,-)

CK# i

ID#_

CK#

ID#

CK#

ID#

CK#

ID# -

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL $

TOTAL (if last page of this schedule) $

^

Money

"

--~'-'--~-^~ ~~ [r^~~~~~^^^^^`~^^^]

from Committee Account

Citizens for Maddox

.

.~

~

~Postmaster. BumhnaamK8m!Entry, 11852nd- ~~04-Jan-01 -

'Av

'Permit Fee

~

100.00-_----_---_- ._

_--.----fh--_--_--------_---_--.-------------------------

------~

~~~ho~~ Marketing ~ervk~xa5O85~E17

/

~.

.552OD,----- . .'-----.

-=-.=~+---~~--~

IA 50313

'Republican rai!ycxum~ .

fUou~uf,~~

~'

'Des

* Contribution50309

toPm~v

~

365.00[-----'- -----'

-

-------------------'-^-------i---- -"--

~ '^"==^^°===,""---

'.

.

.O4-Fab'Q1~

138th

~Web Site Maintenance

~

9OOQF~~---'-+-----' ~

--------'+------------------'+---'~--~

!C3a~' Martens. 2127 NVVBOU~~~ dive.V\ : '

~

~_93-Mar-01 ______ .5O325

!noarte ..... . ..... . . . .

__210`OO_

- -----' ---'-----' - -----------'r------11-Kn~pO1-------------- St~t~ofkz~~.~ee

1nconm~Tm~

. 15`OO-------------------- -

-------------- .. . . . ...'BuU's Eye P.CiBox 392, Polk City, IA

11-NhapD1~

'5O22G

'Survey Inserts

~

24OOO---_.----- . -_-.------.------.~-~---~-_----------_- .+---.~-_~

Q.~m~ LLP~ 15O1 42nd ~L .

~

~~

/Ste 445, West DeaMoines, A 50266-

11

~

~.

.

.

.-K8a!-O1~ ~5948

Ts~

~ S86O------+---_--+~. .

---.

--_--..+-.'.------.`-_--_----+------ .~

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.

.22-Jul-O1-

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69.78V\

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.

'.

.

.

.22-Ju~O1~

'IA 50325

~Pmnade

~

6888-----_+-_--- . - ---.--.-_.+-------^---------- .+------~ !VVmh6utCrmehV~Wb 2151NVV ~

~22-Ju~O1~~

'136t-

'Web Site Fee50325

~

woo-------------~

~

B527Un~arady.~hva. k~ ~

~

22-Ju~O1~

~

' Printing .

088

'.Note Pads

~

48738------+---_- . . -_---+--__--_--_-----_--.+------~

~P~~znmater 11G5DndAw.~n~22~[~oa

~

~

24-Jul-O1/

'

5~~1B-9S51

'

for --^--nxijs~one

~

442.00------.-~----- .~~~~~~~ .

--_--. .---- -/------------ -------~

~

~Cjdene KAmddox. 875SEh~oreatD~~U*a . ~

.---

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1' 'V\5O325

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~6.88

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!11-Auq-01 .

Postage

! 34.00-----------_-_---_.

..

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District~

84 .82. - ------'PrhohtyPrhdhnQ 8527Un~er~ty ~Uwe V\ 'B'7hy !nv~c~~n6-!nv~s~oh~e~~

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./5O32511069

~ 528.23_----.

._-.------__------------------------------ -------------The~N~mder{ShUer ~145GE ~

~

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`----------'+------~(~C~en~KA~dd~~~758Ehncr~otDr, CUwe ~

~

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!

82

. . . .

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~ ~PM~~typMnUn~85~7Un~~redy.CUve U\ ~ ~

~O3-k8apO1 : - .SO326- .D68 --'

74577-----+---- . -_------ . ---_ .~--

~ ~ ~xn~rna/oenmcW. xvmnnnQo~n . ~ ~

11 -Mar-01 , -* D.C . -IncomeTax 9&00

FOR INSTRUCTIONS, SEEBACK OF FORM

COMMIIREE NAME (Must be same as

tatement of Organization)

SCHEDULE

E

I

IN KIND~Rev-()fi197)- CONTRIBUTIONS


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- ofIcommittee. 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 sumame of contributor is the same as candidate, but there is nofamilial relationship, enter "not applicable" in the relationship column .

DATERECEIVED(MMIDDIYR)

NAME AND ADDRESSOF CONTRIBUTOR

RELATIONSHIPTO CANDIDATE" (if applicable)

DESCRIPTIONOF IN KIND

CONTRIBUTION

ESTIMATEDFAIR MARKET

VALUE

4 IF FORFUND-RAISERCONTRIBUTION

f 1265

/ f(a

FOR INSTRUCTIONS, SEE BACK OF FORM

THIS FORM IS USED BY CANDIDATES' COMMITTEES ONLY

COMMITTEE NAME (Must be same as on Statement of Organization)

r

-r'"n S

r auxPART I - ONGOING INVENTORY OF CAMPAIGN PROPERTY

PART II - SALES OR TRANSFERS OF CAMPAIGN PROPERTY "'

TOTAL VALUE CAMPAIGN PROPERTY THIS REPORT(TRANSFER TO SUMMARY PAGE) $

7 7

(TRANSFER TO SUMMARY PAGE) $

' If estimated, show est. beside figure .

"" PROPERTY SALES & TRANSFERS TOTAL

TOTALS

SCHEDULE

H I CAMPAIGN(Rev . 02/96)

PROPERTY

ATTACH SCHEDULE H TOEACH REPORT, MAKINGCHANGES AS REQUIRED .


(Attach Additional Schedules if Needed)

Page

of

Pages(For Schedule H)

Date Purchased(Schedule B)

or Date Received(Schedule E)MM/DD/YR

Description of PropertyPurchase

Price or Est .Value WhenAcquired*

CurrentValue at FairMarket ThisRe rt

~x6 f4o

Date(MM/DD/YR)

Name and Address of Purchaser/Donee Description of Property Sold?YIN

SalePrice

Value ofDonation

forinstructions, rm form … · 31-jul-01 burtwin day, p.o. box293, norway,ia 52318 25.0 x...

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