union council afl-cio political education fund9725scanned

8/7/2019 Union Council AFL-CIO Political Education Fund__9725__scanned

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/ 1 8/ 2 00 4, 1 0 : 21 FAX 3 1 9 2 3 2 6 8 4 5 Bl a ck Hawk Un i o n Co u nc i l

FORI NSTRUCTI ONS, SEE BACK OF FORM #4DDI SCLOSURE SUMMARY PAGECOMMI TTEE NAME ( Mu s t h e s ame as on St a t e me n t o f O r g a n i z a t i o n )Un i on C o u n c i l AF L- CI O P o l i t i c a l E d u c a t i o n F u n d

I MPORTANT : I n d i c a t e b y # 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 . =( t ) S t a t e w i d e t L e g i s l a t i v e % l 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 e P a r t y( 4 ) Co u nt y C e n t r a l Co mmi 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 Ca nd i d a t e ( 7 ) S c h o o l B o a r d o r O t h e rP o l i t i c a l S u b d i v i s i o n Ca nd i d a t e ( 8 ) C o u n t y PAC ( 9 ) C i t yP~' f ~ ) S c h o o l B o a r d o r Ot h e r P a r i t i c d lS u b d i V I S l o n PAC ( 1 1 ) Loco [ Ba l l o t I s s u eCANDI DATE COMMI TTEES ONLY:Ca nd i d a t e Name

4 7O f f i c e Sough t . , . t . ' , D i k i i c t ( i f Se n at e o r House )

S I GN TORE OF ERSON F I L I NG

I AM F I L I NG A Oc t o b e r 1 9( r e p o n d a t e )

[ ] CHECK I F AMENDMENT TO REPORT DATED

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 )

El Check 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 and 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 Fo r m DR3 ,( Y ou mus t c o nt i n ue 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 . )

( ? L c d 232- 24 lELE ONE

STATEMENT OF CASH ON HANDCASH ON HAND a t t h e b eg 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 ommi t t e e- T h i s amoun t MUST b e t h e s am e a s t h e c a s h on han d a t t h e en 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 mus 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 MONEY TAKEN I N THI S PERI OD

Sch ed u l e A . Cash C o n t r i b u t i o n s t o t a l ( A t t a c h Sc h e d u l e A) ( " ' a l s o s e e i n - k i n d b e l ow) . . . . . . . . . .Sch ed u l e F : Loans Re cei v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sch ed u l e H : T o t a l Sa l e s o f Campa 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h ed u l e H a p p l i e s t o Ca nd i d a t e s ' Co mmi t t e e s On l y )SUBTOTAL . . . , . $

SUBTRACT TOTAL MONEY SPENT THI S PERI ODSc h ed u l e B : Ex p e n d i t u r e s t o t a l ( A t t a c h Sc h e d u l e B) ( " a l s o s ee d eb t s and l o a n s b e l o w) . . . .Sc h ed u l e F : Loan Repa y men t s t o t a l ( A t t a c h Sch e d ul e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASHON HAND a t t h e end 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 nc e mus tb e z e r o ) ( A t t a c h DR- 3 ) _ . . . . . _ . _ _ . _ . . . . . . . . . _ _ _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . _ _ _ . . . . _ _ _ . . _ _ . . . _ _ . . . . . . . . $

' UNPA I D BI L L S ( F r o m Sc he d ul e D - A t t a c h Sc h e d u l e D ) - - - - - - - - - - - - . . . . _ _ . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . $- I N KI ND CONTRI BUTI ONS ( Fr om Sc h e d u l e E- At t ac h Sc h ed u l e E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $" OUTSTANDI NG LOANS ( Fr o m Sc he du l e F- At t a ch Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .CANDI DATE COMMI TTEES ONLY,CONSULTANT 13REAKDOWN ( Sc he d ul e G A t t a c h e d? )VALUE OF CAMPAI GN PROPERTY ( Fr o m Sch ed u l e H - A t t a c h Sc h ed u l e H) $

FORMDR- 2 I DI SCLOSURE( Re v . 0 7 1 2 0 0 - 4 ) REPORTFo O f f i c e Us e On l yComm . # ' 2 , 5 6S- 6L og g e d i nS c a n n e dCompu t e rA u d i t e d

L at e r e p o r t s a r e s u b j e c t t opos s i b l e c i v i l a nd c r i mi n a lp e n a l t i e s .

DATE SI GNED

REPORT FOR ( 1 ) ELECT I ON 1 ( 2 ) NON- E L ECT I ON YEAR .I n d i c a t e b y # EJ

L o c a l Co mmi t t e e s . e n t e r Da t e o f E l e c t i o nCo un t y & L o c a l Commi 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

2 44 . 5 9

3 , 1 6 1 - 0 8

3 , 4 0 5 . 6 7

3 , 3 60 . 8 8

44 . 5 9

003


2/4

/ 1 8/ 2 00 4, 1 0 : 2 2 FAX 3192326845 Bl a ck Ha wk Un i o n Cou nc i l

F o r 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 - - MONEY TAKEN I N

( I n c l u d i n g c a n d i d a t e ' , ,; 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 o n St a t e me n t o f O r g a n i z a t i o n )Un i o n Co un c i l AF L- CI O P o l i t i c a l Ed u c a t i o n F u n d

SUB- TOTAL

SCHEDULE

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

0 0 4

A I MONETARY( R e v . 0 7 1 0 : 3 ) I RECEI PTS0 CHECK T HI S BOX I FAMENDI NGFORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECENED FROM A STATE PAC ( P O L I T I C AL ACTI ON C OMMI T T E E ) , L I S T THE PAC I D EN T I F I C A T I O NNUMBER AND THE PAC CHECKNUMBER I N THE DFWONATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Code , p r o h i b i t s t h e u s e o f i n f o r m a 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 m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c omme r c i a l p u r p o s e b y a ny p e r s o n o t h e r t h a n 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 d i d a t e c o m m i 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 a n y r e l a t i v e m a k i n g a c o n t r i b u t i o n t o t h ec o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o wn t o t h e t h i r d d c g r o c 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 ) a n d a f f i n i t y ( r e l a t i v e s b y 1 lma r r i a g e ) . 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 s ome a s c a n d i d a t e , b u t t h e r e i 5 n o Page o f _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 u mn _ ( f o r S c h e d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT J I F FORRECEI VED ( i f a p p f i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MM/ DD1YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMSER I NCOME

I D# MEMBERSHI P DUES $ 3 , 1 6 1 . 0 81 0 1 09 / 0 4 CK#I D#CK#I D#CK#I D#CK# L jI D #CK#I D #CK#I D #CK#I D #CK#

CK# L jI D #CK#


3/4

/ 1 8/ 2 00 4, 1 0 : 2 2 FAX 3192326845 Bl a ck Hawk Un i o n Counc i l 0 0 5

T HI S BOX APPL I ES TO CANDI DATES' COMMI TTEES ONLY :P u r c h a s e s o f 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 t i n g $ 5 0 0 o r mo ve m u s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H . ( R e f e r t o S c h e d u l e H I n s t r u c 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 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 a n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l I t e mi z e d a nS c 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 ma d e b y t h e p e r s o n / e n t i t y a n b e h a l f o f t h e c a n d i d a t e ' s c o mm i t t e e . ( R e f e r t oS c h e d u l e G i n s t r u c t i o n s a n d b o n d Code 6 8 A _ 4 0 2 ( 3 ) ( I ) . )

Pa g e

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

FOR I NSTRUCT I ONS, SEE BACK OFFORMR e s t ~ t F o r m SCHEDULEEXPENDI TURES MONETARY- MONEY SPENT FROM COMMI TTEE ACCOUNT ( R e v _ 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES= NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VE CHECK T HI S BOX I FCANDI DATES, L I S T T HE CANDI DATE I D ENT I F I CA T I O N NUMBER I N THE DESI GNATEDCOLUMN AND THEPAC CHECKNUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NGFORMETHI CS $ CAMPAI GN DI SCLOSURE BOARDCOMMI TTEE NAME ( Mu s t b e s a me 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 )LUn i o n Co u n c i l AF L - CI O P o l i t i c a l Ed u c a t i o n F u n dCANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( MMI DDI YR) AND PACCHECK

NUMBERI D ! # We l l s F a r g o Ba n k Ba n k Fe eWo s t 5 t h a n d Co mme r c i a l S t - c a t $ 6 _ 4 2CK# Wa t e r l o o , I o wa 50701

1 1 9 Co mmi t t e e t o Re - e l e c t Do n Sh ou l t z c a mp a i g n c o n t r i b u t i o n1 0 / 1 0 / 0 4 2 95 Ke n i l wo r t h Ro a d 200 . 0 0

CK# 2 3 0 1 Wa t e r l o o , I o wa 50701I D# 1 7 6 3 3 TomL i t t l e f o r S u p er v i s o r c a mp a i g n c o n t r i b u t i o n

1 . 0 / 1 1 / 0 4 2 3 1 Ri v e r F o r e s t Ro a d 500_00CK# 2 3 0 2 L v a ns d a l c , I o wa 5 0 7 0 71 7 0 7 4 Mi l l e r f o r S u p er v i s o r c a mp a i g n c o n t r i b u t i o n1 0 / 1 1 / 0 4 CK# 4 2 1 3 We s t S b a u l l s Ro a d 500 . 0 02 3 0 3 C ed a r F a l l s , I o wa 5061 . 3

I Q0 1 7 5 7 6 Se h e l i h o m f o r Su p er v i s o r c a mp a i g n c o n t r i b u t i o n1 0 / 1 1 / 0 4 CK#2304 P . O. Box 1 7 4 5 0 0- 0 0G i l b e r t v i l l e , TA 5 0 6 3 4

I D# 1 5 4 4 F r i e n ds o f S t c v c Mi l d e r c a mp a i g n c o n t r i b u t i o n1 0 / 1 2 / 0 4 CK# 2 3 0 5 3 55 2 n d E a s t S t r c c t 200 _ 00Ma y n a r d , I A 50655I D# 1 5 0 4 Kr e s s i g f o r I o wa H o u s e D i s t r i c t 1 9 c a mp a i g n c o n t r i b u t i o n

1 0 / 1 2 / 0 4 3 5 2 3 V e ml t a Dr i v e 2 00 . ( 0CK# 2 3 0 6 Ce d a r F a l l s , J A 5 0 6 1 315 20 M i l l e r f o r I o wa H o u s e c a mp a i g n c o n t r i b u t i o n1 0 / 1 2 / 0 4 3 03 R h o n d a RD 2 0 0 . 00CK# 2 3 0 7 F a i r b a n k , I o wa 5 0 6 2 9

SUB- TOTAL $ 2 , 3 0 6 _ 4 2TOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) $


4/4

/ 1 8 / 2 00 4 . 1 0 : 22 FAX 3 1 9 2 3 2 6 8 4 5 Bl a c k Hawk Un i o n Co u nc i l

T HI S BOXAPPLI ESTOCANDI DATES' COMMI TTEES ONLY :P ur c h a s e s o f c e r t a i n c amp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d on Sc h e 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 c t i o n s . )

0 0 6

E x pe nd i t u r e s t o p e r s o n s / e n r t i = 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 , ( u n d - r a i s i n g , p o l l i n g , mana g i n g . o r g a n i s i n g g e r v i c e s mus t a l s o b e d e t a i l i t e r n I Z e d onSc h e d u l eGb y t h e amoun t , p u r p o s e , and d at e o f e a c h t y p e o f e x pe nd i t u r e made b y t h e p e r s o n / e n t i t y o n b e ha l f o f t h e c a nd i d a t e ' s c ommi t t e e . ( R e f e r t oSc h e d u l e GI n s t r u c t i o n s an d I owa Code 68A. 4 0 2 ( 3 ) ( i ) - )

( ( o r Sc h e d u l e B)

FOR I N ST RUC T I ON S, SEEBACK OF FORM SCHEDULEB MONETARYEXPENDI TURES - MONEY SPENT FROMCOMMI TTEE ACCOUNT ( R e v , 0 7 / 0 3 ) EXPENDI TURESSTATE PAC COr I 1MFTTEES : NOTE : FORCONTRI BUTI ONS MADE TOSTATEWI DEOR L EGI SLATI V E CHECKTHI S BOXI FCANDI DATES, L I S T THE CANDI DATE I DENT I F I CATI ON NUMBER I N THEDESI GNATEDCOLUMN AND THEPACCHECKNUMBER FOREACHEXPENDI TURE . A L I S T OF I D NUMBERS I S AVA I L ABL E FROMTHE I OWA AMENDI NGFORMETHI CSS CAMPAI GN DI SCLOSURE BOARD.COMMI TTEENAME ( Mu s t b e same a s o n St a t e me n t o f Or g an i z a t i o n)Un i on C o u n c i l AF L - CI O P o l i t i c a l E d u c a t i o n Fund

CANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BETRANSACTI ON) EXPENDED

EXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( MMI DDI YR) AND PACCHECKNUMBER

I D# 1 5 5 8 C i t i z t ms f o r Smi t h c a m p a i g n c o n t r i b u t i o n1 0 / 1 2 / 0 4 8 0 3 2nd S t r e e t $ 2 0 0 . 0 0CK# 2 3 0 8 T T a e r , I A 50 6 7 5 -

I D# 1 5 7 4 Od e k i r k f o r I o wa House Commi t t e e c a mp a i g n c o n t r i b u t i o n1 0 / 1 2 / 0 4 9 2 1 L y n d a Ro a d 200 . 0 0

CK# 2 3 0 9 Wa t e r l o o, l A 5 0 7 0 11 3 3 8 D a n i e l s o n f o r S e n a t e c a mp a i g n c o n t r i b u t i o n

1 0 / 1 2 / 0 4 3906 Mo n t e r e y Dr i v e 200 . 0 0CK# 2 3 1 0 Wa t e r l o o , I A 5 0 701 - 3 5 2 71 5 3 4 C i t i z e n s f o r S c h o c n j a h n c a mp a i g n c o n t r i b u t i o n1 0 / 1 2 / 0 4 CK# 2 2 1 P a r k Av e nue 200 . 0 02 3 1 1

A r l i n g t o n , 1 A , 5 0 6 0 6 - 0 1 3 2I D# 1 5 2 3 S u w t e l l e f o r S e n a t e c a m p a i g n c o n t r i b u t i o n

1 0 / 1 2 / 0 4 308 S o u t h 6 t h S t r c c t 2 0 0 _ 0 0CK# 2312 Ma r s h a l l t o wn , 1 A 5 0 1 5 8 - 2 6 5 8I D# We l l s F a r g o Bank c h c c l c sWe s t 5 t h a n d Commer c i a l S t r e e t 5 4 . 4 6CK# Wa t e r l o o , I A 5 0 7 0 1I D#CK#I D#CK#

SUB- TOTAL $ 1 , 0 5 4 . 4 6TOTAL ( N l a s t p a g e o f t h i s s c h e d u l e ) $ 3 , 3 6 0 _ 8 8

union council afl-cio political education fund__9725__scanned

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union council afl-cio political education fund9725scanned