Disclosure Summary Page DR-2: Statement of Cash On Hand
Disclosure Summary Page DR-2: Statement of Cash On Hand
C Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County & Local Committees, enter County in
which Election is held
(You must continue to file reports until a DR-3 is filed.)
IINN
Schedule F: Loan Repayments total (Attach Schedule F) .. .. . .. .. ... .. ... .. ... .. .. . .. .. ... . . .. .. . . ... .. .. . .. -0-
CASH ON HAND at the end of this reporting period (if final report balance must -0-
be zero) (Attach DR-3) .. .. ... .. .. ... .. .. .. .. . . ... .. .. . .. .. ... .. ..... .. . .. .. ... .. ... .. ... .. ... .. .. . .. .. .. . . . .. .. . .. .. .. .. . .. .. ... $
**UNPAID BILLS (From Schedule D - Attach Schedule D) ... .. ... .. ... .. .. . .. .. ... .. ... .. . .. .. .. . .. ... .. .. .. .. . .. .. . . ... .. $
*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .. .. ... .. ... .. ... .. .. ... .. .. . . . .. .. . .. .. .. ... .. $
**OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . .. . .. ... .. ... .. .. . .. .. ... .. .. . .. .. .. .. . .. .. .. . .. .. $ $1,600 (Forgiven)
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 ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
Don Pfeifer
6/7/05 3221 Parkview Ct SE $250
CK#
Cedar Rapids, IA 52403
ID#
J Lloyd International
6/7/05 PO Box 8415 1,000
CK#
Cedar Rapids, IA 52408
I D#
F-1
Michael Odell
6/8/05 1833 Boomington Rd 200
CK#
Marion, IA 52301
l D#
El
Sellers Broadcasting Inc
6/8/05 500
CK# 1957 Blairsferry Rd NE
Cedar Rapids, IA 52402
ID#
Regent Investment Corp
6/8/05 222 3rd St SE 750
CK#
Cedar Rapids, IA 52401
ID#
El
Donald Thomas
6/9/05 4224 Dalewood Ave SE 500
CK#
Cedar Rapids, IA 52403
ID#
Wade Wagner
6/9/05 137 Tomahawk Tr SE - 500
CK# E::]
Cedar Rapids, IA 52403
ID#
F-1
Lyle Hanson
6/9/05 2561 'L' Ave NW 550
CK#
Cedar Rapids, IA 52405
ID#
David Zahn
6/9/05 500
CK# 7417 Idledale Rd NE
Cedar Raids IA 52402
ID#
Leech Lake Knife Inc
6/10/05 CK# 436 Fleetwood Rd SW 750
Cedar Rapids, IA 52404
SUB-TOTAL
` Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee . Relationship must be shown to the third degree of consanguinity tolood relatives) and affinity (relatives by 1 3
marriage) . If surname of contributor is the same as candidate, but there is no Page of _
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A
CONTRIBUTIONS -- MONEY TAKEN IN
(Including candidate's personal funds)
(Rev . 07/03) I MONETARY
RECEIPTS
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 ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
I D# 6/10/05
Otto Eichacker
6/10/05 168 West Post Rd NW $25
CK#
Cedar Rapids, IA 52405
ID#
Rex's Custom Concrete Inc
6/10/05 375 Collins Rd NE # 108 1,000
CK#
Cedar Rapids, IA 52402
I D#
Providence Transportation Corp
6/10/05 CK# PO Box 5399 500
Cedar Raids, IA 52406
I D#
Midwest 3rd Party Logistics
6/10/05 CK# PO Box 5399 500
Cedar Raids, IA 52406
I D#
Paul Pate
6/13/05 6801 Bowman Ln NE 1,000
CK#
Cedar Rapids, IA 52402
ID#
Lora Summerwill
6/13/05 1618 C Ave NW 100
CK#
Cedar Rapids, IA 52405
ID#
Dale Brodt
6/14/05 204 Alma Dr NW 50
CK#
Cedar Rapids, IA 52405
ID#
Peter Teahen
6/14/05 3 100 F Ave NW 300
CK#
Cedar Rapids, IA 52405
I D#
Ck to Signs Etc
6/15/05 Lost in mail .. . .re-entered into cking acct 475
CK#
ID#
Robert Levi
6/16/05 CK# 141 21st St NW 100
Cedar Rapids, IA 52405
SUB-TOTAL
* Disclosure law requires candidate committees to disclose 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 2 3
marriage) . If surname of contributor is the same as candidate, but there is no Page of _
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
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 ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
Wayne Engle ,
8/3/05 796 11th Street $250
CK#
Marion, IA 52302
I D#
Don Novak
8/4/05 10400 Club Rd 200
CK#
Cedar Rapids, IA 52401
ID#
Jim Novak
8/4/05 CK# 2040 44th Street SE 100
Cedar Raids, IA 52403
ID#
Ralph Palmer
8/5/05 CK# 4069 Hickory Hill Ln 145
Cedar Raids, IA 52403
1D#
Jim Sattler
8/9/05 3801 River Ridge Dr NE 145
CK#
Cedar Rapids, IA 52402
I D#
C K#
I D#
C K#
ID#
C K#
ID#
CK#
ID#
CK#
SUB-TOTAL
* Disclosure law requires candidate committees to disclose 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 3 3
marriage) . If surname of contributor is the same as candidate, but there is no Page of
familial relationship, enter "not applicable" in the relationship column . (for Schedule --
A)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form
SCHEDULE
ID#
umulus Media (KDAT) Ads
6/10/05 CK# 25 2nd Street SE 750
edar Rapids, IA 52403
ID#
MT Radio AM Ads
6/10/05 CK# 00 Old Marion Rd NE 410
edar Rapids, IA 52402
ID#
GAN TV Ads
6/10/05 CK# 00 Old Marion Rd NE 337.50
Cedar Rapids, IA 52402
ID#
Signs Etc Yard Signs
6/15/05 CK# 1111 I Ave NE Bumper Stickers 3,796.54
Cedar Rapids, IA 52402
ID#
MRY AM Radio Ads
6/15/05 957 Blairs Ferry Rd NE 1,900
CK# Cedar Rapids, IA 52402
ID#
Marge Wong Contract Phone Calling
6/15/05 CK# 5335 Avenida DeDespaico 750
Yorba Linda, CA 92887
ID#
ailing Srvices Inc Mailings
7/5/05 CK# 00 50th Ave Dr SW 247.86
edar Rapids, IA 52404
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/entity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 68A.402(3)(i) .)
Page 1 of 2
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form SCHEDULE
ID#
Sajme as above Same as above
8/4/05 CK# 500
ID#
eed Communications Ad writing
8/9/05 CK# 15 Wasatch Ct NE 453 .35
Cedar Rapids, IA 52402
I D#
CK#
1D#
CK#
ID#
CK#
I D#
CK#
ID#
CK#
Purchases of certain campaign property costing $500 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/entity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 68A.402(3)(i) .)
2
Page _ of 2
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM
SCHEDULE
NOTE : This schedule reports money loaned to the committee which is deposited in the committee account . QCHECK THIS BOX IF
AMENDING FORM
TOTAL UNPAID LOANS FROM LAST REPORTING PERIOD $ 1,600
PART I - MONETARY LOANS RECEIVED THIS REPORTING PERIOD PART II - MONETARY LOAN REPAYMENTS MADE THIS REPORTING PERIOD
(Original source of loan, such as a bank, must be shown if a third party is (Loans forgiven must be reported on Schedule E -- In-kind Contributions.)
involved. Include loans from candidate's personal funds.)
DATE NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT DATE PAID NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT
RECEIVED (Include Endorser's Name, If Applicable) TO CANDIDATE OF LOAN (MM/DD/YR) (Include Endorser's Name, If Applicable) TO CANDIDATE' REPAID
MMIDDNR If A licable* If A licable
$- $ -0-
TOTAL (PART/) TOTAL CASH REPAYMENTS (PART ll)
$ 1,60 0
From Schedule E -- TOTAL LOANS FORGIVEN
$ -0-
TOTAL OUTSTANDING LOANS END OF REPORT PERIOD
0-'Disclosure law requires candidate committees to disclose 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 surname of contributor is
the same as candidate, but there is no familial relationship, enter "not applicable" in the
relationship column when it applies . Page I of 1
(for Schedule F)