Professional Documents
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E]O19CK IF AMBVOMEMTO RFJ'ORT DATW n.e Local Committees, enter Date of Election
~ 4-
Check If this is final (termination) report and attach Notice of Dissolution Form DR-3 . County 5 Local Committees, enter County in
(You must continue to fie reports until a DR-3 Is filed .) which Election Is held
rd + e , in q ;lr,d
STATEMENT OF CASH ON HAND
CASH ON HAND at the beginning of the reporting period. (Total of all funds held by the
commlfee- This amount MUST be the same as the cash on hand at the end 3,048 .44
of the last reporting period or must be zero if this is first report filed.) . . . . . . ., . . . . . . . . . . . . . . ., . ., . . . . . . .. . . . . . . ... . . .. .$
ADD TOTAL MONEY TAKEN IN THIS PERIOD
5,357.73
Schedule A : Cash Contributions total (AUach Schedule A) ("also see in-kind below). . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F loans Received total (Attach Schedule F) . . . . . . . . . .. . . . .. ........ .. . .. . . .. . .. .. . . .. . . . . . . . . . . . . . . . . . . . . . . .. . .. . ._ 0_
.00
0 .00
Schedule H: Total Sales of Campaign Property (Attach Schedule H) . . . . .. . . . . . . .. ... ..... . .. ... .., .. . ... . .. .. ... . . . . . .
(Schedule H is piles to C4ndtdatas' ComM1Mes OniV)_
SUia-TOTAL ........ ..............$ 8,406.17
r
**OUTSTANDING
'IN . . .
KIND CONLROXMN3 (From Schedule E - Wfach Schedule E) . . . . . . . . . . . . . . . . .... .. . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .$. . . . . . . -
$ 0.00
LOANS rot Schedule F - Attach Schedule
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
SIQITE C411ILNITTEES. Submit a reconciled campaign account bank statement in January of each year.
10/19/2006 3 :45PM
Oct-19-06 03 :40pm From- T-608 P .002/006 F-629
For Instructions, See Back of Form
STATE CANDIDAT93 NOTE: IF A CONTRIBUTION 16 RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND TH8 PAO CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
NOTE ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATE=LY CONTACT THE BOARD.
CAUTION: Section 68B .32A(6), 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-
IDfx
6084 Iowa State UAW PAC
7/2910b 500.00
CK# 2700 S. River Rd Ste 200
744 Des Plaines, IL 60011
tu+F
Country Junction Fundraiser 860.00
8125/06 CK#
ID#
William and Lori Rokusek 20 .00
9/5106 CK# 2386 Briarwood Dr
Duhnaile JA '9700?
ID#
9710 CWA Local 7110, COPE Fund 100.00
9/21/06 CK9 PO Box 1367
189 Dubuque, IA 52001
ID#
Dubuque Federation of Labor, COPE account 100.00
9/25/06 CK# 1610 Garfield Ave
1055 Dubuque, 1A 52001
SUB-TO
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Oct-19-06 03 :41pm From-
T-608 P .003/006 F-629
Purahwas of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H Instructions .)
Expenditures to peraonslenthles providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail Itemized on
Committee, (Refer to
Schedule G by the amount, purpose, and date of each type of expenditure made by the persontentity on behalf of the candidate's
Schedule G Instructions and Iowa Code 68A.402(3)(1) .)
(for Schedule S)
10/19/2006 3 :45PM
Oct-19-06 03 :41pm From- T-608 P .004/006 F-629
B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 07103) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUM&ER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE, A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS a CAMPAIGN DISCLOSURE BOARD.
ID#
Menards supplies for wood signs
08/29/06 5300 Dodge St 8 .67
CK# 1081
Dubuque, IA 52001
ID# gas for door knocking
Kwik Stop
09/01/06 2360 Central Ave 47 .66
CK# 1008
Dubuque, IA 52001
ID# Menards wood for signs
09/03/06 CK# 1007 5300 Dodge St 19 .12
Dubuque, IA 52001
147# Dubuque Advertiser ad for soup fundraiser
08/18/06 2966 JPK Rd 88 .00
CK# 1088 Dubuque, TA 52001
ID#
fly-vee Gas gas for putting out signs
08110106 2395 NW Arterial 33 .01
CK# 1084 Dubuque, lA 52002
SUB-TOTAL $ 626.8)
TOTAL (if fast page of this schedule) $
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 consulling, advertising, fund-raising, polling, managing, organizing services must also be detail IternIzed on
. (Refer to
schedule G by the amount, purpose, and date of each type of oxpanditure made by the person/entity on behalf of the candidate's committee
Srnedule G instructions and Iowa Code 615A .4020)(0 .)
Page 2 of 3
(for Schedule B)
10/19/2006 3 :45PM
Oct-19-06 03 :41pm From- T-608 P .005/006 F-629
C K#
ID#
CK#
ID#
CK#
Ip#
CK#
ID#
CK#
Ill#
CK#
SUB-TOTAL
TOTAL (Iflast page of this schedule)
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H, (Refer to Schedule H Instructions_)
Expenditures to personslentlties providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail Itemized on
Schedule G by the amount, purpose, and data of each type of expenditure made by the pereonlentity on behalf of the candidate's committee. (Refer to
Schedule G Instructions and Iowa Code BBA,a02(3)(i),)
(for Schedule B)
10/19/2006 3 :45PM
Oct-19-O6 03 :42pm From- T-608 P106/006 F-629
IZI
Jennifer Sindt shirts 30 .00
9/28106 113 21 Mud Lake Rd
Dubuque, IA 52001
'Disclosure law requires candidates to disclose the relationship of any relative making an In kind contribution to the
committee . 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.) 1f surname of contributor is the same as candidate, but there Is no
familial relationship, enter 'not applicable' In the relationship column,
10/19/2006 3 :45PM