8/7/2019 Mineart John__1681__scanned

1/3

FOR I N STRUCT I ONS, SEE BACK OF FORMDI SCLOSURE SUMMARY PAGECOMMI TT EE NAME ( Mu s t b e same 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 )

J ` O f f n j ~ J ( MEAr ) _ _ T kL d f TE S6WAr kI MPORTANT : I n d i c a t e b y # t y p e o f c o mmi t t e e y o u a r e r e p o r t i n g f o r :( 1 ) S t a t e w i d e / L e g i s l a t i v e / J 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 ) C o u n t y C e n t r a l C o mmi t t e e ( 5 ) C o u n t y d a t e ( 6 ) C i t y C a n d 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 C a n d i d a t e ( 8 ) C o u n t g ( Q L t y PAC ( 1 0 ) S c h o o l B o a r d o r O t h e r P o l i t i c a lS u b d i v i s i o n PAC ( 1 1 ) L o c a l B a l l o t I s s u L , ' . , .CANDI DATE COMMI TT EES ONLY :C a n d i d a t e Name

( l r f i - c - v . h fT Ar E S C N A r f _ ~

I AM F I L I N G A Oc t N 2 U ( l ,T( r e p o r t d a t e )

CHECK I F AMENDMENT T O REPORT DATED

Ei s t r i r : t ( i f S a n a t p n r H n i mp )

L a t e r e p o r t s a r e s u b j e c t t o p o s s i b l e c i v i l a n d c r i m i n a l p e n a l t i e s . P u r Z r u a n t t o I o w a Co d e s e c t i o n 6 8 B . 3 2 A ( 7 )t h e c a n d i d a t e , f o r a c a n d i d a t e ' s c o mmi t t e e , a n d t h e c h a i r p e r s o n , f o r a n y o t h e r t y p e o f c o mmi t t e e , i s t h ei n d i v i d u a l r e s p o n s i b l e f o r f i l i n g t i m e l y a n d a c c u r a t e r e p o r t s .

0 Che 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 DR- 3 .( Y o u mu 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 D R- 3 i s f i l e d . )

5 J 5 - 9 V i - 9 'TELEPHONE

REPORT FOR ( 1 ) ELECT I ON / ( 2 ) N ON - E L E CT I O N YEAR .I n d i c a t e b y #

STATEMENT OF CASH ON HANDCASH 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 o t a l o f a l l f u n d s h e l d b y t h ec o mmi t t e e . T h i s a m o u n t MUST b e t h e same a s t h e c a s h o n h a n d a t t h e e n 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 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ADDTOTAL MONEY TAKEN I N T HI S PER I ODS c h e d u l e A C a s h C o n t r i b u t i o n s t o t a l ( A t t a c h S c h e d u l e A ) ( * a l s o s e e i n - k i n d b e l o w ) . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n s R e c e i v e d t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e H : T o t a l S a 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 C a n d i d a t e s ' Co mmi t t e e s On l y )SUB- TOTAL . . . . . . . . . . . . . . . . . . . . . . . $

SUBTRACT TOTAL MONEY SPENT T HI S P E F I I O DS c h e d u l e B: E x p e n d i t u r e s t o t a l ( A t t a c h S c h e d u l e B ) ( * * a l s o s e e d e b t s a n d l o a n s b e l o w ) . . . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n Re p a y me n t s t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ONHAND a t t h e e n d 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 n c e m u s tb e z e r o ) ( A t t a c h D R - 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* " U NP A I D BI L LS ( F r o m S c h e d u l e D - A t t a c h S c h e d u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $I N K I ND CONTR I BUT I ONS ( F r o m S c h e d u l e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* * OU TSTANDI NG LOANS ( F r o m S c h e d u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

FORMDR- 2 DI SCLOSURE( R e v . 1 2 / 2 0 0 5 ) REPORTF o r O f f i c e Us e O n ICo mm . # - l o gL o g g e d I n JS c a n n e dC o mp u t e rA u d i t e d

F i l e w i t h :I o w a E t h i c s a n d C a mp a i g nD i s c l o s u r e B o a r d5 1 0 E. 1 2 ' " , S t e 1 ADes Mo i n e s , I o w a 5 0 3 1 9Fa x : 5 1 5 - 2 8 1 - 3 7 0 1

DATE S I GNED

L o c a l C o mmi t t e e s , e n t e r D a t e o f E l e c t i o n

C o u n t y & L o c a l C o mmi t t e e s , e n t e r C o u n t yw h i c h E l e c t i o n i s h e l d

. 6 -L o l l s , 7 f

CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) - YES I / NOCANDI DATE COMMI TT EES ONLY-

6 , a5 C9 1 6 6

, . 3 2 , 4 I .

8/7/2019 Mineart John__1681__scanned

2/3

T HI S BOX APP L I E S TOCANDI DATES ' COMMI TT EES 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 r e 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 i t 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 m i z e d oS 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 made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e rS c h e d u l e G i n s t r u c t i o n s a n d I o w a C o d e 6 8 A . 4 0 2 ( 3 ) ( i ) . )

t - U H / NS I P f U L : I I U NS , St t 13AGK OFFORM R e s e t n or m / SCHEDULEEXPENDI TURES - - MONEY SPENT FROMCOMMI T T EE ACCOUNT B MONETAR( R e v . 0 7 / 0 3 ) EXPENDI TUSTATE PACCOMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E G I S L A T I V EC A ND I D A T E S , L I S T THE CANDI DATE I D E N T I F I C A T I ON NUMBER I N THE DESI GNATED COLUMN AND THE D CHECK T HI S BOXPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA AMENDI NG FORME T HI C S 8 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 nJ_oHj A / l ~ ( r ~ l i 1 I ~T r S t h r k ~ r i t l , 4 T , &

CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEEXPENDED ( 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( MM/ D D/ Y R) AND PACCHECKNUMBERd 8 I D# ~ u r Wi n q ~ S t r n n t L f F ws c a r d~ r a h O~ 7 p P r % r - f -o f l Op c - l - i - / 4 - c ) - Q - R r l . . F I ` a L . cT P 5 1 ~ c a c . . - c ( $ / ; 2 - 7 5u . e Cs ; t ( v x r T 5276 _ I c ve . r y F e e -I D#

o u V 1 C_1

/ 7e c c a d . p o r t ' b&j l l ~ ,CK# Po r x 3 3 7 S r y H s V A L ' " ; s1 ' r < < C Cw . Q~ r 2 A 5 Z Z 3 3 - D 3 3DS - 3 f - o L I D # 1 / l G &_ 1 44 - ~Sed- P 4 c a l t ACK# t I l e L ; Fo f r a % c ,F r G l . l / , Q , y ( - b2 J 2 ~v2 r EI D# '

CK#I D#

CK#I D#CK#I D#CK#

I D#CK#

SU B - TOT A L $~ DTOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) $ 7

8/7/2019 Mineart John__1681__scanned

3/3

Fo r I n s t r u c t i o n s , Se e Ba c k o f F o 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 ' s 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 S t a t eme n t o f O r g a n i z a t i o n )

SOTE5,1 c _hl l 4 T 7E

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) I RECEI PTS

CHECK T H I S BOXAMENDI NG FORM

STATECANDI DATES NOTE : I F A CONTRI BUT I ON I S RECE I VED F ROM A STATE PAC ( P OL I T I CA L ACT I ON COMM I TTEE) , L I S T THE PAC I DENT I F I CAT I ONNUMBER ANDT HE PAC CHECK NUMBER I N THE DESI GNATED COL UMN . A L I S T OF I D NUMBERS I S AVA I L AB LE F ROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARDNOTE : ANY PERSON, OTHER THAN AN I N D I V I D U A L , THAT CONTRI BUTES MORETHAN $ 7 5 0 TO YOUR CAMPAI GN MAYHAVE F I L I N GR ES PO N S I B I L I T I E S ANDSHOUL D I MMEDI ATELY CONTACT THE BOARD.CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , 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 r f o r an yc o m m e 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 a n s t a t u t o r y p o l i t i c a l c o mm i 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 e

Of I

DATERECEI VED( MM/ D D f Y R )PAC I D UMBER( i f a p p l i c a b l e )AND PAC CHECKNUMBER

ME ANDADDRESSOCONTRI BUTOR RELATI ONSHI PTO CANDI DATE'( i f a p p l i c a b l e )AMOUNTRECEI VED J

II D# q 7 3 ( ) Pr o -- r g 5 S V - o r 1 6Wl l r - PA C_DF_ : 5 / 4 6WC5 , LA 5 , 0 3 02

$I D#CK#I D#CK#I D#C K#I D#CK#I D#CK#I D#CK#I D#C K#I D#CK#I D#CK#

SUB - TOTAL 00$ 5TOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e ) $~ v i m, v o