chiodo frank1013scanned

8/7/2019 Chiodo Frank__1013__scanned

1/16

FOR I NSTRUCT I ONS, SEEBACK OF?MDI SCLOSURE SUMMARY PAGE

COMMTTEE NAME ( Mu s t

s ame a s o n t a t e m e p ( o f O r g a n i z a t i o n )

1C" ) D4 o

e S-k~ l ~ ' S

t ~

I MPORTANT: I n d i c a t e t y p e o f c o mm i t t e e y ou 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 C a n d i d a t e ( 2 ) S t a t e w i d e PAC ( 3 ) S t a t e P a r t y ( 4 ) C o u n t y / L o c a l C a n d i d a t e( 5 ) C ou n t y PAC ( 6 ) B a l l o t I s s u e / F r a n c h i s e C o mm i t t e e ( 7 ) C o u n t y / C i t y C e n t r a l C o mm i t t e e( 8 ) S u p p or t S l a t e A f C a n d i d a t e s

OF TREASURER ( o r p e r s on f i l i n g t h i s r e p o r t )Rou t i n e P e n a l t i e s Du e Fo r L a t e F i l e d Re p or t s Ra n g e f r o m $ 2 0 t o $ 8 0 0

SEE I NSTRUCTI ONS ON BACK ANDCOMPLETE THE FOLLOWI NG SENTENCE :I AM FI L I NG A

REPORT FORAN/ A ( 1 ) EL ECT I ON I ( 2 ) NOWELECT I ON YEAR.

( r e p o r t d a t e )OCHECK I F AMENDMENT TO REPORT DATED

Ch e 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 or m DR- 3 .( Y o u mus 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 N o t i c e o f D i s s o l u t i o n i s f i l e d . )

I n d i c a t e on e

/

/ 7

, 3 - -

DA SI G ED

L o c a l C o mm i t t e e s , e n t e r D a t e o f E l e c t i o nC o u n t y & L o c a l C o mm i 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

STATEMENT OF CASH ON

CASH 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 h i s i s t h e H%f f 2t o t a l 2 2 0 0 2o f a l l mon i e s h e l d b y t h e c ommi t t e e . T h i s amou n t MUST b e t h es ame a s t h e c a s h on ha n d a t t h e e n d o f a s t r e p o r t i n g p e r i o d ,o r mu 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 . ) t h e. . . . i 6 l t / 4 2 . 7 a4 . ' - Q. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . 5 Ul r ] Q

.

ADD TOTAL MONEYTAKEN I N T HI S PERI OD


2/16

Sc h e du l e A : Ca s h


3/16

Fo r I n s t r u c t i o n s , See Back o f Fo r mCONTRI BUTI ONS - - MONEYTAKEN 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 be s ame a s o n St a t e me n t o f Or g a n i z a t i o n)

000

5M(4Cf&~t ' ` 7_Ai 1 V2_ `_-

STATE CANDI DATES NOTE: I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACT I ON COMMI TTEE) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS 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 me 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 o mme 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 mmi t t e e s .

SCHEDULEA MONETARY( Re v . 0 6 / 9 7 ) RECE I PTS0 CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT d I F FORRECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECE I VED FUND-( MM1DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

I D# 1~6 # b ~v 5 t ~ L r r r c , e / LCK# ZI P f i r " i a v r , $ 1 6 0 y

6 F - . 5 wE S . I A~JZ~I D

I D # Vl t PALVr + f Z , . 50CK# X 1 3 r L VAk i

I o ~Z~ ~ ~I D #CK# g~ I c A c , 5 ( _ T4 : t - 5 - ~ ". - -I D # ! ) S PAe-

I ~JDl CK#

( ~ ~ ~ , l b lI D # o o ` t I DWA. a t " T 4 l t - PAeZ f s - - n ~ , s s b s r l 6D 00. ~CK#C=-_~

GZwt . l ~ ' So 3 ZS'I D * p s / n n c p c , , ` J e t - f " i n s v~AnCE A&L ~ r t T S'CK# ~o w~~~~w~ Pr wt l 6 0 A { ~z r a s


4/16

CONTRI BUTI ONS - MONEY TAKEN ~ . .( 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 )

COM I T TEE NAME ( Mu s t be s ame a s o n S t a t e me n t o f Or g an i z a t i on)t

d ( D t ~ o

/ : ; ~Z

$+A+t

VW : C L V L V :

Q CHECK T HI S BOX I FAMENDI NG FORMA MONETARY

( R ev . 0 6 / 9 7 )

RECE I P TS

STATE CANDI DATES NOTE: I F ACONTR I BUT I ON I S R ECE I V ED FROM ASTATE PAC ( POL I T I CA L ACT I ON COMMI T TEE ) , L I ST THEPAC I DE NT I F I CA T I ONNUMBER AND THEPAC CHECKNUMBER I N THEDESI GNATED COLUMN . A L I ST OF I D NUMBERS I S A VA I L A BL E FROMTHE I OWA E T HI CS AND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON : Sec t i on 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 and s t a t e me nt 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 an y c omme r c i a l p u r p os e b y an y p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e es . -

Gl t ~ ~o r

6/20 1 ) ,

& I f u ) C , I

[ I D*CM

[ I D*

I D #CK#

CK#I D #CK#

l v , t 1 ~Am 0 -

v ns . PP

5~0 wr ~s~W~ pK( AeaK PctDs~I / l - s d31Z

Jbwd

I K - r 9 L Ta ' )

04 e

9 y 9 Ci t K2 i n v DPI VEO . 5 r ~ . , A

. f o 3 nf .

l b w. : I L t t ; t ) i c r l Z PACf 0& j

6 r A+zO

~ 9 ~ c ~ x s/ 6 0 o c u x t r l ' T 0 / L - 2 -D5; n . I Qf

W- C r % ; -

z , ~ 2 I

L - 6 - - c _ A Avc

4

$ , r 6b -

r -

6 0

aov-

, s 6 _

/ 8 0

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RE L A T I ONSHI P AMOUNT q I F FORR E CE I V E D ( i f a p p l i c a b l e ) TO CANDI DATE ' RECEI VED FUND-( MM/ DD/ YR ) AND PAC CHECK ( i f a p p l i c a b l e ) R AI S ER

NUMBER I NCOME


5/16

CONTRI BUTI ONS - - MONEY TAKEN( 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

EENAME ( Mu s t e s ame a s o n St a t e me n o f Or g a ni Z a ' o n )

v J V 1 : L : L i V LLA MONETARY( Re v . 0 6 / 9 7 ) , RECEI PTS

CHECK T HI S BOX I FAMENDI NG FORM

STATE CANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I DENTI FI CATI ONNUMBER AND THEPACCHECKNUMBER I N TH E DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHEI OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON: Se c t i o n 6 8 6 . 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 ma t i o n c op i e d f r o m r e p o r t s a n d s t a t e me nt 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 o mmer 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 an s t a t u t o r y p o l i t i c a l c o mmi t t e es . -

DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR REL ATI ONSHI P AMOUNT d I F FORRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE' RECEI V ED FUND-( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# - b6g ~ ~o t (.l 2 ( v J b 6 ~ t o l s r ~ k r / b , 3 ) ( GS' 7 $CK# Q 5 M 5 z > g o 3 (

I D# ~ / OwQ L, FF l , v, r 4-nCE, ~ 1 26 ' o I CK# s/ oo u s ' - s . e . , PX a ~ ~ ~ - -waM. l ar I D# ( 005 t o ~ e 9 4 k e e s v h , 7 ' ~0 1 CK# 9 / 9 0 - - A1, ci ' 05m A s o3 e )I D# &, 8

( o 1 ( 0 / b CK# l lq5 -f T~ s 4

I D# J 0 / + u pkcy25, . i

~ L ~2 5 I C CK# 670 4 ~) 5 T t ' i e NZ . / 6 0n s , n 1 . s ~ - 3 1 Z


6/16

CONTRI BUTI ONS - MONEY TAKEN u v( 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 (Must besameS~ on t at emen Or g an i z a t i o n)Ci h 0 1 ) D

)Q

, -~

u v , : wr w. iA MONETARY

( Re v . 0 6 / 9 7 ) 1

RECEI PTS0 CHECK THI S BOX I FAMENDI NG FORM

STATE CANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROMA STATEPAC ( POL I T I CA L ACTI ON COMMI TTEE) , L I STTHE PAC I DENT I F I CATI ONNUMBER ANDTHEPACCHECKNUMBER I N THE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD.CAUTI ON : Se c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Co d e , 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 me 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 o mme 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 an 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 .

RELATI ONSHI P I AMOUNTTOCANDI DATE'

RECEI VED

( i f a p p l i c a b l e )

$ 5 -0so's ,5 - 6

d I F FORFUND-RAI SERI NCOME

DATERECEI VED( MM/ DD/ YR)PAC I D( i f a p p l i c a b l e )ANDPAC

NUMBER

NUMBERCHECK

NAME ANDADDRESS OF CONTRI BUTOR

I D# ~ J v t . - r E &~ I A_Sr o/ z CK# v. r x Ac0 b + h - i A - . r o 3 z 1I D # ( p e f c r r t( o ) 2 s CK# S - / Os - Sw i 6 ~2 . 5 " f5m So3f SI D# ew s ' l o s ~ a St


7/16

CONTRI BUTI ONS - MONEY TAKEN . .( 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 St a t e me n t o f Or g a ni z a t i o n)

. r m :wwA MONETARY( Re v . 0 6 1 9 7 ) I RECEI PTS

CHECK THI S BOX I FAMENDI NG FORM

STATE CANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D ENT I F I CA T I O NNUMBER AND THE PACCHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON: Se c t i o n 6 8B . 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 ed f r o m r e p o r t s and s t a t e me nt 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 any c o mmer c i a l p u r p o s e by an y p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e es .

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT 4 I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME1 o /

I D# ~ 3S 1 / - C - l J201_&" ' P1 MA , I ( E T t f ~ r z S$CK# 1 3 0 3 S- " 5 t / t o oWl ) M 1 4 So26G

I D #X 6 1 2 5 f J CK# B. x 6 , , 3~7 . l o oA, 1 , o , 1A . / As b c o ~

I D# ~ h J 7 I DwA P4" 01, 1C' r PA I f' 0 S YP 7 ' A- - Z 2 ,

I D# 4 g t 3 PA1r eA- t 1J r ZJ L ) CK# h t 3 5 - eA5 4 O r 0< _ 1 1 1 08 S r ' y t - / A SoSr ~I D# 6 0 5 " 1 I OWA &r y r f , l r C G - U - 4 - ' r o 474 j l e , , s/ b ( CK# / 1 1 2 OF"" E

L e ) ! A . So 2LS~I D#

i UwA s N~


8/16

CONTRI BUTI ONS - MONEY TAKEN I( 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 TT EE NAME ( Mu s t be s ame a s o n S t a t e me n t o f Or g a ni z a t i on )~

o8d

Ar s - k ~ 5 ~e l , 7 - 741- t VC

A MONETARY( Re v . 0 6 / 9 7 ) - RECEI PTS0 CHECK T HI S BOX I FAMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PAC ( POL I T I CA LAC TI ON COMMI TTEE) , USTTHE PAC I DENT I F I C AT I ONNUMBER AND THE PACCHECK NUMBER I N THEDESI GNATED COLUMN. A L I ST OF I D NUMBERS I S AVA I LAB LE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON : Se 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 ma t i o n c op i e d f r o m r e p o r t s a n d s t a t e me nt 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 ny c o mme r c i a l p u r p os e b y a n y p e r s o n o t h e r t h an 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 .

.

,

NAME AND ADDRESS OF CONTRI BUTOR -

/ L k L , ~Sc Q~ .Z 7o v 5 '

r~ ~ s o > = c r

r f ~ y t ~ ~ s

1 z

Gv v - ~ or E c l o * ' 0 - b ao33ya3

PAC I D NUMBER( i f a p p l i c a b l e )AND PAC CHECK

NUMBER

I D#CK#

I D#CK#

15 S Z ' ' '

~ I 4 /h r a w ' i L ) q

3 7 ~-s o t wES - . I A-PA 6

7 r S t

e - 3 6 6v0 e n , . e p 2 . _ eo , ~ o2 D 7 - 3 3 L ~ -i 3 " K , & s U v t . e` l l ~ 6 , Av e

/ ) S r h , l A4 5 5 t / 4 - L - I , r/W1 5 -

RELAT I ONSH I PTO CANDI DATE'

( f a p p l i c a b l e )- AMOUNTRECEI VED

f66~_6o'

DATERECEI VED( MM/ DD/ YR)

~ a I 2 5w~T-r b l ZS~b ~

l o ~?S l o l

4 I F FORFUND-RAI SERI NCOME


9/16

CONTRI BUTI ONS - MONEY TAKEN( 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 TT EE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g an i z a t i o n )

A MONETARY( R e v . 0 6 / 9 7 ) RECEI PTSQCHECK T HI S BOX I FAMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ONNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATEDCOLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .

_ _

. 1 1 ,

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 op i e d f r o m r e p o r t s an d s t a t e me nt 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 an y c o mmer c i a l p u r p o se by a n y p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e es .

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT J I F F ORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MWDD/ YR) ANDPAC CHECK ( f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

cK# F ' U - 6 3X . -75-7 j 6 6C I J S f V I , tI D #1 J D I / v l r f ~ ) S~2 ~~

~~ZS 1 CK# ~~0D I V I ~s I Nt - ) A - . S o 3 1 ZI D # JCf L a " . ( ~AwF v ~7

l b ~5 1 CK# 7 o i 2 t , * ~ j G TEn 5 61X7 f Y l - t -' v t - c S I Y ~ 5- e > o( b ~ 2 5 1 ~ ~ CK# y t e 3 s ' 3 P z 4 e - i e -

I D # ~2~ cE ~a l cL ~YObOE~M~S/ l k - . S p 3 i ZI D # MSS r t e ~L~I DDS

CK# ` h 7 - 3 ?21 P" a - r L ~ S ` ~ Q c - ~ ~~


10/16

Fo r I n s t r u c t i on s , See Back o f Fo r mCONTRI BUTI ONS - - MONEYTAKENI 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 be s a e as on S t a t

e t o f

e/,~oe9o4w- j&Or gan)STATE CANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON : S e c t i o n 6 8B . 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 op i e d f r o m r e p o r t s an d s t a t e me nt 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 o mme r c i a l p ur p o s e b y an 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 mmi t t e es .

SCHEDULEA MONETARY( Re v . 0 6 / 9 7 ) RECEI PTSCHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT 4 I F FORRECE I VED ( i f a p p l i c a b l e ) TOCANDI DATE' RECE I VED FUND-( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

I OWA&~ & , VVA 11 0A e -CK# : " ~ k 2 - $ I os 3 a 5 aI D# SI j q ewP , 4 ~ ~ P I Z i n c ' f ~ w l .rCK# 7 n oo f 6 I ~ _ 360De s 4 6 5 1 1 1 50501

1 ~ 7 / 61, ,

,

I D# r t - / p i v A AA . rJ aoCK# - - , 7 67 ? , ? s tD# G ~ G + Qr m , 6 A o c A ~ t t Hn x . , . ( ; ..CK#~ 6 6 6 l 4 . 1 j ) AVEn . 7 ~ ` .

1/ 7I D# I N4er a4 t ~ " > I I " S

9 , 2 3f ` = At -CK# 7 I ) ~ ~ t i w t . i l k S~Sr L.I D#

1 v c K# 3 1 7 . ; ` ' S+ - 7 , c


11/16

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 ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t b e s am a s

S t a t e

t o f O r g a n i z a t i o n )

STATE CANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D E NT I F I C A T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON : S e c t i o n 6 8B . 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 ma 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 me nt 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 o mme r c i a l p u r p o s e b y an y p e r s o n o t h e r t h an 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 .

SCHEDULEA MONETARY( Re v . 0 6 1 9 7 ) RECEI PTS

CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT v I F FORRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE' RECEI VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

I D# e&C- 11 1 S P- As 6 '7 ) CK# Ab o

$r + Y -" 1 4

I D# ?~ f Cw. Q S O F T I l k ' I r ~ t C I ~ ' ~ CtCK# Zo7 h ' G , - , m t . n

. 5 . 3 t t : ~7I s , , , - I i J 0 3 0 1 1

wcLLs ~~u o boo~ ~ , ~5 De s c K# 6A - 4 i e 14 zoZES

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


12/16

l - U t - f l NS ! HUGI I UNb ; St t t f AGK OF i - . - ? M SCHEDULEEXPENDI T URES - - MONEY SPENT FROM COMMI T T EE ACCOUNT B MONETARY( R e v . 0 9 / 9 7 ) EXPENDI TURES

S T A T E PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STAT EWI DE OR LEGI S LA T I V ECANDI DATES, L I S T T HE CANDI DATE I DENT I F I CA T I ON NUMBER I N THE DES I GNATED COLUMNAND T HE CHECK T HI S BOX I FPA C CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI L ABLE FROM T HE I OWA AMENDI NG FORMETHI CS & CAMPA I GN D I SCLOSURE BOARD .COMMI TTEENAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a ni z a t i o n)~-

CANDI DATE NAME AN ADDRESS T4 WHOM PURPOSE AMOUNTDATE I D NUMBER ( DE SCRI B E TRANSACT I ON ) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADE( MM/ DD/ YR) AND PACCHECKNUMBERI D # G ~ DdnAT o , J

1 t 3d CK # S - $ 0d 5 0 0I D# s Pq l k 1 - F p~ s1 CK #I N SP~~t P6 Sc K# i 0 3 lI NCK # 1p b Z 0 5 i f l JI N I OWA t A( c s CA+N~~ I h n n ~~ . n~ S

, ~f l b l ~l S I L e L a < , 5 - f -s ~ T bU~' R 10 C fcK#w3 DSM, J A L 50301 ` l 1 9 . ` ~c cTI N y I a ' 4 T " I U d S / 11


13/16

1 - U H I NS 1 HUGI 1UNS , SEE BAUK OF i _ I M SCHEDUL EEXPENDI TURES - - MONEY SPENT FROMCOMMI TTEE ACCOUNT B MONETARY( Re v . 0 9 / 9 7 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTR I BUT I ONS MADE TOSTATEWI DEOR L EGI S L AT I VECANDI DATES, L I S T THE CANDI DATE I DENT I F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND T HE CHECKTHI S BOX I FP AC CHECKNUMBER FOR EACH EXPENDI TURE . A UST OF I D NUMBERS I S AVA I L ABLE FROMT HE I OWA AMENDI NG FORMETHI CS & CAMPA I 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 Or g a n i d os

CANDI DATE NAME AN ADDRESS WHOM PURPOSE AMOUNTDATE I D NUMBER RE ( DESCR I BE TRANSACT I ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADE( MM/ DD/ YR ) AND PACCHECKNUMBERI D# 5 7 p a T - S1 / CK# l a d o ,

I D# ~vSE ~ r ' v r 2 1 An6h3)Q1 CK# DI D e l 3d0 re b b f

I D# 5PRi r I T l geS3 ( 1 1 i CK# . / y s l4 7 7712- go

I

I D#CK#

~p c P I ' t / , ( ' q ` 4nf wx11. ~ ^ r ~, 6

1"">~r J a r 7 ~ - f 7o n f G dS~ 3 D e s i M . o , s r.I D #

I z - 7 o 1I CK#I D# /~,An P5hv


14/16

FOR I NS TRUCT I ONS , SEE BACK OF FORM SCHEDULEEXPENDI TURES - - MONEY SPENT FROMCOMMI TTEE ACCOUNT B MONET ARY( R e v . 0 9 1 9 7 ) EXPENDI TURES

STATE PAC COMMI T T EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E G I S L A T I V ECANDI DATES, L I S T T HE CANDI DATE I D E N T I F I C A T I ON NUMBER I N T HE DESI GNATED COL UMN AND THE CHECK T HI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM T HE I OWA AMENDI NG FORME T HI C S i CAMPAI GN DI SCLOSURE BOARD .COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g an i z a t i o n)

CANDI DATE NAME AND ?DDRES~S J OWHOM PURPOSE AMOUNTDATE I D NUMBER EX P f URE ( 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( MM/ D D/ Y R) AND PACCHECKNUMBER

I D#~ - - -( DZS~o1 CK# ( 0 o v t SKv , wES, I A 5, 3 2 1 FL h

I D# Pt i v t T 1 j ~ , V AV k T AT I o . 1SI A CK# 1 - 7 - 0 E i !> S Ac 5o 5 , ' 7I D# 1 3 A ~ 1 ecK#

J PRj A- % PC . S i

so t

( 3 AI AKPST0e; ,

CK#CI D#

l. ~ ~ ~. ~ L z Ev , _ N- 14 , , J q 114* , v r { 1 ( , 1 ) ldv _ I - ) o r C&r2 ~e l l g 7 . sCK# p 3 ` J L ~ ~ t y S ~ . S l 6 ~ t S f a ~ ~ ~ ~ .k

I D# Sf ' , wT Po s


15/16

FOR I NSTRUCT I ONS , SEE BACKOF FORMCOMMI TTEE NAME( Mus t b e same s on S t a t e me n t o f O r g a n i z a t i o n )~ A l C ~ ' )~ t ZS - I ~ T e ~ e - p

NOTE T h i s s c h e d u l e r e p o r t s money l o a n e d t o t h e c o mmi t t e e wh i c h i s d e p o s i t e d i n t h e c o mmi t t e e a c c ou n t

TOTAL UNPAI D LOANS FROM L A ST REPORT I NGPERI OD $PART 1 - MONETARY LOANS RECEI VED T H I S , REPORTI NG PERI OD

( O r i g i n a l s o ur c e o f l o a n , s u c h a s a b a n k , must b e s hown i f a t h i r d p a r t y i si n v o l v e d I n c l u d e l o a n s f r o m c a n d i d a t e ' s p e r s o n a l f u n d s . )

TOTAL ( PARTQ

$

* 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 mmi 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 an y r e l a t i v ema k i n g a c o n t r i b u t i o n t o t h e c o mmi t t e e R e l a t i o n s h i p mus t b e shown t o t h e t h i r d d e g r e e o fc 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 nd a f f i n i t y ( r e l a t i v e s b y m a r r i a g e ) ( S ee Pa g e 2 o f f o r m sp a c k e t . ) 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 same a s c a n d i d a t e , b u t t h e r e i s n o f a mi l i a lr 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 whe n i t a p p l i e s

PART 1 1 - MONETARY LOAN REPAYMENTS MADE T HI S REPORT I NGPER I OD( l o a n s f o r g i v e n must b e r e p o r t e d o n Sc h ed u l e E - - I n - k i n d C o n t r i b u t i o n s , )

TOTAL CASH REPAYMENTS ( PART / 1 )F r o m S c he d ul e E - TOTAL LOANS FORGI VEN

$Oa~ D ? aTOTAL OUTSTANDI NG LOANS END OF REPORT PERI OD

$ ~-

p a g e 1 o f( f o r S ch e d u l e F )

SCHEDULEF LOANS( Re v 0 8 / 9 6 ) RECEI VED& REPAI D[ ] CHECK T HI S BOX I FAMENDI NG FORM

DATERECEI VEDMM/ DD/ YR)NAME AND ADDRESS OF LENDERE n d o r s e r ' s I f( I n c l u d e Name, A p p l i c a b l e ) RELAT I ONSH I PTO CANDI DATE

I f A I l c a b l e *AMOUNTOF LOAN DATE PA I D( MM/ DD/ YR) NAME AND ADDRESS OF LENDER( I n c l u d e E n d o r s e r ' s Name, I f A p p l i c a b l e ) RELAT I ONSH I PTO CANDI DATE*

I f A I i c a b i eAMOUNTREPAI D

a s ~ ~


16/16

FOR I NSTRUCTI ONS, SEE BACK OF FORM

T HI S FORM I S USEDBY CANDI DATES' COMMI TT EES ONLY

COMMI TTEE NAME ( Mu s t b e same 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 )A

PART 1 1 - I T EMI Z E DBREAKDOWN OF UNREI MBURSED EXPENSES P AI D BY CONSULT ANTTO OTHERS I N PERFORMI NG SERV I CES OF CONTRACT ( T h e s e e x p e n s e s s h ou l d NOT b e

PART I - NAME AND ADDRESS OF CONSULTANT

r e p o r t e d o n Sc h e d u l e B , a s t h ey a r e d i r e c t p a yme n t f r o m t h e c o n s u l t a n t . )

Name o f Co n s u l t a n t

Ma i l i n g Ad d r e s s

1JES f i t o 1 4 1 6 5

5& 3 c - ) i

C i t y

S t a t e

Z i p Co d e

TOTAL ANT I C I P AT E DCOMPENSATI ON FOR

CONTRACT PERI OD ( MMI DDNR)

PERFORMANCE

F r o mT o - T Aq ' " 01170

$

/ j 00

EST I MATES OF PERFORMANCE

r ~ A1 ) r 41 5 1) 1 4 t I C c - T ' n ~~ ~ d I 3 , 4 5 c , L a ~~~ ~ ' t r i t P d l f , " )

Pa g e o f S( f o r Sc h e d u l e G)

SCHEDULEG BREAKDOWNOF MONETARY( R e v . 0 2 / 9 6 ) EXPENDI TURESBY CONSULTANT

El CHECK T HI S BOX I FAMENDI NG FORM

DATEEXPENDEDMMI DDI YR NAME AND ADDRESS TOWHOM EXPENDI TUREDi s b u r s e me n WAS MADE AMOUNTPURPOSE EXPENDE

SUB- TOTAL $

TOTAL ( I f l a s t p a g e o f t h i s s c h e d u l e ) $

chiodo frank__1013__scanned

Documents

chiodo frank1013scanned