iana (iowa association of nurse anesthetists pac_6478_dr1_11-03-2009

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  • 8/7/2019 IANA (Iowa Association of Nurse Anesthetists PAC_6478_DR1_11-03-2009

    1/1

    Generated On: 11/3/2009 7:15:02 PM

    IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 1 of 1

    DR-1 Statement of Organization

    712-792-5841Phone:

    Last Name: Knorr, CRNA First Name: John MI: L

    1156 Forest StreetAddress:

    City: Carroll State: IA 51401Zip Code:

    E-Mail: [email protected]

    Committee Chairperson

    515-401-7791Phone:

    Last Name: Wolterman, CRNA First Name: Lisa MI:

    2826 SW Polk City CourtAddress:

    City: Ankeny State: IA 50023Zip Code:

    E-Mail: [email protected]

    Treasurer

    District: 0

    County: NA

    Committee Name: IANA (Iowa Association of Nurse Anesthetists PAC

    Iowa PACCommittee Type:

    Status: Amended Date: 11/3/2009

    Political Party: Not Available

    Committee Code: 6478

    Purpose

    Lobby activities regarding issues of concern to Certified Registered Nurse Anesthetists in Iowa

    DR-1IndexedAudited

    Computer

    Statement of Affirmation By Treasurer and Candidate; or Political Committees, By Chairperson

    STATEMENT OF AFFIRMATION: By filing this document the committee affirms the following1. The committee and all persons connected with the committee understand that they are subject to the laws in Iowa Code chapters 68A and 68Band the administrative rules in Chapter 351 of the Iowa Administrative Code.2. That Iowa Code section 68A.6 and rule 351-4.9 require the filing of disclosure reports and that failure to file these reports on or before therequired due dates subjects the candidate or chairperson (in the case of committees other than a candidate's committee) to the automaticassessment of a civil penalty and the possible imposition of other criminal and civil sanctions.3. That Iowa Code section 68A.14 and rules 351-4.38 through 4.43 require the placement of the words "paid for by" and the name of thecommittee on all political materials except for those items exempted by statute or rule.4. That Iowa Code section 68A.15 and rules 351-4.44 through 4.52 prohibit the receipt of corporate contributions by all committees except forstatewide and local ballot issue PACs.

    5. A candidate and a candidate's committee may only expend campaign funds as permitted by Iowa code sections 68A.40 through 68A.42 andrule 351-4.25.6. That the committee will continue to file disclosure reports until all activity has ceased, committee funds spent, debts resolved, and a final reportand a statement of dissolution (DR-3) has been filed.

    Candidate: Treasurer:(signature and date) (signature and date)

    Year Standing for Election: 2008

    Date of Election:

    Office Sought: