Iowa Right to Life PAC6262scanned

8/7/2019 Iowa Right to Life PAC__6262__scanned

1/7

FOR I NSTRUCTI ONS, SEE BACK OF FORM 'DI SCLOSURE SUMMARY PAGECOMMI TTEE NAME ( Mu s t b e s ame as o n St a t eme n t o f O r g a n i z a t i o n

I MPORTANT : I n d i c a t e b y # t y p e o f c o m m i t t e e y o u a r e r e p o r t i n g f o r : L - J( 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 Co mmi t t e e ( 5 ) C o u n t y C a n d i 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 Ot 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 y PAC ( 9 ) C i 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 e

SI GNATURE OF PERSON F I L I

1 AM F I L I NG A ak i . l 9 aoa - 1 5( r e p o r t d a t e )

I F AMENDMENT TO REPORT DATED

Vese t ~ o r n a

F ~ Chec 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 an d a t t a c h No t i c e o f D i s s o l u t i o n F o r m DR- 3 .( Yo u mu s t c o n t i n ue t o f i l e r e p o r t s u n t i l a DR- 3 i s f i l e d . )

REPORT FOR ( 1 ) ELECTI ON / ( 2 ) NON- E LECT I ON YEAR .I n d i c a t e b y #

STATEMENTOFCASHONHANDCASH ON HAND a t t h e b e gi 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 nd s h e l d b y t h ec o mmi t t e e . T h i s amou n t MUST b e t h e s ame 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 mus t b e z er 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADD TOTAL MONEY TAKEN I N THI S PERI ODSc h e d u l e A : Cash C o n t r i b u t i o n s t o t a l ( A t t a c h Sc 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) . . . . . . . .Sc h e d u l e F L o a n s Re c e i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d u l e H : T o t a l Sa l e s o f Campa i g n Pr o p e r t y ( A t t a c h Sc h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h ed u l e H ap pl i e s t o Ca nd i d a t e s ' Commi t t e e s On l y )SUB- TOTAL . . . . . $

SUBTRACT TOTAL MONEY SPENT THI S PERI ODSc h e d u l e B : Ex p en d i t u r e s t o t a l ( A t t a c h Sc h e d u l e B ) ( * * a l s o s e e d e bt s an d l o an s b e l o w) . . .Sc h e d u l e F : L o a n Re p a yme n t s t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

* * UNPAI D BI L L S ( F r o m Sc h e d u l e D - A t t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* I N K I ND CONTRI BUTI ONS ( F r o m Sc he d u l e E - A t t a c h Sc h e d u l e E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* * OUTSTANDI NG LOANS ( F r o m Sc h e d u l e F - At t ac h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI TTEES ONLY :CONSUL TANT BREAKDOWN ( Sc h ed u l e GAt t a ch ed ? )VALUE OF CAMPAI GN PROPERTY ( F r o m Sc he d u l e H - At t ac h Sc h e d u l e H)

FORMDR- 2 DI SCLOSURE( Re v . 0 7 / 2 0 0 4) REPORTF o r O f f i c e Us e O IComm. #Lo g g e d I nScannedCompu t e rA u d i t e d

L at e r e po r t s a r e s u b j e c t t op o s s i b l e c i v i l a n d c r i mi n a lp en al t i e s .

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 Co u n t y i nw h i c h E l e c t i o n i s h e l d

S- 1 7 - 0 - 5 -DATE SI GNED

/ 3 6 6 . 3 0

YES

J

CASH ON HAND 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 ce mus tb e z e r o ) ( A t t a c h DR- 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . $

NO


2/7

F o r I n s t r u c t i o ns , Se e 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 TTEENAME ( Mu s t b e s ame a s o q St a t e me n t o f Or g an i z a t i o n )

a X21 ~~ CymSTATE CANDI DATES NOTE : I F ACONTRI BUTI ON I S RECEI VED FROM ASTATE PAC ( P OL I T I CA L ACTI ON COMMI TTEE) , L I S T THE PAC I DENTI F I CATI ONNUMBERANDTHEPACCHECKNUMBER 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 68B. 3 2 A ( 6 ) , I o wa C o d e , p r o h i b i t s t h e u s e o f i n f o r mat i o n c o pi e d f r o m r e p o r t s an 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 any c omme 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 .

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c he d u l e )

D i s c l o s u r e l aw r e q u i r e s c a n d i d a t e c ommi 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 e mak i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p mus t b e s h o w n t o t h e t h i r d d e g r e e o f c 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 ) an d a f f i n i t y ( r e l a t i v e s b ym a r r i a g e ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s ame as c a n d i d a t e , b u t t h e r e i s n o Page~-o ff a mi l i a l r 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 . ( f o r Sc h e d u l e A)

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

CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT q 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 NCOMEI D# 7 7 7 7

6 J N~I ~ 9 ~ a y c K# I 0 / v L al ~9 l ~y I D #CK# / 66'

I D# y C ~G o x ~ aG~ '41 eC - ~ hI D# Z o r a - 3 Sc4 / Zl e -! l 0 CK#~~ 3 0 ~4 T s a ~~l 6 I D# . ~j , 1 - s Ty ~ Gy -/ / 7 l a ( CK# 3 ~ . - 3 ` f 6~ L ( r a " ~ e Z - ~ 6 d r -~o a~

I D# ~ - e f eG p

CK# _ 2Ss - /1 6 1 ,

I D#CK# 1~5 7, ) t e a I d - 1 - R n - -2I D# f PI ~ G, C v S 1 i

0 CK# ~d q i s s- ~`v - 0


3/7

F o 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 b e s ame 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 )

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 A CT I ON C OMMI T T E E) , L I S T THE PAC I D E N T I F I C A T I ONNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A V AI L A B L E FROM THE I OWA E T H I C S AND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON : S e 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 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 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 an y c omme r c i a l p u r p o s e b y a ny 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 ommi t t e e s .

SUB- TOTALTOTAL ( i f l a s t pag e o f t h i s s c h e d u l e )

* 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 a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p m u s t b e s h o wn t o t h e t h i r d d e g r e e o f c 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 n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) . 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 s ame a s c a n d i d a t e , b u t t h e r e i s n o Page o ff a m i l i a l r 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 . ( f o r S c he d u l e A )

SCHEDULEA MONETARY( R e v 0 7 1 0 3 ) RECEI PTSCHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR . RELATI ONSHI P AMOUNT 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 SERNUMBER I NCOMEl a ~ / ~ a y i D#CK# a ~ z

7,-7 ,V o l 3 q I ~ Y ~ ' v .S7 -I D#CK# ~' n c L , ~ , lI D#CK# d _

, ~ I D#CK#I D#CK# ElCK# aI D#CK#I D#CK#I D#CK#I D#CK#


4/7

FOR I NSTRUCTI ONS, SEEBACK OF FORMCOMMI TTEE NAME ( Mu s t b e s ame a s o n St a t eme n t o f Or g an i z a t i o n )

NOTE : De b t s p r e v i o u s l y r e p o r t e d t h a t r e ma i n u n pa i d mus t b e i n c l u de d o n t h i sSc h e d u l e , as w e l l a s a n y n ew o b l i g a t i o n s i n c u r r e d i n t h i s p e r i o d .

DEBTS/ OBL I GATI ONS REMAI NI NG THI S REPORTI NG PERI OD( DO NOT I NCLUDE L OANS - - SHOWL OANS ON SCHEDULE F )

' I f a c t u a l f i g u r e i s u n k n ow n , s h o w " e s t i ma t e d " b es i d e t h e f i g u r e .

SCHEDULED I NCURRED( Re v . 0 8 / 9 8 ) I NDEBTEDNESS

CHECK THI S BOXI F AMENDI NGFORMAn " i n c u r r e d d e bt " i s a d eb t f o rg o o d s o r s e r v i c e s o r d e r e d o rr e c e i v e d , b ut n o t p a i d f o r b y t h ee n d o f t h e r e p o r t i n g p e r i o d . ,r e g a r d l e s s o f wh e t h e r an i n v o i c eh as b e e n r e c e i v e d .

Page __I o f( f r Sc h e d u l e D)CANDI DATE COMMI TTEES NOTE :' I n c u r r e d i n d eb t e d ne s s a l s o i n c l u d e s e a c h p e r s o n / e n t i t y w i t h wh om t h e c a n d i d a t e ' s c o mmi t t e e ha s e n t e r e d i n t o a c o n t r a c t d u r i n g t h e r e p o r t i n g p e r i o d f o r f u t u r eo r c o n t i n u i n g p e r f o r ma n ce . E nt e r t h e name o f t h e c o n s u l t a n t who p r o v i d e s o r p r o c u r e s s e r v i c e s f o r i t e m s s u c h a s 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 , manag i n g , o ro r g a n i z i n g s e r v i c e s . R e po r t o n Sc h e d u l e G t h e n a t u r e o f p e r f o r ma nc e an d t h e e s t i m a t e d p e r f o r ma nc e r e a s o n a b l y e x p e c t e d o f t h e c o n s u l t a n t .

DATEI NCURRED( MM/ DD/ YR)

NAME ANDADDRESS OF PERSONTOWHOMDEBTOROBLI GATI ON I SOWEDDESCRI PTI ONOF GOODS ORSERVI CES PROVI DED OR

PURCHASEDBALANCEOWEDATCLOSE OFREPORTI NG

PERI OD'

a- p 0 Ur~ I ' s , ~~0 1 r

~ , p l ,

SUB- TOTAL $

TOTAL DEBTS OWED BYCOMMI TTEE AT THE ENDOF THI S REPORTI NG PERI OD $ l , / / X/ 7


5/7

FOR I NSTRUCTI ONS, SEE BACK OF FORMDI SCLOSURESUMMARYPAGE

COMMI TTEE NAME ( Mu s t b e s ame as o n St a t eme n t o f O r g a n i z a t i o n ), , 4- f. l 'I MPORTANT : I n d i c a t e b # 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( 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 Co mmi t t e e ( 5 ) C o u n t y C a n d i 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 ( S ) C o u n t y PAC ( 9 ) C i t y PAC ( 1 0 ) S c h o o l B o a r d o r Ot 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 B a l l o t I s s u e

CANDI DATE COMMI TTEES ONLY :Ca nd i d a t e Name

I AM F I L I NG A

n CHECK I F AMENDMENT TO REPORT DATED

u * & < 1P o l i t i c a l P a r t y ( i f a p p l i c a b l e )

D i s t r i c t ( i f Se n a t e o r H o u s e )

SI GNATURE O E ON F I L I Nd ' RE PORT TEL EPHONE

0 Chec 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 an 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( Yo u mu s t c o nt i n u e t o f i l e r e p o r t s u n t i l a DR- 3 i s f i l e d . )

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 e

c o mmi t t e e . T h i s amou n t MUST b e t h e s ame as t h e c a s h o n han 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 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ADD TOTAL MONEY TAKEN I N THI S PERI ODSc h e d u l e A : Cas 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 Sc 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) . . . . . . . . .Sc h e d u l e F : L o a n s Re c e i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d u l e H : T o t a l Sa l e s o f Campa i g n P r o p e r t y ( A t t a c h Sc h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h ed u l e H a p p l i e s t o Ca n di d a t e s ' Commi t t e e s On l y )SUB- TOTAL . . . . . $

SUBTRACT TOTAL MONEY SPENT THI S PERI ODSc h e d u l e B : Ex p en d i t u r e s t o t a l ( A t t a c h Sc h e d u l e B ) ( * * a l s o s e e d e b t s an d l o an s b e l o w) . . . .Sc h e d u l e F : L o a n Repa yme n t s t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON HAND 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 mus tb e z e r o ) ( A t t a c h DR- 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

" " ' UNPAI D BI L L S ( F r o m Sc he d u l e D - A t t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* I N K I ND CONTRI BUTI ONS ( F r o m Sc h e d u l e E - A t t a c h Sc h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* * OUTSTANDI NG LOANS ( F r o m Sc h e d u l e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI TTEES ONLY :CONSUL TANT BREAKDOWN ( Sc h ed u l e G A t t a c h e d? )VALUE OF CAMPAI GN PROPERTY ( F r o m Sc h e d u l e H - A t t a c h Sc h e d u l e H ) $

FORMDR-2 DI SCLOSURE

( Re v . 0 7 / 2 0 0 4) REPORTF o r O f f i c e Us e On l yComm. #-~R b2L o g g e d I nScannedCompu t e rA u d i t e d

L at e r e p o r t s a r e s u b j e c t t op o s s i b l e c i v i l a n d c r i mi n a lp en al t i e s .

1-15- -6s-DATE SI GNED

Chn h. - REPORT FOR ( 1 ) ELECTI ON / ( 2 ) NON- E LECT I ON YEAR .( r e p o r t d o t I n d i c a t e b y #

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 Co u n t y i nw h i c h E l e c t i o n i s h e l d

7 1 , ? 1 k

/ _ y l 7~ 1 7 , IYES E: 1 NO


6/7

Fo r I n s t r u c t i o n s , Se e B a 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 e me n t o f O r g a n i z a t i o n )

R e s e t . - F o r m -

STATECANDI DATES NOTE: I F ACONTRI 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 DENTI F I CATI ONNUMBER AND THE PACCHECKNUMBER 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 : 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 o pi e d f r o m r e p o r t s an 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 ny 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 .

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e )

D i s c l o s u r e l a w r e q u i r e s c a n di d a t e c ommi 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 ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p mus t b e s h o w n t o t h e t h i r d d e g r e e o f c 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 n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) I f s u r n a me o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o P a g e o ff a mi l i a l r 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 umn . ( f o r Sc h e d ul e A)

SCHEDUL EA MONETARY

( Re v . 0 7 / 0 3 ) RECEI PTSCHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE" RECEI VED FUND-( MM/ DDNR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D # , ( 3 r > h

I D#/ D / O CK# % ~ S i t s s X 0I D # v Y I e - , - - l lCK# c o E: 1_D" e - : LD# -

CK# 1/ d - ~ - ! by d 1 ~ 1 f ~ - 9 ; / = s S ~

! ! e t ~ 3bs-I D#

D/ P/ Ox I D#CK# ~ , j 7 f l y 3 P ; x - 1 ' 1 t _ " - 1 - - ~- w ~ t wI n / ~ j ~ ~y

I D # 1~l t f i t , ~ -tcK#

7 , 5 7 xA s o 3 ) LI D#


7/7

FOR I NSTRUCTI ONS, SEEBACK OF FORMCOMMI TTEE NAME ( Mu s t b e s ame as o n St a t eme n t o f Or g an i z a t i o n )7a} 1. 1 1 1 2- ` ~ ` g h 7 ) ~_ / ~ 6 ; 4 wr " A4 ! f f e e _NOTE : De b t s p r e v i o u s l y r e p o r t e d t h a t r e ma i n u n pa i d mu s t b e i n c l u d e d o n t h i s

Sc h e d u l e , a s w e l l as an y new o b l i g a t i o n s i n c u r r e d i n t h i s p e r i o d . R e s e t : F o

SCHEDULED I NCURRED

( Re v . 0 8 1 9 8 ) I NDEBTEDNESSO CHECK THI S BOXI F AMENDI NGFORMAn " i n c u r r e d d e bt " i s a d e b t f o rDEBTS/ OBLI GATI ONS REMAI NI NG THI S REPORTI NG PERI OD g o o d s o r s e r v i c e s o r d e r e d o r( DO NOT I NCLUDE LOANS - - SHOWLOANSON SCHEDULE F ) r e c e i v e d , b u t n o t p a i d f o r b y t h ee n d o f t h e r e p o r t i n g p e r i o d . ,r e g a r d l e s s o f wh e t h e r a n i n v o i c eh as b e e n r e c e i v e d .

` I f a c t u a l f i g u r e i s u n k n o w n , s h o w " e s t i ma t e d " b es i d e t h e f i g u r e . Page .~,~~of~( f b r Sc h e d u l e D)

CANDI DATECOMMI TTEES NOTE :' I n c u r r e d i n d eb t e d n es s a l s o i n c l u d e s e a c h p e r s o n / e n t i t y w i t h w h o m t h e c a n d i d a t e ' s c o mmi t t e e h as e n t e r e d i n t o a c o n t r a c t d u r i n g t h e r e p o r t i n g p e r i o d f o r f u t u r eo r c o n t i n u i n g p e r f o r ma nc e . E nt e r t h e name o f t h e c o n s u l t a n t wh o p r o v i d e s o r p r o c u r e s s e r v i c e s f o r i t e m s s u c h a s 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 ag i n g , o ro r g a n i z i n g s e r v i c e s . R e p o r t o n Sc h e d u l e G t h e n a t u r e o f p e r f o r ma n c e an d t h e e s t i m a t e d p e r f o r ma nc e r e a s o n a b l y e x p e c t e d o f t h e c o n s u l t a n t .

DATEI NCURRED( MM/ D D/ YR) NAME ANDADDRESSOF PERSONTOWHOMDEBT OR OBLI GATI ON I S OWED

DESCRI PTI ONOF GOODSORSERVI CES PROVI DED ORPURCHASED

BALANCE OWED ATCLOSE OFREPORTI NGPERI OD'

L,~ S_ I l

L> f > l l i s ~ DrS ~~~-25 f ~. Z-~~~~3I 1

SUB- TOTAL $

TOTAL DEBTSOWED BY COMMI TTEEAT THEENDOF THI S REPORTI NG PERI OD $l , ~ l l ~ a 7

Iowa Right to Life PAC__6262__scanned

Documents

Iowa Right to Life PAC6262scanned