FORI NSTRUCTI ONS, SE E BACK, I RM DI SCLOSUR E SU M RY PAGE CO MMI TT EE NAM E ( Mus t be s ame as o n St at ement o f Organization) I RONW ORKERS L OCAL 8 9 POLI TACAL EDUCATI ON FUND IM PO RTANT: Ind icate type o f committee y o u arereporting f o r : ( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate ( 5 )County PAC ( 6 )Ballot Issue/Franchise C o mmi t t e e ( 7 )County/City Central C o mmi t t e e ( 8 )Support Slate o f Candidates CA N DI DATE CO MMI TT EE S ONLY: Candidate Name Political Party Of f i c e Sought SI GNATURE TREASURER ( o r person filing this report) SE E I NSTRUCTI ONS ON BACK AND COM PL ETE T HE FO L L OW I NGSENTENCE : I AMFILING A t o Indicate oneF21 Wi ct ( i f Senate o r House) , I R/ . 3 9 . R0 5 _ ? TELEPHONE Late filed reports a r e subj ect t o p os s i bl e civil an d criminal penalties . ocTO dE 1 " 1 9 , 2 . 003 REPORT FORAN/ A ( 1 ) ELECTI ON / ( 2) NON- ELECTI ON YEAR (report date) Check i f this i s final (termination) report a n d attach Notice o f Dissolution F o r m DR- 3 . (You must continue t o file reports until a Notice o f Dissolution i s filed . ) ST ATE MENT OF CASH ON HAND " " UNPAI D BI LLS (From Schedule D - Attach Schedule D ) ...... . . . . .... . . .... . . . . ............. . ..... . . . . .................. $ _ - - ' I N K I ND CO NTRI BUTI ON S (From Schedule E - Attach Schedule E ) . . . . . . ............. . ..... . . . . ....... . .......... $ _ . - " " OUTSTANDI NG LOANS (From Schedule F -Attach Schedule F ) . . . . . . . ............. . .... . . . . . .......... . . . . . . .... . $ C A ND I D A T E COMMI TTEES ONLY: CONSULTANT BREAKDOW N (Schedule G Attached?) VALUE OF CAMPAI GN PROPERTY (From Schedule H - Attach Schedule H ) $ FOR M DR- 2 DI SCLOSUR E (Rev . 0712003) REPORT F o r Office U s e On l y Co mm. # Logged I n Scanned Computer Audited CASH ON HAND a t th e beginning o f t h e reporting period . (This i s t h e total o f a l l mo n i e s held b y t h e committee . This amou nt MUST b e t h e s a me as t h e cash o n hand a t t h e e n d o f t h e last reporting period, o r must b e zero i f this i s first report filed . ) ............ . . . . ............. . . . . $ 3 ADD TOTAL M ONEYTAKEN I N T HI S P E RI OD - - Schedule A : Cash Contributions total (Attach Schedule A) ('also s e e in-kind below) . . . ..... . IZIq? '_3_3 Schedule F : Loans Received total (Attach Schedule F ) . . . . . . . ........ . . . . ....... . . . . . . . ..... . ....... . . . . ..... Schedule H: Total Sales o f Campai gn Property (Attach Schedule H ) ................ . . . ..... . . . . .... . ( Sc h e du l e H applies t o Candidates' Commi t t ees Only) SUB- TOTAL . . . . . $ SUBTRACT TOTAL M ONEY SPENT THI S P E RI OD _ , Schedule B: Expenditures total (Attach Schedule B ) ('"also s e e debts a n d loans below) . . . . Schedule F : Loan Repayment s total (Attach Schedule F ) ............ . .......... . . . . . . . .... . ........ . . . . . . . . . Local Committees, enter Date o f Election County & Local Committees, enter County i n which Election i s held YE S F ] NO CASH ON HAND a t t h e e n d o f this reporting period ( i f final report, balancemust 9 7 5 r~ o l b e zero) (Attach DR- 3) ..... . ....... . . . . . . . . . . . . ..... . . . ..... . . . . . . . .... . . . . . . . . . . . . . . .... . . .... . . . . . .... . . . . . . . . . . . . . . . . . . . . . . $ '
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FOR I NSTRUCTI ONS, SEE BACK, I RM
DI SCL OSURE S UMMARY PAGE
COMMI TT EE NAME ( Mu s t b e s ame a s o n St a t emen t o f O r g a n i z a t i o n )
I RONWORKE RS L OCAL 8 9 POL I TACAL EDUCATI ON FUND
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 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 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 o u 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 o r t S l a t e o f C a n d i d a t e s
CANDI DATE COMMI TTEES ONLY :
C a n d i d a t e Name P o l i t i c a l P a r t y
Of f i c e S o u g h t
SI GNATURE TREASURER ( o r p e r s o n f i l i n g t h i s r e p o r t )
SE E I NSTRUCTI ONS ON BACK AND COMPL E T E T HE F OL L OWI N G SENTENCE :
I AM F I L I N G A
t o
I n d i c a t e o n e F 2 1
Wi c t ( i f S e n a t e o r H o u s e )
, I R/ . 3 9 . R0 5 _ ?TELEPHONE
L a t e f i l e d r e p o r t s a r e s u bj ec t t o p os 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 .
ocTOd E 1 " 1 9 . , 2 . 0 0 3 REPORT FOR AN/ A ( 1 ) ELECTI ON / ( 2 ) NON- ELECT I ON YEAR( r e p o r t d a t e )
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 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 m u 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 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 . )
ST ATE MENT OF CAS H ON HAND
" " UNPA 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 CONTRI BUTI 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ _ . -
" " OUTSTANDI 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
CANDI DATE COMMI TTE ES ONLY :
CONSULTANT BRE AK DOWN ( S c h e d u l e G A t t a c h e d ? )
VALUE OF CAMPAI GN PROPERTY ( F r o m S c h e d u l e H - A t t a c h S c h e d u l e H ) $
FORM
DR- 2 DI SCLOSURE
( R e v . 0 7 1 2 0 0 3 ) REPORT
F o r O f f i c e U s e On l y
Comm . # ~~L o g g e d I n
S c a n n e d
C o m p u t e r
A u d i t e d
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 t o t a l o f a l l mo n i e s h e l db y t h e c o m m i t t e e . T h i s amou nt 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 d
o 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3ADD TOTAL MONE YTAKEN I N T HI S PERI OD
- - S c 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 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 ) . . . . . . . . . I Z I q ? ' _ 3 _ 3
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 e du l e H a p p l i e s t o C a n d i d a t e s ' Commi t t e e s O n l y )
SUB- TOTAL . . . . . $
SUBTRACT TOTAL MONE Y SPENT THI S PERI OD
_ , S 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 ee 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 : Loan Repay men t s t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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 y i nw h i c h E l e c t i o n i s h e l d
YES F] NO
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 m u s t
9 7b e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ '
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