Vander Plaats Robert__5097__scanned__amendment

8/7/2019 Vander Plaats Robert__5097__scanned__amendment

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F OP , ' I NSTRUCTI ONS, SEE BACKOF FORM

DI SCLOSURE SUMMARY PAGECOMMI 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 n )

Van de r P l a a t s F o r Go v e r n o r

I 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 : I 1 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 Commi 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 oa 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 y PAC ( 9 ) C i t y PAC ( 1 Q . 4 S A o o l B o a r d o r O t h e r P o l i t i c a l

S 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 eCANDI DATE COMMI TTEES ONL

Ca n d i d a t e Name

R o b e r t L Van de r P l a a t s

O f f i c e So u g h t

G o v e r n o r

SI GNATURE OF PERSON F I L I NG REPORT

I AM F I L I NG ADec ember 3 1 , 2 0 0 4

( r e p o r t d a t e )

CHECK I F AMENDMENT TO REPORT DATED J a n u a r y 1 9 , 2 0 0 5

t i c a l P a r t y ( i f a p p l i c a b l e )

C h 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 No t i c e o f D i s s o l u t i o n Fo r m DR- 3 .

( Y ou 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 . )

R e s e t F o n n

C 7 1 z ) 2 , 5 2 - 6 0 2- 0TELEPHONE

L at e r e p o r t s a r e s u b j ec t t o

p os s i b l e c i v i l a n d c r i mi n a l

p en al t i es .

REPORT FOR ( 1 ) ELECTI ON / ( 2 ) NON- E L ECT I ON YEAR.

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

Co 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 n

w h i c h E l e c t i o n i s h e l d

STATEMENT OF CASH ON HAND

CASH ON HAND a t t h e beg 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 am o u n t MUST be t h e s am e a s t h e c a s h o n h a n d a t t h e en 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 mus t be 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 OD

Sc 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 Sc h ed u l e A) ( * a l s o s ee i n - k i n d b el 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 Ca mp a 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 pp l i es t o Ca n d i d a t e s ' Co mmi t t e e s On l y )

SUB- TOTAL . . . . . $ 3 5 0 , 4 2 5 . 7 9

SUBTRACT TOTAL MONEY SPENT T HI S PERI OD

Sc 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 a n d l o a n s b el o w) . . . .

Sc 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 Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0

* * UNPAI D BI L L S ( F r o m Sc h ed u l e D - A t t a c h Sc h ed u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

* I N KI 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 :

CONSULTANT BREAKDOWN ( Sc h ed u l e G At t a c h ed ? )

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)

FORM

DR- 2( Re v . 0 7 1 2 00 4 )

DI SCLOSURE

REPORT

F o r O f f i c e Us e On l y ~ o r

Comm.t

#

L o g g e d I n

Scanne d

Comp u t e r

A u d i t e d

4 7 4 . 7 6

3 4 9 , 9 5 1 . 0 3

0

0

oal . . ). 1 o ~DATE SI GNED

2 , 7 7 6 . 1 5

CASH ON HAND a t t h e en 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 ba l a n c e mus t 3 4 7 , 6 4 9 . 6 4b e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

5 , 8 9 2 . 1 9

0

4 8 , 0 0 0 . 0 0

$ 500 . 0 0

YES NO

8/7/2019 Vander Plaats Robert__5097__scanned__amendment

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T HI S BOX APPL I ES TO CANDI DATES' COMMI TTEES 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 mu 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 Sc 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 mu s t a l s o b e d e t a i l i t e m i z e d o nS c h e d u l e G b y t h e a m o 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 r t o

S c he d u l e G i n s t r u c t i o n s a nd I o wa Code 6 8 A . 4 0 2 ( 3 ) ( i ) . )

1Page _ _ _ _ _ _ _ _ _ _ o f _

3- - - - - - - -

( f o r S c h e d u l e B )

FOR I NSTRUCT I ONS , SEE BACK OF FORM R e s e t F o r mSCHEDULE

EXPENDI TURES B MONETARY- - MONEY SPENT FROM COMMI TTEE ACCOUNT

( Re v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI DATES, L I S T THE CANDI DATE I DENT I F I CAT I ON NUMBER I N THE DESI GNATED COLUMN ANDTHE J 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 THE I OWA AMENDI NGFORMETHI CS & 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 n )

V a n d e r P l a a t s Fo r Go v e r n o r

CANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNT

DATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED

EXPENDED ( 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/ DDI YR) AND PACCHECK

NUMBER

I D#F i r s t Na t i o n a l Ba n k Se r v i c e Ch a r g e

0 1 / 3 0 / 0 4 CK# 5 t h & Bu r n e t t $ 8 . 2 0Am e s , I o wa 5 0 0 1 0

I D#f i r s t Na t i o n a l Bank Se r v i c e Ch a r g e

0 2 / 2 7 / 0 4 CK# 5 t h &Bu r n e t t $ 8 , 2 2

me s , I o wa 5 0 0 1 0

I D#o wa E t h i c s a n d Ca mp a i g n C i v i l Pe n al t y A s s e s s m e n t -

0 3 / 2 4 / 0 4 1 4 Ea s t L oc u s t , S u i t e 1 0 4 I o wa E t h i c s a n d Ca mp a i g n Di s c l o s u r e $ 1 0 0 . 0 0CK#

e s Mo i n e s , I o wa 5 0 3 0 9 - 1 9 1 2 Bo a r d

I D#f i r s t Na t i o n a l Ba n k Se r v i c e Ch a r g e

0 3 / 3 1 / 0 4 CK# t h &Bu r n e t t $ 8 . 1 9

me s , I o wa 5 0 0 1 0

I D#F i r s t Na t i o n a l Bank Se r v i c e Ch a r g e

0 4 / 3 0 / 0 4 CK# 5 t h &Bu r n e t t $ 8 , 2 1Am e s , I o wa 5 0 0 1 0

I D# i b e r t y Spe a ki n g / Co n s ul t i n g Ma r k e t i n g - Sp e a k e r ' s f e e s a n d c o s t s

0 5 / 1 7 / 0 4 CK# 4 1 3 5 - 2 6 0 t h S t r e e t $ 3 9 6 . 8 4

o r a S p r i n g s , I o wa 5 0 4 5 8

I D#F i r s t Na t i o n a l Bank Se r v i c e Ch a r g e

0 5 / 2 8 / 0 4 5 t h &Bu r n e t t $ 8 . 4 0CK#

Am e s , I o wa 5 0 0 1 0

I D#r h e S e c u r i t y Na t i o n a l Ba n k C h e c k P r i n t i n g Co s t s

0 6 / 3 0 / 0 4 0 1 P i e r c e S t r e e t $ 4 3 . 0 7CK#

i o ux C i t y , I o wa 5 1 1 0 1

SUB- TOTAL $ 5 8 1 . 1 3 r

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

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T HI S BOX A PP L I E S TO CANDI DATES ' COMMI TTEES ONL Y :

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 m o 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 o nS 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 m a d e 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 r t o

S 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 Co d e 6 8 A . 4 0 2 ( 3 ) ( i ) . )

P a g e2_ _ _ _ _ _ _ _ _ _ o f _

3- - - - - - - -

( f o r S c h e d u l e B )

FOR I N STRUCT I ONS , SEE BACK OF FORM R e s e t Fo r m SCHEDULE

EXPENDI TURES B MONETARY- - MONEY SPENT FROMCOMMI TTEE ACCOUNT

( R e v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FORCONTRI BUTI ONS MADE TO STATEWI DEOR 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 NT I F I C A T I O N NUMBER I N THE DESI GNATED COL UMN AND THE R1 CHECK THI S BOX I FPAC CHECK NUMBER FOREACH EXPENDI TURE . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I OWA AMENDI NG FORME T H I C S & CAMPAI GN DI SCLOSURE BOARD .

COMMI TTEE NAME ( M u s t b e same a s o n S t a t e m e n t o f O r g a n i z a t i o n )

V a n d e r P l a a t s F o r Go v e r n o r

CANDI DATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED

EXPENDED ( 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/ DDNR) ANDPAC

CHECKNUMBER

I D#F i r s t N a t i o n a l B a n k S e r v i c e C h a r g e

0 6 / 3 0 / 0 4 CK# 5 t h &B u r n e t t $ 8 . 2 0

Ames, I o wa 5 00 10

~'

e p u b l i c a n P a r t y o f I o wa C a n d i d a t e s p o n s o r e d a t a b l e

0 7 / 2 2 / 0 4

CK #

2 1 E . 9 t h S t r e e t $ 5 0 0 . 0 0

De s Mo i n e s , I o wa 5 0 30 9

I D#i r s t N a t i o n a l B a n k S e r v i c e C h a r g e

0 7 / 3 0 / 0 4 5 t h&B u r n e t t $ 8 . 1 7CK#

m e s , I o wa 5 0 0 10

I D#a r l D r a a y e r C a n d i d a t e ' s T r a v e l - P i l o t s e r v i c e s t o

0 8 / 0 7 / 0 4CK#

5 1 2 Ok o b o j i B o u l e v a r d B u r l i n g t o n $ 2 5 0 . 0 0i l f o r d , I o wa 5 1 3 5 1

I D#F i r s t N a t i o n a l B a n k S e r v i c e C h a r g e

0 8 / 3 1 / 0 4CK #

5 t h & B u r n e t t $ 8 . 1 4Ames , I o wa 5 0 0 1 0

I D# h e S e c u r i t y N a t i o n a l B a n k D e p o s i t S l i p s P r i n t i n g C o s t s0 9 / 3 0 / 0 4

CK #0 1 P i e r c e S t r e e t $ 1 3 . 5 0

S i o u x C i t y , I o wa 5 1 1 0 1

I D#F i r s t N a t i o n a l B a n k S e r v i c e C h a r g e

0 9 / 3 0 / 0 4 5 t h &B u r n e t t $ 8 . 1 2CK #Ames , I o wa 5 00 10

I D#i r s t N a t i o n a l B a n k S e r v i c e Ch a r g e

1 0 / 2 9 / 0 4 CK# 5 t h &B u r n e t t $ 8 . 0 9m e s , I o wa 5 0 0 1 0

SUB - TOTAL $ 8 0 4 , 2 2

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

8/7/2019 Vander Plaats Robert__5097__scanned__amendment

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T HI S BOX A PP L I E S TO CANDI DATES ' COMMI TTEES ONLY :

P u r c h a s e s o f c e r t a i n c a m p a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r m o 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 o n

S c h e d u l e Gb 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 mm i t t e e . ( R e f e r t o

S c h e d u l e Gi 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 ) . )

3 3P a g e _ _ _ - - - - - - o f - - - - - _ _ _ _

( f o r S c h e d u l e B )

FOR I NSTRUCT I ONS , SEE BACK OF FORM R e s e t F or mSCHEDULE

EXPENDI TURES B MONETARY- - MONEY SPENT FROMCOMMI TTEE ACCOUNT

( R e v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E G I S L A T I V EC A N DI D A T E S , L I S T THE CANDI DATE I D E NT I F I C A T I O N NUMBER I N THE DESI GNATED COLUMN AND THE R1 CHECK THI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I OWA AMENDI NG FORME T H I C S 8 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 nt o f O r g a n i z a t i o n )

V a n d e r P l a a t s F o r Go v e r n o r

CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED

EXPENDED ( 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/ DDNR) AND PAC

CHECKNUMBER

I D #I o wa I n f o r m a t i o n , I n c . S t a t i o n a r y - B r o c h u r e s

1 2 / 1 5 / 0 4 CK# P . O . Bo x 1 6 0 , 2 2 7 Ni n t h S r e e t $ 1 , 2 4 9 . 4 8S h e l d o n , I o wa 5 1 2 0 1

I D #e s Mo i n e s St a mp Mf g . Co . Bank E n d o r s eme n t S t a mp f o r

1 2 / 2 8 / 0 4 CK# 5 1 6 t h A v e n u e , Bo x 1 7 9 8 T r e a s u r e r $ 3 0 . 5 6

e s Mo i n e s , I o wa 5 0 3 0 6 - 1 7 9 8

I D #. S T r e a s u r y C h e c k # 2 5 6 1 d a t e d 8 / 2 0 / 0 2 wa s i n

1 2 / 3 1 / 0 4 CK# a n s a s C i t y , Mi s s o u r i e r r o r a n d wa s n o t s e n t ( $ 2 1 . 7 6 )

I D #/ v i n N. T r e l o a r C h e c k # 2 2 2 7 d a t e d 8 / 1 6 / 0 1 d i d n o t

1 2 / 3 1 / 0 4 CK# 5 2 2 K n a p p S t r e e t c l e a r ( $ 4 . 0 7 )

me s , I o wa 5 00 1 4

I D #Th e S e c u r i t y N a t i o n a l Bank Ma i n t e n a n c e F e e

1 2 / 3 1 / 0 4 CK# 6 0 1 P i e r c e S t r e e t $ 1 6 . 5 9S i o u x C i t y , I o wa 5 1 1 0 1

I D # R e p u b l i c a n P a r t y o f I o wa L e g i s l a t i v e B r e a k f a s t

0 9 / 1 0 / 0 4 CK# 6 2 1 E a s t 9 t h S t r e e t $ 1 2 0 . 0 0De s Mo i n e s , I o wa 5 0 3 09

D#

CK#

D#

CK#

SUB- TOTAL $ 1 , 3 9 0 . 8 0

TOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e ) $ 2 , 7 7 6 , 1 5