McCarthy Kevin1385scanned

8/7/2019 McCarthy Kevin__1385__scanned

1/7

Pr i n t e d u s i n g t h e I ECDB Web Re po r t i n g Sy s t em o n 0 4 / 2 7 / 2 00 5 0 8 : 2 1 : 1 9

FORM DR- 2 : Di s c l o s u r e Summar y P a g eS t a t u s : Amended

I D # : 1 3 8 5Co mmi t t e e : Mc Ca r t h y f o r S t a t e Re p r e s en t a t i v e

Ch a i r :Co u n t y : NA

Amended : 4 / 2 6 / 2 0 0 5

S t a t e me n t o f Ca s h o n Hand

Ad d i t i o n al As s e t s a n d L i a b i l i t i e s

FORM DR- 2 : Mc C ar t h y f o r S t a t e Re pr e s en t at i v e

Comm T y p e : St a t e Hous eDa t e Due : 1 0 / 2 9 / 2 0 04Re p o r t Yea r ., 2 0 0 4

Tr e as u r e r : Br i an J Me y e rP r i ma r y Ph . ( 5 1 5) 2 5 5 - 3 9 94 S e c o n d a r y Ph . ( ) -

DR- 2

P r i n t e d u s i n g t h e I ECDB Web Re po r t i n g Sy s t e m o n 0 4 / 2 7 / 2 00 5 0 8 : 2 1 : 1 9 P a g e 1 o f 1I OWA ETHI CS AND CAMPAI GN DI SCLOSURE BOARD 1 5 1 0 EAST 1 2 t h , S UI T E 1 A I DES MOI NES , I A 5 0 3 1 9 1 ( 5 1 5 ) 2 8 1 - 4 0 2 8

S t a t u t o r y Due Da t e 1 0 / 2 9 / 2 0 04Ad j u s t e d Due Da t e / /

Re c e i v e d Da t e 1 0 / 2 9 / 2 0 0 4P o s t ma r k Da t e / /

Amended 0 4 / 2 6 / 2 00 5

Cas h o n H a n d a t S t a r t o f P e r i o d $ 14 , 7 0 2 . 1 2Sc 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 $ 11 , 5 9 0 . 0 0Sc h e d u l e F : L o a n s Re c e i v e d T o t a l $ 0 . 0 0Sc h e d u l e H : Campa i g n P r o p e r t y Sa l e s $ 0 . 0 0SUB- TOTAL I $ 2 6 , 2 9 2 . 1Sc h e d u l e B : Ex p e n d i t u r e T o t a l $ 18 , 8 2 1 . 8 1Sc h e d u l e F : Cas h L o a n Re p a y me n t s( Cas h o n H a n d A t E n d o f P e r i o d 7 , 4 7 0 . 3 1

L o a n s i n Pl ac e a t S t a r t o f P e r i o d $ 0 . 0 0Sc h e d u l e D Un P ai d B i l l s $ 4 , 4 8 4 . 8 6Sc h e d u l e E : I n - K i n d Co n t r i b u t i o n s $ 0 . 0 0Sc h e d u l e F : Fo r g i v e n L o a n sSc h e d u l e F : Ou t s t an d i n g L o a n s $ 0 . 0 0Sc h e d u l e G: Co n s ul t an t B r e a k d o wn ? NoSc h e d u l e H : Campa i g n P r o p e r t y Va l u e T $ 1, 3 0 0 . 0 0


2/7

FORI NSTRUCTI ONS, SEEBACK OF FORM

THI S FORMI S USED BYCANDI DATES' COMMI TTEES ONLYCOMMI TTEE NAME ( M u s t b e same 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 )

PART I - ONGOI NG I NVENTORYOF CAMPAI GN PROPERTY PART 1 1 - SALES OR TRANSFERSOF CAMPAI GN PROPERTY * *

R e s e t F or m

( ) j 2 9 , 20oySCHEDULEH I CAMPAI GN( R e v 0 7 / 0 3 ) PROPERTYATTACH SCHEDULE H TOEACH REPORT, MAKI NGCHANGES AS REQUI REDCHECK THI S BOX I FAMENDI NG FORM

OTAL VALUE CAMPAI GNPROPERTY THI S REPORT ` ~ * * PROPERTY SALES & TRANSFERS TOTAL TOTALS $ $TRANSFER TO SUMMARY PAGE) $ ( TRANSFER TOSUMMARY PAGE) $I f e s t i ma t e d , s h o w e s t b e s i d e f i g u r e t ( A t t a c h A d d i t i o n a l S c h e d u l e s i f N e e d e d ) Page o f / P a g e s( F o r S c h e d u l e H )

D a t e P u r c h a s e d( S c h e d u l e B ) P u r c h a s e C u r r e n to r Da t e R ec e i v e d( S c h e d u l e E )( MM/ DDNR)

De s c r i p t i o n o f P r o p e r t y P r i c e o r E s tV a l u e Whe nA c q u i r e d *

Va l u e a t F a i rMa r k e t T h i sR e p o r t

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Da t e( MM/ DD/ YR) Name a n d A dd r e s s o f P u r c h a s e r / D o n e e D e s c r i p t i o n o f P r o p e r t y S o l d ?Y/ N S a l eP r i c e V a l u e o fD o n a t i o n

APR 2 6 2 0 0

- - - - - - - - - - - - - - -


3/7

FOR I NSTRUCTI ONS, SEE BACK OF FORMDI SCLOSURE SUMMARY PAGE

COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t eme n t o f O r g a n i z a t i o n )

cC a p - ' Nv f a * LI 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 :( 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 ( 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

Of f i c e So u g h t i s t r i c t ( i f Se nS h Tr 4 4

SI GNATURE Of F PERSON F I L I NG REPORT

DWADSUPSOGMP o l i t i c a l P a r t y1 1 1 , 1 ?- ~ ~ z oCANDI DATE COMMI TTEES ONLY :Ca nd i d a t e Name~ L~ Vi N

I AM F I L I NG A ! ( / ' Z4 - Gv( r e p o r t d a t e )

FI CHECK I F AMENDMENT TO REPORT DATED

ASI ~ I v T h7 f v i ,

i f a p p l i c a b l e )AAA".

t o o r H o u s e )7

r _ 1 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 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 o r m DR- 3 .( Yo u mu 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 DR- 3 i s f i l e d . )

? 4 - . 7 4 3 . l -TEL EPHONE

REPORT FOR ( 1 ) ELECTI ON / ( 2 ) NON- EL E CT I ON YEAR .I n d i c a t e b y # 5 1

STATEMENT OF CASH ON HAND

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

SUBTRACT TOTAL MONEY SPENT T HI S PERI ODSc h e d u l e B : Ex p e n 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 a n s b e l 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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 al a nc e mus tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216 . . . . . . . . . . . . . . . ~ . . ~ . \ a y 2 - . F ! ~ . . . . . . . . . . . . . . . . . . . . . . . $* * UNPAI D BI L L S ( F r o m Sc h ed u l e D - At t ac h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* I N KI ND CONTRI BUTI ONS ( F r o m Sc h ed u l e E - A t t a c h Sc h e d u l e E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* * OUTSTAND I NG LOANS ( F r o m Sc h e d u l e F - At t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI TTEES ONLY :CONSULTANT BREAKDOWN ( Sc h e d ul 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)

FORMDR- 2 ~ DI SCL OSURE( Re v 0 7 / 2 0 0 4) REPORTF o r O f f i c e Us e On l yComm. #L o g g e dS c anne dCompu t e rA u d i t e d

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

1 0 - 2 Y_ o 4DATE SI GNED

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 n

C 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

29 ` l Yj 011 8 , $ 2 1 . ~ ~

YES NO

CASH 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 n ds h e l d b y t h ec o mmi t t e e . T hi s amo u 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 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ irADD TOTAL MONEY TAKEN I N T HI S PERI OD 0Sc 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 Camp 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


4/7

Fo r I n s t r u c t i o n s , 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 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 )Ac L0. r+h ~~ 4 - a _%t e

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

SCHEDULEA I MONETARY( R e v . 0 7 / 0 3 ) RECEI PTSCHECK T HI S BOX I FAMENDI NGFORM

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROMA STATE PAC ( P O L I T I C A L ACTI ON C OMMI T T E E ) , L I S T THE PAC I D EN T I F I C A T I ONNUMBE R AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I OWA E T H I C S AND CAMPAI GNDI SCLOSURE BOARD .CAUT I 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 m e 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 .

* 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 mm i 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 m a k i n g a c o n t r i b u t i o n t o t h ec o mm i 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 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 Page _ _ o f _ _f 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 m n . ( f o r S c h e d u l e A )

DATE PAC I D NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE" RECEI VED FUND-( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI S ENUMBER I NCOMI D# 1 3ggV0 =n~~ - &~ Z > r l j r \ L PACo - _ b y CK# a ~ a y 9D I 6r1 ~ ~w d S 3100 $a s o _bD1 - - e - - t . ) V" 9 0 & 6 )9I D# ~ p ` 4 q Mr \ WOYKL I S L Cc ~~7

f o - a a . - ~ CK# 5 ( P - 7 i s o 1 E~r~ a - I D#CK# 137D NWi t 4 t 6 Sf e - go o9 L a- 7 Gt So3~51 D#

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J D- - a 8 - - b L { cK# a ~ I w10- 7 t oSOD- _a: A sa( 53

I D# K- 0 t p Qr ~ - SWn. w" ,~t b cK# 181O Awd" OuDA- enhs aA4 ~ - i 1 1 a: t k 56 3 ; Y7I D# tv~d po~k v" . . r - -

a f _ ' Dt f CK# - 7 9 a - 1 3 5w F \ ZS V\ Y " t x w- e - =SRSvaaII D# LA) wt nVV- e -

I p - 3a- 04 CK# got 6, r * ~" Or - SL I _ S a o " 015a - 'SNko I KS _TA 530 7 . - $O I )I D# ~O~ } - ~P. v ~ SD Y1dAc k ' +SW r n10- 3 0 - - p t ~ CK# 1 ~l )- A sooalI D# P - 0 1 - j o , v -

i o- ao r t i L j CK # 3051 Pwt k s r \ A _ 0 I i w - ' ] : A ~0 3 a 3


5/7


6/7

THI S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY :P ur 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 mus t a l s o b e i n v e n t o r i e d o n Sc h e d ul 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 nd 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 mus t a l s o b e d e t a i l i t e m i z e d o nSc h e d u l e G b y t h e amo 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 pe nd 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 oSc h e d u l e G i n s t r u c t i o n s a n d I o wa Code 6 8A . 4 0 2 ( 3 ) ( i ) . )

P a g e o f _ _ _t- - - -( f o r Sc h e d u l e B)

FOR I NSTRUCTI ONS, SEE BACK OF FORM SCHEDULEEXPENDI TURES B MONETARY- - MONEY SPENT FROMCOMMI TTEE ACCOUNT ( Re v . 0 7 / 0 3 ) EXPENDI TURES

STATE PACCOMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DEOR LEGI SLAT I VE CHECKTHI S BOXI FCANDI DATES, L I ST THE CANDI DATE I DENT I F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBER FOREACH EXPENDI TURE A L I ST OF I D NUMBERS I S AVAI L ABLE FROM THE I OWA AMENDI NG FORMETHI CS &CAMPAI GN DI SCL OSURE 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 )

; ~ - k CM? t 4 r &LCANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( Di s b u r s e me n t ) WAS MADE( MM/ DD/ YR) AND PAC

CHECKNUMBERI D# o~=~cc . ~ ~ MAk ~Qr ' ~~u~a , t i t ~r t 7CK# 274N+ OJ 6 v4f e1 t $ Y97. S_I ( 70 SM A S' d z 12 H C CA, WP~e , i l ~

I D# M( At t , f e~v t Ce j MA 1 i 0 ~ e / } `0 - 1 ~ i - + 4 CK# P a s ~. ~ c So " 2/ T ' 0 0 ,1( 7 1 V RQAI VMt j FJA

I D# CA. . fWP i , t p , Tr y a s PA %t V r g- r RW I I ~1o-U-CI A cK# 7 2 ~MAC Y~ Vt 7 .( t Y Y I C t ' y ' t ~ ,

I D#

CK#~ ~1 4 0 V3 E (OVMI WFl N0 v j J w/ 0 3 R Oem . P n z q Co oT, 21 Vu T ( Q / jW77 0 ~ A S c l Z aI D# 9aq~- t . ~ZA, ~

vM, aPAa t < /10- 11-64 CK# C0,0TA117 J r a 2sad117 A Sv2a9D# q6CL~ I i f ( / 7%JMAAJ (14 co

U- 27- 04 CK# ZP f k" . " A4~i f C0NTel 1 at i! iN SWOO(Mr 4 t - A Soo Io9I D# WRk1 ~ e - t v t cQS vs~ea , v d . v~na . , . 4 8

- o9 CK# ) 1- 7 y l oo l a I S= ST 131rb~ S~ a3 T - " ' '1D#

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SUB- TOTAL $ 01p) ,

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7/7

FORI NSTRUCTI ONS, SEEBACK OF FORMCOMMI TTEE NAME ( Mu s t b e s ame as o n St a t e me n t o f O r g a n i z a t i o n )

r oc Cmml F a t. J?P7sNOTE : 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 mai n u np ai d mu s t b e i n c l u d ed o n t h i s

Sc h e d u l e , as w e l l a s 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 .

` 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 .

DEBTS/ 013 L I GATI ONS REMAI NI NG THI S REPORTI NG PERI OD( DONOT I NCLUDE LOANS - - SHOWLOANSON SCHEDUL E F )

SCHEDUL ED I I NCURRED

( Re v 0 8 / 9 8 ) I NDEBTEDNESSCHECK THI S BOXI F AMENDI NGFORM

An " i n c u r r e d d e b t " i s a d e b 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 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 an i n v o i c eh a s b e e n r e c e i v e d .

Page ( o f Tf o 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 e b t e d n e s s a l s o i n c l u d e s e a c h p e r s o n l e n t i t y w i t h whom 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 n t 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 ms 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 ng , o ro r g an i z i n g s e r v i c e s . Re 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 ma t e d p e r f o r ma n c e r e a s o n ab 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 AND ADDRESS OF PERSONTOWHOMDEBT OR OBL I GATI ON I S OWED

DESCRI PTI ON OF GOODS ORSERVI CES PROVI DED ORPURCHASED

BALANCEOWEDATCLOSE OFREPORTI NGPERI OD'

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C - 1 Y d ' Y - 1 4

SUB- TOTAL $ Y Y~y .TOTAL DEBTS OWED BY COMMI TTEE AT THE ENDOF THI S REPORTI NG PERI OD $

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McCarthy Kevin__1385__scanned

McCarthy Kevin1385scanned