United Union of Roofers Pol Ed and Legislative Fund of Iowa9699scanned

8/7/2019 United Union of Roofers Pol Ed and Legislative Fund of Iowa__9699__scanned

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' FOR I NSTRUCTI ONS, SE E BACK OF FORM

COMMI T TE E 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 )Un i t e d Un i o n o f Ro o f e r s Po l i t i c a l Ed u c a t i o n a n d L e g i s l a t i v eF u n d o f I o wa ~ 4 ' 9I MPORTA NT I n d i c a t e 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 C an 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 mmi t t e e ( 7 ) C o u n t y / C i t y C e n t r a l C o mmi t t e e( 8 ) Su p p o r t S l a t e o f C a n d i d a t e s

O f f i c e Sought

SI GNATURE O 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 )

I AM FI L I NG A

CASH

DI SCL OSURE S UMMA RY PAGE

P o l i t i c a l P a r t y

L a t e f i l e d r e p o r t s a r e s u b j e c t t o p o s s i b l e c i v i l a nd c r i mi n a l p e n a l t i e s .SEE I NSTRUCTI ONS ON BACK ANDCOMPLETE THE FOL LOWI NG SENTENCE :

I C-nCREPORT FORAN/ A ( 1 ) ELECTI ON / ( 2 ) NON- ELECT I ON YEAR .( r e p o r t d a t e )I n d i c a t e on e 1 7

OCHECK I F AMENDMENT TO REPORT DATED

Ch e c k i f t h i s i s f i n a l ( t e r mi n a t i o n ) r e p o r t a nd 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 Fo 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 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 AT EMENT OF CA S H ON HA ND

, 5 i 5 y~W" 7 / e - / 9 - 6 6T EL EPHONE DATE SI GNED

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 mon i e s h e l db y t h e c o mmi t t e e . T h i s amount MUS T b e t h e same a s t h e c a s h on h a nd 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $AD D TOT AL MONE Y 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 : Loans Re 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc 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 Sc h e d u l e H ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

SUBTRACT TOTAL MONE Y SPENT THI S PERI ODSc 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 e e d e b t s a nd l o a n s b e l o w ) . . . .Sc h e d u l e F : L o a n Repa ymen 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 nd 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 mustb e z e r o ) ( A t t a c h - D R - 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

FORMDR- 2 DI SCLOSURE( R e v . 0 7 / 2 0 0 3 ) REPORTFo r O f f i c e Us e O n lComm . #L o g g e dS c a n n e dC o mp u t e rA u d i t e d

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 nC 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

" UNPA I D BI L L S ( Fr om 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 KI ND CONTRI BUTI ONS ( Fr om Sc h e d u l e E - A t t a c h Sc h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* ' OUTSTAND I NG L OANS ( F r o m S c h e d u l e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI TT EES ONL Y :CONSUL T ANT BREA KDOWN ( S c h e d u l e G A t t a c h e d ? ) DYES ONOVALUE OF CAMPAI GN PROPERTY ( Fr o m Sc h e d u l e H - A t t a c h Sc h e d u l e H)

/ G3


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Fo r I n s t r u c t i o n s , Se e Ba c k o f Fo 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 TTEENAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g an i z a t i o n )U n i t e d U n i o n o f R o o f e r s P o l i t i c a l a n dL e c t i s l a t i v e F u n d o f I o w a ( p qq

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

CHECK T HI S BOX I FAMENDI NG FORM

STATECANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON C OMMI T T E E ) , L I S T T HE PAC I D E NT I F I C A T I ONNUMBERAND THE PAC CHECK NUMBER I N T HE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S A V AI L A B L E FROM T HE I OWA E T HI CS AND CAMPAI GND I SCLOSURE BOARD .CAUTI ON : Se c t i o n 6 8B . 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 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 .

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 ) r $ $' 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 k ) 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 umn . ( f o r Sc h e d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT J I FRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUN( MM/ D D / Y R) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SNUMBER ) I NCOr p I D# n t f e ~ 4 ~ ~ , - ~/ Z D, GYo ~ - A l i l t e a ~ $ ~ f i Gl JCK# 0 So 1 6 1 - 0 L _ S t ~j w

I D#CK#I D#CK#I D#CK#I D#CK#D#CK#D#CK#I D#CK#

I D#CK#I D#CK#


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T HI S BOX APPL I E S TO CANDI DATES ' COMMI TTEES ONLY :Pu 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 Sc 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 l 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 a nSc 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 mm i 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 nd I o wa Co d e 6 8 A . 6 ( 3 x i ) . )

( f o r Sc h e d ul e B )

FOR I NSTRUCTI ONS, SEE BACK OFFORM SCHEDULEEXPENDI 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 LEGI S LAT I V ECANDI DATES , L I ST T HE CANDI DATE I D EN T I F I C AT I ON NUMBER I N T HE DESI GNATED COLUMN AND THE D CHECK T HI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S A VA I L A BL E FROMT HE I OWA AMENDI NG FORMETHI C S & CAMPAI GN D I SCLOSURE BOARD .COMMI TT EE NAME ( Mu s t b e s a m e 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 )Un i t e d Un i o n o f Ro o f e r s Po l i t i c a l Ed u c a t i o n andI r e i s l a t i v e F u n d o f I o wa

CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACT I ON ) EXPENDEDEXPENDED ( 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 PACCHECKNUMBER

$ l / ' 7 1 0 ~ o I D# ~ y y l I ~ t } ~ E - t u ~ ~ t ` ' t ~ j 1 ( ~ 0 t l t -~~ ~ ' r t e `L i c m ; 0 rD# t ~ ~o r C e c t r t ~ i 1 Pr { C 00 , 1 f r i ~ ' Ft b Y l ~ o , ~ -~ r , t l e y 1 9 L t ; 1 0 r - S ~ , o r ' A ~ - l a oCK#~a 2 ~ 57 y0 ( , oC

~ I f o b I D # , SWe_ t 3 , , . _ K - s e - v 1 c eCK#-

f r , ~ k ~CK#11 622 - y r z ~F ' O f j ~ Z$ ~. O GC d 0 t 5 , ~ r t c / ' 2 ` 1D#CK#, 1 z 4 4 s CCAP~

f ( ~ / i t l OG 1 D # 1 6 o 7 - 0 / Y t n - r i 1 7` ~ t - ~ Ty l Pr ~ Ol e ~ '. 9. 1 4CK#1b~ y 3 Rs f 7 i : SE : 3 ~ _~ z7

/ o ~ i a ~ D f i I D# T s c ' 1 Ra ~n q ,, 5236

SU B- TOTA L $ 7YZTOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) $


4/4

FOR I NSTRUCTI ONS, SEE BACK OF FORM _ 7 _ 7 1 7 7 7 7 1. i z -EXPENDI TURES - - MONEY SPENT FROM COMMI TT EE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI DATES, L I ST THE CANDI DATE I D EN T I F I C AT I ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWAETHI CS & CAMPAI GN DI SCL OSURE BOARD.

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

CHECK T HI S BOX I FAMENDI NG FORM

COMMI TT EE NAME ( Mu 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 )Un i t e d Un i o n o f Ro of e r s Po i t i c a l Ed uc a t i o n a n dL e g i s l a t i v e r z n d o f I o wa 17

6 , I D# 957

CK#I D#CK#

T , m/ 7 1 w _ 7 t e TI P T - 7C r P

1 4 r ' TY 1~4b* J f ! ~ y .

~l t l i ~~~pC16 , 2 7 - 7

PURPOSE( DESCRI BE TRANSACTI ON)

~ ~J 7 / ~ o~ c f 3 7

AMOUNTEXPENDED

7. / ' z

SUB- TOTAL I $ ~ f YTOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) I $ =2~s. ~~a

T HI S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY :Pu r c h a s e s o f c e r t a i n c amp 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 must a l s o b e i n v e n t o r i e d on Sc h e d ul 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 . )Ex 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 dv 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 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 onSc h e d ul e G b y t h e amoun 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 nd i d a t e ' s c o mmi t t e e . ( R e f e r t oSc h e d ul e G i n s t r u c t i o n s a nd I o w a Code 6 8 A. 6 ( 3 x i ) . )

P a g e 69 o f

( f o r Sc h e d ul e B)

CK# / t L ~ 2 7/ , 6 / / 2 _ / 6 & I D# 1347 L ? ~f r ~e ~t s ~a o . pbe e ~ , ~oq~CK# / &RK 75D O - l i s

7 1 3 1 I D# / L , , l eCK#

C~ ~ ~ ( , ? 7 L n t uS- v s r c - _~ ; 030Ci

CANDI DATE NAME AND ADDRESS TOWHOMDATE I D NUMBER EXPENDI TUREEXPENDED ( 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/ DD/ YR) AND PACCHECKNUMBER

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United Union of Roofers Pol Ed and Legislative Fund of Iowa__9699__scanned

United Union of Roofers Pol Ed and Legislative Fund of Iowa9699scanned