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03
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SIGNATURE OF PERSON FILING REPOR TELEPHONE DAT SIGNED
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMDCR AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 66B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
Darryl Montgomery
01104/05 552 Evcrgrccn Drive $ 650.00
CK#
Ma ndeviIIe, LA 70448
I D#
Ben Acilts
1,000 .00
O1/l II05 C0 550 Soutliforlc Drive
Waukcc, IA 50263-9559
ID#
Jayson Green
03130105 300 .00
CK# 5864 W . 145th Street
Overland Park . KS 66223
ID#
Jonathan Ahnen
04/04105 1,000 .00
CK# 14895 Woodcrest Drive
Clivc, IA 50325
ID#
Kenton Murphy
04!27105 700 .00
CK# 1201 W . Mulberry Lane
Highlands Ranch, CO 80129-6265
ID#
CK#
ID#
C K#
[Dot
CK#
IDfk
CK#
ID#
CK4
SUB-TOTAL
I
$ 3,650,00
- Dlsdosure law requires candidate commlnees to disclose the relationship of any relative making a contribution to the
commIttee . Relailonsnlp must be shown to the third degree of consangulnliy (blood relet"s) and affinity (relatives by I 1
marriage) . If surname of contributor is the same as candidate, but there Is no Page of
famlllal relationship . enter"not applicable" in the relationship column . (for ScheduleA)
JUL-14-2005 THU 04 :11 PH WF FINANCIAL-CONTROLLERS FAX NO, 515 557 7691 P, 05
ID#
klalioma I.Lhics Commission 2005 Annual Registration Fee
01/27/05 300 N . Lincoln Boulevard, Room 13-5 50 .00
CK# 1~3~
1282 City, OK 73105-4812
ID#
Tennessee Consumer Finance Political Contribution
02115/05 Campaign Committee, P . O, Box 2,500,00
CK# 1`84
2
488, Chattanooga, TN 37401
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
Purchases of certain campalpn property casting $500 or more must also be inventoried on Schedule FI . (Refer to Schociulo H instructions )
Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be derail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee . (Refer to
Schedule G Instructions and Iowa Coda 6BA.402(3)(i) .)
(for Schedule B)
JUL-14-2005 THU 04 ;11 PH WF FINANCIAL-CONTROLLERS FAX NO, 515 557 7691 P. 06
F7
S
Wells Fargo Financial, Inc. Administ, Cost 25 .00
a
Various b00 Walnut Street Postage .4c Salary
Dcs Moines, IA 50309-3636
F7
71
0
0
F-1
E]
F7
Ej
SUB-TOTAL 1 5
25 .00
-Disclosure law requires =andldatos to disclose the relationship of any relative making an In kind contribution to the Page I of I
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule E)
by marriage), (See Page 2 of forms packet .) If sumame of contributor is the came as candidate, but there Is no
familial relationship . enter 'not applicable" In the relationship column .