Shields Les A1615scanned

8/7/2019 Shields Les A__1615__scanned

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FOR I NSTRUCT I ONS, SEE BACK OF FORM

DI SCLOSURE SUMMARY PAGECOMMI TTEE NAME( Mus t b e same as o n S t a t e me n t o f O r g a n i z a t i o n )

I MPORTANT : I n d i c a t e b y # t y p e o f c ommi 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 Ca nd i d at 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 Ce n l , a l Commi t t e e ( 5 ) Co u nt y Ca nd i d a t e ( 6 ) C i t y Ca n d i d a t e ( 7 ) S c h o o l B o a r d o r Ot h e r

P o l i t i c a l S u b d i v i s i o n Ca n d i d a t e ( 8 ) Co u nt y PAC ( 9 ) C i t y PAC ( 1 0 ) S c h o o l Boa r d o r Ot 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 ^ ) L o c a l B a l l o t I s s u e

CANDI DATECOMMI TTEES ONLY :

C a n d i d a t e Name c P o l i t i c a l P a r t y ( i f a p p l i c a b l e )

O f f i c e So u g h t D i s t r i c t ( i f S e n at e o r House )

I AM F I L I N G A

HAPPY JOES S6 9 24 2 7090

L a t e 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 an d c r i m i n a l p e n a l t i e s . Pu r s u a n t t o I o wa C o d e s e c t i o n 6 8 B . 3 2 A( 7 )

t h e c an d i d a t e ; f o r a c a n d i d a t e ' s c o mmi t t e e , an d t h e c h a i r p e r s o n , f o r an y o t h er t y p e o f c ommi t t e e , I s t h e

i n d i v i d u a l r e s p o r ) s i b l e f o r f i l i n g t i m e l y an d ac c u r a t , r e p or t s

/ _ G

SI GNATURE OF PERSON F I L I NG REPORT TELEPHONE DATE S I GNED

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

[ CHECK I F AMENDMENT T O REPORT DATED -

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 an d a t t a c h No t i c e o

( Y ou 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 . )

CASH ONHAND 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 o t a l o f a l l f u n ds h e l d b y t h e

c o mmi t t e e T h i s amount MUST b e t h e same as 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 . ) . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADD TOTAL MONEY TAKEN I N T HI S PERI OD

S c h e du 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 S c h e du l e A) ( ' a l s o s e e i n - k i n d b e l o w) . . . . . , . . . . . . . . . . . .

S c h ed u l e i = : L o a n s Re c e i v e d t o t a l ( A t t a c h S c h e du l e F ) . . . . . . . , . . , . . . . . . . . . . . . . . , . . . . . . . . . . . . , . , . , . . , . . . . . . . , . .

S c h ed u l e H: T o t a l S al e s o f Cam a i n P r o p e r t y A t t a c h S c h e du l e H

( S c h ed u l e HV aao l i e s t o Ca nd i d a t e s ' C o mmi t t e e s On l y )

SUBTRACT TOTAL MONEY SPENT T HI S PERI OD

M UN

ROo / ( 2 ) N ON - E L EC T I ON YEAR .

J AN 1 3 20Pi catby #

Mi o f F a i ` r n OR- 3 .

STATEMENTOFCASHONHAND

SUB- TOTAL . . . . . . . . . . . . . . . . . . . . . . $

S c h e du l e B : Ex p e nd i t u r e s t o t a l ( A t t a c h S c h ed u l e B ) ( " a l s o s e e d e bt s an d l o a ns b e l o w) . . . . . . . . . . . . . . . S c h ed u l e F " : L oan Re p a y me n t s t o t a l ( A t t a c h S c h e du l e F ) . . . . . . . . . , . . . , . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASHON 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 mu st

b e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S

0 1/ 1 9/ 0 7 02 : 0 6pm P . 009

FORM

DR- 2 DI SCLOSURE

( Re v . 1 2 / 2 0 0 5) REPORT

Fo r O f f i c e Us e On l y

Comm. t 1

l o g ge d I n ' ~-

S c a n n e d

C ompu t e r

Au d i t e d

I U P f - 5 -

F i l e w i t h :

I o wa E t h i c s an d Campa i g n

Di s c l o s u r e Bo a r d

5 1 0 E . 1 2 ' " , St e . 1 A

Des Mo i n e s , I o wa 5 0 3 1 9

Fa x : 5 1 5 - 2 8 1 - 3 7 0 1

L o c a l C ommi t t e e s , e n t e r Da t e o f E l e c t i o n

Co u n t y 8 L o c a l C ommi t t e e s , e n t e r Co u n t y i n

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

4 5 0 " 60

' " UN PAI D BI L L S ( I - r o r n S c h e du l e D - At t ac h Sc h ed u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . $

' I N KI N D CONTRI 6UT I ONS ( F r o m S c h ed u l e E - A t t a c h S c h ed u l e E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ - y o ! 5 , y I Z .

' " OU T ST AN DI N G LOANS ( F r o m S c h ed u l e F - A t t a c h S c he d ul e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

CONSULTANTW: EAKDOWN ( S c h ed u l e G At t ac h e d) ) - YES -NO

CANDI DATE COMPA I T TEES ONLY :

VALUE OF CAMPAI GN PROPERTY( Fr om S c h e du l e H - A t t a c h S c he d ul e H)

STATE COMMI TT EES : Su bmi t a r e c o n c i l e d c amp a i g n ac c o u n t b an k s t a t e me n t i n J a n u ar y o f e a c h y e a r .



HAPPY JOSS SGS 242 7030

F o r I n s t r u c t i o n s , Se e B a c k o f Fo r m

CONTRI 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 TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a n i z a t i o n)

01 / 1 9/ 07 02 : 0 6pm P . 004

SCHEDULE

A MONETARY

( Re v . 0 7 / 0 3 ) RECEI PTS

CHECK THI S BOX I F

AMENDI NGFORM

STATE CANDI 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 COMMI TTEE) , L I S T THE PAC I DE NT I F I CA T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATEDCOLUMN A L I S T OF I D NUMBERS I S AVAI LABLE

FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .NOTE : ANYPERSON, OTHER THANAN I NDI V I DUAL , THAT CONTRI BUTESMORE THAN $ 7 5 0 TOYOUR CAMPAI GN MAY HAVE F I L I NG

RESPONS I B I L I T I ES AND SHOULD I MMEDI ATELY CONTACT THEBOARD .

CAUTI ON : Se ct i on 68 B . 3 2 A ( 6 ) , 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 nd s t a t e me nt 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 r f o r a ny

c omme 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 an s t a t u t o r y p o l i t i c a l c ommi 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 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 ny 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 e

c o mmi t t e e . R e l a t i o n s h i p mu s t b e s h own t o t h e t h i r d d i V 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 y

ma 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 same a s c a n d i d a t e , b u t t h e r e i s no 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 umn . ( f o r S c h ed u l e A)

SUB- TOTAL

TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT I F ORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RA I SER

NUMBER I NCOME

I D#t l Z . G~ t i ~. ? ~ C n J 1 + " r v ' 2' 3v v

e ' f. ~ ,

- 77 C r . , L~~ , , ~ ,

ID# ~ l < r t J ~l i v F l ) l I h f < - .

I D#

CK#. 3

. - Z 4 5I D #

CK#

I D#

CK#

I D#

CK#

! D#

CK#

I D # .

CK#

I D #

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I D #

CK#



HAPPY J OES SGS 2 42 7 0 9 0 0 1 / 1 9 / 0 7 0 2 : 0 6pm P . 0 0 5

T H I S BOX A P " . ! , ' S T O CANDI DATES' COMMI TTEES ONL Y :

P u r c h a s e s o f c " 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 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 I 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 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 G b " , . 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 nd 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 : d o n s a n d I o w a Code 6 6 A . 4 0 2 ( 3 ) ( i ) . )

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

F OR I NSTRUCTI ONS, SE E BACK OF FORM SCHEDULE

EXPENDI TURES B MONETARY- - MONEY SPENT F ROM COMMI TT EE ACCOUNT

( R e v 0 7 1 0 3 ) EXPENDI TURES

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E GI S L A T I V ECHECK T H I S BOX I FCANDI DATES , 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

PAC CHECK NUMBER FOR EACH EXPENDI TURE A L I S T OF I D NUMBERS I S A V AI L A B L E FROM THE I OWA AMENDI NG FORM

E THI CS & 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 n t o f O r g a n i z a t i o n )

CANDI DATE NAME AND ADDRESS TO WHOM 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

( MMI D DI Y R) AND PACCHECK

NUMBER

I D#

/ 11 7 + 147 4 5 _ , 2 _ 73 4

CK#

I D#

77

CK# )

C K#

1 D/ I

C K#

; j r

K#

y D#

CK#

f , I v #

SUB- TOTAL $

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

.



HAPPY DOES SGS 2 42 7 0 5 0 0 1/ 1 9/ 0 7 0 2 : 0 6p m P . 007

FOR I N ST R U N , ' S , SEE BACK OF FORM

COMMI TI AE ( M u s t b e s a m e 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 )

DATERECE I VED( MM/ DDNR)

SCHEDULE

E I N - K I N D( R e v . 0 6 / 9 7 ) 1 CONTRI BUTI ONS

[ ~ CHECK THI S BOX I F

AMENDI NG FORM

P a g e o f

f a r S c h e d u l e E" D i s c l o s u r e l a ; o r e s c a n d i d a t 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 n i n k i n d c o n t r i b u t i o n t o t h e

c o mmi t t e e I ~ ! v p mu 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 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 y ma r r i a g e ) ' a g e 2 o f f o r m s p a c k e t . ) 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

f a m i l i a l r e l a i i , 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 mn

NAME AND ADDRESSOF CONTRI BUTOR

RELAT I ONSHI PTO CANDI DATE

' i f a p p l i c a b l e )

DESCRI PT I ONOF I N K I ND

CONTRI BUTI ON

EST I MATEDF AI R MARKET

VALUE

J I F FORFUND- RAI SER

CONTRI BUTI ON

e ~ u - / , r

! , # ,,

-

1 4 , 7 " , i 4

$

6 - k r e : , 1 , f N

E l

F - 1F 7

F 7

SUB- TOTAL $

TOTAL ( i f l a s t

p a g e o f t h i s

s c h e d u l e )

$



FOR I NSTRUCT I ONS , SE E BACK OF FORM

COMMI TT EE NAME( Mus 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 )

, . c ' i - = ; : _ mu s t b e s h own i i a ; n i r c p ar t y i s

i n v o ' v e ^ I n c l u d e l o a ns f r o m c a n d i d a t e ' s p e r s o n a l f u n d s . )

TOTA L ( PART I ) $

' 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 e c o m m i t t e e . R el a t i o n s h i p mu s t b e s h own t o t h e t h i r d d e g r e e o f

c o ns 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 y ma r r i a g e ) I f s umame 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 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 er e l a t i o n s h i p c o l u m n wh e n i t a p p l i e s

SCHEDULE

F I LOANS

( R e v 0 7 1 0 3 ) RECEI VED& REPAI D

' I f - HFCK T HI - , RQX I F

RE " T S , ' . P DE T H I S REPORTI NG PERI OD

( L o a n s i o r g i v e n mus t b e r e p o r t e d o n S c he d u l e E- I n - k i n d C o n t r i b u t i o n s . )

TOTAL CASH REPAYMENTS ( PART f l ) $

F r o m S c h ed u l e E- TOTAL LOANS FORGI VEN S

TOTAL OUTSTANDI NG LOANS END OF REPORT PERI OD $

P a g e o f

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

DATE P AI D( MM/ DDf YR)

NAME ANDADDRESS OF LENDER( I n c l u d e E n d o r s e r s N a m e , I f A p p l i c a b l e )

RELATI ONSHI PTO CANDI DATE'

I f A l i v a b l e

AMOUNTREPAI D

f ~9

L ~ = ~ ~ f 7 l L Zr : J sRf

5~ 7 3 Z

$

DATERECEI VEDMMI DDI YR

NAME AND ADDRESS OF LENDER "( I n c l u d e E n d o r s e r s Name, I f A p p l i c a b l e )

RELAT I ONSHI PTO CAND I DATE

I f A l i v a b l e '

AMOUNTOF LOAN



HAPPY JOES 5 6 3 2 4 2 7 0 3 0 0 1 / 1 9/ 0 7 0 2 : 0 6p m P . 0 0 1

No t i c e o f Di s s o l u t i o n

Ma i l t o :

l ECD13

510 E a s t 1 2 ° ' , S u i t e I A

De s Mo i n e s , I o wa 5 0 3 1 9

n f ~ 30 ' A

WHEN TO F I L E :

Th e N o t i c e o f D i s s o l u t i o n mus t b e f i l e d w i t h i n t h i r t y ( 3 0 ) d a y s o f c o m p l e t i o n o f a l l t h e f o l l o w i n g :

1 A l l d e b t s , l o a n s a n d o b l i g a t i o n s h av e b e e n p a i d o r t r a n s f e r r e d ;

2 A l l c a mp a i g n f u n d s h a v e b e e n s p e n t ;

3 A l l c a mp a i g n p r o p e r t y s o l d o r t r a n s f e r r e d ( c a n d i d a t e s o n l y ) ; a n d

4 , A f i n a l r e p o r t d i s c l o s i n g a l l t r a n s a c t i o n s c l o s i n g t h e c o mmi t t e e

F o r s t a t e c a n d i d a t e s a n d s t a t e PACs , a f i n a l b a n k s t a t e m e n t mus t b e f i l e d w i t h t h e N o t i c e o f D i s s o l u t i o n o r a s s o o n a s

p o s s i b l e i f t h e b a n k s t a t e m e n t i s n o t a v a i l a b l e a t t h e t i m e t h e 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 .

COMMI TTEENAME

FOR I NSTRUCTI ONS, SEE BACK OF FORM

T h i s f o r m i s n o t a pp l i c a b l e t o 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 .

FORM ( R e v 0 7 / 0 3 )

DR- 3NOT I CE OFD I SSOLUT I ON

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

Co mm . #I n d e x e dA u d i t e dCo mp u t e rC e r t i f i e d D a t e o f D i s s o l u t i o n

S i g n a t u r e . o f ' C a n d i d a t e o r T r e a s u r e r ( i f c a n d i d a t e ' s c o m m i t t e e ) / S i g n a t u r e o f C h a i r o r T r e a s u r e r ( i f PAC)

Da t e S i g n e d

O f f i c i a l Name o f Co mmi t t e e

V l ,S t r e e t

C i t y , S t a t e , Z i p C o d e

Ar e a Te l e p h o n e

C o d e

Shields Les A1615scanned

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Transcript of Shields Les A1615scanned

Shields Les A__1615__scanned

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Shields Les A1615scanned

Transcript of Shields Les A1615scanned