Seymour James__scanned__1411

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    FOR I NSTRUCTI ONS, SEEBACK O1F FORMDI SCLOSURE SUMMARY PAGE

    Z & _ : &n ~r - f o o a~* -rWPORT : I n d i c a t e b y S t y p e o f c o r r r n i r e e y o u a n r e p o r t i n g f o r( 1 ) S f a t e w i d e / L e g s s i a t i - 6 W J u d g eSOSf 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( 4 ) Co u nt y C e n t r a l Co nv n l t e e ( 5 ) C o u n t y C a n d i d s t e ( 6 ) C i t y C a n d i d a t e ( 7Pal S u b d i v i s i o n C a r r i i d d e ( 8 ) Co ur t y PAC ( 9 ) Ci y PAC ( 1 D) Sc h o o lS u b d r v i s i m PAC ( 1 1 ) L o c a l B a l l o t I s s u eCANDI DATE COMMI TTEES ONLY :Ca n d i d a t e Name . ,_ _ J r + mGS A. ~~

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    OC14ECK I F AMENDMENT TOREPORT DATED

    P o l " I P a r t y ( i f a p p l i c a b l e )c 1 v 2 ~1 2 iD i s t r i c t ( i f Se n a t e o r H o u s e )

    0 C h e c k i f t h i s i s f i n a l ( t e r f r t i n a t i o n ) r e p o r t a n 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 Fo r m DR- 3 .( Y ou m u s t c o n t i n u e t D 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 . )

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    STATEMENT OF CASH ON HANDCASH ON HAND a t t h e b eg 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 ec o mmi t t e e . Th i s am o u n t MUST b e t h e s am e a s t h e c a s h o n h an 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 m u s t b e z e r o i t 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 ODSc h e d u l e A : Ca 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 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    ( Sc h e d u l e H a pp l i e s t o Ca n d i d a t e s ' Co n mt N1 e e s On l y )SUBTOTAL . . . $

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

    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 al a nc e m u s tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ a

    ' UNPAI D BI L L S ( F r o m Sc h e d u l e D - At t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S' I N KI NDCONTRI 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 ( S c h ed u l e G At t a c h e d? )VALUE OF CAMPAI GN PROPERTY ( F r o m Sc h e d u l e H - At t a c h Sc h e d u l e H)

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    Fo r I n s t r u c t i o n s , See 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 ( 0 l 6 t s f b e s ame a s on _ Of _

    R e s e t F or m A MONETARY( R e v . t ) 7 J 0 3 ) RECEI PTSCHECK T HI S BOX I FAYENOMFORM

    STA TE CANDI DA TES NdTE : I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PAC ( P O L I T I C A L ACT I ON C O MMI T T E E ) , L I S T T HE P AC I D EN T I F I C A T I O NNUMBER AND THE PACCHECK N U M 1 3 E R 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 O N : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a 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 an 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 an 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 ommi t t e es .

    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 )

    * 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 mu 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 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 P a g e~_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 u mn . ( f o r S c h e d u l e A )

    DATE PACI D NUMBER NAMEANDADDRESSOF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE* RECEI VED FUND( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RA I S ENUMBER I NCOM

    7 I t 9 ( ' n I D# qX59 FEI J J ~ V # 'A) o T t 1 t ~ ; ~ VYZI r $cK# . 317 s ~ ~ l d ~ ~r a 3 0 1 50D_ u / 4I D# g a~a f l a x o S' t " i 1 ' r x I SO _ E :7 CK# r - ; ~ r ~ , 5 , 7 7 071S- ~ p CK# . S e k3 z o S v v 3 . - , I r i , 5 7 ` z s _ o3 G 3 I _ - ~ - r 4 Z7 0 WA To 3 ZI D# , f ~' COSH~NN~

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    Fo r I n s t r u c t i o n s , Se e Back o f F o 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 TTEE NAME ( Mus t be s ame as o n S o f Or g an i z at i o n)

    K e s e t Fo r m SCHEDULEA I MONETARY( Re v . 0 7 1 0 3 ) RECEI PTS0CHECK T HI S BOX I F

    AMENDI NGFORMI LZ -040UP, -!~ZhAdD_;STATE CANDI DATES NOTE : I A CONTRI BUTI ON I S RECEI VED FROMASTATE PAC ( POL I T I CAL ACTI ONCOMMI TTEE) , L I S T THEPAC I DENTI F I CATI ONNUMBER ANDTHEPACCHECKNUMBER I N THEDESI GNATED COLUMN. A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS ANDCAMPAI GNDI SCL OSURE BOARDCAUTI ON : Se ct i o n 68B . 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 nf o r mat i o n c op i e d f r o m r e p o r t s an d s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o rf o r any c omme r c i a l p u r p o s e b y any 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 o mmi t t e e s .

    SUB- TOTAL

    TOTAL ( i f l a s t page o f t h i s s c h ed u l e )D i s c l o s u r e l aw r e q u i r e s c a n d i d a t e c ommi 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 an y r e l a t i v e maki ng a c o n t r i b u t i o n t o t h ec ommi t t e e . R e l a t i o n s h i p mus t b e s h o w n t o t h e t h i r d d e gr 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 ) an d a f f i n i t y ( r e l a t i v e s b ym a 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 as c a n d i d a t e , b u t t h e r e i s no Page a ' 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 Sc h e d u l e A)

    DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR REL AT I ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MM/ DD/ YR) ANDPAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# ( 0 r s - s - / OEC; UN ; l a5 - ~ 3 4 / 8 , , 0 l . ~ - _, bI D# Rf r

    Nc 6I D# SM; J ~ - " - i i e l d r u v d s ~, J l j e -- ~ - ~ CK# OK ~ F , S' ~ ( L l g o, y99 0W4 0CK# a wal w 1 5 1 " 1 ~ ~ I Z, Up `I D # J - ~ ' ' I f C i a L t ~ GO . ~~ 1 1 Cr ; n ~CK# wc , qmi - , j - ~ ~ - 170a TQ. - 7 0 ~ - - '0M( 1 , N rI D # _v l / M C-T-~Tr3 r l i 9 -~? S7' ST L t 2; 70c K# , .5 ( ) , AJ VZ. v " ~J 1 gdo, ; ~-' l

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    Fo r I n s t r u c t i on s , See Bade o f Fo r mCONTRI BUTI ONS - MONEY TAKEN I N

    O n c h x N m 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 ( Mo s t b e s ame a s on St a e n t o f Or g a r d z a 6 o n )

    T RI B UT I ON I S RECE I V ED FROM A STATE PA C ( P O L I T I C A L ACT I ON C OMMI T T E E ) , L I S T T HE PA C I D EN T I F I C A T I ONNUMBER AND THE PAC CHECK NUMBER I N THE DES I 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 HI C S AND CAMPA I GNDI SCLOSURE BOARDC A UT I ON : S e c t i o n t i t 3 B . 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 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 ny c omme r c i a l p u r p o s e b y a ny 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 es .

    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 )

    ' 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 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 same a s c a n d i d a t e , b u t t h e r e i s n o Page 3o 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 mn . ( f o r S c h e d u l e A )

    SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) R EC E I PT SOCHECK T HI S BOX I FAMEND I N G FORM

    D A T E PA C I D NUMBER NAMEANDADDRESSOF CONTR I BUTOR R E L AT I ONS HI P AMOUNT 4 I F FORR EC E I V E D ( i f a p p l i c a b l e ) T O CANDI DAT E ' RE CE I V E D FUND-( MM/ D D/ Y R) AND PA C CHECK ( i f a p p l i c a b l e ) R AI S E RNUMBER I NCOMEI D# CY i - 1 C t ' , l UE r L , SEr v a Ve r 1 ~ $ 1 "LC9 - z q

    -0 CK#I D# 1 0 0 ( o Z at - 4 vL, ` s vC ~ J / 1 , r i - Tx c , Cc ? . r ~ C ) 1 ~ 0E 33 - s i . i 3 , S T , . b i oI D# ( 0 4 04 c - QVCK# t . . ( ~ / c a m l . ~ c l 7 3 r d - 1 u Q . 'I J L - 3 7 4 6 . 4 7 Z_ CK# - 3 f ( ~ C~ k ~., 5: p 4 1 1I D# 1 6, j C ~ ( 2 4 - C

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    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 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 pe 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 mi z e d o nSc h e d u l eGb 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 pe nd i t u r e made b y t h e p er s o Ne nt i t y o n b e h a f 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 Cod e 6 8A . 4 0 2 ( 3 ) ( 0 . )

    ( f o r Sc h e d u l e B)

    FOR I NSTRUCTI ONS, SEE BACKOF FORM 1 . RescFo l ml SCHEDULEEXPENDI TURES B MONETARY- MONEY SPENT FROMCOMMI TTEE ACCOUNT ( Re v _ 0 7 / 0 3 ) EXPENDI TURES

    STATE PAC COMMI TTEES : NOTE : FORCONTRI BUTI ONSMADE TOSTATEWI DEOR LEGI S LAT I V ECANDI DATES, L I ST THE CANDI DATE I DE N TI F I CATI ON NUMBER I N THE DESI GNATEDCOLUMN AND THE D CHECKTHI S BOXI FPAC CHECKNUMBER FOR EACHEXPENDI TURE . A L I STOF I D NUMBERS I S AVAI L ABL E FROMTHE I OWA AMENDI NGFORMETHI CS & CAMPAI GN DI SCLOSUREBOARD.COMMI TT EE NAME ( Mu s t b e s ame a s o n St a t e m o f Or g a z a d o n )

    UVCANDI DATE I 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 ) ( D i s b u r s e me n t ) WASMADE

    ( MM/ DD/ YR) AND PACCHECKNUMBER

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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 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 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 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 oS c h e d u l e G i n s t r u c t i o n s a n d l o v w a Co d e 6 8 A . 4 0 2 ( 3 ) ( ) . )

    P a g e o f . v

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

    FOR I N STRUCT I ONS , SEE BACK OF FORM Rc 9 c l F SCHEDUL EEXPENDI TURES B MONETARY- MONEY SPENT FROMCOMMI TTEE ACCOUNT ( R e v . 0 7 / 0 3 ) EXPENDI TURES

    STATE PAC COMMI TTEE S : NOTE : FORCON TRI B UT I ON S MADE TO S T A T E U 1 1 1 D E OR L E G I S L A T I V EC A N D I D A T E S , L I S T THE CANDI DATE I D E N T I F I C A T I O N NUMBER I N THE DESI GNATED COLUMN AND T HE CHECKTHI S BOX I FPA C 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 T HE I OWA AMENDI NG FORME T H I C S & CAMPAI GN D I SC LOSURE BOARD .COMMI TTE E NAME ( u s t b e s am e a s o n S t a t e t o f O r g a n i z a t i o n )

    NCANDI D 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 ) ( D i s b u r s e m e n t ) WASMADE( MM/ D D / Y R ) AND PACCHECKNUMBER

    D# \ l " r MY r l 4&r l ~w C&- v . V t yo c 19 _ r ~ i a4 W0- Wewyl l f 3S,( ~ , . w , ~ n . S( SdI D# c J QCK#

    oI D# ~ ~ , - - , -( ~ / / 3 J 0 CK# r J L 4 1 T~v r dww

    ~ub, 41J~%-.~ 0 0CK #

    I D#CK #1 D #CK #I D#CK #1 D #CK #

    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 ) $ o f o . . .