Swaim Kurt1357scanned

8/7/2019 Swaim Kurt__1357__scanned

http://slidepdf.com/reader/full/swaim-kurt1357scanned 1/7

- Oc t - 27- 04 08 : 53A SWAI M LAW FI RM641 664 2622

S I G N A

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

EI CHECK I F AMENDMENTTO REPORT DATED

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 )

SWAI M FOR HOUSE

I MPORTANT : 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 po r t i n g f o r :

( I ) S t a t e w i d e l l e g i s l a t i v e C a n d i d a t e ( 2 ) S t a I e m d e PAC ( 3 ) S t a t e P a r t y ( d ) 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 mm i t t e e ( 7 ) C o u n t y l C i t y C e n t r a l Co mmi t t e e( 8 ) S u p p o r t S l a %o f C a n d i d a t e s

- J

_

c

- G

3~d

! o a

o

REO

R

( r p e r s o n f l i n g t h i s r e p o r t )

TELEPHONE

DAT S I G N

Ro u t i n e Pe n al t i e s Du e Fo r L at e F i l e d Re p or t s Range f r o m 00 t o $ 8 0 0

SEE I NSTRUCTI ONS ON BACK AND COMPLETE THE FOLLOWI NG SENTENCE :

l

Oc t obe r 2 9

( AM F I L I NG A OCt o b e r 1 9 - Fr i d ay P r = o

G c r l e r a l REPORT FORAN / A ( 1 ) ELECTI ON I ( 2 ) NON- E L ECT I ON YEAR .

I n d i c a t e o n e

P . 0 2

FORM

DR- 2 DI SCLOSURE

( Re v 0 1 / 9 8 )

REPORT

F o r Of n c e Us e On l

I Comm #

I n d e x e d

A u d i t e d

C o mp u t e r

aL o c a l C o mm i t t e e s , e n t e r Da t e o f E l e c t i o n

DC 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 f D i s s o l u t i o n F o r m DR- 3 . C o u n t y & L o c a l Commi t t e e s , e n t e r Co u n t y i n

( Yo u mus t c o nt i n ue 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 )N h l c h E l e c t i o n I s h e l d

STATEMENT OF CASH ON HAND

CASH 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 h i s i s t h e t o t a l

o f a l l mo n i e s h e l d b y t h e c o mmi t t e e . T h i s amo u n t MUST b e t h e



Oc t - 2 7- 0 4 0 8 : 5 4A SWAI M L AW F I RM6 41 6 6 4 2 6 2 2P . 0 3

L

Fo r I n s t r u c t i o n s , See Back o f Form

CONTRIBUTI ONS - - MONEYTAKENI N

( i n cl u di 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 b e s ame a s on St at ement o f Or g a n i z a t i o n)

SWAI M FOR HOUSE

STATE CANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROMASTATEPAC( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THEPAC I DENT I F I CAT I ON

NUMBERAND THEPACCHECKNUMBER I N THEDESI GNATED COLUMN. A L I S T OF 1 0 NUMBERS I S AVA I L ABLEFROMTHE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD

CAUTI ON : Se c t i o n 68B. 3 2A( 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 or ma t i on c o pi e d f r o m r e p o r 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 an y c o mme r c i a l p u r p o s e b y an 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 .

SCHEDUL E

A MONETARY

( Re v 0 6 1 9 7 )

RECEI PTS

CHECK T HI S BOX I F

AMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESSOF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FOR

RECEI VED ~ ( i f a p p l i c a b l e ) 70 CANDI DATE' RECEI VED FUND-

( MMI DD/ YR) AND PAC CHECK ( f a pp l i c a b l e ) RAI SER

NUMBER I NCOME

I D# Un i t emi z ed . r e c e i p t s f o r t h e p er i od

1 0 / 1 8 / 0 4

t h r o ug h Oct o ber 2 6 t h f o r con t r i b ut on s $

2 5 . 0 0CK# not exceed i n g . , $ 25 . 0 0 per per so n

1 0 / 1 9 / 0 4I D#

Bet t y Swai m 200 . 0 0CK#

Or akes v i l l e I A 5 2 5 5 2

I D# 6 0 7 0 I o wa Law PAC1 0 / 2 1 / 0 4 5 2 1 E . Locus t 1 0 0 0 . 0 0c K r e

Des Moi nes, I A 50309-

-I D#

T o m/ Ma r y St ewar t1 0 / 2 1 / 0 4 CK# 1 6 1 8 N_ Cour t 7 5 . 0 0

Ot t umwa I A 5 2 5 0 1

I D# St eve/ Mar l ene Sp r o use



Oct -27-04 08 : 54A SWAIMLAWFIRM

r

4Fo r I n s t r u c t i o ns , Se e Back o f For m

CONTRI 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 TTEENAME ( 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 )

SWAI M FOR HOUSE

641 664 2622 P-04

STATECANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROMA STATEPAC ( POL I T I CAL ACTI ON COMMI TTEE) . L I ST THE PAC I DENT I F I CAT I ON

NUMBERAND THE PACCHECKNUMBER I N THEDESI GNATED COLUMN . AUST OF I D NUMBERS I S A VA I L A B L E FROMTHE I OWA ETHI CS AND CAMPA I GNDI SCLOSURE BOARD

CAUTI ON : Se c t i o n 6 8 8 . 3 2 A ( 6 ) . I o wa Code . p r o h i b i t s t he u s e o f i n f o r ma t i o n c o pi e d f r o m r e p o r t s and s t a t e me nt s f o r s o l i c i t i n g c ont r i b ut i o ns o rf o r a n y c o mme r c i a l p u r p o s e b y an 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 o mmi t t e e s .

SCHEDULE

A MONETARY

( Re v 0 6 1 9 7 )

RECEI PTS

[ ] CHECK T HI S BOX I F

AMENDI NGFORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FOR

RECEI VED ~ ' ( i t a p p l i c a b l e ) TOCANDI DATE' RECEI VED FUND-

( MM/ DDI YR) ANDPACCHECK ( f a pp l i c a b l e ) RAI SERNUMBER I NCOME

- I D# Ri c har d / Sh i r l e y Tur ne r

1 0/ 2 5/ 0 4 , 2 0 1 1 1 2 05 t h A v e $ 50 . 0 0CK#Cen t e r v i l l e , I A 5 2 5 4 4

I o# 6 1 6 0 I o wa I n dependen t Bank er s Pol i t i c aL

1 0/ 2 6 / 0 4 Ac t i on Commi t t ee PAC 200 . 0 0CK# 1 6 0 3- 2 2 n d St r e et Su i t e 202

Wes t1 )

De s Moi ne s I A ( 02Z : ,

I t D#

CK#

I D#

y

CK#

I D#



Oc t - 2 7- 0 4 0 8 : 5 4A SWAI M L AW F I RM6 4 1 6 6 4 2 6 2 2P . 0 5

FORI NSTRUCTI ONS, SEEBACK OF FORM

V

EXPENDI TURES - - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FORCONTRI BUTI ONSMADE TO STATEWI DEOR LEGI SLATI VECANDI DATES, L I ST THE CANDI DATE I DENT I F I CA T I ON NUMBER I N THE DESI GNATED COLUMN AND THE

PACCHECKNUMBER FOR EACH EXPENDI TURE A L I ST OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA

ETHI CS d CAMPAI GN DI SCLOSURE BOARD

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

SWAI M FOR HOUSE

SCHEDULE

( Re v 0 9 / 9 7 )

MONETARY

EXPENDI TURES

CHECKTHI S BOX I F

AMENDI NGFORM

CANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNT

DATE I D NUMBER EXPENDI TURE ( DESCRI BE M, NSACTI ON) EXPENDED

EXPENDED ( i f a p p l i c a b l e ) ( Di s b u r s e me n t ) WASMADE f ,

( MM/ DD/ YR) ANDPAC VCHECK

NUMBER

I D#Bl oo mf i e l d Ne ws pa per s

1 0 / 2 0/ 0 4

CK# 1 1 3 0

P . O . Bo x 1 9 Ad v e r t i s i n , ;

$

3 9 2 . 5 9

Bl o o mf i e l d , I A 5 2 5 3 7 - 0 0 1 9

I D# Sey mo ur Her a l d

1 0 / 2 0 / 0 4 CK# 1 1 3 11 1 6 N . Fo ur t h St Ad v e r t i s i n , ; 10 5 . 0 0

Se y mo u r , I A 5 2 5 9 0

I D# F a r m Bu r e a u Spo k es man

1 0 20 / 0 4 1 1 3 2 PO BOX 6 7 0 Ad Yv e r IGz s i n ; 7 4 . 4 0CK# I o wa

I D# j en t e r v i l l e I o we g i a n A d - -10 / 20 / 0 1 1 3 3 POp B o x s 6 1 0 Adv er t i s i n g 2 6 1 . 0 0

CK#

Ce n t e r v i l l e , I A 5 2 5 4 4 '

I D# Mou l t on Tr i bu ne



Oc t - 27- 0 4 0 8 : 5 5A SWAI M LAW FI RM641 664 2622P- 0 6

FOR I NSTRUCTI ONS, SEE BACK OF FORM

EXPENDI TURES - - MONEY SPENT FROMCOMMI TTEE ACCOUNT

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI S LAT I VECANDI DATES, L I S T THE CANDI DATE I DE NT I F I CA TI ON NUMBER I N THE DESI GNATEDCOLUMN AND THE

PAC CHECKNUMBER FOR EACH EXPENDI TURE A L I ST OF I D NUMBERS I S AVAI LABLE FROMTHE I OW4

ETHI CS 8 CAMPAI GN DI SCLOSURE BOARD

Cen t e r v i l l e l o we gi a n AdEx p r e s s

PO BOX 160Ce n t e r v i l l e , I A 5 2 5 4 4

Bl o omf i e l d Ne ws p ap er

PO Box 1 9

Bl o omf i e l d , I A 5 2 5 37 - OOl q

CANDI DATE

NAME AND ADDRESS TOWHOM

I D NUMBER

EXPENDI TURE

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

( D i s b u r s e r n e n l ) WAS MADE

AND PAC

CHECK

NUMBER

A d y g x ; t i s i r n ,

COMMI TT EE NAME ( Mus t b e s ame a s o n St a t emen t o f Or g an i z a t i o n)

SWAI M FOR HOUSE

SCHEDULE

B MONETARY

( Re v . 0 9 1 9 7 )

I

EXPENDI TURES

O CHECKTHI S BOXI F

AMENDI NGFORM



Oc t - 2 7- 0 4 0 8 : 5 5 A SWAI M L AW F I RM6 4 1 6 6 4 2 6 2 2P_07

FOR I NSTRUCTI ONS. SEE BACK OF FORM

COMMI TTEE NAME ( Mu s t b e sa me a s o n St a t e me n t o f Or g a n i z a t i o n)

SWAI M FOR HOUSE

SCHEDULE

E

I N K I ND

( R e v , 0 6 / 9 7 ) 1 CONTRI BUTI ONS

CHECK T HI S BOX I FAMENDI NG FORM

DATE

RELATI ONSHI P DESCRI PTI ON ESTI MATED J I F FOR

F ECEI VED NAMEANDADDRESS TOCANDI DATE OF 1 1 4 K I ND F AI R MARKET FUND- RAI SER

( h , M1DD/ YR) OF CONTRI BUTOR ' ( f a p p l i c a b l e ) CONTFJBUTI ON VALUE CONTRI BUTI ON

Ku r t Swa i m Ca rVa r i o us 5 0 4 N . Da v i s Se l f Mi l e a g e 1 5 0 . 0 0

Bl o o mf i e l d I A 5 2 5 3 7 Es t

Ku r t Swa i m

Va r i o u s 5 0 4 N, Da v i sSe l f Ph o t o c op i e s 4 0 0 . 0 0

Bl o omf i e l d , I A 5 2 5 3 7 ( E ; t ( Es t )

Ku r t Swa i mSe l f T o l l : h a r g e s 5 . 0 0

Va r i o us 5 0 4 N, Da v i s( Es t )

Bl o omf i e l d , I A 5 2 5 3 7

Va r i o usKu r t Swa i m

Se l f Po s t a g e , 9 . 0 0504 N . Da v i s ,

t . ~ ; t ) :_ Bl o omf i e l d - - - I ' A " 52537 . .

I o wa Demo n c r a t i c Pa r t y

' ,.Ma i l 2 0 0 9 . 0 01 0 / 2 5 / 0 4 1 4 0 8 Loc us t St r ee t

De s Mo i n es , I A 5 0 3 0 9



T E _ T h i s s c h e d u l e r e p o r t s m o n e y l o a n e d t o t h e c o m m i t t e e w h i c h i s d e p o s i t e d i n t h e c o m m i t t e e a c c o u n t _

T AL U NP A I D LOANS FROM LAST REPORTI NG PERI OD $11 OOQ . OO

. R T I - MONETARY LOANS RECE I VED T H I S REPORTI NG PERI OD( O r i g i n a l s o u r c e o f l o a n , s u c h a s a b a n k , m u s t b e s h o w n i f a t h i r d p a r t y i s

i n v o l v e d . I n c l u d e l o a n s 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 . )

TOTAL ( 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 m m i t t e e s t o d i s d 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 e c o m m 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 y m a r r i a g e ) . ( S e e P a g e 2 o f f o r m sp a c k e t. ) I f s u r n a m e 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 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 w f i e n i t a p p l i e s ,

CHECKTHI S BOX I F

AMENDINGFORM

PART 1 1 - MONETA RY LOAN REPAYMENTS MADE T H I S REPORTI NG P ER I OD( L o a n s f o r g i v e n m u s t b e r e p o r t e d o n S c h e 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 ( P A RT 1 1 ) S ' O -

t. ;

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

$

~ . - T O T A L OUTSTANDI NG LOANS END OF REPORT PERI OD

; 1 , 0 00 , 0 0

P a g e 1 o f I

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

NC INN

O0 3

DATE P A I D( M M I D D I Y R )

NAME AND ADDRESS OF LENDER

( I n c l u d e E n d o r s e r ' s N a m e , I t A p p l i c a b l e )R E L A T I O N S H I PTO C A N D I D A T E '

I f A p p l i c a b l e )

AMOUNTR EP A I D

f

.

4 5 .

DATEECEI VED

I M I D D I Y R

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

RELATI ONSHI PTOCANDI DATE

I t A p p l i c a b l e )

AMOUNTOF LOAN

I INSTRUCTI ONS, SEEBACKOFFORMSCHEDULE

MMI T T E E N AME ( 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 )F LOANS

( Re v . 0 6 1 9 6 ) ~ RECEI VED

SWA I M F OR HOUSE I 3 REPAI D

Documents

Swaim Kurt__1357__scanned

Swaim Kurt1357scanned