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ruff INSTRUCTIONS, SEE BACK OF FORM

DISCLOSUK .SUMMARY PAGE

COMMITTEE NAME (Must be same as on Statement ofOrpanizaWN

IMPORTANT: Indicate type of cornmittes yoU we report100 for.

(11 )StatewidoWLegislauveCandidate (2 )Statswids PAC

(S )County PAC (6 )Ballot

(3 )State Party

(4)CountyA.ocsl CwWidais

lsswWFranchiio CommiNss (7 )Gounty/lylty Csntral

8 )Support Slate of Candidates

st<

y` -C

(319) !Ifir.-fil Q7

RE OF TREASURER (or person filing this report)

TELEPHONE

FORM

DR-2

cacw6

(Raw .o2M) FSrotrce Use Only

Comm .e

mdwted

Audited

Computer

CL-

pEpbRT

D

TE S

NEO

Penalties Due For Late Filed Repof Range from $10 to $4400

SEE INSTRUCTIONS ON BACKAND COMPLETE THE FOLLOWING SENTENCE :

I AM FILING A

, G

fi-

(repo :aw)

[]CHECK IF AMENDMENT TO REPORT DATED

REPORT FOR AWA (1) ELECTION t(Z)NOWELECTION YEA.

Local Cornnuttees, eruer Date of Etttiypt) . . .

Q Check if this is final (termination) report and attach Notice of Dissolution Form OR-3 . (You must continue to file reports until a Notice of Dissolution ii,W)

County X Local Commiuses, safer C444 in Which Ewclion is held

JAN 2 2 Z03Z ,q :~Y,

STATEMENT OF CASK QN HAND

CASH ON HAND at the beginning of the reporting period . (This Is the totlil of all monies held by the contrnittee . This amount MUST be Idle

same as the cash on hand at the end of or must be zero if this is first report filed .)

ADD TOTAL MONEY TAKEN IN THIS PERIOD

the last repo" period,

,

Schedule A : Cash ContriWtions total (Attach Schedule A)

Schedule C : Fund-raising Events total (Attach Schedule C)

Schedule.

Schedule H : Total Sales of Campaign Property (Attach Scheduls H)

F : Loans Received total (Attach Schedule F)

Schedule H a

Ides to Candidates' Committses Onl

 

i

 

:

.,

 

Sub-TOTAL _-i

SUBTRACT TOTAL MONEY SPENT THIS PERIOD

Schedule

8 : Expenditures WW

Schedule 8)

,r,

:

Schedule F : Loan RepaynW% total (Adacxt $chedule F)

:.

CASH ON HAND at the end of this reporting period (if final report, OAW fit

be zero) (Attach DR-3)

,.

UNPAID BILLS (Front Schedule D - Attach Schedule 0)

IN KIND CONTRIBUTIONS FFrom Scusdule E - Attach Schedule Q

OUTSTANDING LOANS (From Schedule F - Attach Schedule F) CANDIDATE COMMITTEES ONLY :

:

.,

s

 

.,

*

,

 

.,

.$

 

i

CONSULTANT BREAKDOWN (Schedule G Attached

VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule M)

YES

For Instructions, See Back of Form

CONTRIBUTIONS - MONEY Tw

.:N IN

(Including candidate's personal funds)

SCHEDULE 1

A I

(Rev . 02/96)

MONETARY

RECEIPTS

COMMITTEE NAME (Must be same as on Statement of Organization)

DIG9 TAYLOR FQR $TAT

S°~e~rmmTr~

Q CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED

NUIabER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . DISCLOSURE bOARD.

FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION

A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMP"N

CAUTION :

for any commercial purpose by any person other than statutory political committees .

Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or

DATE

RECEIVED

(MM/DD/YR)

PAC ID NUMBER (it applicable) AND PAC CHECK NUMBER

8/6/01

ID# 8026

CK#

02829

ID# 6411

9/28/01

CK41158

ID#

NAME AND ADDRESS OF CONTRIBUTOR

JBEW COPE

1125

15th ST . NW

Washington, DC

20005

MCI IOWA PAC 707 17th ST . Denver,CO 80202

 

6089

Operating Engineers Local 234

10/29/01

CK# 157

4880 - Hubbell

 

Des Moines

IA

50317

 

ID'

-

 

Pass the Hat

12/10/01 CK#

RELATIONSHIP

TO CANDIDATE'

(if applicable)

AMOUNT

RECEIVED

5 1,000 .00 --

100 .00

200 .00

15 .00

ID#

C K#

ID#

CK#

ID9

C K#

ID#

ID#

ID#

CK#

SU&TOTAL

TOTAL

(if last page of this schedule)

5

' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no tamllial relationship, enter'not applicable' in the relationship column.

Page ~- of (for Scliedule A)

_

FOR INSTRUCTIONS, SEE BAC

)F FORM

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT

STATE PAC COMMITTEES : NOTE

CANDIDATES, LIST THE

PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA

ETHICS & CAMPAIGN DISCLOSURE BOARD .

: FOR

CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE

CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE

SCHEDULE

B MONETARY

(Rev . 02196)

EXPENDITURES

r/ CHECK THIS BOX IF AMENDING FORM

COMMITTEE NAME (Must be same as on Statement of Organization)

.

+'

DISK TAYLOR FOR STATE REPRESENTATIVE

 

CANDIDATE

DATE

ID NUMBER

EXPENDED

(if applicable)

(htiwVD01YR)

AND PAC

2/14/01

4/20/01

6/26/01

8/7/01

9/15/01

9/16/01

9/27/01

CHECK NUMBER

ID#

CK# 1049

ID#

0 4050

ID#

CK# 1051

ID#

CK#1052

!D#

CK# 1053

CK#

1055

ID#

CK# 1055

NAME AND ADDRESS TO WHOM EXPENDITURE

(Disbursemer ;Q WAS MADE

PURPOSE

(CANDIDATES SEE BELOW & ENTER

1,2,3)

AMOUNT

EXPENDED

JAN TAYLOR

2721

Cedar

31st

ST . SW

Rapids, IA 52404

fill

- .

fill

.'

""

""

Doris

708 Old Marion Road Cedar Rapids, IA 52402

Peick

Jan Taylor

Doris Peick

Iowa's Women in Public Policy PO Box 71142 D es Moines IA 50325

Newspaper

Ad

Reim .

Photo

Reim .

( 1

(1

Gazette AD

Reim

Reim .

Postage

Reim .

(

1

( 1

Copier Toner (

Reim

Postage

(!

F6rum

Workshop (

)

1)

3)

SUB-TOTAL

$ 710 .15

340 .51

363 .98

84 .00

568 .44;

;

.

.

70 .00

 

_

125 *00

262 .08

TOTAL (iflast page of this schedule) $

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Campaign funds may be used only for. (1) campaign purposes, (2) constituency expenses, and (3) educational and other expenses associated with duties of office .

Please insert the applicable number in the purpose column for each expenditure .

Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)

Expenditures to pzrsonsientities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail 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 Code 56 .6(3)(i) .)

Page _-~ of ,(for Schedule f3)

FOR INSTRUCTIONS, SEE BAt

)F FORM

EXPENDITURES

-- MONEY SPENT FROM COMMITTEE ACCOUNT

STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE

CANDIDATES, LIST THE

PAC CHECK NUMBER FOR EACH

ETHICS & CAMPAIGN DISCLOSURE BOARD.

CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE

EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA

COMMITTEE NAME (Must be same as on Statement of Organization)

DICK TAYLOR FOR STATE REPRESENTATIVE

 

CANDIDATE

DATE

ID NUMBER

EXPENDED

(&IlwVDD1YR)

11/6/01

11/9/01

12/8/01

(If applicable)

AND PAC

CHECK NUMBER

ID#

CK# 1056

I014

CK#

ID#

1057

CK# 1058

1014

1/1/O1-

12/31/01 CK#

ID#

CK#

ID#

CK#

04

NAME AND ADDRESS TO WHOM EXPENDITURE

Doris Peick

Jan Taylor

Doris Peick

,

(DisbursemenQ

WAS MADE

Bank Service Charges

SCHEDULE

B

(Rev . 02d96)

MONETARY

EXPENDITURES

CHECK THIS BOX IF AMENDING FORM

PURPOSE (CANDIDATES SEE BELOW 8 ENTER

1,2,3)

Reim .

Postage

(1

Reim .

ailing

(

1

Labels

eim .

Postage

1

_

AMOUNT

EXPENDED

$

96 .60

) 12 .90

)

34 .00

82 .95`

SUB-TOTAL $

TOTAL (if last page of this schedule)

$

2

.45

i

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY;

Campaign funds may be used only for. (1) campaign purposes, (2) constituency expenses, and (3) educational and other expanses associated with duties of office,

Please insert the applicable number in the purpose column for each expenditure .

Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H, (Refer to Schedule H instructions .)

Expenditures to personslentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemised on Schedule G by the amount, purpose, and date of each type of expenditure made by the persoNentity on behalf of the candidate's committee. (Rotor to

Schcoule

G instructions and Iowa Code 56 .6(3)(i) .)

Page

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