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01/18/2005

18 :09

STATE BANK OF WAPELLO -> 15152813701

FOR INSTRUCTIONS, SIX 13ACK OF FORM

DISCLOSURE SUMMARY PAGE

COMMITTEE NAMC (Mual Do same as on Statement or Organllation)

Wilson For Supervisor

IMPORTANT: Indicate "of committee you an reporting for:

(1

)Statswidelleaisladve Candidate (2 )StalaWids

(S )County PAC (6

PAC (3 )Stale Party (4 )CauntAocal Candidate

)ballot IsauarFranchW Commlttae- (7 )ownt rqt~ C®nlml Ccmmhtae

CANDIDATE COMMITTEES ONLY,

Candidate Name

David K . Wilson

Office Sought

JAN

1

8

2005

Louisa Co unty ,Supe-rvistst ------

political Party

Republican

Disldct (if Senate or House)

,.

563-2 .63-7618

TELEPHONE

FORM

DR-2

(Rev . 0712000)

DISCLOSURE

REPORT

For fJRleo Use On Y / ~~ ~~

CO mm. E

Lopped In

,1<0/1~~

simnned

Computer _

Audited

January 1~8, 2005, DATE SIGNED

Late filed reports are subject to possible civil and criminal penalties.

SEE INSTRUCIIONS ON BACK AND COM~ THE

~ FO LLO IS SETENCE :

I AM FILING A _-_January 16, 2005-FTNAL

port dale)

REPORT FOR AN/A 1 ELECTION 1(2)NON-ELECTION YEAR.

Indicate one

CCHECK IF AMENDMENT TO REPORT DATED

Local Committees, enter Dato of Election

[Iq Check If this is final (termination) report and attach Notice of Dissolution Form DR-3 . (You must ooalnue to file Imports tinil) a Notice of Dissolution is filed)

County

which

8. Local Cafnrnldees, enter County In Irleclion is held Louisa Count :

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting

period . (This is the totai or all monles held

by the committee. This amount MUST be the same as the cash on hand at the end of the last reporting period, or must be zero if this is first report flied .)

ADD TOTAL MONEY TAKEN IN THIS PERIOD

Schedule A :

Schedule F: Loans Received total (Attach Schedule F)

Schedule H :

Cash Conhfbulions total (Attach Schedule A) ('also see in-Kind below)

Total Sales of Campaign Property (Attach Schedule H)

ISchadu ail applies Io Candidate®'Committees Only)

$ -13810,1

_-0-

- 0-

SUB-TOTAL

,

i

SUBTRACT TOTAL MONEY SPENT THIS PERIOD

Schedule 8 :

Schedule F: Loan Repayments total (Attach Schedule F)

Expenditures total (Attach Schedule B) ("also sea debts and loans below)

CASH ON HAND at the end of this reporting period (iffinal report, balance must be zero) (Attach DR-3)

"UNPAID SILLS (From Schedule D -Attach Schedule D)

'IN KIND CONTRIBUTIONS (From Schedule E -Attach Schedule E)

"OUTSTANDING LOANS (From Schedule F-Attach Schedule F) CANL)tDATE COMIIA1ITEES ONLY,-

CONSULTANT BREAKDOWN (Schedule G Attached?)

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

,

$

 

.

.S

 

$

$

$

138 .01

138 .01

-0 -

None

None

None

YES IM NO

01/18/2005

18 :09

STATE BANK OF WAPELLO 4 15152813701

N0,659

FOR INSTRUCTIONS, SEC BACK OF FORM EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT

STATE PAC COMtAITTEFS . NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDEOR LEGISLATIVE CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND

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

ETHICS A CAMPAIGN DISCLOSURE BOARD,

THE

SCHEDULE

B MONETARY

(Rev . 07I03)

EXPENDITURES

D CHECK THIS BOX IF AMENDING FORM

COMM1TTEE NAME (Must be same as on Sla(ement d Organlzauvn)

Wilson FoT Super'v'isor.

 

CANDIDATE

NAME AND ADDRESS TO WHOM

DATA:

ID NUMBER

EXPENDITURE

EXPENDED

(itapplicable)

(D10wsernmV WAS MADE

(MMIDDlyR)

AND

PAC

CHECK

 
 

NUMBER

1-10-05 ID# #1012

CK#

'

-

ID#

 

CK#

ID#

CK#

[D#

CK#

ID#

CK#

IQ#

CK#

CK#

ID#

CK#

David 1C . Wilson 11513 Co . Rd . G-62 Wapello, Ia . 52653

PURPOSE (DESCRIBE TRANSACTION)

Final Disbursement to Close Account

SUB TOTAL

TOTAL (iflast page of this aahoduM)

$

$,

AMOUNT

EXPENDED

$138 .01

138 .01

138 .01

THIS BOX APPLIES TO CANDIDATES' COMMfITEES ONLY .

Purfses of certain campaign propertycosgng $500 or mom must also be Inventoried on Schedule H. (Refer to Schedule H Instructions_)

Eapendlluros to personslenlilles providing consulting, advertising. fund-raising, polling, managing, organtzJng services must also be detail Itemized an

Schedule G by the amount . purpose, and dale of each type of expendllwe made by

Schedule G instrucllons and Iowa Code 6111&402(3)(I) ,)

the

personlentity an behalf of the candidate's commutes. (Refer to

(for Schedule B)

P03