t-UH INS I RUCTIONS, SEE BACK OF FORM

FORM
DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
COMMITTEE NAME (Must b9 same as on Statement or Organmation) (Rev . 0712404) PFSPORT

For Office Use Only

CITIZENS FOR POLICE & FIRE SAFETY
Comm, #
IMPORTANT; Indicate by # type of committee you are reporting for. Logged In
(1 )Statewide&eaislativeIJudge Standing for Retention Candidate (2 )State PAC ( 3 )State Party
Re-annrd
( a )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or Other
Political Subdivision Candidate ( $ )County PAC ( 9 )City PAC ( 10 )School Board or Other Political Computer
Subdivision PAC 11 Local Sellot Is
Audited
CANDIDATE COMMITTEES ONL .
Candidate Name LAbl l& Political Party (if applicable)
Late reports are subject to
possible civil and criminal
Office Sought District (if Senate or House) penalties.

~~-27^0C
,61s_2 41 -aggL -
TELEPHONE DATE SIGNED

APRIL, 28TH 2006

I AM FILING A REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate by #R

OCHEGK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election

5/2/2006

[~ Check if this is final (termination) report and attach Notice of Dissolution Form DR-3, County & Local Committees, enter County In
(You must continue to file reports until a DR-3 is filed .) which Election is held
POLK

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period, (Tuldl ur ail funds 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 filed .) . . . . . . . .  . . . . . . . . . . . . . . . . . . . . . . . . $ 000_00

ADD TOTAL MONEY TAKEN IN THIS PERIOD

Schedule A : Cash Contributions total (Attach Schedule A) ('also see in-kind below) . . . . . . . . . . 2,820 .00
Schedule R Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 .00

Schedule H ; Total Sales of Campaign Property (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , 00.00

Schedule H aPPfes to Ca didates' CommitteesOnly)
SUB-TOTAL .. . ..$ 2,820 .00
SUBTRACT TOTAL MONEY SPENT THIS PERIOD

Schedule B' Expenditures total (Attach Schedule B) ("also see debts and loans below)  1,192 .50

Schedule F : Loan Repayments total (Attach Weoule t") . . . . . . . . . . . . . . . . . . . . . . . . . . .  , . . . . . . . . . . . . . . . . . . . . . . oo .oo

CASH ON HAND at the end of this reporting period (If final report balance must
1 .,628 .0()
be zero) (Attach DR-~) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

-UNPAIR BILLS (From Schedule D-Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 00 .00

-IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . .  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  , $ 00 .00
-- OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . . . . $ 00 .00
CANDIDATE-CQMtAITTEES ONLY:
CONSULTANT BREAKDOWN (Schedule G Attached?)
VALUE OF CAMPAIGN PROPERTY (From Schedule H -Attach Schedule H) $ 00 .00
 For Instructions, See Back of Form SCHEDULE
CONTRIBUTIONS M MONEY TAKEN IN
A MONETARY
(Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
CITIZENS FOR POLIC13 & FIRE SAFETY

STATE CANDIDATES NO FL : 11' A GUNTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD,

CAUTION: Section I38B.32AM), Iowa Coda, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
RECEIVED (If applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DDIYR) AND PAC CHECK (If applicable) RAISER
NUMBER INCOME
Ilk#
Larry C Ireland
A/2012006 2170 New 84th Avo NONE $100 .00
CK4
4565 Ankcny IA 50023
ID#

LWE
Jcffrcy A & EHT,,aI7rth H HUOI]1Gft
4/20/204G 317 NE 31st Street NONE 100.00
CK#
17770 Ankeny, IA 50021
ILM
ZANE SMITH
4/2012006 CK# 1200 South 60th Street NONE 500.00
1 1609 VVcst Dc: Muincs IA 50266
ID#
Steven . D. & Christa L Cargve
4/70/20(16 OK# 3205 SE Cherry Blossom .Dr. NONE 20 .00
1824 Anken 1A 50021
ID#
Or Tara Meredith
IVlat1hcw
1,000.00
4/20/2006 CK# 2713 NE Seneca Dr . NONE
6778 Ankeny IA. 5002 .1

Lj
I Dft
David M Dirks
250-00
4/20/2006 CK# 4760 2311 NW 84th Ave NONE
Ankeny,TA 50021
IDN

a
Judith J Dirks
NONE 250.00
4/20/2006 C.K# 6093 2311 NW 84th Ave
Ankeny,IA 50021
ID#
David J Kissinger for Council
4!20/2006 806 SE Innsbruck Dr . NONE 500'00
CK# 1023
Ankeny, .IA 50021
ID#
Accumold 100.00
4/20/2006 CK# 1711 SE Oralabor Rd NONE
9932 Ankeny iA 50021
. . . . _.
ID#

CK#

SUB-TOTAL

TOTAL (if last page of this schedule)

" Disclosure law requires oandldate Committees to disclose the relebanshlp of any rrlatlvm. making n rnntrihntinn to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by 1 1
marriage) . If surname of oontrlbutor Is the same as candidate, butthere Is no Page of
familial relationship, enter "not applicable" In the relationship 00lurttn . (for Schedule A)
 FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

B MONETARY
EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT
(Rev. 07103) EXPENDITURE$
STATE PAC COMMITTEES : NOTE! FOR CONTRIBUTIONS MADE TO ETATEWIDC OR I .cGIoLATIVC
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE, A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.

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

CITIZENS FOR POLICE c$ FIRE SAFETY

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (DIsbursoment) WAS MADE
(MMIDDIYR) AND PAC
CHECK
NUMBER
ID#
Carter Printing Advertising Expense
412112006 1739 East Grand Avr. 1,192.50
. GK# loin
Des Moines, TA 5031.6

ID#

CK#

C I<*

ID#

CK#

iD#

CK#

_
ID#

CK#

ID#

CK#

ID#

CK#

SU B.TOTAL

TOTAL (If last page of this schedule)

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Purchases of certain cempeign property Costing $500 or more must also be inventoried on Schedule 11 . (Refer to Schedule I I Instructions.)

Expenditures to personstantltles providing oonsvlting, 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 personlentlly on behalf of the candidate's committee. (Refer to
Schedule G Instructions and Iowa Code BSA.402(3)() .)

(for schedule 5)