FOR INSTRUCTIONS, SEE BACK OF FORM FORM

DISCLOSURE SUMMARY PAGE

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DR-2 DISCLOSURE
(Rev . 0712004) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization)
For Office Use Only /
MICHAEL C. HANSMEIER Comm . #
IMPORTANT: Indicate by #type of committee you are reporting for Logged In k
(1 )Statewide/Legislative/Judge Standing for Retention Candidate (2 )State PAC (3 )State Party Scanned
( 4 )County Central Committee ( 5 )Coup Candidate 6 )City Candidate 7 School Board or Other
Political Subdivision Candidate ( n ( o rd or Other Political Computer
SubdIvIs1on PAC~ 1 Local Ball ~, Audited
CANDIDATE COMMITTEES
Candidate Name Party (if applicable)
~~ AUG Late reports are subject to
MICHAEL C. HANSMEIER
possible civil and criminal
Office Sought §tfidt ~if Senate or House) penalties.
HANCOCK COUNTY SHE

SIGNATURE OF PERSON FILING REPORT

-5-65-328 210.5
TELEPHONE DATE SIGNED

I AM FILING A 8/08/05 REPORT FOR (1) ELECTION I(2)NON-ELECTION YEAR .

(report date) Indicate by #

QCHECK IF AMENDMENT TO REPORT DATED 7120/05 Local Committees, enter Date of Election
08/16/05
C 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
HANCOCK

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (Total of all 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.) ... ... ... ... . .. . .. ... ... ... ... ... . $ 0
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A. Cash Contributions total (Attach Schedule A) ("also see in-kind below) ... ... . ... 100.00
Schedule F: Loans Received total (Attach Schedule F) . .. . ... .. . .. .... ... ... ... ... .. .... ... ... .. ..... . .. . . .. .
Schedule H: Total Sales of Campaign Property (Attach Schedule H) . .. .... .. ... ., .. ... .. ., . . .. ,
(Schedule H applies to Candidates' Committees Only)

SUB-TOTAL ..... $ 100.00

SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ("*also see debts and loans below) . . ..
Schedule F: Loan Repayments total (Attach Schedule F) .. .... . . . .. ... ... ... .. . ... ... ... .. . ... ..... . ... ... ..
CASH ON HAND at the end of this reporting period (if final report balance must
be zero) (Attach DR-3) . .. . .. . .. . .. .. . ... ... ... .. . ... .. . .. . . . .... .. . .. ... ... ... . . . ... ... . .. . .. ... .... .. . .. ... ... .... . .. . .
. .. ... .. $ ~.,
"UNPAID BILLS (From Schedule D - Attach Schedule D) . ... ... ... . .. . . . ... ... . .. ., . ... ......, .. ... .... $
"IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . ... ... ... ., ... . ... , .., .. . ,.... $
**OUTSTANDING LOANS (From Schedule F - Attach Schedule F),.. ... ... . ..... .... .. .. ..,. ... . $
Jo 179.59
CONSULTANT BREAKDOWN (Schedule G Attached?)
YES V NO
CANDIDATE COMMITTEES ONLY
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)
$-0-
.00
For Instructions, See Back of Form Reset Form
SCHEDULE

A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 07103) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

MICHAEL C. HANSMEIER

STATE CANDIDATES NOTE : IF A CONTRIBUTION 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 88B.32A(8), Iowa Code, 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 PACIDNUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR

RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
ALAN A. LARSON
07/29/05 4400 N SCOTTSDALE RD . PMB255 $ 100.00
CK#
2097 SCOTTSDALE . AZ 85251
ID#

CK#

ID#

CK#

CK#

CK#

ID#

CK#

!D#

CK#

ID#

CK#

ID#

CK#

ID# -

CK#

SUB-TOTAL

TOTAL (Klast page of this schedule)

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) . If surname of contributor is the same as candidate, but there is no I 1
familial relationship, enter'not applicable' in the relationship column . Page of _
(for Schedule A)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN-KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev. 06/97)1 CONTRIBUTIONS

MICHAEL C. IfANSMEIER
rl CHECK THIS BOX IF
AMENDING FORM

DATE RELATIONSHIP DESCRIPTION ESTIMATED q IF FOR

RECEIVED NAME AND ADDRESS TO CANDIDATE OF IN KIND FAIR MARKET FUND-RAISER
(MWDDIYR) OF CONTRIBUTOR ' (if applicable) CONTRIBUTION VALUE CONTRIBUTION
5
MICHAEL C. HANSMEIER - SELF SELF - IA SECRETARY 17 .64
06/02/05 1015 330TH ST CANIDATE OF STATE
FOREST CITY, IA 50436

SAME SAME GIFTS SEW 262.52

07/12/05 SWEET - T
Qu1D'rC

SAME SAME BRITT NEWS 234 .00

07/14/05 TRIBUNE - ADS

SAME SAME CHRIS WAGLER 40 .00

07/14/05 - SIGNS

F
SAME SAME GARNER 135.90
07/14/05 LEADER-ADS

F7
SAME SAME FOREST CITY 66 .00
07!14/05 SUMMIT - ADS

SAME SAME STAPLES- 80.88

07/18/05 PRINTING &
QI IDDI IQQ

?1~~~0~ Si14h2~

Jot A. - -
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'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page I of
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule )
by marriage). (See Page 2 of forms packet .) If surname of contributor is the same as candidate, but there is no
familial relationship, enter 'not applicable' in the relationship column .
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN-KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev . 06/971 CONTRIBUTIONS

MICHAEL C. HANSMEIER
0 CHECK THIS BOX IF
AMENDING FORM
Reset Form

DATE RELATIONSHIP DESCRIPTION ESTIMATED q IF FOR

RECEIVED NAME AND ADDRESS TO CANDIDATE OF IN KIND FAIR MARKET FUND-RAISER

E:1
" (if applicable) CONTRIBUTION VALUE CONTRIBUTION
m
MM/DDNR) OF CONTRIBUTOR
1 1

1015 330th St.

4Tt'E~I~5J
FOREST CITY, IA 50438
F
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D
O ~o SELF, Y -_-
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PRi! 7

0
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'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule E)
by marriage). (See Page 2 of forms packet .) If surname of contributor is the same as candidate, but there is no
familial relationship, enter 'not applicable" in the relationship column .