Dotzler William - 1040 - Scanned
Dotzler William - 1040 - Scanned
DR-2 I DISCLOSURE
DISCLOSURE SUMMARY PAGE (Rev . 02/96) REPORT
JAN 1 5 2002
For Office Use Only
COMMITTEE NAME (Must be same as on Statement of Organization) Comm . # 104 61
Indexed
Audited
IMPORTANT: Indicate type of committee you are reporting for: 0 Computer
( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party (4 )County/Local Candidate
( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee
( 8 )Support Slate of Candidates
Penalties Due For Late Filed Reports Range from $10 to $400
CASH ON HAND at the beginning of the reporting period . (This is the total
iaa~,3q /
of all monies 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 .) . .. .. ... .. .. ........... .. .. .. .. ......... .. .. .. .. . .. .. .. .. ... .. .. ....... .. ... $
'RLkg Lk . a -6°
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) .. .. ....... .. .. .. .. .. . .. .. .. .. ... .. .. ... .. .. .. ... C~
Schedule C: Fund-raising Events total (Attach Schedule C) .. ...... .. .. ......... .. .. .. .. . .. .. .. ... .. .. .....
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 .....$ C --I ~5zg1
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ..... .. .. .. .. ....... .. .. .. .. ......... .. .. .. ... .. .. ... .. .. ..
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) .. .. .... ..... .. .. .. ... .. .. .. .. ..... .. .. ......... .. .. .. .. ...... ..... .. .. .... . .. .. .. ......... .. ..... .. .. .. .. $ b 1 L~ 1 .S`~'-,
UNPAID BILLS (From Schedule D - Attach Schedule D) . .. .. .. .. .. .... . .. .. .. .. .. ......... .. .. .. . . . .. .. .. .. ... .. .. ....... .$
IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .. .. .. ....... .. .. .. .. .. . .. .. .. .. . .. .. .. .. ... .. .. .$ ~° 5 y
OUTSTANDING LOANS (From Schedule F - Attach Schedule F) .. .. .. .. .. ..... .. .. .. .. .. .. . .. .. .. .. . .. .. .. ..... .. .. .$
CANDIDATE COMMITTEES ONLY:
YES NO
CONSULTANT BREAKDOWN (Schedule G Attached?)
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $ ~~(>(~ ~~ ~ CEO -
For Insi .uctlons, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN
(Rev . 02/96) RECEIPTS
(Including candidate's personal funds)
I] CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
C~ -A To ~\ e ~- ~, I \ I ) Cl-'V- - \ .r-
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 68B .32A(6), 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 .
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SUB-TOTAL
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 Page of~~
familial relationship, enter 'not applicable' in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEWED 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 ISAVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD .
CAUTION : Section 68B .32A(6), 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.
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SUB-TOTAL
$a 5
TOTAL (iflast 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) (See Page 2 of forms packet.). If surname of contributor is the same as candidate, but there is no Page ,~- of
familial relaUonship, enter 'not applicable' in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
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 68B .32A(6), 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 .
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SUB-TOTAL
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 Page 3 of
familial relationship, enter not applicable' in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
}A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN
(Rev . 02/96) RECEIPTS
(Including candidate's personal funds)
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 68B .32A(6), 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 .
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SUB-TOTAL
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 sumame of contributor Is the same as candidate, but there is no Page ~- of ~_
familial relationship, enter 'not applicable' in the relationship column . (for Schedule A)
For Instructions, See Back of Form
CAUTION : Section 68B .32A(6), 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 .
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SUB-TOTAL
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 Page of ~_
familial relationship, enter 'not applicable' in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 02/96) RECEIPTS
(Including candidate's personal funds)
0 CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
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 68B.32A(6), 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 .
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SUB-TOTAL
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 68B .32A(6), 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 .
ID#
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SUB-TOTAL
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 Page _~ of ~_
familial relationship, enter 'not applicable' in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 02/96) RECEIPTS
(Including candidate's personal funds)
101 CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
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 68B .32A(6), 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 .
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SUB-TOTAL
$ I"~h
TOTAL (if lastpage 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) (See Page 2 of forms packet.) . If surname of contributor Is the same as candidate, but there is no Page , - of -L
familial relationship, enter 'not applicable' in the relatlonship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 02196) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
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 68B .32A(6), 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 .
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SUB-TOTAL
$
TOTAL (if last 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 consangulnlty (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 Page 'A of
familial relationship, enter 'not applicable' in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 02/96) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
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 68B .32A(6), 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.
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SUB-TOTAL
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 68B .32A(6), 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 .
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SUB-TOTAL
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TOTAL (if last page of this schedule) L4l
a Jd-
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 Page \- of (,
familial relationship, enter 'not applicable' in the relationship column . (for Schedule A)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
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SUB-TOTAL $
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TOTAL (if last page of this schedule) $ (S
U
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to persons/entities 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) .)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev . 02/96)1 CONTRIBUTIONS
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LA c J A \ ~,OCb h c \~ o. .
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SUB-TOTAL $
QD 'a
TOTAL (if last page of this $
schedule)
'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page ~- of
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev. 02/96)1 CONTRIBUTIONS
X0\3-31 7
SUB-TOTAL $
Date Purchased
(Schedule B) Purchase Current
. or Date Received Description of Property Price or Est. Value at Fair Date Name and Address of Purchaser/Donee Description of Property Sold? Sale Value of
(Schedule E) Value When Market This (MM/DD/YR) YIN Price Donation
(MM/DDNR) Acquired* Report
12. CA' ~o
TOTAL VALUE CAMPAIGN PROPERTY THIS REPORT ** PROPERTY SALES & TRANSFERS TOTAL TOTALS $ $
(TRANSFER TO SUMMARY PAGE) $ g.o(-,) o - UU (TRANSFER TO SUMMARY PAGE) $
* If estimated, show est. beside figure . (Attach Additional Schedules if Needed) Page of i Pages
(For Schedule H)