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Fill and Sign the How Do I Get an E Zrep Form Tr 2000 Tax Information

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FORM ID Type Status Name DR-1 : Statement of Organization 17901 County Candidate Amended Curry for Supervisor ad/Amended Date 312712006 Committee Treasurer Name Tim Ihlenfeldt Address 4989 Sharon Center Rd Sw Iowa City, IA 52240 Primary Ph. (319) 683-3203 Secondary Ph . (nul) Inu-null e-Mail Form DR-1 " Statement of Organization __Rev_ . 0_9_ /2_00_3__ _Web Reporting System For Office_ Use Only Comm. # 17901 Indexed Audited Computer (niro sear 3Name Address Committee Chair Primary Ph. Secondary Ph. e-Mail Purpose Office Sought: Supervisor Party: Republican County : Johnson Primary Bank Account Name Farmers and Merchants Savings Bank Address 4985 Sharon Center Rd SW Account Type Checking Account Name Curry for Supervisor (alan Curry) District: 0 Year Standing for Election: 0 Date of Election:-14RYY006-"Sl Candidate name & address Name Alan M. Curry Address 4985 Sharon Center Rd Sw Iowa City, IA 52240 Ph Primary . (319) 683-2911 e-Mail currysauto@aol .co m Statement of Affirmation By Treasurer and Candidate ; or Political Committees, By Chairperson STATEMENT OF AFFIRMATION: By filing this document the committee affirms the following : 1 . The committee and all persons connected with the committee understand that they are subject to the laws in Iowa Code chapters 68A and 68B and the administrative rules in Chapter 351 of the Iowa Administrative Code . 2. That Iowa Code section 68A.6 and rule 351-4.9 require the filing of disclosure reports and that the failure to file these reports on or before the required due dates subjects the candidate or chairperson (in the case of committees other than a candidate's committee) to the automatic assessment of a civil penalty and the possible imposition of other criminal and civil sanctions. 3. That Iowa Code section 68A.14 and rules 351-4.38 through 4.43 require the placement of the words "paid for by" and the name of the committee on all political materials except for those items exempted by statute or rule. 4. That Iowa Code section 68A.15 and rules 351-4 .44 through 4.52 prohibit the receipt of corporate contributions by all committees except for statewide and local ballot issue PACs . 5. A candidate and a candidate's committee may only expend campaign funds as permitted by Iowa code sections 68A.40 through 68A.42 and rule 351-4.25. 6. That the committee will continue to file disclosure reports until all activity has ceased, committee funds spent, debts resolved, and a final report and a statement of dissolution (DR-3) has been filed . Candidate : (signature and date) Treasurer: ,-s-e6-(signature and date) IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD 1510 EAST 12th, SUITE 1A I DES MOINES, IA 50319 1(515) 281-4028

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