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Generated On: 4/22/2010 10:15:06 AM

Indexed DR-1
DR-1 Statement of Organization Audited
Computer
Committee Name: CARNAHAN FOR IOWA HOUSE
Committee Type: State House Committee Code: 1918
County: Scott Political Party: Democratic
District: 84 Date of Election: 11/2/2010
Year Standing for Election: 2010 Office Sought: STATE REPRESENTATIVE
Status: Filed Date: 4/21/2010
Purpose

Treasurer
Last Name: Engelmann First Name: Tom MI:
Address: 1111 East River Dr
City: Davenport State: IA Zip Code: 52803 Phone: 563-323-3568
E-Mail: tengelmann@revealed,net

Candidate
Last Name: Carnahan First Name: Sheri MI:
Address: 2007 Emerald Dr
City: Davenport State: IA Zip Code: 52804 Phone: 563-210-7685
E-Mail: sherintom1999@yahoo.com

Bank Accounts
Account Name Bank
Carnahan for Iowa House IH Mississippi Valley Credit Union
Type: Checking 2121 47th Street
Moline, IL 61265

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 1 of 2
Generated On: 4/22/2010 10:15:06 AM

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 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: (signature and date)

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 2 of 2

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