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Generated On: 10/19/2010 12:15:16 AM

Schedule A: Contributions Sch-A


Cedar Rapids Physician-Hospital Organization PAC (PHO- Status: Filed
PAC)
Committee Type: Iowa PAC Statutory Due Date 10/19/2010

County: _NA Adjusted Due Date

District: 0 Filed Date 10/19/2010 12:03:14 AM

Committee Code: 9694 Postmark Date

Political Party: Not Available Amendment Date

Contribution Contribution Name and Address of Contributor Relationship To Contribution Fund-Raiser


Date Committee ID Candidate Amount
Check # Roehr, Cynthia
8/18/2010 320 McKinsie Court NE None $250.00
Cedar Rapids, IA 52402
Check # Bertoche, Sharon
9/15/2010 3221 Falcon Dr. NE None $100.00
Cedar Rapids, IA 52402
Check # Crumley, David Dr.
9/15/2010 7118 Walden Rd NE None $100.00
Cedar Rapids, IA 52402
Check # Eilers, Stan
9/15/2010 5070 Northridge PT SE None $250.00
Cedar Rapids, IA 52403
Check # Murray, Kevin & Janet
9/15/2010 3000 Cornerstone Court None $100.00
Cedar Rapids, IA 52403
Check # Tyler, Mark
9/15/2010 7 High Ridge Ct SE None $250.00
Cedar Rapids, IA 52403
Check # Hirleman, Michael
10/4/2010 229 Abbotsford Rd None $250.00
Cedar Rapids, IA 52403

Total Regular Contributions $1,300.00


Total Fundraiser Contributions $0.00
Grand Total All Contributions $1,300.00

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

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