FORM DR-1: Statement of Organization Form Statement of

ID 9703 DR-1 Organization

Type Iowa PAC Web Reporting System Rev. 09/2003
Status Amended For Office Use Only
Name Ankeny Area Democrats Comm. # 9703
Indexed
Filed/Amended 8/1/2007 Audited
Date Computer

Committee Treasurer Committee Chair

Name Barbara A. Sorlie Name Rob Tucker
Address 320 NE 31st Street Address 3111 SW 24th Street

Ankeny, IA 50021 Ankeny, IA 50023

Primary Ph. (515) 964-0292 Primary Ph. (515) 965-9113
Secondary Ph. (nul) lnu-null Secondary Ph. (nul) lnu-null
e-Mail BarbaraAnn5417@msn.com e-Mail robtucker@qwest.net
Purpose
Distribute information on legislative issues. Social events. Informational talks. Suppport local candidates.
Contribute money to local candidates.

Office Sought: District:

Party: Year Standing for Election:
County: Polk Date of Election:
Primary Bank Account PAC Parent Entity, Affiliate or Sponsor
Name Deere Community Credit Union Name
Address P.O. Box 319 Address

Ankeny, IA 50021
Account Type Checking Primary Ph.
Account Name Ankeny Area Democrats e-Mail

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.

________________________________________________________
______________________________________________________
Chair Person: Treasurer:
(signature and date) (signature and date)

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028
 Filed/Amended
Committee Accounts 8/1/2007
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Default
Checking Ankeny Area Democrats
1 Deere Community Credit Union
Default Account P.O. Box 319

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Other
Savings Ankeny Area Democrats
2 Deere Community Credit Union
P.O. Box 319

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 Filed/Amended
Committee Officers 8/1/2007

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Role Name and Address

Co-Chair Don Miller
2822 SW Tradition Circle

Ankeny, IA 50023-8922

co-secretary Arvid D. Oliver

1709 NE Lowell Ct.

Ankeny, IA 50021

co-secretary Mary Oliver

1709 NE Lowell Ct.

Ankeny, IA 50021

co-treasurer Ray Blase

913 NE 34th Street

Ankeny, IA 50021

Vice Chair Gary Schmidt

2318 NW 17th St.

Ankeny, IA 50021

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 Filed/Amended
DR-1 Auditors Notes 8/1/2007

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