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8/7/2019 Braun Charles__1527__scanned

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0 5 1 1 9 1 2 9 0 2 2 1 : 5 5 5 1 5 2 9 2 4 9 2 4FOR I NSTRUCT I ONS SEE BACK OF FORM

DI SCLOSURE SUMMARYPAGECOMMI TT EE NAME ( M u s t b e s ame a s o n S t a t e me n t o f O r g a n i z a t i o n )Ch a r l e s Br a u n f o r S t a t e Re p r e s e n t a t i v e

( t i I D J S T O N CHAPPELL

I MPORTANT I n d i c a t e b y # t y p e o f c o mmi t t e e y o u a r e r e p o r t i n g f o r( 1 ) S t a t e w i d e / L e g i s l a t i v e / J u d g e S t a n d i n g f o r R e t e n t i o n C a n d i d a t e ( 2 ) S t a t e PAC ( 3 ) S t a t e P a r t y( 4 ) C o u n t y C e n t r a l C o mm i t t e e ( 5 ) C o u n t y C a n d i d a t e ( 6 ) C i t y C a n d i d a t e ( 7 ) S c h o o l B o a r d o r O t h e rP o l i t i c a l S u b d i v i s i o n C a n d i d a t e ( 8 ) C o u n t y PAC ( 9 ) C i t y PAC ( 1 0 ) S c h o o l Ho a r d o r O t h e r P o l i t i c a lS u b d i v i s i o n PAC ( 1 1 ) L o c a l B a l l o t I s s u eCANDI DATE COMMI TT EES ONL Y :C a n d i d a t e Name

C h a r l e s Br a u n

S I GNATURE OF PERSON F I L I N G REPORT

AMF I L I N G A Oc t o b e r 2 9 , 2 0 0 4( r e p o r t d a t e )

[ : ] CHECK I F AMENDMENT TO REPORT DATED

O f f i c e S o u g h t 1

1 ,

Z

O i s t r i c l ( i f S e n a t e o r H o u s e )

H o u s e o f Re p r e s en t a t i v e

C h e c k i f t h i s i s f i n a l ( t e r m i n a t i o n ) r e p o r t a n d a t t a c h N o t i c e o f D i s s o l u t i o n F o r m DRS( Y o u m u s t c o n t i n u e t o f i l e r e p o r t s u n t i l a DR - 3 i s f l e d . )

REPORT FOR ( 1 ) ELECT I ON / ( 2 ) NON- ELECT I ON YEARI n d i c a t e b y # EJ

STATEMENT OF CASH ON HANDCASH ON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d . ( T o t a l o f a l l f u n d s h e l d b y t h ec o m m i t t e e T h i s a m o u n t MUST b e t h e s ame a s t h e c a s h o n h a n d a t t h e e n do f t h e l a s t r e p o r t i n g p e r i o d o r mus t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . , . . . . . , . . . . . . . . . . . $ 1 0 4 7 . 9 1

L a t e r e p o r t s a r e s u b j e c t t op o s s i b l e c i v i l a n d c r i m i n a lp e n a l t i e s

L o c a l C o mmi t t e e s , e n t e r D a t e o f E l e c t i o nC o u n t y & L o c a l C o mm i t t e e s e n t e r C o u n t y i nw h i c h E l e c t i o n i s h e l d

PAGE 0 16 2 4DATE S I GNED


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0 5/ 1 8/ 2 00 2 2 1 : 5 65152924924I a I I NS TON CHAPPELL P A ( ' 3 E 0 2Fo r I n s t r u c t i on s , Se e Ba c k o f Fo r mCONTRI BUTI ONS - - MONEYTAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t b e s ame a s on S t a t emen t o f Or g a n i z a t i on )Ch a r l e s Br a u n f o r S t a t e R e p r e s e n t a t i v e

SCHEDULEA MONETARY( Re v . 0 7 / 0 3 ) IRECEI PT SCHECK T HI S BOX I FAMENDI NG FORMSTATE CANDI DATES NOTE : I F A CON TRI BUT I O N I S RECEI VEDFROMA STATE PAC ( POL I T I C AL AC T I O N COMMI T TEE) , L I S T THE PAC I DEN T I F I C AT I ONNUMBER AND THE PACCHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ET H I C S AND CAMPAI GNDI SC LOSURE BOARD

.

CAUTI ON : S e c t i o n 6 3 B . 3 2 A ( 6 ) , I o wa Cod e, p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me nt s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c omme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e es .

DAT E PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELA T I ON S HI P AMOUNT " I I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE` RECEI VED FUND-( MM/ DDI YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

1 0 # 1 5 2 7 FAS PAC 5 2 5 0 . 0 01 0 , - 1 6 / 0 4 CK4 2 6 0 0 E . 8 t h S t .5 1 7 0 Bo on e, I A 5 0 0 3 6

1 0 / 1 6 / 0 4I D # 6 0 0 8 A s s o c . B u i l d e r s &C o n t r a c t o r sRd S t e .4 7 5 A l i c e s A 1 0 0 . 0 0 ElCK# 2 1 1 3 Wa uk ee , I A 5 0 2 6 3I D# Do n a l d & , S h i r l e y Br o c k1 0 / 1 9 1 0 4 CK# 1 3 4 7 2 7 4 t h L n . 1 5 . 0 0 E : 1Boone . 1 A 5 0 0 3 6I D# Re p ub l i c a n P a r t y o f I o wa1 0 . / 2 0 / 0 4 CK# 6 2 1 E 9 t h St . 3 8 4 5 . 0 02 2 1 0 6 Des Mo i n e s . I A 5 0 3 0 9I D# J ame s &J u d y B r a u n

1 0/ 2 0/ 0 4 CK# 2 6 0 D i l l i o n S t . u nc l e &a u n t 2 5 . 0 0Dubuque, L A 5 2 0 0 3I D # P e t e r &Nf a r y Bi l d en

1 0 . / 2 0 , / 0 4 CK# 5 0 3 S . S t o w S t . 2 5 . 0 0Beone , I A 5 0 0 3 6


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0 5/ 1 8/ 2 00 2 2 1 : 5 65152924924WI NDTON CHAPPELL PAGE 0 3Fo r I n s t r u c t i on s , See Back o f Fo r mCONTRI BUTI ONS - - MONEY TAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a n i z a t i o n )C h a r l e s B r a u n f o r S t a t e Re p r e se n t a t i v e

R e s e t Fo r m

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) . L I S T THE PAC I D EN T I F I C AT I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN, A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON : S e c t i o n 63 6 . 3 2 A ( 6 ) , I o wa Co d e, p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me nt s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c omme r c i a l p u r p o s e b y a n y p er s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

SCHEDULEAMONETARY( Re v . 0 7 / 0 3 ) RECE I PTSCHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSH I P AMOUNT J I F FORRECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECE I VED FUND-( MM/ DDI YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI S ERNUMBER I NCOME

I D# u n i t e mu e dl O r ' 2 6 i 0 ~ 4 $ . 3 3CK#I D#CK#

1 0 #CK#I D#CK#I D#CK#I D#CK#


4/7

0 5 / 1 8 / 2 00 2 2 1 : 5 55 1 5 2 9 2 4 9 2 4I A DI S TON CHAPPELL PAGE 0 4FOR I N ST RUCTI ON S . SE E BACK OF FORM R e s e t Fo r m SCHEDUL E

EXPENDI TURES B MONETP,- MONEY SPENT FROM COMMI TT EE ACCOUNT ( Re v . 0 7 1 0 3 ) E XP E ND I T UESSTATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLATI VECANDI DATES, L I S T THE CANDI DATE I DENT I F I CAT I ON NUMBER I N THE DESI GNATED COL UMN AND THE D CHECK T HI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA A ME N DI N G FORMETHI CS & CAMPAI GN DI SCLOSURE BOARD .

COMMI TT EE NAME ( Mu s t b e s a me a s c n S t a t e me n t o f O r g a n i z a t i o n )C h a r l e s Br a u n f o r S t a t e R e p r e s e n t a t i v e

CAND I DATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCR I BE TRANSACT I ON ) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( MM/ DDI YR ) AND PACCHECKNUMBERI D # P o s t ma s t e r p o s t a g e

1 0/ 2 0/ 0 4 CK# 8 1 5 Ar d e n S t . 6 8 . 2 01 5 7 1 B o o n e , 1 . A 5 0 0 3 61 0 9 B o o n e Co u n t y A u d i t o r Ab s e n t e e l i s t

1 0 . / 2 0 / 0 4 CK#1572 B o o n e Co u r t H o u s e 4 5 . 0 0Bo o n e , 1 A 5 0 0 3 6I D# V i c t o r y S t o r e r a d i o a d v e r t i s i n gl 0 i 2 0 / 0 4 5 2 0 0 S . W. 3 0 t h St . 3 8 8 3 . 4 4CK#1573 B o o n e , I A 5 0 0 3 6D# Cu s t o m Ne ws p a p e r n e w s p a p e r a d s1 0/ 0 / 0 4 CK#1580 3 1 9 E . 5 t h 8 2 9 . 2 0De s Mo i n e s , I A 5 0 3 0 9I D# Wa l ma r t t h a n k y o u s1 0 / 2 2 / 0 4 CK# 1 8 1 5 S . S t o r y S t . 9 . 4 71 5 7 4 Bo o n e , I A 5 0 0 3 6I D # P o s t m a s t e r p o s t a g e


5/7

0 5 / 1 B/ 2 0 02 2 1 : 5 55 1 5 2 9 2 4 9 2 4t , 0 I H S TON CHAPPELLFOR l NSTRu cT10NS, SEE BACK OF FORMCOMMI TT EE NAME ( Mu s t b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )C h a r l e s Br a u n f o r S t a t e R e p r e s e n t a t i v e

NOTE : De b t s p r e v i o u s l y r e p o r t e d t h a t r e ma i n u n p a i d must b e i n c l u d e d o n t h i sSc h e d u l e . a s w e l l a s a n y n e w o b l i g a t i o n s i r c u r r s d i n t h i s p e r i o d .

DEBTSI OBLI GATI ONS REMAI NI NG T HI S REPORTI NG PERI OD( DO NOT I NCLUDE LOANS - - SHOWLOANS ON SCHEDULE F )

Re s e t Fo r m i

PAGE 0 5SCHEDULED I NCURRED( Re v . 0 a 1 9 8 ) L I NDEBTEDNESSCHECK T HI S BOXI F AMENDI NGFORM

An ' i n c u r r e d d e b t " i s a d e b t f o rg o o d s o r s e r v i c e s o r d e r e d o rr e c e i v e d . b u t n o t p a i d f o r b y t h ee n d o f t h e r e p o r t i n g p e r i o d . ,r e g a r d l e s s o f wh et h e r a n i n v o i c eh a s b e e n r e c e i v e d .

DATEI NCURRED( MM/ DD/ YR) NAME AND ADDRESS OF PERSONTO WHOM DEBT OR OBL I GAT I ON I S OWED

DESCR I PT I ON OF GOODS ORSERVI CES PROVI DED ORPURCHASEDBALANCE OWED AT

CLOSE OFREPORTI NGPERI OD -

8 . / 1 7 / 08 / 1 7 / 0 4 5200 S . W. 3 0 t h S t .D a v e n p o r t , L N 52 802y a r d s i g n s , s t a k e s , b a l l o o n s 1 , 1 3 5 . 1 5


6/7

0 5 ! 1 8 ! 2 00 2 )2 1 : 5 55 1 5 2 9 2 4 9 2 4WI D 4 5 T O r i CHAPPELLP A ( I E I 3 hFOR I NSTRUCTI ONS . SEE BACK OF FORMCOMMI TTEE NAME ( Mv s t b e same a s o n S t a r o me n t o f O r g s n i z a l f o n )Ch a r l e s Br a t m f o r S t a t e Re pr e se n t a t i v e

Rese t Fo r m

SCHEDULEE

I N KI ND( Re v . 0 6 1 9 7 ) CONTRI BUT I ONSCHECK T HI S BOX I FAMENDI NG FORMDATE RELAT I ONSHI P DESCRI PT I ON EST I MATED t i I F FORRECEI VED NAME AND ADDRESS TO CANDI DAT E OF I N KI N D FAI R MARKET FUNO- RA I SER( MM/ DD( YR) OF CONTRI BUTOR " ( i f a p p l i c a b l e ) CONTRI BUT I ON VALUE CONTRI BUT I ON

Ru Pu b l i c a n P a r t y o f I o wa p r i n t i n g 3 , 0 0 0 . 0 01 0 / 1 91 0 4 6 2 1 E . 9 t hDe s Mo i n e s , I A 5 03 09Ru P u b l i c a n P a r t y o f I o wa p o s t a g e 3 , 0 0 0 . 0 01 0 1 9 1 0 4 6 2 1 E . 9 t hDe s Mo i n e s , 1 A 5 0 3 0 9Ru p u b l i c a n P a r t y o f I o wa p r i n t i n g 2 , 0 0 0 . 0 01 0 / 2 0 / 0 4 6 2 1 E . 9 t hDe s Mo i n e s , I A 5 0 3 0 9Ru p u b l i c a n P a r t y o f I o wa p o s t a g e 7 5 0 . 0 01 0 . 1 2 0 , 1 0 4 6 2 1 E . 9 t hDe s Mo i n e s , I A 5 0 3 0 9Ru p u b l i c a n P a r t y o f I o wa r a d i o a d 3 0 0 . 0 01 0 / 2 2 . / 0 4 6 2 1 E . 9 t hDe s Mo i n e s , I A 5 03 09


7/7

FOR I N S TRUCT I ONS , SEEBACK. OF FORMCOM16 I TTEE NAME ( Mu s t b e s a r r r e a s o n S t a t e m e n t o f O r g a n i z a t i o n )Ch a r l e s B r a u n f o r S t a t e R e p r e s e n t a t i v e

NOTE : T h i s s c h e d u l e t e p o r t s mon e y l o a n e d t o t h e c o mm i t t e e v r h i c h i s d e p o s i t e d i n t h e c o m m i t t e e a c c o u n t .TOTAL UNP A I D LOANS FROM LAST REPORTI NG PERI OD $ 2 5 0 0 . 0 0PART I - MONETARY LOANS RECE I VED T H I S REPORTI NG PERI OD( O r i g i n a l s o u r c e o f l o a n , s u c h a s a b a n k , m u s t b e s h o w n i f a t h i r d p a r t y i si n v o l v e d . I n c l u d e l o a n s I r a r n c a n o r i d a t e ' s p e r s o n a l f u n d s . )

TOTAL ( PART I )

$ 0

' D i s c l o s u r e l a w r e q u i t e s c a n d i d a t e c o m m i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v em a k i n g a c o n t r i b u t i o n t o t h e c o m m i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o fc o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y m a r r i a g e ) . i f s u r n a m e o f c o n t r i b u t o r i st h e s am e a s c a n d i d a t e , b u t m e t e i s n o f a m i l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " I n t h er e l a t i o n s h i p c o ' u m n w h e n i t a p p l i e s -

R e s e t Fo r m

PART I I - MONETARY LOAN REPAYMENTS MADE T HI S REPORTI NG PERI OD( L o a n s l o p g i v e n m u s t b e r e p o r t e d o n S c h e d u l e E - - I n - k i n d C o n i r i b u t f o n s . )

TOTAL CASH REPAYMENTS ( PART 1 1 )F r o m S c h e d u l e E - - TOTAL LOANS FORGI VEN

TOTAL OUTSTAND I NG LOANS END OF REPORT PERI OD

P a g e

$ 0$ 0

2500 . 0 0

( ( o f S c h e d u l e F )

SCHEDULEF LOANS

( R e v . 0 7 1 0 3 ) RECEI VED& R EP A I DQCHECK T HI S BOX I FAMENDI NG FORM

DATERECE I VEDMMI DDI YRNAME AND ADDRESS OF LENDER( I r t i l u d e E n d o r s e r ' s N a m e , I f A p p l i c a b l e ) RELAT I ONSHI PTO CAND I DATEI f A i c a b l a `

AMOUNTOF LOAN DATE P A I D( M M I D D I Y R ) NAME AND ADDRESS OF LENDER( I n c l u d e E n d ( ms e l ' s Name , I t A p p l i c a b l e ) RELAT I ONSHI PTO CANDI DATE"I f A p p l i c a b l e )AMOUNTREPA I D

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