FORINSTRUCTIONS,

SEEBACK OF FORM
CHECKONE:
El fnis is anInltial'Statement
ofOrganization
E fnis is anamendecF Statement
of Organization
*An initial Statementof Organizationmustbe filed within 1a days of the ommiftee's accepting contributions,
making expenditurcs,or incuning idebfedness exceeding$750. Amendmentsmustbe fibd within 30 days ot Oonm. #
a change. Penaftiesmay be impsed for lat+filed Statementsof Organization.A candidatewith an open lndexed
commifteethat exceeds$750 in adiviU for anotherofrce shall file within 10 days either a new or amended Audited
DR-1 disclosinginformationan@ming the campaignfor the new offioe sought.

COMMITTEENAME I I (Acandidate'scommitteemu$irrcludethecandidate'slastnarneinthenameolthecommitte€.)
Johnstonfor SchoolBoard

COMMTfTEETREASURER ior all COMMTfTEECHAIR foracandid#'s

It
MartinEdelson
MailingAddress | | MailingAddress| |
2417Duft Ave. 540 Brookridge
citv,srateI I ZpcodeI I city,stateI I zpcode J I
A*"s. tA 50010 Ames.lA 50014
Phone1515) 232-1690 Pfpne ( 515') 232'8544
e_Md mcel@mac.com
Advocate
Commentor E Rorrocate balbt

Ofibe Sought: Ames SchoolBoard

County: Story
Politi:al Party (if applbable) (f aAive
Distrid Ames Community Schools Dateof Etecrion.911212006
Year icr Election:2006
It
I I Affillate. or Sooneor
Johnstonfor SchoolBoard GailJohnston
Name ot FinancialInstitutionrtypeof Account tl

1st NationalBankof Ames/Checking

MailingAddress I I city I,l srarel I zip I.l
2406GrandAvenue Ames lA 50014
city Stale I zipll
I I I ernne1515 ) 232-8il4
Ames IA 50010

STATEIIENTOF AFFIRMATIOI{:By filing thls documentthe committeeafllrms the tollowirg:

1. The committeeard all persons@nnectedrviththe committeeunderstardthat theyare subiectto the lawsin lowaCodechapters68Aand688 and the administrative
rulesin Chapter351ol the lowaAdministrative
Code.
2. That lowaCodesection68A.402ard rule351-4.9 requirethefilingof disclosurereportsard thal the failureto file thesereportson or beforethe requireddue dates
subjectsthe candidateor cirairperson(in the caseof committeesotherthana candidate'scommittee)to the automaticassessmentof a civil penaltyandthe possible
impositionof othercriminaland civilsanctions.
3. ThatlowaCodesection684.405ard rules351-4.38 throwh 4.4i!requiretheplacement ot thewords'paidlor b/ andthe nameof thecommiftee on all political
materialsexceptfor thoseiternsexemptedby statuteor rule. A committeethatwish€sto registera committeenametor purposesof usirEthe shorter'paidfor b)/ arid
doesnot interdto crossth€$750filingthreshoushallfilethe Fom DR-SFAbrm.
4. That lowaCodesection68A.503and rules351*4.44 through4.52 prohibitther€ceiptof corporatecontributionsby all oommitteesexceptfor statewideand localballol
issuoPACS.
5. A cardidateanda candidate's
commiftee lundsas permitted
mayonlyexperdcampaign by lowacodesections684.301through684.303ard rule351-4.25.
6. Thatthe committeewill clntinue to file disclosurereportsuntilall activityhasceas€d,committeefundsspent,debtsresolved,and a tinal reportanda statementof
(DR-3)hasbeenfiled.
dissolution
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