Beltrame Marc - 1317 - Scanned

FOR INSTRUCTIONS, SEE BACK OF FORM
DISCLOSURE SL MARY PAGE DR-2

(Rev . 01/2001)
I DISCLOSURE
COMMITTEE NAME (Must be same as on Statement of Organization) REPORT
Citizens for Beltrame
For Office Use Oniv /
IMPORTANT. Indicate type of committee you are reporting for: Fil Comm . #
Indexed ,5w
( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party( 4 )County/Local Candidate -11 _() 7;
( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee
( 8 )Support,Slate of Candidates
SIGNATURE OF TREASURER (or person filing this report)
Routine Penalties Due For Late Filed Reports Range from $20 to $800
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :
I AM FILING A 12/31/01 REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR.
(report date) Indicate one
nCHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election
0 Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County 8< Local Committees, enter County in
(You must continue to file reports until a Notice of Dissolution is filed.) which Election is held
STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (This is the total of all monies held
by the committee. This amount MUST be the same as the cash on hand at the end
of the last reporting period, or must be zero if this is first report filed.) .... ..... ........ ..... ..........$ 0
ADD TOTAL MONEY TAKEN IN THIS PERIOD

Schedule A: Cash Contributions total (Attach Schedule A) (*also see in-kind below) ......... 14,790 .00
Schedule F: Loans Received total (Attach Schedule F) . .. .. .. .. .................... .. . ........ ........ .... .. . 0
Schedule H: Total Sales of Campaign Property (Attach Schedule H) ... .. ..................... ....... . 0
(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL......$ 14,790 .00
SUBTRACT TOTAL MONEY SPENT THIS PERIOD

Schedule B: Expenditures total (Attach Schedule B) (**also see debts and loans below) ... 3,926 .06
Schedule F: Loan Repayments total (Attach Schedule F) .. .. .. ....... .. ......... ........... ..... ....... .... 0
CASH ON HAND at the end of this reporting period (if final report, balance must
be zero) (Attach DR-3) .. . . . . .... . . . ...... .. . . ... .. .. . .. .. ......... ........... .. .. .. .. ..... .. .................... ............ ... .$ 10,86 3 .94
**UNPAID BILLS (From Schedule D - Attach Schedule D) ............. .. .. .. .. .................. ................ ..... .. ..$ 619 .04
*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .. ....... .... ......................... ..... ....$ 3,116 .79
**OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . ........... ....... .. .. .. ... .. .. .. ..... ............ $ 0
CANDIDATE COMMITTEES ONLY :

CONSULTANT BREAKDOWN (Schedule G Attached?) _X YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $ 0
For Instructions, See Back of Form SCHEDULE
CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

(Rev. 06/97) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions
or
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
U111 /l Ip# Jason W21Ke
1828 Vine St. $ 100.00
CK# West Des Moines, IA 50265
ID# Gary Sandquist
8009 Heather Bow 1,000.00
CK# Johnston, IA 50131
tYA10IL1r ID# Larry an Ina etrame
1115 Caulder Father & 2,000 .00
CK# Des Moines, IA 50315 Mother
08/03/01 ID# Patricia Shoff
666 Walnut, Suite 2500 100 .00
CK# Des Moines, IA 50309
08/03/01 ID# Brian Galligan
2825 Grand Ave . 100 .00
08/03/01 ID# Theresa Funaro
2303 S.E . 7th St. 40.00
CK#
Des Moines, IA 50315
08/03/01 ID# Clayton Copple
10922 Lincoln Ave . 100 .00
CK#
08/10/01 ID# Nick Kurt
CK# 12407 W. 102nd St. 100 .00
Lenexa, KS 66215
ID#
08/10/01 Fred Stines
680 58th Street 100 .00
CK#
West Des Moines, IA 50265
ID#
08/10/01 Darren Schlapkohl
CK# 2633 Fleur Dr. 100 .00
L
SUB-TOTAL
$ 3,740.00
TOTAL (if last page of this schedule)
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms packet.). If surname of contributor is the same as candidate, but there is no
1 23
Page of_
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)

(Rev . 06/97) RECEIPTS
CHECK THIS BOX IF

NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
or
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE` RECEIVED FUND-
NUMBER INCOME
08/28/01 ID# Brian-Hook
1945 Lorraine Ave . $ 150 .00
CK# McLean, VA 22101
08/30/01 ID# Sean and Melissa e e ler
13927 Bryn Mawr Dr . 100 .00
CK# Urbandale, IA 50323
09/1/01 ID# Kirsten and Erik Booth
1840 3rd Ave . S.E . 100 .00
CK# Cedar Rapids, IA 52403'
09/21/01 ID# Thad and Jean Murphy
2839 E. 32nd St. 250 .00
CK#
Davenport, IA 52807
09/24/01 ID# Edward Beltrame
3837 Murray View Ave . NE Grandfather 500 .00
CK#
Lowell, MI 49331
09/30/01 ID# Matthew Coulter
11932 Hickory Spring Dr. 250 .00
CK#
Brimfield, IL 61517
ID#
09/30/01 Matt and Jennifer Cronin
CK# 4011 Fagen Dr. 200 .00
ID#
10/7/01 Thomas Schlapkohl
CK# 550 39th St. 100 .00
ID#
10/16/01 Tony and Grace Montognese
CK# 3025 Ashworth Rd. 50.00
ID#
10/19/01 Doris and Anthony Beltrame
CK# 3319 E . 291h N/A 25.00
SUB-TOTAL
$ 1,725.00
` Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no
2 23
Page of

CHECK THIS BOX IF
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD .
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
RECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-
NUMBER INCOME
10/20/01 ID# Louis Alford
4110 N. Paulina $ 20 .00 d
CK# Chicago, IL 60613
10/20/01 ID# Bethany Winyerd
2400 Lakeview Dr. Apt 1112 20.00 ,l
10/20/01 ID# Matt Krambeck
1048 W. Dickens #24 20.00 d
10/20/01 ID# Steve Frake
2400 Lakeview Dr. Apt 1112 20.00
CK#
Chicago, IL 60612
10/20/01 ID# Dave McDevitt
1048 W. Dickens #24 20.00 d
CK#
Chicago, IL 60614
10/20/01 ID# Tom Fanter
CK# 3722 Southport Ave . #2 20.00 d
Chicago, IL
ID#
10/20/01 Kavian Boots
CK# 858 W. Wrightwood Ave. 20.00 d
Chicago, IL
ID#
10/20/01 Mari Swift
CK# 1875 N. Fremont 20.00
Chicago, IL 60614
ID#
10/20/01 Egan Dufon
CK# 2358 Prairie 20 .00 d
Evanston, IL 60201
ID#
10/20/01 Fafy Boots
CK# 3528 N . Fremont 20.00 d
Chicago, IL
SUB-TOTAL
$ 200 .00 I -'
* Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by 3 23
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page of _
CHECK THIS BOX IF


DISCLOSURE BOARD.
CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
NUMBER
INCOME
10/20/01 ID# Katie Linehan
5522 W. Leland $
CK# 20.00 d
Chicago, IL 60630
10/20/01 ID# Courtney Worrell
5522 W. Leland 20.00
CK# f
Chicago, IL 60630
10/20/01 ID# Mike Davis
4257 N . Mozart
CK# 20.00 d
Chicago, IL 60618
10/20/01 ID#
Todd Pagel
CK# 816 W. Waveland 20.00 d
Chicago, IL 60613
10/20/01 ID# Dan Bonert
CK# 3343 N. Leavitt 20.00 d
Chicago, IL 60622
ID#
10/20/01 Jason Veeder
CK# 1209 Deerfield Pkwy #102 20.00
Buffoal Grove, IL 60089
ID#
10/20/01 Josh Alesch
CK# 1341 West Addison 20.00 d
Chicago, IL
ID#
10/20/01 Robert Wagner
CK# Chicago, IL 220 .00
ID#
10/20/01 Tim Kelsch
CK# 2240 N . Halsted #13 20.00 d
Chicago, IL
1D#
10/20/01 Steph Sadowskey
CK# 2240 N. Halsted #13 20.00 d
Chicago, IL
Card; r w- e- 160iC {-'i;,r allAl" p~5 SUB-TOTAL
$ 400 .00 `
' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
marriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page 4 of 23
familial relationship, enter "not applicable" in the relationship column. (for Schedule A)
CONTRIBUTIONS -- MONEY TAKEN IN A I MONETARY
CHECK THIS BOX IF
DISCLOSURE BOARD.
NUMBER INCOME
11iIi~~Ill1 ID# Justin Stender
11391 /2 W. Welster #2F $ 20.00 f
CK# Chicago, IL
10/20/01 ID# John Kuethe
1139 1/2 W. Welster #2F
CK# 20.00 d
Chicago, IL
10/20/01 ID# Milissa Lind
401 W. Fullerton #1308-E
CK# 20.00 d
Chicago, IL
10/20/01 ID# Phillip Bennett
3229 N. Clark 20.00
CK# d
Chicago, IL
10/20/01 ID#
Ryan Swoll
3822 N . Wayne
CK# 20.00 d
Chicago, IL 60613
10/20/01 ID#
Meredith Burke
CK#
1947 Trevino 20 .00 d
Chicago, IL
ID#
10/20/01 Phil Boots
3528 N . Fremont
CK# 20.00
Chicago, IL
ID#
10/20/01 Andy Patrick
2240 W. Holsted
CK# 20.00 d
Chicago, IL
ID#
10/20/01 Amy Justice
CK# 1922 N. Orchard 1 R 20.00 d
Chicago, IL
ID#
10/20/01 Kevin O'Donnell
CK# 1902 Buckingham Dr. #4 20.00 ,
Cedar Rapids, IA
SUB-TOTAL
$ 200 .00 1 '-'
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page 5 of 23
CONTRIBUTIONS -- MONEY TAKEN IN

A
(Rev . 06/97)
I MONETARY
RECEIPTS
CHECK THIS BOX IF

DISCLOSURE BOARD.
or
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT d IF FOR
NUMBER INCOME
10/20/01 ID# Rob Wagner
1548 N. Hanover $ 20.00
CK#
Chicago, IL 60622
10/20/01 ID# Chad Lower
1942 N . Mohawk #2R
CK# 20 .00 d
Chicago, IL 60614
10/20/01 ID# Ryan Prince
5520 W. Leland 20.00 f
CK#
Chicago, IL
ID#
10/20/01 Carin Fanter
CK#
3722 Southport Ave . #2 20.00 f
Chicago, IL
ID#
10/20/01 Brian Boots
3528 N . Fremont
CK# 20.00
Chicago, IL
ID#
10/20/01 Lisa Boots
CK#
3528 N . Fremont 20.00 d
Chicago, IL
ID#
10/20/01 Nate Olds
CK# 2720 N. Magnolia 20.00 d
Chicago, IL 60614
ID#
10/20/01 Alex Ledger
CK# Richfield, NY 20.00 d
ID#
10/20/01 Kyld Ledger
CK# 2722 N . Magnolia 20.00 d
Chicago, IL 60614
ID#
10/20/01 A .J. Atta
CK# 3822 N. Wayne 20.00 ,
Chicago, IL 60613
SUB-TOTAL
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page
6 of 23

A MONETARY
CHECK THIS BOX IF

DISCLOSURE BOARD .
CAUTION : Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
(MM/DDNR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
10/20/01 ID# Unitemized Contributions
Gala Event $ 100 .00
CK# Chicago, IL
10/24/01 ID# Charles and Sandra Caligiuri
512 SE Diehl 100.00
10/24/01 ID# Richard Pasutti
2113 SE 9th 30.00
10/24/01 ID# Jon Hoffman
2825 77th St. 20 .00
CK#
Urbandale, IA 50322
10/25/01 ID# Dominic & Virginia Armentaro
520 Wall Ave. 25.00
CK#
10/29/01 ID#
Dennis & Maxine Flaherty
1834 Evergreen 20.00
CK#
11/01/01 ID#
Lawrence and Mary Gina Beltrame
1115 Caulder Father &
CK# 100 .00
Des Moines, IA 50315 Mother
ID#
11/01/01 James and Nancy Galloway
CK# 5501 Woodland Ave 100 .00 d
ID#
11/01/01 William and Cynde Fanter
CK# 3410 SW 24th St 100 .00 1
ID#
11/01/01 Ryan Garland
CK# 3217 SW 12th St 35.00
SUB-TOTAL
TOTAL (if last page of this schedule) F$
marriage) (See Page 2 of forms packet.) . If sumame of contributor is the same as candidate, but there is no Page 7 of 23

CHECK THIS BOX IF
DISCLOSURE BOARD.
NUMBER INCOME
11/i1Ij/Ll1 ID# William Fanter
608 11th St $ 50 .00 d
11/1110111 ID# GG and George unaro

2909 Southern Hills Circle 25 .00 d
11/01/01 ID# Kristine Beltrame

2706 Glover N/A 100.00 d
11/01/01 ID# JT and Elenora Galloway

6300 School St ., Apt 318 50 .00 ,Ir
11/01/01 ID# Lucia and Allen Hale

3805 SW 14th 20 .00
11/01/01 ID# Mario and Anna Falbo

3925 SW 28th Place 20 .00
CK#
11/01/01 ID# Frances and Joseph Faino

4122 Aurora Great Uncle
CK# & spouse 300.00 d
11/01/01 ID# Helen Goodwin

CK# 3131 Fleur Drive, Apt. 603 25 .00 f
ID#
11101/01 V .C . Heideman
CK# 3837 SW Thorton 30 .00 d
ID#
11/01/01 Von Heideman
CK# 3837 SW Thorton 10 .00 d
SUB-TOTAL
630 .00
TOTAL (lf last page of this schedule) r$
marriage) (See Page 2 of forms packet.). If surname of contributor is the same as candidate, but there is no
8 23
Page of _

CHECK THIS BOX IF
DISCLOSURE BOARD.
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
NUMBER INCOME
11/01/01 ID# J . Campbell Helton
5808 Forest $ 50.00
11/01/01 ID# Paul Herrin
490 County Line Road 50.00 ,(
11/01/01 ID# Dorothy Hill
1100 Caulder Ave . 20.00
11/01/01 ID# Sharon Hackbarth
1446 Wild Prairie Drive 100 .00 ,T
CK#
Iowa City, IA 52246
11/01/01 ID# Steve and Julie Heideman
4219 SW 27th St 50.00
CK#
11/01/01 ID# Jason Huizenga
CK# 1643 Beaver Ave 100 .00 d
11/01/01 ID#
Warren and Sun Huizenga
CK# 4722 Hawthorne Drive 50.00 d
ID#
11/01/01 Nicholas laria
CK# 3420 SW 12th Place 15.00 f
ID#
11/01/01 Michael or Marylee Kelly
CK# 1209 Edgemont St 25.00 d
ID#
11/01/01 James and Cynthia Kite
CK# 4400 43rd St 50 .00 f
SUB-TOTAL

A MONETARY
CHECK THIS BOX IF

DISCLOSURE BOARD.
NUMBER INCOME
11/00111 ID# Brian or Emily Beltrame
2829 44th St N/A $ 55.00
11/01/01 ID# Robert and Linda Ervin
4401 Parklawn Drive 50.00
CK# d
11/01/01 ID# John and Mary Kay LaBonia
4333 SW 31st 25.00 d
CK#
11/01/01 ID# David and Mary Beltrame
6119 SW 9 1 ' N/A 25.00 1
CK#
11/01/01 ID# Antonio and Rosa Leo
3728 SW 12th 50.00 1
CK#
11/01/01 ID#
Guido Leo
2907 Summit Vista Dr. 25.00 f
CK#
ID#
11/01/01 Jim and Jeri Leo
CK#
2131 SE 3rd Street 20.00 d
ID#
11/01/01 Joe and Lidia Leo
CK# 3419 SW 12th 50.00 1
ID#
11/01/01 Michael Leo
CK# 3708 S.W. 28th PI . 25.00
ID#
11/01/01 Loretta Dotson
CK# 4101 SE 22nd St 25.00 1
SUB-TOTAL
$ 350 .00
marriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page
10 of 23

CHECK THIS BOX IF

DISCLOSURE BOARD .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT q IF FOR
N UMBER INCOME
11/01/01 ID# Giovanni Leo
4101 Wolcott Ave . $ 100 .00 d
11/01/01 ID# Peter Leonetti
2924 SW 9th 50.00 d
11/01/01 ID# Charles and Doris Ligouri
1072 42nd St 75.00 d
CK#
11/01/01 ID# Annamaria and Nick Loiocomo
2500 SE 18th ST 30.00
CK#
ID# Anthony and Mary DeFino
11/01/01
CK# 5400 S.W. 20th St. 20.00 d
ID#
11/01/01 Ralph Marasco
CK# 3009 SW 29th 50.00 d
ID#
11/01/01 Joseph and Ruth Lakers
CK# 3116 Summit Vista Dr. 30.00 d
ID#
11/01/01 Isabella and Connie Marturello
CK# 3620 SW 9th 20.00 d
ID#
11/01/01 Michael and Dorothy Mauro
CK# 4325 SW 31 st ST. 25.00 d
1D#
11/01/01 Matt and Jenny McCoy
CK# 2421 E . Leach Ave . 250 .00 d
SUB-TOTAL
$ 650 .00
marriage) (See Page 2 of forms packet .). If surname of contributor is the same as candidate, but there is no
11 23
Page of

CHECK THIS BOX IF

NUMBER ANDTHE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT ~I IF FOR
(MM/DD1YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
11/001 ID# Josep or Mary e.azlo
2022 South Union $ 25.00 d
11/01/01 ID# Vic Mele
1627 E . Lacona Ave . 20.00
11/01/01 ID# Vincent DeAngelis
312 SW 32nd St 20.00
11/01/01 ID# Thomas C. Caligiuri
10 Fulton Dr. 20.00 d
CK#
11/01/01 ID# Sarah and Gene Behrens
1522 SW Frazier 50.00 d
CK#
11/01/01 ID# Joe or Rosa Baratta
1701 Kenyon 50.00 f
CK#
11/01/01 ID#
Cynthia Nahas
3214 Summit Vista Drive 50.00
CK#
ID#
11/01/01 Jean Ann De Biaggio
CK#
328 SE Edison 25 .00 d
ID#
11/01/01 Jim and Yvonne Nucaro C-.-=-._..
CK# Des Moines, IA 50315 30.00 d
ID#
11/01/01 Michael and Judity Oliver
CK# 5925 EP True Pkwy #12 50.00 f
SUB-TOTAL
12 23
Page of _
I

A MONETARY
CHECK THIS BOX IF

DISCLOSURE BOARD.
CAUTION: Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
NUMBER INCOME
11/01/01 ID# Dwight and Lou Olson
3339 N . Ave $ 100 .00 d
CK# Adel, IA 50003
11/01/01 ID# George and Joyce Paletta
4415 SW 31 st ST. 25.00
11/01/01 ID# LaVera Cunningham
925 Caulder Ave . 5.00 d
CK#
11/01/01 ID#
John Pascuzzi
4200 SW 27th 50.00 1
CK#
11/01/01 ID#
Ed and Yolanda Pasutti
832 Hartford Great Aunt
300 .00 d
CK#
Des Moines, IA 50315 & spouse
ID#
11/01/01 Ralph or Juanita Marasco
3009 SW 29th 50.00 f
CK#
ID#
11/01/01 Rob Pasutti
CK#
2117 SW 9th 50.00 1
ID#
11/01/01 Charles and Mary Backstrom
CK#
3617 SW 4th 15.00
ID#
11/01/01 Jim and Pam Peters
CK# 925 S. 14th 20.00 1
Adel, IA 50003
ID#
11/01/01 Frances Fazio
CK# 1301 SW Virginia 10.00 d
SUB-TOTAL
* Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
13 23
Page of _

A MONETARY
Q CHECK THIS BOX IF

DISCLOSURE BOARD.
NUMBER INCOME
11/01/01 ID# David and Julia Phipps
215 28th Street $ 100.00 f
11/01/01 ID# Richard Beltrame

1403 SW 1st Great Uncle 25 .00 d
CK#
11/01/01 ID# Dominic Berardi

2959 E . Leach Ave . 20 .00 ,(
CK#
11/01/01 ID# Frank or Mary Quijano

326 E. Hillside 50 .00 d
CK#
11/01/01 ID# Rose Quijano

1403 SW 1st 100 .00 1
CK#
11/01/01 ID# Mary Quinn

CK# 1935 SE 9th 75 .00 1
ID#
11/01/01 Ronald Rabinovitz
CK# 5931 Windsor Dr . 30 .00
ID#
11/01/01 JoAnne Corigliano
CK# 2611 SE 7th 25 .00 d
ID#
11/01/01 Thomas and Tracy Rial
CK# 111 51 st St 25 .00 d
ID#
11/01/01 AI and Rose Bisignano
CK# 1713 S. Union 20 .00 d
SUB-TOTAL
$
TOTAL (if last page of this schedule) r$
marriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page 14 of 23

COMMITTEE NAME (Must be same as on Statement of Organization)

0 CHECK THIS BOX IF
AMENDING FORM

DISCLOSURE BOARD .
NUMBER INCOME
11/01/01 ID# Dominic and Kay Rizzuti
212 SE Hartford Ave . $ 25.00 d
11/01/01 ID# Rocco and Melissa Rizzuti
4210 SE 71 st St 50.00
CK# d
11/01/01 ID# Anna Ruggiero
3926 SW 29th 10.00
11/01/01 ID# Vincent and Kay Ruggiero
3506 SW Rose Ave 25 .00 ,/
CK#
11/01/01 ID# Todd Copic
512 Cutler 100 .00 f
CK#
I D#
11/01/01 Joe Aversa
326 E. Hartford Ave . 10.00 d
CK#
ID#
11/01/01 Bob and Liz Connor
5400 SW 19rh Great Aunt
CK# 50.00
Des Moines, IA 50315 & spouse
ID#
11/01/01 Robert and Susan Conner
CK# 3211 SW 39th 100.00 1
ID#
11/01/01 James and Jenelle Sarcone
CK# 3142 Druid Hill Dr. 50.00 d
ID#
11/01/01 John and Nancy Sarcone
CK# 3004 SW 39th St. 25.00 1
SUB-TOTAL
23
marriage) (See Page 2 of forms packet .). If sumame of contributor is the same as candidate, but there is no Page 15 of

A MONETARY
CHECK THIS BOX IF

DISCLOSURE BOARD.
NUMBER INCOME
11/01/01 ID# Vic and Penni Scavo
CK# 2701 SW Caulder $ 25.00 d
11/01/01 ID# Richard and Roberta Peters
2571 Guthrie, Apt. 308-A 50.00 d
11/01/01 ID# Scott and Kemberlyn Anderson
CK# 907 32nd St 50.00 d
11/01/01 ID#
Richard and Joanna Schmeling
CK# 516 SE Broad 25.00 d
ID#
11/01/01 Donald Scrignoli
CK# 1226 Birch Lane 25 .00 d
ID#
11/01/01 Lonnie or April Severino
CK# 115 SW Watrous 25.00 d
ID#
11/01/01 Gasper and Lucia Anania
CK# 714 Davis Ave 25.00 d
1D#
11/01/01 Mary Sitroneto
CK# 21 Hartford Ave . 15 .00 d
ID#
11/01/01 Terry and Maribel Slinde
CK# 1557 NW 107th St 25.00 d
Clive, IA 50325
ID#
11/01/01 Joe and Mary Soda
CK# 930 Jarvis d
15.00
Des Moines IA 50315
SUB-TOTAL
$ 280 .00
` Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
familial relati on sh ip, enter "not applicable" in the relationship column . (for Schedule A)

CHECK THIS BOX IF

DISCLOSURE BOARD .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT V IF FOR
N UMBER INCOME
11/01/01 ID# Marilyn Spina
2545 E . Ovid $ 20.00 d
11/01/01 ID# Nick or Cindy Sposato
310 SE Creston 50.00 d
11/01/01 ID# Roger Stefani
513 NE 3rd St 20.00 1
CK#
Ankeny, IA 50021
11/01/01 ID# Phyllis Stegman
1809 Southlawn Dr 5.00
CK# ,Ir
11/01/01 ID# Esther Anania
CK# 1007 Jarvis 20.00
11/01/01 ID# Doreen Stokes
CK# 3609 Wolcott 50.00 ,/
ID#
11/01/01 Jaimi and Jason Storm
CK# 25 E Olinda Ave . 25.00
ID#
11/01/01 Andrew and Sarah Susanin
CK# 5700 Woodland Road 150 .00 d
ID#
11/01/01 Krista Tanner
CK# 5308 Pommel Place 75 .00 d
ID#
11/01/01 Irene Tantillo
CK# 3131 Fleur Drive, Apt. 403 20.00 d
E
SUB-TOTAL
$ 435 .00
marriage) (See Page 2 of forms packet .) . If sumame of contributor is the same as candidate, but there is no Page 17 of 23
familial relationship, enter 'not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form
I
SCHEDULE

A MONETARY
Q CHECK THIS BOX IF


NUMBER ANDTHE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 688.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
NUMBER INCOME
11/01/01 ID# Sonya and Jeff Taylor
1951 Winter Park Dr. $ 50.00
CK# Ankeny,IA 50021
11/01/01 ID# Bryan Tiedeman
243 E . Porter 20 .00 1
CK#
11/01/01 ID# Michael J . Tonini
2135 SW 9th 50.00 d
CK#
11/01/01 ID#
Ralph and Frankie Ann Compiano
4022 SW 31 St 25.00
CK#
11/01/01 ID# Richard and Sharon Tuller
2914 Kendallwood Cir. 20.00 d
CK#
ID#
11/01/01 Joe Tumea
610 Davis 50 .00 1
CK#
ID#
11/01/01 Joe Tursi
CK# 3514 SW 37th Street 20.00 d
ID#
11/01/01 Joe and Mary Tursi
CK# 937 Caulder 50.00 d
ID#
11/01/01 Pete and Gert Tursi
CK# 1122 Wolcott 25.00 d
ID#
11/01/01 John and Holly Tyler
CK# 317 E . Marion 25 .00 d
SUB-TOTAL
$ 335 .00
marriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page
Ig of 23
For Instructions, See Back of Form
I
SCHEDULE

CHECK THIS BOX IF


STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM ASTATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD.
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT q IF FOR
RECEIVED (if applicable) TO CANDIDATE` RECEIVED FUND-
NUMBER
INCOME
11/01/01 ID#
Carl VanTyle $
3214 Brinkwood Rd
CK# 20.00 d
11/01/01 ID#
Charles Colosomo
806 Maish Ave . 25.00
ID#
11/01/01 Theresa M. Colasino
CK# 1810 SE 2nd 15.00
ID#
11/01/01 Louis or Judy Amodeo
CK# 712 Pioneer Rd 20 .00
ID#
11/01/01 John Civitate
CK# 2200 South Union 10.00
ID#
11/01/01 Brandon Wark
CK# 512 Cutler 20.00 d-
ID#
11/01/01 Dennis and Linda Waterman
CK# 409 Caulder Ave . 25.00
ID#
11/01/01 Theresa Watts
CK# 908 E 17th A-4 20.00 f
Norwalk, IA 50211
ID#
11/01/01 Barbara and Larry Willis
CK# 3200 SW 31 St Street 25.00 f
Des Moines IA 50321
ID# -
11/01/01 Dennis and Mary Lou York
CK# 1230 Bell Ave 25.00 d
chair
SUB-TOTAL
$ 205 .00
marriage) (See Page 2 of forms packet .). If surname of contributor is the same as candidate, but there is no Page 19 of 23

Q CHECK THIS BOX IF
Mme
DISCLOSURE BOARD.
or
NUMBER INCOME
11/01/01 ID# Victoria and Anthony Cianciaruso
2442 SW 8th $ 25.00
CK#
ID#
11/01/01 Frank Chiodo
417 E. Burnham Ave . 50.00 -1
CK#
ID#
11/01/01 Claire Celsi
CK# 704 5th Street 25 .00
ID#
11/01/01 Gene and Mary Cardamone
CK# 3606 Rose Ave . 25.00 d
ID#
11/01/01 Ralph or Katherine Caracciolo
CK# 1822 SW Porter 50.00 d
ID#
11/01/01 Thomas M. and Rosa Caligiuri
CK# 10 Fulton Dr. 50.00 d
ID#
11/01/01 John and Holly Bonanno
CK# 3216 SW Watrous 20.00 d
ID#
11/01/01 Sandra Kay Bell
CK# 4218 SW 27th St 50.00 d
I D#
11/01/01 Rosemary Moody
CK# 5285 E . Oakwood Drive 50.00 f
ID#
11/01/01 Pete Leo
CK# 2946 E. Seneca 25.00 ,(
Des Moines IA 50317
SUB-TOTAL
$ 370 .00
TOTAL (lf last page of this schedule)
marriage) (See Page 2 of forms packet .). If surname of contributor is the same as candidate, but there is no Page
20 of 23
CHECK THIS BOX IF

DISCLOSURE BOARD.
NUMBER INCOME
11/01/01 ID# R.E. Myers
9 Woodland Heights $ 50.00
CK# Iowa City, IA 52240
11/01/01 ID# Unitemized Contributions
Izaak Walton 280 .00 d
CK# Des Moines, IA
11/4/01 ID# Richard and Margeret Prey
12051 Lincoln Ave . 50.00
CK# Clive, IA 50325
11/05/01 ID# Evelyne Villines
3300 49th St. 25.00
CK#
11/05/01 ID# Tim Walker
317 6th Ave . Ste 1200 500 .00
CK#
11/8/01 ID# Thomas Reavely
CK# 317 6th Ave . 100 .00
11/12/01 ID#
Gary and Donna Runge
CK# 3020 SW Thornton 20.00
ID#
11/12/01 Paul Bonanno (cash)
CK# 307 38th Street 50.00
ID#
11/12/01 Chad and Jessica Ervin
CK# 808 14th St. 25.00
ID#
11/16/01 Gerard Neugent
CK# 5000 Westown PKWY 100 .00
SUB-TOTAL
$1,200 .00
TOTAL (If last page of this schedule)
marriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no
21 23
Page of _
CHECK THIS BOX IF

DISCLOSURE BOARD.
CAUTION: Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT

RECEIVED 4 IF FOR
(if applicable) TO CANDIDATE' RECEIVED FUND-
NUMBER INCOME
11/19/01 ID# Mary Berry
1818 Patricia Acres Lane $ 30 .00
CK# Winterset, IA 50273
11/26/01 ID# Cecilia Backstrom

8069 Crestview Dr. 20 .00
11/26/01 ID# Ralph and Norma Costanzo
1808 SE 2nd St . 25 .00
11/26/01 ID# Edward Beltrame

3837 Murray View Ave. NE Grandfather 100.00
CK#
Lowell, MI 49331
11/28/01 ID# Bob and Ann Gernes

1011 45th St .
CK# 50 .00
12/10/01 ID#
William and Mary McCoy
CK# 3127 SW 6th St . 25 .00
12/11/01 ID#
Chadwyn and Janelle Cox
CK# 2742 Tiffany Ct . 25 .00
Dubuque, IA 52001
ID#
12/15/01 Willis Hamilton
CK# P.O . Box 188 50 .00
Storm Lake, IA 50588
ID#
12/15/01 Tom and Nancy Riley
CK# non given 100.00
Cedar Rapids, IA
ID#
12/15/01 Charles and Paige Fiedler
CK# 4449 Kensington Cir. 25 .00
Johnston, IA 50131
SUB-TOTAL
CONTRIBUTIONS - MONEY TAKEN IN A MONETARY

(including candidate's personal funds)
CHECKTHIS BOX IF
COMMITTEE NAME (Must he same as on Statement of Organization) AMENDING FORM

DISCLOSURE BOARD.
RECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-
NUMBER INCOME
12/18/01 ID# George La Marca
1300 50th St. Ste . 104 $ 50.00
12/18/01 ID# Edward and April Poulsen
7610 Winston Ave . 50.00
CK# Urbandale, IA 50322
12/18/01 ID# Ann Trimble
3532 Humboldt Ave . S. Apt. Upper 100 .00
CK# Minneapolis, MN 55408'
12/18/01 ID# Marc Harding
3211 Lincoln Place 50.00
12/31/01 ID# Walker, Knopf, P.L.C.
208 N. 2nd Ave . W. 50.00
Newton, IA 50208
12/31/01 ID# Hagemann & Goeke Partnership
100 East Bremer Ave . 100 .00
CK# Waverly, IA 50677
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by 23 23
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page of _
familial relationship, enter 'not applicable" in the relationship column . (for Schedule A)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY

(Rev . 09/97) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
ID# Bank of America Check Order
8/23/01
CK# P .O . Box 798 $ 26 .00
Wichita, KS 67201
ID# Carter Printing Photocopies of flyers
9/4/01 1739 E . Grand Ave . handed out
CK# 1001 Des Moines, IA 50316 $137 .80
ID#
Bank of America Service Charge
9/20/01
CK# P .O . Box 798
Wichita, KS 67201 $ 7 .00
ID# Freeman Decorating Vinyl campaign banner
10/2/01 2000 Easton Blvd .
CK# 1003
Des Moines, IA 50317 $174 .90
ID#
Postmaster Rate mail permit
10/4/01 116 S . 2nd Ave .
CK# 1004
Des Moines, IA 50301 $250 .00
ID# Postmaster Fundraiser invitation
10/12/01 CK# 116 S . 2nd Ave . mailing
1005
Des Moines, IA 50301 $126 .18
ID# Jason Kent Musical entertainment for
11/1/O1 1015 Ashworth Rd . campaign kick off event
CK# 1006
West Des Moines, IA 5026 on November 1, 2001 $200 .00
ID# Tiffany Allen Reimbursement for lodging
11/1/O1 4001 Adams Ave . expenses associated with
CK# 1007
Des Moines, IA 50310 fundraiser in Chicago $236 .00
SUB-TOTAL $ 1157 .88
TOTAL (iflast page of this schedule) $
1
__j
THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY:
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instr uctions .)
Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must a Iso be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(i) .)
Page 1 of 2
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY

(Rev . 09/97) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE El CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
ID#
Something Italian Food services for campaign
11/2/01
CK# 1008 400 Walnut Street kick off event on
Des Moines, IA 50309 $1431 .00
November 1, 2001
ID#
Carter Printing "Cowboy" cards amd thank
11/10/01 1739 E . Grand Ave . you cards and envelopes
CK# 1009
Des Moines, IA 50316 $ 780 .16
ID# Iowa Trial Lawyers Assoc . Member mailing labels
11/15/01 218 6th Ave ., Ste . 526
CK# 1010
Des Moines, IA 50309 $ 50 .00
ID# Polk County Auditor Database of voter lists
11/15/01 111 Court Avenue
CK# 1011
Des Moines, IA 50309 $ 33 .06
ID# Carter Printing Campaign stickers and
11/18/01 1739 E . Grand Ave . indoor event signs
CK# 1012
Des Moines, IA 50316 $ 440 .96
ID#
Bank of America Service Charge
11/30/01 P .O . Box 798
CK#
Wichita, KS 67201 $ 33 .00
I D#
CK#
I D#
CK#
SUB-TOTAL $
2,768 .18
TOTAL (if last page of this schedule) $
3,926 .06
THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instr uctions .)
Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must a ]so be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(1) .)
Page 2 of 2
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORD'
SCHEDULE
D INCURRED
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev . 08/98)1 INDEBTEDNESS
Citizens for Beltrame 0 CHECK THIS BOX
IF AMENDING
NOTE : Debts previously reported that remain unpaid must be included on this
Schedule, as well as any new obligations incurred in this period . FORM
An "incurred debt" is a debt for

DEBTSIOBLIGATIONS REMAINING THIS REPORTING PERIOD goods or services ordered or
(DO NOT INCLUDE LOANS - SHOW LOANS ON SCHEDULE F) received, but not paid for by the
end of the reporting period .,
regardless of whether an invoice
has been received .
DATE DESCRIPTION OF GOODS OR BALANCE OWED AT
INCURRED NAME AND ADDRESS OF PERSON SERVICES PROVIDED OR CLOSE OF
(MM/DD/YR) TO WHOM DEBT OR OBLIGATION IS OWED PURCHASED REPORTING
PERIOD'
Izaak Walton League Beverages for November $ 619 .04
11/1/O1 4343 Valley Drive 1, 2001 campaign kick
Des Moines, IA 50321 off event
SUB-TOTAL $ 619 .04
TOTAL DEBTS OWED BY COMMITTEE AT THE END OF THIS REPORTING PERIOD $

619 .04
'If actual figure is unknown, show "estimated" beside the figure . Page ,-j`- of 1
(for Schedule D)
CANDIDATE COMMITTEES NOTE :

'Incurred Indebtedness also includes each person/entitywith whom the candidate's committee has entered into a contract during the reporting period for future
or continuing performance . Enter the name of the consultant who provides or procures services for items such as advertising, fund-raising, polling, managing, or
organizing services . Report on Schedule G the nature of performance and the estimated performance reasonably expected of the consultant .
F'OP INSTRUCTIONS, SEE BACK OF FOF, SCHEDULE
E IN KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev . 06/97] CONTRIBUTIONS
CHECK THIS BOX IF
AMENDING FORM
DATE RELATIONSHIP DESCRIPTION ESTIMATED IF FOR

RECEIVED NAME AND ADDRESS TO CANDIDATE OF IN KIND FAIR MARKET FUND-RAISER
(MM/DDNR) OF CONTRIBUTOR ` (if applicable) CONTRIBUTION VALUE CONTRIBUTION
Marc Beltrame Purchased vote $ 52 .33
7/18/01 3409 S .W . 44th Place self registration
Des Moines, IA 50321 information
Jenn Morrison Designed 75 .00
10/1/O1
1 Prairie Meadows Drive campaign logo
Altoona, IA 50009
Will Schultz Design of 1500 .00
10/15/01
2925 Brattleboro campaign
Des Moines, IA 50311 web site
11/27/01 Marc Beltrame Purchased 33 .06

3409 S .W. 44th Place detailed voter
self lists from
Des Moines IA 50321
Marc Beltrame Postage for 28 .40
12/12/01 3409 S .W . 44th Place self thank you
Des Moines, IA 50321 cards
Michael Galligan Expenses and 560 .00
12/12/01 postage
2425 Jordan Trail associated w/
West Des Moines, IA 50265 ITLA mailing
Mark Gray Donation of 73 .00
12/15/01 202 S .W . Cherry St . wires for
Ankeny, IA 50021 yard signs
Basil F . Nimry Hosting of 795 .00
12/15/01 3201 Southern Woods Drive campaign web
Des Moines, IA 50321 site
TOTAL (if last

page of this
schedule)
'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page 1 of 1
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule E)
by marriage). (See Page 2 of forms packet.) If surname of contributor is the same as candidate, but there is no
familial relationship, enter "not applicable' in the relationship column .

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FOR INSTRUCTIONS, SEE BACK OF FORM

DISCLOSURE SL MARY PAGE DR-2

SIGNATURE OF TREASURER (or person filing this report)

STATEMENT OF CASH ON HAND

ADD TOTAL MONEY TAKEN IN THIS PERIOD

SUBTRACT TOTAL MONEY SPENT THIS PERIOD

CANDIDATE COMMITTEES ONLY :

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

Citizens for Beltrame

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

CHECK THIS BOX IF

Citizens for Beltrame

CONTRIBUTIONS -- MONEY TAKEN IN

Citizens for Beltrame

TOTAL (if last page of this schedule)

CONTRIBUTIONS -- MONEY TAKEN IN

Citizens for Beltrame

TOTAL (if last page of this schedule) F$

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

11/1110111 ID# GG and George unaro

11/01/01 ID# Kristine Beltrame

11/01/01 ID# JT and Elenora Galloway

11/01/01 ID# Lucia and Allen Hale

11/01/01 ID# Mario and Anna Falbo

11/01/01 ID# Frances and Joseph Faino

11/01/01 ID# Helen Goodwin

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

TOTAL (if last page of this schedule)

CONTRIBUTIONS -- MONEY TAKEN IN

Citizens for Beltrame

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

Citizens for Beltrame

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

Citizens for Beltrame

TOTAL (if last page of this schedule)

CONTRIBUTIONS -- MONEY TAKEN IN

Citizens for Beltrame

TOTAL (if last page of this schedule)

CONTRIBUTIONS -- MONEY TAKEN IN

Citizens for Beltrame

11/01/01 ID# Richard Beltrame

11/01/01 ID# Dominic Berardi

11/01/01 ID# Frank or Mary Quijano

11/01/01 ID# Rose Quijano

11/01/01 ID# Mary Quinn

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

COMMITTEE NAME (Must be same as on Statement of Organization)

Citizens for Beltrame

TOTAL (if last page of this schedule)

CONTRIBUTIONS -- MONEY TAKEN IN

Citizens for Beltrame

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

Citizens for Beltrame

CONTRIBUTIONS -- MONEY TAKEN IN

Q CHECK THIS BOX IF

Citizens for Beltrame

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

CHECK THIS BOX IF

Citizens for Beltrame

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

Citizens for Beltrame

Citizens for Beltrame