FOR INSTRUCTIONS,

SEE BACK OF FORM

CHECKONE:
Z Thisis an inifial'Statementof OrganEation
I Thisis an amended'Statement of Organization Re*etForrrr
" Statement musl be frled within 10 days of ammlftee a@pilng @ntibutions, maktng Comm. #
incuning debts exeeding $750. Amendments musl be ftled within 30 days of a change. Indexed
EfiectiveJanuary1, 2O1O,
all statementsandreportsfiledby newcommittees for stateofficemustbe filed Audited
efectronically
andeffecliveJanuary1,2012,all stratemenlsandreportsfitedby all committees
for stateoffce
mustbefiledelectronically.
EfiecfiveMav 1. 2010. all statemenlsand must be filed
J J (A candidate'scommitteemust includethe candidate'slast name in the name of the committee.)f amendin€mmif.tee name,
put old name in ( ).
:b ,.i>
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JILL KISTLERFOR COUNWATTORNEY
L , |

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IMPORTANT: Indlcate type of commltlee you are
( I )Sratewlde/Leglslatlvor{!9geStandlngforRetontlon
candldate ( 2)statewldePAc(3 )statePaily (4)countycentrat coml
(Slcguntyc ndldate(6)cttyCandldale(7)SchoolBoardorOtherPoltUcalsuMlvlstonGandtdare iaicountipAc (9)clty
Subdlvlslon PAC ( 1l ) Ballot lesue (lncludlng commlttee Involved In

COMMITTEETREASURER
Name J J
HBlX*o KSTLER
YeU$ffi?ffiddve
r.rw MalllngAddress J J

l^d2qftder t
9Vn8flbr{, Cfty,State J J Zp Code J J

pnone
(563)-569!0# Phone ( )
e_Maitdkistler@q.com eMall
lNulGA I E l'Ut{FoSE oF G9MMITTEE r Check One Box !!J Advocateforlagainstcandidate(s) tr Advocatefor ballotissue(s)
Comment or description: tr Advocateaoainstballotissue(s)
t6tt Nrvnno nru
& J,i'diL",iF ev sounty29l-Candldd€.qd Ballot lssue Committees Enter:

count( ALISMAKEE )
Party(if applicaorelREPUBLICAT*I
Political (|f
".{i
District_
i ij , Dareof Etecfion: NOVEMBER 4 2010
for Efeclion: 2O11
YearStandino
nanK A.ccpunt Name (must match cominittee name)
vv Afnllate.,
or Sponsor
JILL KISTLERFOR COUNTYATTORNEY JlLL MARIEKISTLER
Name of Financial Institutionltype of Account J J MaillngAddress J J
WAUKONSTATEBANK,CHECKINGACCOUNT 1605PRAIREAVE NW
MailingAddress J J clty J J SrareJ t ztp tT--
22 WESTMAINSTREET WAUKON,1A52172
city J J srarel I zp J J
WAUKON.1A52172 Phone(Sffi I 568-3054
e_Ma[ JKTSTLER@BERTROCHEIAW.COM

STATEMENT
OF AFFIRMATION:By filing thb documentthe commlttseafRrmathe fottowtng:

1. The committeeand all personsconnectedwith the committeeunderstandthat they are subjectto ihe larvsin lowa Codechapters69A and 6g8 and the administrative
rulesin Chapter351of the lo\i,aAdministrative
Code.
2. ThatlowaCodesec-tion 68A.402and rule351-4.9 requiretho filingof disclosurereportsand thatthe faitureto file thesereporbon or beforethe requiredcluedates
subjec{sthe candidateor chairperson(inthe caseof committees
otherthana candidate'scommittee) to the automaticassessment of a civilpenaltyand the possible
impositionof oihercriminaland civilsanctions.
3. ThatlowaCodesection68A.405and rules3514.38 through4.43 requirethe placementof the words'paidfor byr andthe namgof the committeeon all political
-for
materialsexceptfor those itemserempted by statuteor rule. A committeethat wishesto registera commitdeenamo purposesof usingthe shorter"paidfor by"and
doesnot intendto crossthe $750filingthresholdshallfilethe FormDR-SFAformin lieuof filingthisform.
4. ThatlowaCodesection68A.503and rutes351-4.44 through4.52 prohibiithe receiptof corporatecontributions exceptbr ballotissuepACs.
by all committe€s
5. A candidateand a candidate'scommitteemayonlyexpendcampaignfundsas permittedby lowacodes€ctions68A.301through684303 and rute351-.4.25.
6. Thatthe committeewill continueto file disclosurereportsuntil all activityhas ceasEd,committeefunds spont,debts resoh,ed,and a final reportand a statementof
(DR-3)has beenfiled.
dissolution

s- 7- tq Dale Slgned

<_ (\
_.-?-tu DateSigned