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User:
Independent Expenditure

This form may not be used by a candidate, candidate’s committee, or a political committee.

Individual Making the Expenditure

First Name
*
Middle Initial
Last Name
*
Address
*
Address
City
*
State
*
Zip Code
*
Email
*
Phone
*

This expenditure expressly advocates:

For a candidate:
Enter name or id of candidate:
For a ballot issue:
Enter name or id of committee, if known. Otherwise, enter description of issue:
Against a candidate:
Enter name or id of candidate:
Against a ballot issue:
Enter name or id of committee, if known. Otherwise, enter description of issue:

Expenditure Details

Date of Expenditure
Show Calendar *

Amount (total amount of completed expenditure)
*
Type of Communication (Newspaper ad, Radio, Television, Flier, etc)
*
Vendors (to enter more than one separate by comma)
*
Distribution Date
Show Calendar *
* = Required

Review the Terms of Agreement

Criteria to use this form:

  • An independent expenditure in excess of $1000 in the aggregate to expressly advocate the nomination, election, or defeat of a candidate or the passage or defeat of a ballot issue
  • Independent expenditure complies with the attribution requirement of Iowa Code section 68A.405

Statement of Certification

I affirm that the independent expenditure reported above is accurate. I also affirm that this expenditure was made without the prior approval or coordination with a candidate, candidate’s committee, or a ballot issue committee. I affirm I was the only individual who paid for the costs of this expenditure. I understand that by filing this form, I am subject to the campaign laws in Iowa Code chapter 68A and rules in chapter 351 of the Iowa Administrative Code. I also understand that the failure to timely file this form leads to the imposition of civil penalties and the intentional failure to file this form may lead to additional civil and criminal sanctions.

Name
*
Date
*
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