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* Specifications and Order Form for Voter Lis(
Rcad the instructions on the reverse_ It is your responsi- Send completed form to:
Dility to be aware of the information provided on the reverse. State Registrar of Voters
Hoover State Office Bidgg
Des Moines IA 50319-0143
That[rind of list do you want? Check one or more of the boxes below. If you Phone: (S1S)281-5781
:ed a customized report, attach a separate sheet detailing your requirements_ Fax: (515) 242-5953
Paper(prin(ed) List-See the descriptions on the reverse. E-mail:
❑ One line per voter
votere os.state.ia.us
El Two lines per voter
I Index cards-See the description on the reverse. Information also available
Mailing labels-See the description on the reverse. at:www.sos.state.ia.us
❑ One label per voter —
❑ One label per household ` U
Magnetic Media-See the descriptions on the reverse. q
❑ Cartridge tape-Compacted Data-Choose one from below
❑ 18-track ❑ 36-track
❑ Reel tape-See descriptions on the reverse-Choose one from each row below.
Encoding: ❑ ASCII ❑ EBCDIC l/
Density: ❑ 1600 bpi ❑ 6250 bpi
Labeling: ❑ Std IBM ❑ None C
Max block size: ❑ 36 KB ❑ Other(specify)
❑ Diskette for PC-See description on the reverse �e
CD-ROM for PC-See description on the reverse
What voters do you want included in your list? Describe the voters to be included in the list,specifying that which differenti-
ates�them fro the ones you do not want included. CAUTIO C If you'put"all voters"you will receive the whole 1.9 million!
C. _5 � o0
Rhat sequence do you want the voters listed? Describe the order in which the records are to be listed_ CAUTION: If you
eave these lines blank,the entire list will be alphabetical by the voters' last names.
Delivery-Check one box below.
❑ Deliver to county auditor,where I will pick up and pay for'the list_
❑ Send COD via UPS directly to me at the address below. Address cannot be PO box.
❑ Hold at the Registrar's office,where I will pick up and pay for the list
❑ For governmental agencies only:Send with invoice;payment will be made within 60 days.
Updates-Updates may be ordered only with an original list Updates to lists previously supplied, or to lists supplied by others
are not available. Updates are produced and must be picked up every two weeks and at registration closes for regularly scheduled
elections. Updates may be canceled at any time by the list purchaser. Updates will be canceled by the registrar if the charges for
an update have not been paid before the next update is due to be run. Once canceled,updates cannot be restarted-
❑ I do not want to receive updates.
❑ Provide updates(choose 1) ❑ until I notify you in writing.❑ until (date).
Personal int ation-Complete all blanks
Name: O Daytime phone
Address: ,5 /_6 C.la r A \/e Please cancel this order if the list cannot
City,State,Zip:. rr1 , "T A ,,5oo /[(��"- � be shipped by(date):
Intended Use of List: w vik l� I 1 U
I am aware that information from voter registration records may be used lawfully only to request a registrant's vote,for a genuine
political purpose,for bona fide political research, or for a bona fide official purpose by an elected official. I understand that string
the information for any commercial purpose is a serious misdemeanor under Iowa law. [agree to pay the cost of the above ordered
list upon delk'MT-
Signature: Date: ��
=' ST0ify�'hi'
MARY MOSIMAN
W ' V i Story County Auditor and
*'• •'* �' Commissioner of Elections
r220,97
CITY CLERK
April 30, 2007 CITYO"
Diane Voss
Ames City Clerk
Ames, IA 50010
Dear Diane:
Please find the enclosed CD of statistics from 3 different elections, an invoice, and a request
form. Please sign the enclosed request form; I am required to have this on file for public
information. Return it to my office along with the amount listed on the request form.
Please contact me with any continents, questions, or concerns.
Re ,
Mary osim
Story County Administration, 900 Sixth Street, Nevada, Iowa 50201-2087
515-382-7210 Fax 515-382-7221
Assistant Auditor: Lisa M. Markley
Deputies: Danielle J. Dunham, Lucinda J. Martin
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