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FOR I NSTRUCT I ONS, SEE BACK OF FORMDI SCLOSURE SUMMARY PAGECOMMI TTEE NAME ( Mu s t b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )

C, Y t Zwt S F o / - / -Qt Gl c r SS l ~yI MPORTANT : I n d i c a t e b y # t y p e o f c o m m i t t e e y o u a r e r e p o r t i n g f o r :( 1 ) S t a t e w i d e / L e g i s l a t i v e / J u d g e S t a n d i n g f o r R e t e n t i o n C a n d i d a t e t a t e PAC ( 3 ) S t a t e P a r t y( 4 ) C o u n t y C e n t r a l Co mmi t t e e ( 5 ) C o u n t y C a n d i d a t e - 4~: ( 7 ) S c h o o l B o a r d o r O t h e rP o l i t i c a l S u b d i v i s i o n C a n d i d a t e ( 8 ) G y TAG. . ( 9 _ AF k l D) S h o o l B o a r d o r O t h e r P o l i t i c a lS u b d i v i s i o n PAC 1 1 L o c a l B a l l o t I A S . -CANDI DATE COMMI TTEES ONLY :

L a t e r e p o r t s a r e s u b j e c t t o p o s s i b l e c i v i l a n d c r i m i n a l p e n a l t i e s . P u r s u a n t t o I o w a Cod e s e c t i o n 6 8 B . 3 2 A ( 7 )t h e c a n d i d a t e , f o r a c a n d i d a t e ' s c o mmi t t e e , a n d t h e c h a i r p e r s o n , f o r a n y o t h e r t y p e o f c o mmi t t e e , i s t h ei n d i v i d u a l r e p-Q p s i b l e f o r f i l j y g t i me l y a n d a c c u r a t e r e p o r t s

RE OF PERSON F I L I N G REPORT

I AM F I L I N G A / V . / t ? , Z( r e p o r t d a t e )

HECK I F AMENDMENT TO REPORT DATEDMChec k i f t h i s i s f i n a l ( t e r mi n a t i o n ) r e p o r t an d a t t a c h N o t i c e o f D i s s o l u t i o n F o r m DR- 3 .

( Yo u mu s t c o n t i n u e t o f i l e r e p o r t s u n t i l a DR-3 i s f i l e d . )

SUBTRACT TOTAL MONEY SPENT THI S PERI OD

STATEMENT OF CASH ON HANDCASH ON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d . ( T o t a l o f a l l f u n d s h e l d b y t h e

c o mmi t t e e . T h i s amou n t MUST b e t h e same a s t h e c a s h o n h a n d a t t h e e n do f t h e l a s t r e p o r t i n g p e r i o d o r mu s t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ADD TOTAL MONEY TAKEN I N THI S PERI ODSc h e d u l e A : Cash C o n t r i b u t i o n s t o t a l ( A t t a c h Sc h e du l e A ) ( * a l s o s e e i n - k i n d b e l o w) . . . . . . . . . . . . . . . . . . . . . .Sc h ed u l e F : L o a n s Re c e i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e H : T o t a l S a l e s o f Campa i g n P r o p e r t y ( A t t a c h S c h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h ed u l e H a pp l i e s t o Ca n di d at e s ' Co mmi t t e e s On l y )SUB- TOTAL . . . . . . . . . . . . . . . . . . . . . . . $

Sc h ed u l e B E x p e n d i t u r e s t o t a l ( A t t a c h Sc h e d u l e B ) ( * * a l s o s e e d e b t s a n d l o a n s b e l o w ) . . . . . . . . . . . . . . .Sc h e d u l e F : L o a n Repa y men t s t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON HAND a t t h e e n d o f t h i s r e p o r t i n g p e r i o d ( i f f i n a l r e p o r t b a l a n c e mu stb e z e r o ) ( A t t a c h D R- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

FORMDR- 2 I D I S C L O S U R E( Re v . 1 2 / 2 0 0 5 ) REPORTF o r Of f i c e Us e On i vComm #L o g g e d I nSca nnedCompu t e rA u d i t e d

F i l e w i t h :I o wa E t h i c s an d Campa i gnD i s c l o s u r e B o a r d5 1 0 E . 1 2 ' " , S t e . 1 ADe s Mo i n e s , I o w a 5 0 3 1 9F a x : 5 1 5 - 2 8 1 - 3 7 0 1

, 7 / - ? - . ?Sl - ; ~Le, - t - 1 e r a ? 6 , . 2 00TELEPHONE DATE SI GNED

REPORT F OR ( 1 ) ELECT I ON / ( 2 ) NON- EL ECT I ON YEAR .I n d i c a t e b y # 7

L o c a l C o mmi t t e e s , e n t e r D a t e o f E l e c t i o n

C o u n t y & L o c a l C o mm i t t e e s , e n t e r Co u n t y i nw h i c h E l e c t i o n i s h e l d

* * UNPAI D BI L L S ( F r o m S c h e d u l e D - A t t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* I N K I ND CONTRI BUT I ONS ( F r o m S c h e d u l e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* * OUTSTANDI NG LOANS ( F r o m S c h e d u l e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) - YES _XNOCANDI DATE COMMI TTEES ONLY :VALUE OF CAMPAI GN PROPERTY ( F r o m Sc h e d u l e H - A t t a c h Sc h e d u l e H) $STATE COMMI TTEES : Su bmi t a r e c o n c i l e d c ampa i g n a c c o u n t b a n k s t a t e m e n t i n J a n u a r y o f e a c h y e a r .

S4 s ~ 3s

~ 0 7 , i w 7 / . 33


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F o r I n s t r u c t i o n s , Se e B a c k o f F or mCONTRI BUT I ONS - - MONEY TAKEN I N( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( M u s t b e s a m e a s o n S t a t e m e n t o f O r g a n i z a t i o n )

I C, & I I L , e o s Ai rr ( a - t ( r r v ~ s s I Q"

SCHEDULEA I MONETARY( R e v 0 7 1 0 3 ) R E CE I P T S

CHECK T H I S BOX I FA M E ND I N G FORM

S T A T E C AN DI DA T E S N O T E I F A C ONT R I B U T I O N I S R E CE I V E D F R O M A S T A T E P A C ( P O L I T I C A L A CT I ON C OM MI T T E E) , L I S T T H E P A C I D E N T I F I C A T I O NN U M B E R A ND T H E P AC C H E C K N U M B E R I N T H E D E S I GN A T E D C O L U M N A L I S T OF I D N U M B E R S I S A V A I L A B L E F R O M T H E I O WA E T H I C S A N D C A MP A I GND I S C L OS U R E B O A R DCAU T I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o mme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o m m i t t e e s

SUB- TOTATOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) s ( 2 7b .$

' D i s G o s u r e l a w r e q u i r e s c a n d i d a t e c o m m i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e m a k i n g a c o n t r i b u t i o n t o t h ec o m m i t t e e R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b ym a r r i a g e ) . I f s u r n a m e o f c o n t r i b u t e i s t h e s a m e a s c a n d i d a t e , b u t t h e r e I s n o P a g e~ o ff a m i l i a l r e l a t i o n s h i p , e n t e r * n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u m n , ( f o r S c h e d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT J I F FORRECEI VED( MMI DD/ YR) ( i f a p p l i c a b l e )AND PAC CHECK TOCANDI DATE'( i f a p p l i c a b l e ) RECEI VED FUND-RAI SER

NUMBER I NCOMEI D#

3 1 / / s ' ~ l J o h . a x a ~r r ~ I e Z s l , s n o t : oI D#C K # 8 ~ g a VC 0 63 r nJ s s a p Nedoe r l A. , o r 00t r sCK# o 1 8 a a / 1o # 0 - . S t k A v e , Apt i vs a v e r / T / 4 G7a / a 6 I D# a l C o w 5 CK# ~ l 9 A ? ~Qa d

~ ~ / ~ v b I D# GJ : r l . a a r KG


3/14

F o r I n s t r u c t i o n s , Se e B a c k o f F o r mCONTRI BUT I ONS - - MONEY TAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a n i z a t i o n)Cf ' - i CAOS t ' o t - PC&~ 6-y- 4. SS1STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROMA STATE PAC ( P OL I T I C AL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ONNUMBER ANDTHEPACCHECK NUMBER I N THE DESI GNATED COLUMN. A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se c t i o n 6 8B . 3 2 A ( 6 ) , I o wa C o d e , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s an d s t a t e me nt s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o mme r c i a l p u r p o s e by an y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

TOTAL ( i f l a s t page o f t h i s s c h e du l e )D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a ny r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mmi t t e e R e l a t i o n s h i p mus t b e s h own t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a nd a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s a m e a s c a n d i d a t e , bu t t h e r e I s nof a mi l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u mn .

P a g e_~o f( f o r S c h e du l e A)

SCHEDULEA MONETARY

( Re v . 0 7 / 0 3 ) RECEI PTS~~ CHECK T HI S BOX I FAMENDI NG FORM

DATERECEI VED

PAC I D NUMBER( i f a p p l i c a b l e ) NAME ANDADDRESS OF CONTRI BUTORRELA T I ON SHI PTO CANDI DATE' AMOUNTRECEI VED 4 I F FORFUND-

( MM/ DD/ YR) AND PACCHECKNUMBER( i f a p p l i c a b l e ) RAI SE R

I NCOME0 l / l ?/ D6 I D # -/ %00 dKs X AndeesoAb Ot ._ /

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bl l 8 o POP& Dam. CK # ~3y d ( , . . ~. q . ~ a 1 o ~ + a s 39VAI D #01 1 1 J 1 0 4 CK# a( ~g / ! l a ' o ? Qka:mvee lI D # Z c t ( e p ,

0 1 - I D # to / I r . d y0a . r k s l o s t . Z ' 4 . S' o6 L5I D # / YJ q , ~ cOl / ~ Y S i d 9 D 0 2 5 0CK# 9 0 / 3 Z wt r A-4 / / S , 4 S ' o G / . ?I D # 0" . v c .A/A.-S"l / 0 6 9S4 f e & r e e sW o a r , c CK# 79 07

/ ~g l 6I D # _J e ~ ' ~ Pl a~ 3 eX01001~. ' d 9 s 0 ." so9 54, oeCK#12~a raI D # I d 1 1 4 , n d v t G aCK# ( p $ i a Co. , 3e d St , Ap t . 2 1 7~r l c t v a r - ~ i A 10/6 77 c l l a _ T r ) T n l


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F o r I n s t r u c t i o ns , Se e Back o f Fo r mCONTRI BUTI ONS - MONEY TAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME~M u s t b e s a me a s o n S t a t eme n t o f O r g a n i z a t i o n )

VSTATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECE I V E D FROM A S T A T E PA C ( P OL I T I C A L AC T I O N C OMMI T T E E ) , L I S T THE P AC I D EN T I F I C A T I O NNUMBER AND T HE P AC CHECK NUMBER I N T HE DESI GNATED COLUMN A L I S T OF I D NUMBERS I S A V A I L A B L E FROM T HE I OWA E T H I C S AND CAMPAI GNDI SCLOSURE BOARD .CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a Co de , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s an d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r an y c o mme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o m m i t t e e s .

TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e )D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o m m i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b ym a r r i a g e ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n of a m i l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u m n .

S UB - T

Page 3 o f( f o r S c h e d u l e A )

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECE I P TSCHECK T HI S B OX I FAMENDI NG FORM

DATERECE I VED PAC I D NUMBER( i t a p p l i c a b l e ) NAMEAND ADDRESS OF CONTR I BUTORREL A T I ONSH I PT O CANDI DATE ' AMOUNTRECE I VED J I F F ORFUND-

( MM/ DD/ YR ) AND PAC CHECKNUMBER ( i f a p p l i c a b l e )R AI S ERI NCOME

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avt r ! . Z 7 ~ s' 0677.


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F o r I n s t r u c t i o n s , S e e Ba c k o f F o r mCONTRI BUT I ONS - - MONEY TAKEN I N( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TT EE NAME ( M u s t b e s a m a s o n S t a t e m e n t o f O r g a n i z a t i o n )~i f i Z~ I n s r ' n a a - L - G- v r c - S s (

S T A T E C A N D I D A T E S N O T E : I F A C O N T R I B U T I O N I S R E C E I V E D F R O M A S T A T E P A C ( P O L I T I C A L A C T I O N C O M MI T T E E ) , L I S T T H E P A C I D E N T I F I C A T I O NN UMB E R A N D T H E P A C C H E C K N U M B E R I N T H E D E S I G N A T E D C O L U M N . A L I S T O F I D N U M B E R S I S A V A I L A B L E F R O M T H E I O W A E T H I C S A N D C A M P A I G ND I S C L O S U R E B O A R D .C A U T I O N : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o m m e r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o m m i t t e e s .

S U B - T O T A L $ qqSTOTA L ( l f l a s t p a g e o f t h i s s c h e d u l e ) $ 7 - ?30 .

' D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o m m i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e m a k i n g a c o n t r i b u t i o n t o t h ec o m m i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b ym a r r i a g e ) . I f s u r n a m e o f c o n t r i b u t o r i s t h e s a m e a s c a n d i d a t e , b u t t h e r e i s n o P a g e o ff a m i l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u m n . ( f o r S c h e d u l e A )

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECEI PTSHECK T HI S B OX I FMENDI NG FORMf

DATERECEI VED PAC I D NUMBER( i f a p p l i c a b l e ) NAME AND ADDRESS OF CONTR I BUTOR RELAT I Q1 4 SH I PT O CAND I DATE' AMOUNTRECEI VED d I F FORFUND-( MMI DD / YR) AND PAC CHECKNUMBER ( i f a p p l i c a b l e ) RAI SERI NCOME

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l p6 c K # 33 Po - 8x . ( ~ T , ~ - d 6o8 O. oK t l lI D # GCa7C- / ~ . v + l r ~ J: 7 . 7 6 9 - 6 t r a i l Ave . ~wv oo CK#


6/14

T H I S BOX A P P L I E S T O C A ND I D A T E S ' C OMMI T T E E S O N L Y :P u r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H . ( R e f e r t o S c h e d u l e H I n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s / e n t i f e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mu s t a l s o b e d e t a i l i t e mi z e d o nS c h e d u l e G b y t h e a mo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e r t oS c h e d u l e G I n s t r u c t i o n s a n d I o w a C o d e 6 8 A . 4 0 2 ( 3 x 1 ) . )

P a g e I o f 41

( f o r S c h e d u l e B )

t - V K I NS I HUC I I ON S, SEE BACK OF FORM I " ` x4P SCHEDULEEXPENDI TURES B- MONEY SPENT FROM COMMI TT EE ACCOUNT MONETARY( R e v 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E GI S L AT I V ECANDI DATES, L I S T THE CANDI DATE I D E N T I F I C A T I O N NUMBER I N THE DES I GNATED COL UMN AND THE CHECK THI S BOX I FPA C CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWAETHI CS 8 CAMPAI GN DI SCLOSURE AMENDI NG FORMBOARD.COMMI TTE E NAME ( Mu s t b e s a me a s o n St a t e me n t o f O r g a n i z a t i o n )

ZGr 1$ i ' - o ' r Pa . k &r ass~ -CANDI DATE NAME AND ADDRESS TO WN l ` ' ~ ~ ~ ~URP E AMOUNTDATE I D NUMBER EXPENDI TURE ( f 3 S 3 f ~ 1 6 E TR SACTI ON) EXPENDEDEXPENDED ( i f a pp l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE - ,( MM/ DDI YR) AND PACCHECKNUMBERI D # S t q S

a t l o ~ 0 6 ~ s ~ z ~h~ . H a~ f i r _ /CK # 1 0 1 7 W, ~e Ho - , X1 4 SD~ p'I D # ? l e - S 'F l p . , . t i ~ , r bl . - p AP c _ I ' a AGI o 7 r7 i ~_ G _CK # l 0 /~ 1 . ) , ~ " t t l o o , . r f l , . S - O J ' p e 7 SuP~ l ' e s

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. z l t 3 l o 6 . 2 1 T - k so . r 5 1 2 ' . S 8 voCK # l p j ~ S ~ o ~ x C~~y , . Z , Q S l l o l a wf~1 i 3 / O6

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re a . r - s e w , e " ~ - r~y l , " l Ca ~e ` f ~3 26~~I eS10~v so c , y , . . . t , ~ X106 ~t ! , j as pe rI D# Gr geKe ~GC. o 1 ' d E ' ! '

~ l t 6 1~6 c K# ( 0 l 0 a q s s~~n~s ~rewsPaPe' ~ 02~. o0

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7/14

T H I S BOX A P P L I E S T O C A N D I D A T E S ' C O M M I T T E E S O N L Y :P u r c h a s e s o f c e r t a i n c a m p a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r m o r e m u s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H . ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , m a n a g i n g , o r g a n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l i t e m i z e d o nS c h e d u l e G b y t h e a m o u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e m a d e b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o m m i t t e e . ( R e f e r t oS c h e d u l e G I n s t r u c t i o n s a n d I o w a C o d e 8 8 A . 4 0 2 ( 3 x i ) . )

P a g e ~ 07 o f


FOR I N ST R UC T I ON S, S EE B AC K O F FORM 1 < SCHEDULEEX PENDI TURES B MONETARY- MONEY SPEN T FROM COMMI T T EE ACCOUNT ( R e v . 0 7 / 0 3 ) EXPENDI TURES

ST AT E PAC COMMI TT EES : NOTE : FO R CONT RI B UT I O NS MADE T O STATEWI DE OR L E GI S L A T I V ECANDI DATES, L I S T T HE CANDI DATE I D E N T I F I C A T I O N NUMBER I N T HE DESI GNATED COLUMN AN D T HE CHECK T HI S BOX I FPAC CHECK NUMBER F O R E ACH EXPENDI TURE. A L I S T OF I D NUMBERS I S A V AI L A BL E FROM T HE I OWA AMENDI NG FORME T HI C S t i CAMPAI GN D I S C L OS U RE BOARD . ,COMMI TT EE NAME ( Mu s t b e s a me a s o n S t a t e me n t o f O r g a n i z a t i o n )G1 " ~ r " z e r g s f o r Pq 7 ` G r a s s l e > -

^ .C AN DI D AT E NAME AND A DD RE S S T O WHOM PURKV S E " . AMOUNTDAT E I D NUMBER EXPENDI TURE - ( [ WESCf t I B E T R AN SA T I ON ) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADE( MM/ DDNR) A N D P A CCHECKNUMBE R

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o d / 0 . r 7 ; ~ 7 ~ f 1 S ~ So , ~ Sf ~Ks iI D# ( / , Y. 5 t o r e -CK# ; 2 " Sa O St i d 3, r ~ S f . C4 r / ~a ~ ~ t C s r f ' ~ t S '/ 0 02 _ f . 4 . S ` ~ Sa dI m o _

pQf Gr oss l y ' R e ~ , " t L ~ r s G . r t e , t ~ - - ma r3047t. 4 , 1 e , , , , , ; l e g 9 ~; Pa s t a >e . l6 cK#spa / ' l Rr t f I A a ~ l . o t e I , a, ~ - a l i t r i + gI D # WC. f . r t ' . S ? ~ r x - 1 _OOA My ~Ba; AL y0 pe r / ^ ,l S CK# So2c o SW3a r a ` / I l o h - p a d s ~ t o t 5 A l ' r 7 -s ~Obo~ 3"/ 06 / oa ~ - c t d t i ' A o ! ' ~ ' X, 9 J L " ~ SO r - Gwt a t " nl ( 0/ ,

_3d l T i i l , r d ( ~ ~ - ~~r t -" , I ~ l e a ~ . SOY. . Z S~ ~ Y 0?03 To.6 CK# goo . 7 03 , To

S U B - T O T A L $T O T A L ( i f l a s t p a g e o f t h i s s c h e d u l e ) $ e ' - " U~


8/14

FOR I NSTRUCT I ONS, SEE BACK OF FORMDI SCL OSURE SUMMA RY PAGE

COMMI TT EE NAME ( Mu s t b e same a s o n St a t e me n t o f O r g a n i z a t i o n )

/ Z RLA r a . S S I GI MPORTANT : I n d i c a t e b y # t y p e o f c o mm i t t e e y o u a r e r e p o r t i n g f o r( 1 ) S t a t e w i d e / L e g i s l a t i v e / J u d g e S t a n d i n g f o r R e t e n t i o n C a n d i d a t e ( 2 S t a t e PAC ( 3 ) S t a t e P a r t y( 4 ) C o u n t y C e n t r a l C o mm i t t e e ( 5 ) C o u n t y C a n d i d 6 ) C i t y C a n d i d a t e ( 7 ) S c h o o l B o a r d o r O t h e r P o l i t i c a lS u b d i v i s i o n C a n d i d a t e ( 8 ) C o u n t y PAC ( 9 ) C i t y / A c o o l B o a r d o r O t h e r P o l i t i c a l S u b d i v i s i o n PAC( 1 1 ) L o c a l B a l l o t I s s u e /CANDI DATE COMMI TT EES ONL Y :C d i d a t e Name~Cc . ~ Ur a > < s lwO f f i c e S o u g h t

L a t e r e p o r t s a r e s u b j e c t t o p o s s i b l e c i v i l a n d c r i mi n a l p e n a l t i e s . P u r s u a n t t o I o w a Code s e c t i o n 6 8 B . 3 2 A ( 7 ) t h e c a n d i d a t e , f o r a c a n d i d a t e ' s c o mm i t t e e ,a n d t h e c h a i r p e r s o n , f o r a n y o t h e r t y p e o f c o mm i t t e e , i s t h e i n d i v i d u a l r e s p o n s i b l e f o r f i l i n g t i me l y a n d a c c u r a t e r e p o r t s

I AM F I L I NG A( r e p o r t d a t e )

OCHECK I F AMENDMENT T O REPORT DATED

C h e c k i f t h i s i s f i n a l ( t e r mi n a t i o n ) r e p o r t a n d a t t a c h N o t i c e o f D i s s o l u t i o n F o r m DR- 3 .( Y o u mus t c o n t i n u e t o f i l e r e p o r t s u n t i l a DR- 3 i s f i l e d . )

( Sc h e d u l e H a p p l i e s t o Ca n d i d a t e s ' Co mmi t t e e s On l y )

FORMDR- 2 DI SCL OSURE( Re v . 1 2 / 2 0 0 5 ) REPORTF o r Of f i c e Us e On l yCo mm #L o g g e dS c a n n e dCo mp u t e rA u d i t e d

T EL EPHONE DATE S I GNED

REPORT FOR ( 1 ) ELECT I ON / ( 2 ) NON- EL ECT I ON YEARI n d i c a t e b y # V]

L o c a l C o mmi t t e e s , e n t e r D a t e o f E l e c t i o n

C o u n t y & L o c a l C o mmi t t e e s , e n t e r C o u n t y i nw h i c h E l e c t i o n i s h e l d

. Od

SUB- TOTAL . . . . . . . . . . . . . $SUBTRACT TOTAL MONEY SPENT THI S PERI ODSc h e d u l e B : E x p e n d i t u r e s t o t a l ( A t t a c h Sc h e d u l e B) ( * * a l s o s e e d e b t s an d l o a n s b e l o w ) . . . . . . . .

. , O7 - 7Sc h e d u l e F : L o a n Re p a yme n t s t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b

CASH ON HAND a t t h e e n d o f t h i s r e p o r t i n g p e r i o d ( i f f i n a l r e p o r t b a l a n c e must O* Ob e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

NO

* * UNPAI D B I L L S ( F r o m Sc h e d u l e D- At t a c h Sc h e d u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* I N K I ND CONTRI BUTI ONS ( F r o m Sc h ed u l e E - A t t a c h Sc h e d u l e E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* * OUT ST AND I NG L OANS ( F r o m Sc h ed u l e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . $CONSUL T ANT BRE AK DOWN ( S c h ed u l e G A t t a c h e d? ) - YESCANDI DATE COMMI T T EES ONL Y :VALUE OF CAMPAI GN PROPERT Y ( F r o m Sc h e d u l e H - A t t a c h Sc h e d u l e H ) $STATE COMMI T TEES : Submi t a r e c o n c i l e d c a mp a i g n a c c o u n t b a n k s t a t e m e n t i n J a n u a r y o f e a c h y e a r .

ST AT EMENT OF CASH ON HANDCASH ON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d ( T o t a l o f a l l f u n d s h e l d b y t h ec o mmi t t e e . T h i s amou n t MUST b e t h e same a s t h e c a s h o n h a n d a t t h e e n d YO?o f t h e l a s t r e p o r t i n g p e r i o d o r must b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADD TOTAL MONEY TAKEN I N THI S PERI ODSc h e d u l e A Ca s h C o n t r i b u t i o n s t o t a l ( A t t a c h Sc h e d u l e A) ( * a l s o s e e i n - k i n d b e l o w) . . . . . . . . . . . . . . . . 07 , 7Sc h e d u l e F : L o a n s Re c e i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . .Sc h e d u l e H : T o t a l Sa l e s o f Camp a i g n P r o p e r t y ( A t t a c h Sc h e d u l e H ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


9/14

Fo r I n s t r u c t i o n s , Se e Back o f Fo r mCONTRI BUTI ONS - - MONEYTAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEENAME ( Mu s t b e s ame as o n St a t e me n t o f O r g a n i z a t i o n )

C, " 1 ~~ Le VI 6 r eo- G ( - r

SCHEDULEA I MONETARY( R e v . 0 7 / 0 3 ) RECEI PTS

CHECK T HI S BOX I FAMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PAC ( P O L I T I C AL ACTI ON C OMMI T T E E ) , L I S T THE PAC I D EN T I F I C A T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A VA I L A B L E FROM THE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD .CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Code , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s an d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r an y c omme r c i a l p u r p o s e b y an y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

TOTALSUB -TOTAL ( i f l a s t p a g e o f t h i s s c h e d ul e )

675.L1D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mm i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e m a k i n g a c o n t r i b u t i o n t o t h ec o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) I f s u mame o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o Page I

f a m i l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn . ( f o r S c h e d u l e A )

DATERECEI VED PAC I D NUMBER( i f a p p l i c a b l e ) NAME ANDADDRESS OFCONTR I BUTOR RELAT I ONSH I PTOCANDI DATE' AMOUNTRECEI VED d I F FOFUND-

( MM/ DD/ YR) AND PAC CHECKNUMBER( i f a p p l i c a b l e ) RAI SEI NCOM

I D# phi l t i - S Sc~l i , Jc ~ , I , 1G' $a~oo D0 1 / 1 -2 / 0 ( 0 CK#3y / 6 ' 4 0 . a x 0 7 ( 0 ~Or1 h ' - s i l e L4 o000 7/ 0 6 I D#CK# 8 ! o g a

VC a ) 0 ,3 . t I r n n . Y e o , b o - . 9s s 8 Ne wr l l ~ + ~ r ~5 o l ,e ~ s0 a ? ` CK# a 8 a a / t o f 0 " f , 4 * 4p e j Ap t i o v o 2 5 " o0move r / 1 6 ,0677O~~l a~o 6

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x / 0 6 I D# Al " , " l ~ t i %r t ~ S `~. ~ es 0 6- 14 l ~ u+ ~~, coCK# 6~ ~J r a 8 1 / 4 9 , 7 YQ, / i ova 0 0

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&a. / e n 4 9 * . t i t " Y l e . -"y , 7 , 6 / J J ~S I B boo. a ~.d / ~ / 06 I D# Ros5, 0. Ui ~~ " s t c . . s ex , Dos aS' " 4 9 0CK# ~ ' 3v d r f l 7v f / f l l t s f1 ` " A S ' o ' l o . ?_ / a . *11 p/ ob

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10/14

Fo r I n s t r u c t i o n s , Se e Ba c k o f F o r mCONTRI BUTI ONS - - MONEY TAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f O r g a n i z a t i o n )Cl 6LWISAf PU, ( , . r ' 0. SsIQ

SCHEDULEA MONETARY( R e v 0 7 / 0 3 ) I RECEI PTS0CHECK T H I S BOX I FAMENDI NG FORMSTATE CANDI DATES NOTE : I F A C ON T R I B U T I O N I S R E CE I V E D FROMA S T A T E PAC ( P O L I T I C A L A CT I O N C OMMI T T E E ) , L I S T THE PAC I D EN T I F I C AT I O NNUMBER AND T H E P AC C HE CK NUMBER I N T HE D E S I G NA T E D COL UMN . A L I S T OF I D NUMBERS I S A VA I L A B L E FROMT HE I O WA E T H I C S AND C A MP A I G ND I S C L O S UR E BOARD .CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s an d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o mme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e )

' D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b ym a r r i a g e ) I f s u r n a m e o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o P a g e o ff a m i l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn . ( f o r S c h e d u l e A )

DATERECEI VED PAC I D NUMBER( i f a p p l i c a b l e ) NAME AND ADDRESS OF CONTRI BUTOR REL ATI ONSHI PTOCANDI DATE' AMOUNTRECEI VED I F FOFUND( MM / D D / Y R ) AND PAC CHECKNUMBER ( i f a p p l i c a b l e ) RAI SEI NCOMQl / ~ ~~ 0 6 I D# 7 A o r r r a s XAn d e r s 0 A $/ oo . ooCK# v / 8 bd - / 1aKb t -01/ / 8 / 0 ( 0

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11/14

F o r I n s t r u c t i o n s , S e e B a c k o f F o r mCONTRI B UT I ONS - - MONEY TAKEN I N( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )C OMMI T T E E NAME ~ M u s t b e s a me a s o n S t a t e m e n t o f O r g a n i z a t i o n )~. E i t e v ~ , s - t ^ o + - l a - ~ - Cr - Ca i s l "

S T A T E C A N D I D A T E S N O TE I F A C O N T R I B U T I O N I S R E C E I V E D F R OM A S T A T E P A C ( P O L I T I C A L A C T I O N C O M M I T T E E ) , L I S T T H E P A C I D E N T I F I C A T I O NN U M B E R A N D T H E P A C C H E C K N U M B E R I N T H E D E S I G N A T E D CO L UM N A L I S T O F I D N UMBE R S I S A V A I L A B L E F R OM T H E I O W A E T H I C S A N D C A M P A I G ND I S C L O S U R E B O A R DC A U T I ON S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o m m e r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o m m i t t e e s

S U B - T OT A LT O T A L ( i f l a s t p a g e o f t h i s s c h e d u l e )

D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o m m i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e m a k i n g a c o n t r i b u t i o n t o t h ec o m m i t t e e R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b ym a r r i a g e ) I f s u r n a m e o f c o n t r i b u t o r i s t h e s a m e a s c a n d i d a t e , b u t t h e r e i s n o P a g e 1 3 o ff a m i l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u m n ( f o r S c h e d u l e A )

S C H E D U L EA MONETARY( R e v . 0 7 / 0 3 ) RECEI PTSQCHECK T HI S BOX I FAMENDI NG FORM

DATERECE I VED PA C I D NUMBER( i f a p p l i c a b l e ) NAME AND ADDRESS OF CONTRI BUTORRELAT I ONSHI PTO CANDI DATE ' AMOUNTRECE I VED 4 I F F OFUND-

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r c 4 G 2 so0 0 6 o 6 c K # ` f ' l 9 ' 9 o f f 4 1 , / wc a W. r / e r ! , I A ! ! ' 0 6 ? ' T


12/14

Fo r I n s t r u c t i o n s , Se e Back o f Fo r mCONTRI BUTI ONS - - MONEYTAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t b e s am a s on S t a t e me n t o f O r g a n i z a t i o n )Ci I L " Ze. i n s ~ l ' , 4 A - ~ ( i - - y ` c t i SS~~

f o r a n y c o mme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

SCHEDULEA I MONETARY( Re v . 0 7 / 0 3 ) RECE I PTSCHECK T HI S BOX I FAMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C AL ACTI ON COMMI T T E E ) , L I S T THE PAC I D EN T I F I C A T I ONNUMBER AND THE PAC CHECK NUMBER I N TH E DESI GNATED COL UMN . A L I S T OF I D NUMBERS I S A V AI L A B L E FROM TH E I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARDCAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Code , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r

SUB- TOTAL !$aZf os.TOTAL ( i f l a s t page o f t h i s s c h e du l e )

" D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mm i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b ym a r r i a g e ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o Pa ge o ff a m i l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn . ( f o r S c h e d u l e A )

DATERECEI VED PAC I D NUMBER( i f a p p l i c a b l e ) NAME AND ADDRESS OF CONTRI BUTORRELAT I ONSHI PTOCANDI DATE" AMOUNTRECEI VED I F FOFUND-

( MM/ DD/ YR) AND PAC CHECKNUMBER ( i f a p p l i c a b l e )RAI SEI NCOM

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13/14

FOR I NSTRUCT I ONS, SEE BACK OF FORMEXPENDI TURES - - MONEY SPENT FROM COMMI TT EE ACCOUNT

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI S LAT I VECANDI DATES, L I S T THE CANDI DATE I D EN TI F I CA T I ON NUMBER I N THE DESI GNATED COL UMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWAETHI CS & CAMPAI GN DI SCLOSURE BOARD .

SCHEDULEB MONETARY( Re v . 0 7 / 0 3 ) EXPENDI TURESCHECK T HI S BOX I FAMENDI NG FORM

COMMI TT EE NAME ( M u s t b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )l . . . I ~ i Zs PC . , ( P a - k G' r a s s t "

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T HI S BOX APPL I E S TO CANDI DATES' COMMI TTEES ONLY :P u r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n S c he du l e H . ( R e f e r t o S c h e du l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s t e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mu s t a l s o b e d e t a i l i t e m i z e d o nS c he d u l e G b y t h e a mo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e ( R e f e r t oS c he d u l e G i n s t r u c t i o n s a n d I o w a Code 6 8A . 4 0 2 ( 3 ) ( i ) . )


CANDI DATE NAME ANDADDRESS TOWH M PURPOSEDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) IEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( MM/ DDI YR) AND PACCHECKNUMBER


14/14

T HI S BOX A PP L I E S TO CANDI DATES ' COMMI TTEES ONLY :P u r c h a s e s o f c e r t a i n c a m p a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r m o r e m u s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H . ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l i t e m i z e d o nS c h e d u l e G b y t h e a m o u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e r t oS c h e d u l e G i n s t r u c t i o n s a n d I o w a C o d e 6 8 A . 4 0 2 ( 3 ) ( i ) . )

P a g e X; ~ o f a( f o r S c h e d u l e B )

FOR I NSTRUCT I ONS , SEE BACK OF FORM R e s e t F o r m SCHEDULEEXPEND I TURES B MONETARY- - MONEY SPENT FROM COMMI TT EE ACCOUNT ( R e v . 0 7 / 0 3 ) EXPEND I TURES

STATE PAC COMMI TTE ES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI S LATI V ECANDI DATES, L I S T THE CANDI DATE I D EN TI F I CA T I ON NUMBER I N THE DES I GNATED COLUMN AND THE CHECK THI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA AMENDI NG FORMETHI CS & CAMPAI GN DI SCLOSURE BOARD .COMMI TTEE NAME ( M u s t b e s am e a s o n S t a t e m e n t o f O r g a n i z a t i o n )G i ' ~ ` ~ z e r r s f o r P o t G r a s s l e ~ -

CAND I DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPEND I TURE ( DESCR I BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADE( MM/ DD/ YR) AND PACCHECKNUMBERI D# l i v ~ a - t o m - r a y i l / C- ~ s ~ a

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SUB- TOTAL $ $5 0, 3TOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) $10 cr . . . 3 o Z

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