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FORINSTRUCTIONS, SEEBACK OF FORM
DISCLOSURE SUMMARY PAGECOMMITTEE NAME (Must be same as on Statement of Organization)
AO, SJe.4`IMPORTANT: Indicate by # type of committee you are reporting for: I
I
I( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party( 4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board orOtherPolitical Subdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 10 )School Board or Other PoliticalSubdivision PAC ( 11 )Local Ballot Issue
GUS".-
SIGNATURE OF PERSON FILING REPORT
I AM FILING A
Cey:'
\'I(report date)
[CHECK IF AMENDMENT TO REPORT DATED
Political Party (if applicable)
District (if Senate or House)saln e - 37
515-cf(1-1_1)~TELEPHONE
C Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 .(You must continue to file reports until a DR-3 is filed .)
REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .Indicate by #
STATEMENT OF CASH ON HAND
CASH ON HAND at the beginning of the reporting period. (Total of all funds held by thecommittee . This amount MUST be the same as the cash on hand at the endof the last reporting period or must be zero if this is first report filed .) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
ADD TOTAL MONEY TAKEN IN THIS PERIODSchedule A: Cash Contributions total (Attach Schedule A) (*also see in-kind below) . . . . . . . . . .Schedule F :
Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Schedule H : Total Sales of Campaign Property (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Schedule H applies to Candidates' Committees Only)SUB-TOTAL . .. . . $
SUBTRACT TOTAL MONEY SPENT THIS PERIODSchedule B : Expenditures total (Attach Schedule B) (**also see debts and loans below) . . . .
Schedule F : Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CASH ON HAND at the end of this reporting period (if final report balance mustbe zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. . $
**UNPAID BILLS (From Schedule D - Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . .. . . . .. . $
*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . . .. . . . .. . .. . . . .. . . . .. .. . .. .. . . . . . . .. . . . .. . $"'OUTSTANDING LOANS (From Schedule F -Attach Schedule F) . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$CONSULTANT BREAKDOWN (Schedule G Attached?)CANDIDATE COMMITTEES ONLY:VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)
FORMDR-2
I DISCLOSURE(Rev . 07/2004)
REPORT
Comm . #Logged
_
ScannedComputerAudited
Late reports are subject topossible civil and criminalpenalties .
LL-/5=c)(QDATE SIGNED
Local Committees, enter Date of Election
County & Local Committees, enter County inwhich Election is held
1, qa
~ ~ 44a
~.w
3 3 /o
YES V~NO
For im°tructions, SeeBack of Form
CONTRIBUTIONS -MONEY TAKEN IN(Including candidate's personal funds)
COMMITTEE NAIVE (Must be Same as on Statement ofOrganization)
STATE CANDIDATES NOTE: IFACONTRIBUTIONIS RECEIVED FROM ASTATE PAC (POLITICAL ACTION COMMrCfEE), LIST THE PAC IDENTIFICATION .NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LISTOF ID NUMBERS IS AVAILABLE FROM THE iowA ETHICS AND CAMPAIGNDISCLOSURE BOARD.
CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person otherthan statutory political committees.
' Disclosure law requires candidatecommittees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must beshown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . Ifsumame of .contributor is the same as candidate, but there is nofamilial relationship, enter'not applicable` in the relationship column .
SUB-TOTAL o0
TOTAL (iffastpage of Upis schedule)
Page / of(for Schedule A)
SCHEDULEA MONETARY
(Rev. 07/03) RECEIPTS
CHECK THIS BOX IFAMENDING FORM
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MNVDD(YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOMEID# ("-01777rn;~ay~ $clcID# R"C-ly all,f
-7 - IS-C6 CK# 1 too Nr h O 00 E:1ID# ~u~e p~cK~
TQ-C~ cK# 0° E].e
ID# ,r,;e r~r~X11CK# 3t31 -1ex .~ ~.k . . 70~..qp )Co. 66 EJ
aID# ~ect sZ ~~~~~oan
66 E]C,ID# 1e ~n. ti`'1 a E:1ID# QLN,iCy
"I -C(o CK# P.O. Qlr-Al M+-~ Lj
ID#~Iome' M~ks
-1 -r~Co-O(o CK# 1NOa ~11,e~r~e. t.SV/bc
no
-
ID#
CIC# P.O. \(DS0, E:1
ID# CC~~~ c~rv~ ~r~ ~ OO
CK# 13 ,1 ~esS`'lo ; r1pS ~fr 5031+`1 E:1
For !Instructions, See Back of Forth
CONTRIBUTIONS - MONEY TAKEN IN(Induding candidate's personal itrrds)
COMMITTEE NAME (Must be same as on Statement ofOrganization)
STATE CANDIDATES NOTE : IF A CONTRIBUTION1S RECEIVEDFROM A STATE PAC (POLITICAL ACTION COMMITTEE), USTTHE PAC IDENTIFICATION .NLJMBER ANDTHE PAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF IDNUMBERS ISAVAILABLE FROMTHE IOWA EtHCS AND CAMPAIGNDISCLOSURE BOARD.
CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees .
SUB-TOTAL
TOTAL (if last page of this schedule)
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If surname ofcontributor is the same as candidate, but there is no
paw O~-offamilial relationship, enter'not applicable' in the relationship column .
(forSchedule A)
SCHEDULEA MONETARY
(Rev. 07/03) RECEIPTS
CHECK THIS BOX IFAMENDING FORM
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(11AM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOMEID# damesCK# rRvn
ID# I M~CK# 3R 1a~a .
CQr~~'f .̀`gli~~crnL.Jf\r1ZMrZed-
ID#
CK#Calu(Y~ll`~ICtI
/GO, E:1Fjl ; zR s) s
ID# Cle&~~ ~~~%w, t_
.31-No
I
CK# P.o. ~,~ 1oN~ 7:Go
oo~I3 O~ S~'Ia,nPs~ ~~.
C ©Oa~~~~1J ~" .C. Kssr. ,
ID#y-a -~ CK# . > sk.
ID# ,~y g~hKq-a-O166 CK# E:1C
mc.f1e5,--~+1T S?~3i2.
-3-0~
lD#
CK# ~36~, rr 5 . E:1ID#
~- -Co C lsv3 N8'" . 00
For Instructions, See Back of Form
CONTRIBUTIONS -MONEYTAKEN IN(Including candidate's personal finds)
COMMITTEE NAME (Must be same as on Statement ofOrganization)
STATE CANDIDATES NOTE: IF ACONTRIBUTION IS RECEIVEDFROM A STATE PAC (POLITICAL ACTION COMMITTEE), USTTHE PAC IDENTIFICATIONNUMBER AND THE PAC CHECKNUMBER IN THEDESIGNATED COLUMN. A LIST OF ID NUMBERS ISAVAILABLE FROMTHE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.
CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.
` Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) .
tfsumanleofcontributor is the some as candidate, butthere is nofamilial relationship, enter not applicable` in the relationship column .
Page
r
ofj(for Schedule A)
SCHEDULEA MONETARY
(Rev. 07103) RECEIPTS
CHECK THIS BOX IFAMENDING FORM
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (d applicable) RAISER
NUMBER INCOMEID# R~r: vk1~Q.
CK# oJ-S -OCo
ID# ~l h _n h ElCK#~ SO
ID# nrte. ~r
~-S-OCfl CK#
ID#
S-bCo CK# 31 3 3 ~. oz~
ID# cJh;~S- CK# 101 ~-e Rd.
~.cy-
ID#9mnm (CIO
S-O(o CK# 11CrkiI4 Lcxc2s 9adce
ID#'`~,R ac.R S
_,.-AID#
4> --~5-U C
ID#
CK#nco4\ IRX~ rrnsPo SZ
Od
I r,I-WWt,9K W-1I_ ~C,
For Instnrctions, See Back of Fonn
CONTRIBUTIONS - MONEY TAKEN IN(including candidae's personal Aeds)
COMMITTEE NAME (Must be same as on Statement ofOrganization)
r -~ .
STATECANDIDATES NOTE: IF ACONTRIBUTION IS RECEIVEDFROM ASTATE PAC (POLITICAL ACTION COMMITTED, LISTTHEPAC IDENTIFICATIONNUMBERANDTHEPACCHECKNUMBER IN THEDESIGNATED COLUMN. ALIST OF IDNUMBERS ISAVAILABLE FROMTHEIOWAETHICSANDCAMPAIGNDISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees .
Disclosure law requires candidate committees to disclose the relationship ofany relative making a oontriburion to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . Ifsumame of contributor is the same as candidate, but there is no .
Page
-of5famifial relationship, enter `not applicable" in the relationship column . (for Schedule A)
SCHEDULEA MONETARY
(Rev. 07/03) RECEIPTS
0 CHECK THIS BOX IFAMENDING FORM
DATE PAC ID NUMBER 'NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-(MNIIDDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOMEID# Q 777e7-~
1 6' 3 \ 5S'~. cx%sr,C~,ctr~\G~~ ~~
ID# U<,,A-em o'-wo 1 . -17 IZICK#
ID#
CK# ~~~ ~~ ~. 0110.00
ID# q (e-fo f~~1 ~rner.cc; PRC E:1ID#
CK# 4~, ~x I~i-f7 S . ElID# wce 1 `
60 E:1ID# Cece\
QK',r i:n
CK#
ID# (~ ?1 1 PRcCK#jgN9
,q Mo.n~s` - .:S=t
Sam.ID#
he/~ l ~~ Y>
CK# ~S S. o1.a ~F. ~~` ao~:n~~ ~O1~T3
ID# bran ~~ne.
CK# 3 15` -l-.~nc ln c~~s~nes r~- ~~
ForInstructions, See Back of Form
CONTRIBUTIONS -MONEYTAKEN IN(Including candidate's personal hinds)
COMMITTEE NAME (Must be same as on StatementofOrganization)
STATE CANDIDATES NOTE: IFA CONTRIBUTION IS RECEIVEDFROM A STATE PAC (POLIt1CAL ACTION COMMlT EE), UST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECKNUMBER IN THEDESIGNATED COLUMN . A LISTOF ID NUMBERS ISAVAILABLE FROMTHE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.
CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees . .
Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee . Relationship must be shown to the third degreedfconsanguinity (blood relatives) and affinity (relatives bymaniage) .
If sumame ofcontributor is the same as candidate, but there is no
.
Page
offamilial relationship, enter not applicable' in the relationship column .
(for Schedule A)
SCHEDULEA MONETARY
(Rev. 07/03) RECEIPTS
© CHECK THIS BOX IFAMENDING FORM
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOMEID# ~cxtlL~i~ne
owl O~-. $ 60CK#
ID# ~~ S',o .~a m v~S'~31awtt5'h`Ve. Re'~te, rs'sno 00 EJCK#
0)W3 S`i1~,~s,si4 S
ID# ~g99- We\\ Pcx. .CK ,SN,
.
ID# ~rra 1. '~ecan
a3-~ CK# 0~1~ r -c /~~ to.rves ~~r 503ia1
ID# M
~s Mo;nes~ X316ID# qj ~~,~ l ocal 3N7
a~-C(O CK#aq1ytr sue.
~'~)es vnes . R5031ID#
h9 Sin g(~-~ OCp CK# 5 r l C~r~l C~
'a-)MMt -S ,.yes S1~CoSr
ID# ~~ht^11
n
CK#_Zk~%cxr%AQ --v} ~1b1~
ID# 1:JI~z.ub ~n COf'tl--
9,0l'4 -CG CK# SAO C 00
ID#
q-o l -E CK# flscu~'4h .(
\.J.~ 1 1Gn~ -y. ~ '
ForInshuctions, See Back of Form
CONTRIBUTIONS - MONEY TAKEN IN(Including candidaws personal funds)
COMMITTEE NAME (Must be same as on StatementofOrganization)
J~~fKi~C.
STATE CANDIDATES NOTE: IF ACONTRIBUTION ISRECEIVEDFROM A STATE PAC (POLITICAL ACTION COMMITTEE), USTTHE PAC IDENnFICATION .NUMBERANDTHE PAC CHECKI.JMBER IN THE DESIGNATED COLUMN . A LIST OF IDNUMBERSISAVAILABLE FROMTHE IOWAETHICSAND CAMPAIGNDISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees .
' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to theCommittee. Relationship mustbe shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If surname ofcontributor is the same as candidate, but there is no
.
, .
Page(_ offamilial relationship, enter"not applicable` in the relationship column.
(for Schedule A)
SCHEDULEA MONETARY
(Rev. 07103) RECEIPTS
CJ CHECK THIS BOX IFAMENDING FORM
DATE ' PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MHVDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOMEID# }~~e~n 'teams
~J10 CK#
ID# rc~nCC)
-owl-C(o CK# 4.0 . ~ M-T /oaID#
CK# 00
iD#oe
1
Mr- An,r4C CK# Q,0. I'~~~
ID# CM' 7Z8AjN
CK# 4 a 3. -QaKs C~- .re.
ID# Cam,
CK# 00
rID#
e% el ,ZS' J'~o CK# t3 '- ~Q .
~s r'~,rlesID# ''% cUtUN~PACCIC# .~3 1~13s WE
AmenID# ~'ecL.SR rrtrl~.an
aa- .o CK# kxix IZIID#
C ~1(aI7 CQme Qc:/00- a5 Elo6 ~s .
For Instructions, SeeBack of Form
CONTRIBUTIONS - MONEY TAKEN IN(Including candidate's personal funds)
COMMITTEE NAME (Must be same as on Statement ofOrganization)
STATECANDIDATES NOTE : IF ACONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBERANDTHE PAC CHECKNUMBER IN THE DESIGNATED COLUMN . A LIST OF IDNUMBERS ISAVAILABLE FROM THE IQWA ETHICSAND CAMPAIGNDISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees .
Disclosure law requires candidate committees to disclose the relationship ofanyrelative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If sumame of contributor is the same as candidate, but there is no
Page~^offamilial relationship, enter' not applicable` in the relationship column.
(for Schedule A)
SCHEDULEA MONETARY
(Rev. 07103) RECEIPTS
CHECK THIS BOX IFAMENDING FORM
DATE PAC ID NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (Ifapplicable) TO CANDIDATE" RECEIVED FUND-(MM/DDYR) ANDPACCHECK (if applicable) RAISER
NUMBER INCOMEID# ~~n No~.lecK
-SSO6 CK# rr-fl-5
ID# 1~e. arts'
ID#
CK# / 0Manes~- ~ID#
CK#sa c;a t,~~K El
ID#
LUCKA-ee,ID#
CK# 16A 1 PAC flve .
ID# ~.;n~ ~en~crn-,j-~ CK# ~i~o Slk> ~ P14~y . CIO El
~fwes~ ~ID#
S`'l~o;rles ~f~ID#
(Q CK#
ID# (Q,KV ---!'r1 f\ tom,-hS~sl.~cal
tJ~ ~.oi(Ies ~A- Sa3~3
ForInstructions, See Back of Form
CONTRIBUTIONS -MONEYTAKEN INpndudimg candidate's personalfunds)
COMMI7TEE NAME (Mustbe same as on Statement ofOrganization)
STATE CANDIDATES NOTE: IF A CONTRIBUTION ISRECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBERAND THEPAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF IDNUMBERS ISAVAILABLE FROMTHE IOWAETHICSANDCAMPAIGNDISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees .
* Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must beshown to the third degreeof consanguinity (blood relatives) and affinity (relatives by
15-familialmarriage) . Ifsumame of contributor is the same as candidate, but there is no
Page~-ofrelationship, enter'not applicable' in the relationship column . (for Schedule A)
SCHEDULEA MONETARY
(Rev. 07103) RECEIPTS
O CHECK THIS BOX IFAMENDING FORM
DATE PAC ID NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (ifapplicable) TO CANDIDATE* RECEIVED FUND-(NtNVDD1YR) ANDPAC CHECK (if applicable) RAISER
NUMBER INCOMEID# ~t~c-~-~ ~nc~evv~ctn
S CK# Cdr U . Ono
Q-S--C)(Q 'ID#
CK# Glo ' . loo `0 Q-\,ID# Q
_j6,, 5 ~S -1uF \"vm~
c llao,rc ~ve .,
tol3ID# e-
119`-S o CK# 3L31 F1~^,
,ob
,
ID# C -by~,-5- cK# ,~~3,
CK#
ID#\ ~ICA
~m iII J iID#
-'r oo
ID#
21_~
ID#
_
FE-~OCo CK#,Qr~~ -
ForInshuctions, See Back of Form
CONTRIBUTIONS -MONEYTAKEN IN(Ir>dudngcane's personal funds)
COMMITTEE NAME (Must be same as on StatementofOrganization) .
~e
STATECANDIDATES NOTE: IFACONTRIBUTION IS RECEIVED FROM ASTATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER ANDTHEPAC CHECKNUMBER IN THEDESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THEIOWA ETHICS ANDCAMPAIGNDISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orforany commercial purpose by any person other than statutory political committees.
* Disclosure law requires candidate committees to disclose the relationship orany relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . Hsurnameof.contributor is the same as candidate, but there is no
.
Page
of
~~familial relationship, enter'not applicable' in the relationship column .
(for Schedule A)
SCHEDULEA MONETARY
(Rev. 07103) RECEIPTS
FEW CHECKTHIS BOXIFAMENDING FORM
DATE PACID NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-(MlWDDIYR) AND PACCHECK (if applicable) RAISER
NUMBER INCOMEID#
CK#
~
`&x 7 $ cc
lD#
q- CK# 1ao1,~,c~''
lD# Suit pi n
CK n uo
ID#
sID#
~ h~~ct1 00CK#
G s~ID# I~av,~ SG,
C aCK#~.s ~in sfl~3
ID# Pln-)M-1- Mc.,,e14q~- CK# ~QJ W, cans C a°
... \`ID# l.ltJi_.y Qprntxsa~s
-1y El
q4-c(Q CK# IZIID#
CK# ` ~~a- t~lJiwmS~.
ForIastructions, See Back of Form
CONTRIBUTIONS -MONEYTAKEN IN(Indudmg candidate's personal funds)
COMMITTEENAME (Must be same as on Statement ofOrganization)
STATE CANDIDATES NOTE: IFA CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMrfTEE~, LISTTHE PAC IDENTIFICATIONNUMBERAND THE PAC CHECK NUMBER INTHE DESIGNATED COLUMN . ALISTOF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.
CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person otherthan statutory political committees.
SUB-TOTAL
Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must beshown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) .
Ifsumome ofcontributor is the same as candidate, but there is no
Page
offamilial relationship, enter"not applicable' in the relationship column .
(for ScheduleA)
SCHEDULEA MONETARY
(Rev . 07/03) RECEIPTS
CHECK THIS BOX IFAMENDING FORM
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (f applicable) TO CANDIDATE' RECEIVED FUND-(MhAIDDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOMEID# ' 7;77-777 Cam,
CK# b-0ID#
CK# 1 4.. "" ' l tics
ID# ilv:11Q,M e,n
t-Ct -C6p CK# loci Mec C~:_
~ ,ID#
CK# ~d0 ~,~11e,,n Ave.,
ID# ~,Ct3rlcc ~'`er1~
9-1M-CJC~ CK# /
ID# \aM ~M ~\'6Y1
CK# M1o C- er, a q~.
~
ID#
CK#
,-d~ 21~A- 0
ID# Pa`~t~c~a 1~.cKS9'-IS-C CK# 9c~ . C ZI~pc-
ID#
~r1~yvCerto~'r ~- ~1olS
For Instructions, See Back of Form
CONTRIBUTIONS - MONEY TAKEN IN(In
g
date's personal funds)
COMMITTEE NAME (Must be same as on Statement of Organization)
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATEPAC (POLITICAL ACTION COMMITTEE), LISTTHEPAC IDENTIFICATIONNUMBERANDTHE PAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICSAND CAMPAIGNDISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statementsfor soliciting contributions orfor any commercial purpose by any person other than statutory political committipes .
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If sumarne of contributor is the same as candidate, but there is no
Page~_offamilial relationship, enter not applicable' in the relationship column .
(for Schedule A)
SCHEDULEA MONETARY
(Rev . 07103) RECEIPTS
CHECKTHIS BOX IFAMENDING FORM
DATE PAC ID NUMBER NAME ANDADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MMIDDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOMEID# an Kos`a.~s
ll~~es ~n S~' :~ID# xllne ~Se~n.~rc.~
G-15'-- CK# i 4 l~ a,, Vi
lD#vo
CK#
lD#
q- 1160-0 CK# Zed %CK\ H640
lD#
CK#Wc_..A ~W 3
lD#
CK# ~ ~ G0I&n \-w OD alD#
CK#JAAem%2e k C-CnA'VN\Z16~CAs ~S El
lD# CJ $.nCK#
_ v .;sci4p
cva-1rar,
~11~ 'KA40RA.
'D") ElC'34 .16* ,
ID# "Zconne ~~
9-1j=0(o CK# lOol"I R 1a~i~~s.»asO: EJID# Nks . x`1 .1. . rvKlrlC, 00
~ Marle's~F~ ssa3 )O ,
For I-wtructions, See Back of Form
CONTRIBUTIONS - MONEY TAKEN INoncftumn9 candid~s personal funds)
COMMITTEE NAME (Must be same as on Statement ofOrganization)
STATE CANDIDATES NOTE : IF ACONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICALACTIONCOMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBERANDTHE PAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS ANDCAMPAIGNDISCLOSURE BOARD .
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statementsfor soliciting contributions orfor any commercial purpose by any person other than statutory political committees .
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship mustbe shown to the third degree of consanguinity (blood relativeS) and affinity (relatives bymarriage) . If sumarne ofcontributor is the same as candidate, but there is no
Page~a
of_ Is-familial relationship, enter"'not applicable' in the relationship column.
(for Schedule A)
SCHEDULEA MONETARY
(Rev. 07/03) RECEIPTS
CHECK THIS BOX IFAMENDING FORM
DATE PAC ID NUMBER NAME ANDADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (If applicable) TO CANDIDATE' RECEIVED FUND-(MIINDD(YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
O, CK# $~~~~2yw~~~t
sula e-+W/r
ID# C,\\ert t-.L7p
-@O-O& CK# q /per, 0ID#
-~-CL CK# El4 -~
ID#
CK#
-Ito
~1-1_--i M~:-,.~\a-C'm.1 ED10~
ID# ,C . Cler'h~c-~~pCt~`n_"~ CK#
~ r6) WE 00
ID# nes 'VIJC~\ec',00 E]
ID# ~~s n ~ J\ginCK# 331s ~'- Pi . °° ElC~M; z~ So3i~DID# ~CZ1e SchJCK# ~~..~C, ~ID# Cdvm;rle_CK P~1 8\ .
oo
3
'o QID#
CK#
"n t.ca eDCrn%e\1e C~.
lot
ED
ForInsdmctions, See Back of Form
CONTRIBUTIONS -MONEYTAKEN IN(Indudmg candidate's personal funds)
COMMITTEE NAME (Must be same as on StatementofOrganization)
STATECANDIDATES NOTE: IFACONTRIBUTION IS RECEIVED FROM ASTATE PAC (POLITICAL ACTION COMMITTEE), USTTHEPAC IDENnFICATIONNUMBER ANDTHEPAC CHECKNUMBER IN THEDESIGNATED COLUMN . AUSTOF IDNUMBERS ISAVAILABLE FROMTHEIOWAETHICSANDCAMPAIGNDISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports andstatements forsoliciting contributions orfor any commercial purpose by any person other than statutory political committees .
Disclosure lawrequires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage).Ifsumarne ofcontributor is the same as candidate, but there is no
Page 8 offamilial relationship, enter not applicable` in the relationship column .
(for ScheduleA)
SCHEDULEA MONETARY
(Rev. 07/03) RECEIPTS
CHECKTHIS BOX IFAMENDING FORM
DATE PACID NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (f applicable) TO CANDIDATE' RECEIVED FUND-(MMDD(YR) AND PACCHECK (fapplicable) RAISER
NUMBER INCOMEID# tn Mcz wCK# an
mID#
I CK#I
,n; vnzr~ Ccsn
-`c~ s
~,ao
ID# cam0C)
CK#0~9 i UZ
~ ~ VA~31+~1 Sam .
ElID#
00Boy- (Gel a
ID#
-aa-Co CK# VMhM~zed C a,-, 013p
kD-3-C(oID#
v ElCK#
~0-3--~ CK#@~( /s U, P41 y s\a.,sL;:a'eJ loo 020«~
. ElPMY,er, Sf~ ".: ,
CK# E:1/o-H -OHO
V
CK# +~3 !U .U~. flue-.00
Co3i15 fles ~'1o,nes~
ForInstuct3ons, See Back of Form
CONTRIBUTIONS -MONEYTAKEN IN(Including canddate's personal hinds)
COMMITTEE NAME (Must be same as on Statement ofOrganization)
Sena
STATE CANDIDATES NOTE : IF ACONTRIBUTION ISRECEIVEDFROM A STATE PAC (POLrnCALACTIONCOMMITTEE), LIST THE PAC IDENTIFICATIONNUMBERAND THEPAC CHECKNUMBERIN THE DESIGNATED COLUMN. A UST OF ID NUMBERS IS AVAILABLE FROM THE IQWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political commItWes.
Disclosure lawrequires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If surname of contributor is the same as candidate, but there is no
Page
Nof
15familial relationship, enter not applicable' in the relationship column .
(for Schedule A)
SCHEDULEA MONETARY
(Rev . 07/03) RECEIPTS
CHECK THIS BOX IFAMENDING FORM
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MMIDDfYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOMEID# ( ~ ucc Ccsvwr . Cn -bt~-,CGi JCsrTwn E~F1-.-C~~
~.s Mo,nc~,SR 5J~~1 K
ID# a - P c)o-l4-po CK#
.
S~o1C~ UJes c~Kuza °°o ~, aID# (0a V,0 :MELL) 1 a3 .
IO -~-b(o CK# 1a,57 3-70 Ska"rs " Pra., N.t . /00.~ Ljec'A AS
ID# ('oolq C.LuA ~-~1 -I IICA~0-~4-c7Co CK# 3(o1a w sue, ~OQ. orr~~
Oes~.nes~1~ 5~3~5
r~K~- °aX09
10# &0-1 -7/b -CXo CK# V~H 9151S 5~;, l(c Ejo,r .~R/O-(o -O4o C
°Y`rl1-1 -ZS K Un,~~ cx~ Sw
/O-(D-C(oID# Qa-~ "~
,3~ef0 CoyJlv9ElCK#
ID#
CK# , . a
ID#
CK#900 s,~Aksee \NW
00
For lnstnrctions, See Back of Form
CONTRIBUMNS -MONEYTAKEN IN(Including candidal e's personal funds)
COMMITTEE NAME (Must be same as on StatementofOrganization)
oe1 -,;r Se",~~~
STATE CANDIDATES NOTE: IF ACONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDEN11FICATIONNUMBERANDTHE PAC CHECKNUMBER IN THEDESIGNATEDCOLUMN . A LIST OF IDNUMBERS ISAVAILABLE FROMTHE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees .
Disclosure law requires candidate committees to disclose the relationship ofany relativemaking a contribution to thecommittee. Relattonship must be shown to the third degree of consanguinity (bwod relatives) and affinity (relatives bymarriage) . If sumame of contributor is the same as candidate, but there is no
Page
/1-5-
of-15-familial relationship, enter"not applicable` in the relationship column.
(for Schedule A)
SCHEDULE
A MONETARY(Rev. 07103) RECEIPTS
CHECK THIS BOX IFAMENDING FORM
DATE PAC ID NUMBER NAME ANDADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED(MMIDDIYR)
(if applicable)AND PAC CHECK
TO CANDIDATE"(if applicable)
RECEIVED FUND-RAISER
NUMBER INCOMEID# 7e.7C, ~ Q;4- ;,, ( ?,A . 0, 0ID# (DI`7Q(D rL)F FJ14
~o -ion CK# i 1 ao cellr1ec,~C1`\ Rue .,kw 5*.11co °° E:11041 ,O:C .GID# (DISC Urn; vGAe s - v~C.v I-c ~3
k~- I 1-O(o CK#x"17 ia5 SU~.3 ~Qess'1c~r~s~~
y
~3r3
00
ID# <q:5C~q : C~v ~~IC>-11 -C(o CK#
01Ig311 V+~~'v ,
S`'l,n 1~S ~sv
CK# DSC5~ 1- nmAkon Ve zs~. ElRrr ".E,~ 9comID# Rn n &~e'Mne
10-11 -(Yc CK# 90-A R-4f\'~" Os'. oCE]
ID# p~ --~ N1Q~~-
10- 11 -0(0 CK# 1931 Su~ , ~1 CJ~- . oc
c.U n~-~~~ ~aT3
,
ID# ~ey
IC)--Q-0(o CK# loo.
lD#
Cic#00
~s Ma~nessi~ID#
CE:1
THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :
Purchases of certaincampaign property costing 5500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions) .
Expenditures to Personstentities Providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, Purpose, and date of each type ofexpenditure made by the PersWentity on behalf of the candidates committee. (Refer toSchedule G instructions and Iowa Code 68A.402(3)() .)
(for Schedule B)
FOR INSTRUCTIONS, SEEBACK OF FORM SCHEDULE
EXPENDITURES B-MONEY SPENT FROM COMMITTEE ACCOUNT MONETARY(Rev. 07/03) EXPENDITURES
STATE PAC COMMITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS ISAVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD.
COMMITTEE NAME (Must be same as on Statement of Organization)
1 .-~- Ae,CANDIDATE NAME ANDADDRESS TO V1MOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDEDEXPENDED (d applicable) (Disbursement) WAS MADE(MM/DD/YR) AND PAC
CHECKNUMBER
ID# %ce, cMarn "Mew -%e
~'ot -1'ao CK#$
o
cK#~,o~nes~,~' sa3~1
ID#
CK#~9~p'"~
ID# m~x'r°.etre~~' r ~~X.i-
00CK# cxxns,~ . . w-c1, ~.s Ot~(p .~C q wcr `, ,rU`
SUB-TOTAL $ OCo
TOTAL (if lastpage ofthis schedule) $
THIS BOXAPPLIES TO CANDIDATES' COMMITTEES ONLY:
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to personsfentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule Gby the amount, purpose, and date of each type of expenditure made by the persorderdity on behalf of the candidate's committee . (Refer toSchedule Ginstructions and Iowa Code 66A.402(3)().)
(for Schedule 8)
FORINSTRUCTIONS, SEEBACK OF FORM ` SCHEDULE
EXPENDITURES B- MONEY SPENT FROM COMMITTEE ACCOUNT MONETARY(Rev. 07/03) EXPENDITURES
STATE PAC COWITTEES: NOTE: FOR CONTRIBUTIONS MADE TOSTATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN ANDTHE CHECKTHIS BOX IFPAC CHECK NUMBER FOREACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS 8 CAMPAIGN DISCLOSURE BOARD.
COMMRTEE NAME (Must be same as on Statement of Organization)
CANDIDATE NAME ANDADDRESSTO WHOM PURPOSE AMOUNTDATE9 ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE(MMIDDYR) AND PAC
CHECKNUMBER
I 1 -" ~t'"ldUa
I-0(o`~
CK#
ID#~S'75~
~ces ltwvri r~no,r.~~ cx~4,-,-(~(o ~q1~^S~.
CK#~C~Co 3cx~~uno~7~~ SD\~
I-o(p CK# X31 .IcS3`1 ~~~ti~ID# ~S~e. C .zr'n Qav ~s.~
5,
CK#
ID# CJ- °1 ;'evw~a men r Ce.
~-
ID# nrlNvs7~.) 4 S
4s~- ?-co >GS3
CK#
ID# DA55Sis S~-oCo 60
CK#laqSUB-TOTAL $ ~la
TOTAL (fflast page ofthis schedule) $
THIS BOX APPLIES TO CANDIDATES'COMMITTEES ONLY :
Purchases of certain campaign property costing 5500 or more must also be inventoried on Schedule H. (Refer to Schedule H Instructions.)
Expenditures to personslentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule Gby the amount, purpose, and date ofeach type of expenditure made by the persoNentity on behal ofthe candidate's committee. (Refer toSchedule Ginstructions and Iowa Code 68A.402(3)(i).)
(for Schedule B)
FOR INSTRUCTIONS, SEEBACK OF FORM I Fg ~ l~ ! SCHEDULE
EXPENDITURES B- MONEY SPENT FROM COMMITTEE ACCOUNT MONETARY(Rev. 07/03) EXPENDITURES
STATEPACCOMMITTEES: NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMNANDTHE D CHECKTHIS BOXIFPAC CHECK NUMBER FOR EACH EXPENDITURE. ALISTOF ID NUMBERS ISAVAILABLE FROM THEIOWA AMENDING FORMETHICS &CAMPAIGN DISCLOSURE BOARD.
COMMITTEE NAME (Must be same as on Statement ofOrganization)
CANDIDATE NAME ANDADDRESSTO WHOM PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDEDEXPENDED (if applicable) (Disbursement) WASMADE(MWDD/YR) ANDPAC
CHECKNUMBER
IM
Kctirw,e~. : -.1C'A3 dKLrlo~G ~ ~ $$
-i I-OCp cK# w911o'Ilogy s ,U-)'P - Ica
1D#lpcl~
~o 011 W , 1st' flue.CK#5z> I&S-
.
ID# wskC- S- f'~S -LJtO
SC~1 F Q~ ;~.O o CK#
1Cqq grrr,,ol~ h~A ~r
~Itltot,CK# :57.1D# Pv6''h ce "~~ . S rn~t d-f7!o fCK# I~ c2rtOq -tirZ- ~Ia~
SUB-TOTAL
TOTAL (fflast page ofthis schedule) $
THIS BOXAPPLIES TO CANDIDATES'COMMITTEES ONLY:
Purchases of certain campaign property costing $600 or more mustalso be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to personslentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, arid date ofeach type of expenditure made by the persoNentity on behalf of the candidate's committee. (Refer toSchedule G instructions and Iowa Code 68A.402(3)(i).)
(for Schedule B)
FORINSTRUCTIONS, SEEBACK OF FORM SCHEDULE
EXPENDITURES B-MONEY SPENT FROM COMMITTEEACCOUNT MONETARY(Rev. 07/03) EXPENDITURES
STATEPACCOMIIIITFEES : NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMNANDTHE CHECKTHIS BOX IFPACCHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS &CAMPAIGN DISCLOSURE BOARD.
COMMITTEE NAME (Must be same as on Statement of Organization)
CANDIDATE NAME ANDADDRESSTOWHOM PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WASMADE(MM/DD/YR) ANDPAC
CHECKNUMBER
ID# Ukt1 V)urvq-N-0(o clc# j5bc ~U ,'fi n 19
1 ~ 1 ~~no~,~ ~~as 13 ,ID#
CK# Q~l0ai yesNb nrs S~ ~_.
ID# ~nc~cenb\a a\ ~ 00Q--W'0( lo1WIIa SW. ae CK# 1103 ;or,c -ZPr 5a~4S .
ID# Oft-CknMjC:~~~ OU
11o~iID#
-uld~C AM, m\oyk" b,3Q <<
q-~-c( CK#zleu-geo -V S
ID# CJ rc.~ aINC1 itcP"W- '
-~-G~ CK#
ID# a vn CIOCK# tsm ~.- - X61-Q"~'' 391\v1 .->. ,zAs~~~ .1D#
190k W."CK# 1 : 1K 1a ; ~~as
SUB-TOTAL $a O~?TOTAL (if last page of this schedule) $
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 instructions.)
Expenditures to personVentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each type of expenditure made by it* persoNentity on behalf ofthe candidate's committee . (Refer toSchedule G Instructions and Iowa Code 68A.402(3)().)
(for Schedule B)
FORINSTRUCTIONS, SEEBACK OF FORM t SCHEDULE
EXPENDITURES B- MONEY SPENT FROM COMMITTEE ACCOUNT MONETARY(Rev. 07/03) EXPENDITURES
STATE PAC COMMITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWAETHICS & CAMPAIGN DISCLOSURE
AMENDING FORMBOARD.
COMMITTEE NAME (Must be same as on Statement of Organization)
DATEEXPENDED
CANDIDATEID NUMBER(d applicable)
NAME ANDADDRESS TO WHOMEXPENDITURE
(Disbursement) WAS MADE
PURPOSE(DESCRIBE TRANSACTION)
AMOUNTEXPENDED
(MMIDDIYR) AND PACCHECKNUMBER
ID#
q-~-o(O CK#11 9
-7u~,;, ,~Rsba~3
ID# c ,«
110 ~~~~A sa1~
q~~- CK# WOOQ1x1 N R 440(oo 9r 0-7
ID#
CK#
C~L° ' I~I ' ~~"_~ Ftx,
re~~ men\ - ,-c ce s,7 hes
ID#~, rY1G~rIG- rye - moCO(I1y oen''T r'
dD
r l 2 XeM6)~says
ID# ,'A,
CK#1~t39 aa-~ta Ave . "'
CDIAJ.
4q CK# Po ecw~(
1D#
SUB-TOTAL $ eTOTAL (iflast page ofthis schedule) $
THIS BOXAPPLIES TO CANDIDATES'COMMITTEES ONLY :
Purchases of certain campaign property costing X500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions.)
Expenditures to personsfentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule Gby the amount, purpose, and date ofeach type of expenditure made bythe peMonlentity on behalf of the candidate's committee. (Refer toSchedule Ginstnxtions and Iowa Code 68A.402(3)()-)
(for Schedule B)
FOR INSTRUCTIONS, SEEBACK OF FORM SCHEDULE
EXPENDITURES B-MONEY SPENT FROM COMMITTEE ACCOUNT MONETARY(Rev . 07/03) EXPENDITURES
STATE PAC CORIIrrTEES: NOSE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMNANDTHE CHECKTHIS BOX IFPACCHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE KNNA AMENDING FORMETHICS &CAMPAIGN DISCLOSURE BOARD.
COMMITTEE NAME (Mustbe same as on Statement of Organization)
1`e
CANDIDATE NAME ANDADDRESSTO 440M PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED rrf applicable) (Disbursement) WASMADE(MM/DDIYR) ANDPAC
CHECKNUMBER
iD#~~-~IIc,
-.A ~~~ t~~m~osemers;-~ac- a
c(-1o1-fY-fYo C"IC~iol~a
ID# ~crannc. ~.~z ce�,r ,~rh "_i3-CXp CK#
Kax~B'S~~~~~ID# LUC ,~ ~cu~~o ac~S o0
ID# r . ~c :+L~,n CIIc 1t Ca~s,n
C~ '. ~sa3{(oID# ~r~r,rle r,?--u-A1o~ A . se-<- lt-"%n
~f-I~,UCowrelTa~
~" eSt t
CK#a
ID#H3Ica~t
CK#~ ~aa
ID# one. ( ~~°^ ? z2a~Ool-l ~a - r s n vo ~'CK#
ID# -c c~t compn , CA
oaCK#
Z)
' SUB-TOTAL $~ QO
TOTAL (fflast page ofthis schedule) $ '
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 instructions.)
Eghenditures to pemonslentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each type ofexpenditure made by the personlentity on behalf of the candidate's committee. (Refer toSchedule G instructions and Iowa Code BaA.402(3)() .)
Page--of-10
(for Schedule B)
FORINSTRUCTIONS, SEEBACK OF FORM SCHEDULE
EXPENDITURES B- MONEY SPENT FROM COMMITTEE ACCOUNT MONETARY(Rev. 07/03) EXPENDITURES
STATE PAC CONMETTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATEDCOLUMN AND THE CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWAETHICS
AMENDING FORM& CAMPAIGN DISCLOSURE BOARD.
COMMITTEE NAME (Mustbe same as on Statement of Organization)
DATEEXPENDED(MMIDDIYR)
CANDIDATEID NUMBER(d applicable)AND PAC
NAME ANDADDRESSTO WHOMEXPENDITURE
(Disbursement) WAS MADE
PURPOSE(DESCRIBE TRANSACTION)
AMOUNTEXPENDED
CHECKNUMBER
ID# =o+.~q GJec\Cr~e ~a-. t'. C.an' ~4'~~n -~ one
° CK# l I&SSZoCo~ F ~Lk!
pes S1o 1e5, l
1GC~ c.$30CO,~CYJ
~3-EXp cK#S\C Wcx-K
90"~ID#
CK# 11a_7 ncwano\a 3~ SD1aS
_-
,;,-~tar-
9x6-06ID#
CK#Ila~
Cpr~\S1r'- C\~ly2~erlc~,s~,~~ ~a~1
~~ ..,,~Jog .
O
1D#
CK# tiaqT,~~\onAcl Pie-" -ala.iq° t w. 4"& 1 'E~w.a , ~~~ ads
IS67,
-~--~
ID#
CK# iQ~iWCOAA.t V ~s
o0
l
1D#
-6?-C(P CK#113~
X10 S. ls~ S`~ .C~-\.s~,~~n
C\ I T QAs ~
°o,
ID#
CK#flue.
SUB-TOTAL
TOTAL (iflastpage ofthis schedule) $
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 instructions_)
Expenditures to personslerffities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each type of expenditure made by the pen oNentity on behaff ofthe candidate's committee. (Refer toSchedule G instnictions and Iowa Code 68A.402(3)(i).)
Page
(for Schedule B)
FORINSTRUCTIONS, SEEBACK OF FORM AS-' SCHEDULE
EXPENDITURES B- MONEY SPENT FROM COMMITTEE ACCOUNT N(Rev. 07/03)
EXPENDITUDfTURES
STATE PAC COMMITTEES: NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LISTTHE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMNANDTHE CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS ISAVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD .
COMMITTEE NAME (Must be same as on Statement ofOrganization)
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE(MM/DD/YR) AND PAC
CHECKNUMBER
ID#
10- 1 39 e.as-\ -C eve.CK#
ID# c, ac,ao,bla : ~h ~ae k,~. y, ;/o-o1-Q(o CK# P. C- x 9 r
ID# Lkl~~ Matio-3-o(o CK# C*
3. 90
113(0 ~N1o,~aes~ gJ~ID# ru+iok+ New 1~.
igot <N.~,a aCK#13Y1 S11c~.~'rrb~RhS ' was
ID# Mot %'S"01crr1 f`vu. CIio-J'-(2( CK# 4a cu: C~:1-~-fl~. \ 00
113 ~'rf~~e~,~ X13ID# ~o
104~CK#
1D# CaAsNe C.Vze. OAio-5-off CK#
lab s. wt s`t.neu,--1 s-
1!off,1Mo cQ-a~s~,~A a-7
SUB-TOTAL $ IC)c'1,,~ Ciol..TOTAL (Iflast page ofthis schedule) $
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 instructions .)
Expenditures to persons/entities providing consulting, advertising, fund-raising, poling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each tSchedule G instructions and Iowa Code
ype of expenditure made by the persoNentity on behalf of the candidate's committee . (Refer to68A.402(3)f) .)
(for Schedule B)
FORINSTRUCTIONS, SEEBACK OF FORM SCHEDULE
EXPENDITURES B- MONEY SPENT FROM COMMITTEE ACCOUNT MONETARY(Rev. 07/03) EXPENDITURES
STATE PAC COMMITTEES: NOTE : FOR CONTRIBUTIONS MADE TOSTATEWIDE OR LEGISLATIVECANDIDATES, LISTTHE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMNANDTHE CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD .
COMMITTEE NAME (Must be same as on Statement ofOrganization)
CANDIDATE NAME AND ADDRESSTO WHOM PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE(MMIDD/YR) AND PAC
CHECKNUMBER
ID#
CK#Roe . ~ rt~s S
~ 1H 1 ~,~,ob,~~ somasID#
lo-~-C P ©. 8~ NcK#
K5-1-C cK# P.o . ~x Ink, 91
ID#(00
CK#
ID# ' i,tcnrr,Al bless - ;Y,~,Jn1~ s~S* -i-J0°-9'-CXt, CK# ULtARM
ID# e Rea1 3 ~ANY. (VKlt-f(-1-0(o CK# at't~ !1~u3 '' .rasae 1 c~unea' - - , ~°
11 146ID#
mc3rtla ~var~ C'2~rn cam,JO-R-()Co 0`10 { E .Sam' _ ~~ e ~
CK# f'~ .~ ; '"'r~ilol5~ID#
PO. -~gt~( 39cK# u. ~a1
SUB-TOTAL $ 130
TOTAL (fffastpage of this schedule) $
THIS 13OX APPLIES TO CANDIDATES' COMMITTEES ONLY :
Purchases ofcertain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions.)
Expenditures to personslenfties providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each type of expenditure made bythe personlentity on behalf ofthe candidate's committee. (Refer toSchedule G instructions and Iowa Code 68A.402(3)(Q.)
(for Schedule B)
FORINSTRUCTIONS, SEEBACK OF FORM SCHEDULE
EXPENDITURES B- MONEY SPENT FROM COMMITTEEACCOUNT MONETARY(Rev. 07/03) EXPENDITURES
STATE PAC COIIMIIITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE D CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD.
COMMITTEE NAME (Must be same as on Statement of Organization)
CANDIDATE NAME ANDADDRESS TO WHOM PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE(MM/DD/YR) AND PAC
CHECKNUMBER
ID# 4cgnne LUtAit'n ~.hMnX men~ f. ! s~.r_
10-13 joa~R'4~-4 C~--11#1)H9$
ID#o
CK#
ID#8 S i.~;.~ S~v;ces lckk^ maa;;ncL Ccl
CK# is7s~ Kim . ~o
1 IS I ~ S,Pr 9~1a.SID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL$v
~ C~OCr"~
TOTAL (iflast page ofthis schedule) $
FOR INSTRUCTIONS, SEE BACK OF FORM
COMMITTEE NAME(Must be same as on Statement of Organization)
fl~i -~Zx- s -- -NOTE : This schedule reports money loaned to the committee which is deposited in the committee account.
cfiTOTAL UNPAID LOANS FROM LAST REPORTING PERIOD $
ADCC),
PART I - MONETARY LOANS RECEIVED THIS REPORTING PERIOD(Original source of loan, such as a bank, must be shown if a third party isinvolved. Include loans from candidate's personal funds.)
TOTAL (PART I)
$
"Disclosure law requires candidate committees to disclose the relationship of any relativemaking a contribution to the committee . Relationship must be shown to the third degree ofconsanguinity (blood relatives) and affinity (relatives by marriage) . If surname of contributor isthe same as candidate, but there Is no familial relationship, enter "not applicable" In therelationship column when it applies .
PART 11- MONETARY LOAN REPAYMENTS MADE THIS REPORTING PERIOD(Loans forgiven must be reported on Schedule E -- In-kind Contributions.)
TOTAL CASH REPAYMENTS (PART ll)
$
l
From Schedule E - TOTAL LOANS FORGIVEN
$
TOTAL OUTSTANDING LOANS END OF REPORT PERIOD
$
Page of(for Schedule F)
SCHEDULE
F LOANS(Rev . 07/03) RECEIVED
REPAID
CHECK THIS BOX IFAMENDING FORM
DATERECEIVEDMM/DD/YR
NAME AND ADDRESS OF LENDER(Include Endorser's Name, If Applicable)
RELATIONSHIPTO CANDIDATE
If Applicable*)
AMOUNTOF LOAN
$
DATE PAID(MM/DD/YR)
NAME AND ADDRESS OF LENDER(Include Endorser's Name, If Applicable)
RELATIONSHIPTO CANDIDATE`
If Applicable)
AMOUNTREPAID
J~G1f:~ ~~ s,*. 1l I~Ve,
$
oC
FOR INSTRUCTIONS. SEEBACK OF FORM
COMRiTTEE NAME (Must besame as on Statement ofOnjanimdon)
SCHEDULE
_ Rev.E IN-KIND.0619 CONTRIBUTIONS
[] CHECK THIS BOX IFAMENDING FORM
-Disclmaue law tequkw cam6daies two
ite relationship ofany refa6ve moMgan in idnd
nto"committee. Rolafmmsldp must beshown totothird degmee of
guidy(blood naistives) and
y (relatives
(forSdmdule E)bY marriag4 (See Page 2 offorms padcel.) Usumeme of car*&ulor isthe somascandidate, butthereis nofamiral relafionsNP, enter "not appWable' in the relationship cok>rnn .
DATERECEIVEDMMDDIYR)
NAME AND ADDRESSOFCONTRIBUTOR
RELATIONSHIPTO CANDIDATE` (if l'!-3"e)
DESCRIPTIONOF IN KIND
CONTRIBUTION
ESTIMATEDFAIR MARKET
VALUE
d IF FORFUND-RAISERCONTRIBUTION
o
v
C-".6,tJt fKe. mw-Slit-6k
~1 ctEVs i~9 aM F-1Cs~n+rac v-1v RIC . ,n5l:RNlce. C~s 00
coFk7l
9D,C~
.p~,~,~Tp\-lf%Z0QK 40-
,nSucu~ee, joy;. C]O~~;r e'ss
P~ ~~~ 0s
oesM~,ns,~R~3a~ c)c F-1
O~ �
FOR INSTRUCTIONS. SEE BACK OFFORM
COYYITTEE NAYS (AAfust be same as on Statement ofOrgarfmOion)
SUB-TOTAL / $
.TOTAL (if last Ipage ofthis Is ue)
SCHEDULEE IN-KIND
(Rev. 06/97M CONTRIBUTIONS
~ CHECKTHIS BOX IFAMENDING FORM
'OW=" la- requkes wrdidales to d
the re4abonship ofany relatNe magng an m Idnd oontrlrdion to the
page Q _of_a_conxniltae. Relationship must be shown to the third degas of oorssanguinily (blood relatives) and atfmity (relatives
(for schedule E)by mairiage~ (See Page 2of farms packet.) Ifswname of oontribubor is the same ascandidaft, butthane is nofamilial relationship, enter "not applicable" in the relationship column.
DATERECEIVEDMM/DDnR)
NAME-- ANDADDRESSOF CONTRIBUTOR
RELATIONSHIPTO CANDIDATE* K f-±able)
DESCRIPTIONOF IN KIND
CONTRIBUTION
ESTIMATEDFAIR MARKET
VALUE
d IF FORFUND-RAISERCONTRIBUTION
$
.`~" a
_ ,_)~9 . 0
F-1
aF-IF-1F]
FOR INSTRUCTIONS, SEE BACK OF FORM
THIS FORM IS USED BY CANDIDATES' COMMITTEES ONLY
COMMITTEE NAME (Must be same as on Statement of Organization)
PART I - ONGOING INVENTORY OF CAMPAIGN PROPERTY
PART II - SALES OR TRANSFERS OF CAMPAIGN PROPERTY **
TOTAL VALUE CAMPAIGN PROPERTY T
P~~T(TRANSFER TO SUMMARY PAGE) $
* If estimated, show est. beside figure .
SCHEDULE
H CAMPAIGN(Rev . 07/03) I
PROPERTY
ATTACH SCHEDULE H TOEACH REPORT, MAKINGCHANGES AS REQUIRED.
CHECK THIS BOX IFAMENDING FORM
** PROPERTY SALES & TRANSFERS TOTAL
TOTALS
$
$(TRANSFER TO SUMMARY PAGE) $
(Attach Additional Schedules if Needed)
Page
I
- of
I
Pages(For Schedule H)
Date Purchased(Schedule B)
or Date Received(Schedule E)MMIDD/YR
Description of PropertyPurchase
Price or Est .Value WhenAcquired*
CurrentValue at FairMarket This
Report
:YE l~osO.x{I1
C.
Date(MM/DD/YR)
Name and Address of Purchaser/Donee Description of Property Sold?YIN
SalePrice
Value ofDonation