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8/7/2019 Hoversten Greg__1212__scanned

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FOR WSTRUCTI ONS. SEEBACK OF FORM

DI SCLOSURESUMMARYPAGE

I ) S t a t e w i d e / L e g i s l a t i v e Ca n d i d a t e ( 2 ) S t a t e w i ( J e PAC 3 ) S t a t e P a r t y ( 4 ) C ou n t y / L o c a l Ca n d i d a t e5 ) Co u nt y PAC ( 6 ) B a l l o t I s s u e/ F r a n c h7o mmi t t e e

7 ) C o u n t y / C i t y C e n t r a l Co mmi t t e e

i 8 ) S u p p o r t S l a t e o f Ca n di d a t e s

S I GN-A1 U- RE Of =VREASURER ( o r p e r s o n f i l i n g t h i s r e p o r t )

TELEPHONE

DATE S I GNED

Ro u t i n e P e n a l t i e s Du e F o r L a t e F i l e d Re p o r t s R a n g e f r o m $ 2 0 t o $ 8 0 0SEE I N S TRUC TI ON S ONBACK AND COMPLETE THE FOLLOWI NG SENTENCE- -

JAN ' '

2 0 0 "s

I AMF I L I NG A

REPORT FORANNA ( 1 ) ELECT I ON / ( 2 ) N O

ELECT I ON YEAR.

( r e p o r t d a t e )

I n d i c a t e o n e. _ , . f - I n

( 0 y ! - \ A

CHECK I F AMENDMENT TOREPORT DATED

0C h e c k i f t h i s i s f i n a l ( t e r m i 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 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 N o t i c e o f D i s s o l u t i o n i s f i l e d . )

CASH ONHAND 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 h i s i s t h e t o t a lo f a l l mo n i e s h e l d b y t h e c o mmi t t e e . T h i s amo u n t MUST b e t h es a m e a s t h e c a s h o n h a n d a t t h e e n d 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 mus t b e z e r o i t t h i s i s f i r s t r e p o r t f i l l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ADDTOTAL MONEY TAKEN I N THI S PERI ODSc h e d ul e A: C a 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 S c he d u l e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

STATEMENTOF CASH ON HAND

FORMDR- 2DI SCLOSURE( Re v . 0 1 / 9 8 )REPORT

F o r O f f i c e Us e On l y

w K -

/ / 7 5 ~ i ~ 3/ > l LOD

C o mp u t e r ,

COMMI TT Comm ., Vr VCEE NAME ( Mu s t b e s a m e/

a s o n S t a t e me n t o f n l z a t i o n)I n d ex e dAu d i t e d

I MPORTANT : I n d i c a t e t y p e o f c o mmi t t e e y ou a r e r e p o r t i n g f o r :


2/17


3/17

FOR I NSTRUCT I ONS, SEE BACKOFFORMSCHEDULE" "" "_EXPENDI TURES B MONETARY- - MONEY SPENT FROM COMMI TTEE ACCOUNT ( R e v . 0 9 / 9 7 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DEOR LEGI SLAT I VE CHECK T HI S BOX I FCANDI DATES, L I S T THE CANDI DATE I DENT I F I CAT I ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NG FORMETHI CS & CAMPAI GN DI SCLOSURE BOARD.CO E NAME ( Mu s t b e s ameOrganzaon)a s o n St a t e me n t o f7 6 t ~ ' S7 L Ph 46- r Sf ~ f 7 ~~ ~ovs ~

CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI 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( MWDDI YR) AND PACCHECKNUMBERI D # ~ J e r l ' o c , o ~ (CK# p , o ' Bx 97o z3o~ / j o ve r s f e n . ~o . y t $j ( 0 ( / / a s , 7X 7. 5 3 ` / ' 7 - a 3o9D# P o s t r l a S e e r "

O ~4 El ~ r~.~ r ' c S' c SL e 7 y Cr ' 3. sDCK# ( d o Z SouX c r ~' . l / 9 . S~ I D~ Po S f a ~

I D # ~ I ' ~ 7 ` , r E ~ t t e r P r > ' s e s 2e f l 7 a ~ e ! ' a 7 co r / ` 1 a n e r ` SCK# 1 ( 0 3 3 a ~- _ . 0 M l l l

~ . y f r r ~on t S7 :Da v e r t o r t . Z -A go aI D # - Towa Ge n e r a r F G r r t o ( , ~ e c o , t c r r ' ~ r a t ~ ' o i t o f "dl ~ f r - ~ u s t , . . , / a s p Yoo u r l i o ( e " t t i ' f a bl e ~,~0CK# ~~a ~ De s ~ ' ' l o l % I e S S~ , 5 0 , 3 0 ` ~ Gon f T i " . ~ u 7 ` ) o n SI D #

CK# C r

CK# 1 0 0 ' 3 1 1 J I t - ? V , ~ ; q Z7 / . Co f~~ . 5 / o


4/17

FORWST RUCTI ONS, SEE BACK OF . ! M SCHEDULEEXPENDI TURES B MONETARY- MONEY SPENT FROM COMMI TTEE ACCOUNT ( Re v . 0 9 / 9 7 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STAT EWI DE OR L E G I S L A T 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 DESI GNATED COLUMN AND THE HECK T HI S BOX I FPAC CHECKNUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S A VA I L A B L E FROMTHE I OWA AMENDI NG FORME T HI C S t i CAMPAI GN DI SCLOSURE BOARD .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 )H o \ l e 6 ' 5 - f e 1 1 f o r S f a f ( f d e t ; 5 e

CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D s b u r s e r n e n t ) WAS MADE( MM/ DD/ YR) AND PACCHECKNUMBERI D # "c K# l U/o6 3 2 - v N_Pcc- r ~r v o t , N 3 o a 3

0 4I D# RC A ~ t 4 0 / 6 ' " ' %/ , C ~CK# 1 0 I o 7o o , pk ! t, I r " l e s , . h 5t . I ~y, e ' Z, 'n . 1 A 7 - A - 1I D#~ JCAcob ~~ s " n , ~ , ~ ` ho

~ , . 36 . ~dK#I D#CK#

` I D #CK#I NCK#


5/17

FOR I NSTRUCTI ONS . SEE BACK OF FORM

'

DISCLOSURESL.AMARYPAGE0 ( 1 9 ~ uCOMMI TT EE NAME ( M u 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 )I MPORTANT I n d i c a t e 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

) S t a t e w i d e / L e g m l a t t v e C a n d i d a t e ( 2 ) S t a t e w i d e OAC

3 S t a t e P a r t y ( a ) C o u n t y / L o c a l C a n d i d a t e5 ) C o u n t y PAC ( 6 ) B a l l o t i s s u e / F r a n c h i s e C o mmi t t e e

7 ) C o u n t y / C i t y C e n t r a l C o m m i t t e e

8 ) S up p or t S l a t e o f C a n d i d a t e s

S I GNATURE OF TREASURER ( o r p e r s o n f i l i n g t h i s r e p o r t )

TELEPHONE

DATE SI GNED

Ro ut i n e Pe na l t i e s Du e Fo r L a t e F i l e d Re p or t s R a n g e f r o m $ 2 0 t o $ 8 0 0SEE I NSTRUCT I ONS ON BACK AND COMPLETE THE FOL L OWI NG SENTENCEAMF I L I N G A

9ni r 4r

( r e p o r t d a t e )OCHECK I F AMENDMENT TO REPORT DATEDE D Che c k i f t h i s i s f i n a l ( t e r m i 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 D R - 3( Y o u m u 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 N o t i c e o f D i s s o l u t i o n i s f i l e d . )

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 h i s i s t h e t o t a lo f a l l m o n i e s h e l d b y t h e c o mm i t t e e T h i s a m o u n t MUST b e t h es ame a s t h e c a s h o n h a n d a t t h e e n d 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 m u 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 T H I S PERI ODS c h e d u l e A : C a 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 S c h e d u l e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

FORMDR-2 I DI SCLOSURE( R e v . 0 1 1% )REPORT

F o r O f f i c e U s e o n l yComm xI n d e x e d t ,A u d i t e dC o mp u t e r

JAN 1 7 2002

LECTI ON / ( 2 ) NON- ELECT I ON YEARI n d i c a t e o n e

L o c a l C o mm i 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

/ 6 / 5 . d 3/ , 3 / 5


6/17

Fo r . i i. s t r u c t i o n s , Se e Back o f Fo rCONTRI 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 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 )Rov e r , ~de v n 4 ' - o r 5- 4~e o s e -

STATE CAND I DATES NOTE : I F A C ON T RI B UT I O N I S R E CE I V E D FROM A S T AT E P AC ( P O L I T I C A L A C T I O N C OM MI T T E E ) , L I S T THEPAC I DE NT I F I CA T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I OWA E T H I C S AND CAMPA I GND I S C L O S U RE BOARD.CAUT 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 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 m m i t t e e s .

SCHEDULEA MONETARY( Re v . 0 6 / 9 7 ) REC EI P T SQCHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RE L A T I ONS H I P AMOUNT 4 I F FORRECE I V ED ( i f a p p l i c a b l e ) T O CAND I D A TE ' RECE I V ED FUND-( MM/ D DI YR) AND P AC CHECK ( i f a p p l i c a b l e ) RA I S E RNUMBER I NCOMED# 7 7 7 7 7 7 7 Der U7 7 7 " ,

( 7~ o ~ CK# l ~as7 su . l s e t %e N' a _ el l ~ ~ CK# 3aoo G~ ~ f t l ~ e . ~Do~ g0 Cr b e s / 1 ' l o r $ ~ e S , l ~ 3d 3 / a ?

1 1/ 7 / 0I D # ~~3~CK# , 4 T3 . 4 T~p ~f G3 l l S E a 3 1 ' n o d e i t J E ~U~ > ' 3 Ge c l g r ' r P a ~ o ( s , . I f l S a 2 ~ 4 ~I D # Rf c ~ ai ~ l N! . KoT' L DUCK# 3 a ~~t c s r SDl l f q o t i e s / t 1~ l ~e . s , _r X . 5 -o 3 t oI D # 60~3 . . . ~ owQ , b e n7 ` a l ~ s So ~ i a f i o ~ j p / QCc K#

De s / 4 1 o i r 1 e S . . z A v~o. 3o 91 (

I D# c f c ~~ t ,j h ; t e ,/7l O( CK# ^ 1 ' s , 1 , . 4 ve .De s / I ' f o r h a s , l " Q 3-03/ 3


7/17

Fo r I n s t r u c t i o n s , See Ba c k o f Fo r mCONTRI BUTI ONS -MONEYTAKEi : . J

( 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 eme n t o f O r g a n i z a t i o n )~l ov~r s7en

f a f - 5- r e f f 6 / l ouse,

STATE CANDI DATES NOTE : I F A C ON T RI B U T I O N I S R E CE I V E D FROM A S T A T E PA 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 HE P AC I D E NT I F I CA T I O NNUMBER AND T HE PA C CHECK NUMBER I N THE DESI GNATEDCOLUMN . 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 HI C S AND CAMPAI GND I SCLOSURE BOARDC AU 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 mm i t t e e s .

SCHEDULEA MONETARY( Re v . W97) R E CE I P T SQ CHECK T HI S BOX I FAMENDI NG FORM

DATERECE I V ED( MMl D D/ Y R)

PAC I D NUMBER( i f a p p l i c a b l e )AND P AC CHECKNUMBER

NAME AND ADDRESS OF CONTRI BUTOR R EL A T I ON SH I PTO CAND I DA TE '( i f a p p l i c a b l e )AMOUNTRECE I V ED I F FORFUND-R AI S ER

I NCOMEI D# 6~a5 . r o w e r ~ eal f ~Or s f ~G1 - T - o f CK# ~ l 9Des $~Od

l ~ - 7 - 0lI D# 60 7 7CK#

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~ f omE b w/ c ~e l 5 f f S S o G~ ~ t f ~ i c r l Pi 4 C .De s / t ' t o ~ i t 8 s , . Z " . q l ~0

I D I f~ ~ - - 7 - 0( c K# l 7 0 ~~~~ 0 _ r p l ~ - e p ar k RW.L , l G s J ' 6e s - K o i : t e s o0/ l -

I D #c K# 666

4 , j y L. Ca . ~ f 6 e / ( - f %wn ' n J r -a l a s - ~ ' 8 - > ` ` ' , ~ ` - .bes Nt o~~es , . . L - f l So - l a f Ob

t~I D # H u ~ l MQ/ i/ r . 7- o f c K# 1 , ) e s ~ - be s / L f o t : , ~ e sI D # Fh an c ~ ' S


8/17

Fo r I n s t r u c t i on s , Se e Ba c k o f Fo r m` CONTRI BUTI ONS - MONEYTAKEt - A

( 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 a s on S t at e me n t o f O r g a n i z a t i o n )11o ( l e r s he A

I ; ~ "

v5f 7~ - 6use ,

STATE CANDI DATES NOTE : I F A C ON T RI B U T I O N I S R EC EI V E D FROM A STATE PAC ( P OL I T I C AL A C T I O N C OM MI T T E E ) , L I S T T HE PAC I D ENT I F I CA T I ONNUMBER AND T HE PAC CHECK NUMBER I N THE D E S I G NA T E D COLUMN. A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I O WA E T H I C S AND CAMPAI GND I S C L O S UR E BOARD .CAUT 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 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 mm 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 .

SCHEDULEA MONETARY( Re v . 1 ) 6 1 9 7 ) R EC EI P T SCHECK T HI S BOX I FAMENDI NG FORM

DATERECEI VE D( MM/ DD/ YR)PAC I D NUMBER( i f a p p l i c a b l e )AND PACCHECKNUMBER

NAME ANDADDRESS OF CONTRI BUTOR REL A T I ON S HI PTO CAND I D ATE '( i f a p p l i c a b l e )AMOUNTRECEI VE D ) I F FORFUND-R AI S E R

I NCOME

1 1 - 7 - 0 1 I D# 6 . 7 7 ?CK# 1 , o 7 7- L o wa oP~ y ~~G/ 3W t l ~ t o t o ~ ruv M _ Sl ! e e ~L Sui t e / 3 3 $mi l D

I D# 6 0 , Sg _ . r s , P 1 4c/ / - 7 - 0 / CK# 1 6 5 1 6 aS N A, . E e . , Y L ~l v d. , Su i t e l o o. 9 4 k e - 1 1 1 rA oo~~l 7 - DI

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9/17

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 m' CONTRI BUTI ONS - - MONEY TAKES _ . A

( 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 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 )

ov el ' s 7 4en

i r

e i hus

S T A T E C A N DI D A T E S NOTE : I F A C ONT R I B U T I O N I S R E CE I V E D FROMA S T A T E P A C ( P O L I T I C A L A CT I O N C OM MI T T E E ) , L I S T T HE P A C I D E N T I F I C A T I O NN U M B E R AND T H E P A C CHECK NUMBER I N T H E D ES I G NA T E D COLUMN A L I S T OF I D NUMBERS I S A V A I L A B L E FROM T H E I O WA E T HI C S AND C A MP A I G ND I S C L O S U RE B O A R DCAUTI 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 mmi t t e e s

SCHEDUL EA MONETARY( Re v . 0 6 J 9 7 ) RECE I PTSQCHECK THI S BOX I FAMENDI NGFORM

DATERECEI VED*

PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FOR( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED F UND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME1 D # 6 , p 70 . ~t n l C c L ~ w P a ~O ~3 c1 d c ' s . ~ t a ; : 2 e s , . 2 7 4 3 - aJ oj - - / ~3I D # L e a n a r o ~ ~- ~ nc ~ P~ l ' S~ i

CK# . 3 l l a / Ve b n x s ~ a 5 7 ` : AP7~a30 S r o u ) C _ s ` / l 0 / / -I D # R o h r - l ' 1 `l l t CK# u a l ` S o . ~ r ! l~~ r n L a 0l o ' g T~ 6 - 3 U - u1 D # s - t " e - A cr CK# 5 _D2 3 Loa. t ~f ~' c h i d G > / I v.S S; o r , 1 c f ty274I D #0 ( CK# ~0: 3~ t ~+ 3 St p1, ~0S; ouK C ; ~~ ~_l l o ~

I D # j Z e r i ? d w ~~ o l ( Mq~l aCK# 1 4 o a , Sa ~ s ~ ~ , t. z , 4I D #


10/17

Fo r I n s t r u c t i o n s , See Back o f FLCONTRI 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 a s on St a t e me n t o f Or g a n i z a t i o n)/ / at JeTs7Le11

7 ; / - . s Rt&/ h0Ks~

STATECANDI DATES NOTE: I F ACONTRI BUT I ON I S RECEI VED FROMASTATE PAC( P OL I T I CAL ACT I ON COMMI TTEE) , L I S T THEPAC I DENT I F I CATI ONNUMBERANDTHEPACCHECKNUMBER I N THE DESI GNATED COLUMN A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CSAND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON: Se c t i o n 68B . 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 mat i on c o pi e d f r o m r e p o r t s and s t a t e me 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 mmer c i a l p u r p o s e by an y p er s o n o t h er t h an s t a t u t o r y p o l i t i c a l c o mmi t t e es .

SCHEDULEA MONETARY( Re v . 0 6 / 9 7 ) RECEI PTS

[ ] CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FORRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE" RECEI VED FUND-( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME" 2 qa 1 , ~ ~ , N I I ' l t a~ L 3 l ' d $ o~~UCK# 1 3 0 . - 7 C; 1 7 ` - _ " / l o b

I D# J ' 13 ; o 7` ~ er s1 1 - 15 - 0 CK# 3 6 7 ~ r S i ~ e C , .o u L ~ 9 , S%/ o3

I D# i / t _ l eMCK# 3 ` r 7~G C~u ~t f l ~ ' C( 4 - t d 3 / 1 4 1_ 4 , SDII D# R~ i t ~ l l ' l l ~ 'I I - I S - - C CK# ~ a 5 ~ , 300 ~. l 4~ Lq . ~ eSr o u C~ R~ r r 4 ~1/ l oEI D# Ja r n es ~. l. J h ar Y~ . ~

Sr ' ot C, " 7` ~ S/ l DI D# Li n G t 7a j 3 , %~"~ l i v 1

1 l - i s - - a l CK# p~Da l ~ , ST:/ ' , Q ~S' l l oI D# G=ear g~ G. s pe l l ~ r a ~t s ' r .


11/17

Fo r I n s t r u c t i o n s , Se e Ba c k o f F s .,CONTRI 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 ds )COMMI TT EENAME ( Mu s t b e s ame a s on St a t eme n t o f Or g a ni z a t i o n)

STATECANDI DATES NOTE: I F ACONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I CAL ACT I ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ONNUMBER AND THEPACCHECK 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 ct i o n 68B . 3 2 A ( 6 ) , I o wa Co d e, p r o h i b i t s t h e u se o f i n f o r ma t i o n c o pi e d f r o m r e p o r t s an d s t a t e me 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 ns o rf o r a n y c o mme r c i a l p u r p o s e by a n y p er s o n o t h e r t h an 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 .

SCHEDUL EA MONETARY( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-( MMl DD1YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D ~ r l ma r t u t _h 6 r I ~ " ' a f C~S_ ~OE 6 i t Cou i - f $ v ~ ` oI D# Dar l i Oe L. . l ~a ve r ~P a! ~~ -

l l ' l 5 - v l CK# v~D ; L 79 110 y - e ? 4I D# J ' l e ( e A H ma 5 , , i ?

1 1 - l S - m i l CK# f ' o & - , K - 2 0 , ; ' sSouX c i . ~X . S/ / OI D# Wa 1SxCK# 36 a ' w ` l 6 a s _ Zr Xl D# Hu r o l a ' f %. 1 ~ ~ t ~ , n s

I l - J ~5 - o l CK# ~43, 77 Sl 6 P~ %~ e s 7 : ~~X78~-

s. i l l e . l . . 5 - i o a 8CK# _30q o 0pI D # L a l c t , D . : E A MC k e


12/17

Fo r I n s t r u c t i on s , See Back o f F 4 LCONTRI 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 be s ame a s o n St a t e me n t o f Or g a n i z a t i o n)

l Loae/ ' S7~/~_f/ - X7l e

I t-ous6-

STATE CANDI DATES NOTE: I F ACONTRI BUTI ON I S RECEI VED FROMASTATE PAC ( P OL I TI CAL ACTI ON COMMI TTEE) , L I S T THEPAC I DENTI F I CATI ONNUMBER ANDTHEPACCHECKNUMBER I N THEDESI GNATED COLUMN. A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS ANDCAMPAI GNDI SCL OSURE BOARD.CAUTI ON: Sec t i o n 68B . 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 ma t i on 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 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 omme r c i a l p u r p o s e by any p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e es .

SCHEDULEA MONETARY

( Re v . 0 6 1 9 7 ) RECEI PTSCHECKT HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FORRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE` RECEI VED FUND-( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

I D# J " TM 4 4 1 4/Si o c t c r - l ,~ . . ~l l o~

I D# L a r r l l e ' L ' ' ~ o t + l CCK#, S' o u e ; ' - ~ : S r l l O~I D# I c~ w4l e a d f ' ~b ~S~CK# BTI ~ ~ d 3 P r ~ l ' , e P Y s s u y e ~D(~akDt Du p e . s ~ . ~ ?0 5 ~ ~ - 3 0 _ oI D# ~ a l ' h C ~ f a r t Sh i tCK# l o o - 3 v7 Cc w?~ 6I D# , Nt r s . . Z ' r v 7 . - F T e n s e w T r ,c o 0~3~ 5 3 a e Y a YSduX~; ~ . 1r . 4 ' ~ l l D~I D# ~ ~e l ~ ~~ Ch ~ r 5 ~ r 4 n a k r ' O n Gl 'CK# ~~ r o~0~3 / 1 f e . . l r ~ o r k C. r ' o l e ,o l - e I / + o 32 z - -I D# 7 Pe r r e - Pl 9 C


13/17

Fo r I n s t r u c t i o n s , Se e Back o f Fo r m. CONTRI BUTI ONS - MONEYTAKE44

( I n c l u d r l y c an dWW' s p e r s o n a l h i n d s ) .COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a l e me n t o f Or g a ni z a t i on )

HDv, er 5~ef , ` - Fo g ' -5+uf e You-5cSTATE 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 D E NT 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 AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON : Se 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 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 omme r c i a l p u r p os e by a ny p er 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 es .

SCHEDULEA MONETARY( Re v . D8 / 9 7 ) RECE I PTS0 CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELAT I O NS HI P AMOUNT J I F FORRECE I VED ( i f a p p l i c a b l e ) TOCANDI DATE ' RECE I VED FUND-( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# C. Aar l e s c - 4 A, PI V Z l - sCK# ~~3~ Sl - - l a~1cI Dr 1 f a . t d a f f S P l ' a ~ c t e. 3 4 1 f C ' g 7 ` e r i Goodc K l r s - ~ Z a ~ Si o~. x ~ r~ Si l o 6 3 a - o a . _,

~ I D I i t i t 7~~ . I owa Ce r > r ' P a 6 l i ' G f ~ GG o r r n l 4 RCKw 131. 3

Y S- 0 0 7 9 F c - e Pa r k 5.. Y_ 30o P4CWe s ~ 1 > e s / t 1 e . ~ e s l q so?~s- - mssI D# ( 0 ~$ Town 67r. 9V1 de r S Pf 1CC K I I ) p s ~ 7 1 9 A 5 H( L k ` n e c v , / 3d/r < T 03y~I D# 0 0 ? ? PE-PR6 . -- r Q " pZ I c o p av ~f e . Z o o , Ner f 1 ~l CK#I D# Cr a, h A f e%s o . ~ -1 0 2 - CKk 7005 b 2~ iwe( 5+ CI r ~ -i t t i Ve a / VV ` l ) )I D# c a 1 , 4 1 7 f 4nes ( 0 1 05 ' 5 + 5


14/17

. FOR I NSTRUCTI ONS, SEE BACK OF FCEXPENDI TURES - - MONEY SPENT FROM COMMI TT EE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUT I ONS MADE TO STATEWI DE OR L EGI S L AT I V ECANDI DATES, L I ST THE CANDI DATE I DENT I F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THEPA C CHECKNUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWAETHI CS & CAMPAI GN DI SCLOSURE BOARD.

SCHEDULEB MONETARY( Re v . 0 9 / 9 7 )

IEXPENDI TURESQ CHECK T HI S BOX I FAMENDI NG FORMCOMMI TT EE NAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g a n i z a d o n )D V e I ^ 57 ' e~

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15/17

- FOR I NSTRUCTI ONS, SEE BACKOF FC SCHEDULEEXPENDI TURES B MONETARY- - MONEY SPENT FROM COMMI TT EE ACCOUNT ( Re v . 0 9 1 9 7 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLATI VECANDI DATES, L I S T THE CANDI DATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COLUMNANDTHE 0 CHECK T HI 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 E NAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g an i z a t i o n )7 Ue~S7~P~ ' ? " C r ' sl ~f P ~DVSeCANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI 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( MWDDI YR) AND PACCHECKNUMBER

I D # Ve r ' o Go r - ?5 - 2 - 7 - 0 t CK# r v . E. x 1 7 730? Ri o ve r s ~ e r l ~ o. 1 - t $o / / a S, TX 7 S 3Y 7 - X309 -P o s t r l a s ~ e ~ ~ f ~ r ~ s L e e r - . ~ . ~DC ( 0~ . So u x c r f y . l q S i l o / Po S J ~ aJ~I D # Vry F t ~ p r y ' s e s 2 e f r r d ~ e r ' a f o l ~ Q ~ n ~ 7 ` sCKX 1 > a v e x o r J -, - Z 1 4 9 0 aI D # ~owa Ge n e r a / ' 1 &z a ( , ~ e c o / ~ G r ' l i a 7 ~ ~ o i t ob l ~ ' ~ . a s l ` Lo c u s t , ~ ' t e / O~ - Y00 u r r c t ' e n f 7 ' f a ~ l 2 , ~Jr~>CK# ~~ a ~ P e s / K o r % ! ~ S . L , Q ~ S o 3 0 ` ~ G v n t ' ! ' i u ~ 7 ' o ~ SI D #CK#I D #CK#


16/17

FOR; I WSTPUCnONS, SEE BACK OF FOP' tCOMMI TT EE NAME ( Mu s t b e s a r a n a s o n St a t e r w t o f Or p n ni z a & n )

~ ' 1 c ~ v e r 5 ` ~ e s 1

I N K I NDCONTRI BUTI ONSSCHEDULEE( Re v . 0 6 / 9 7 XCHECK T H I S BOX I FAMENDI NG FORM

DATERECEI VED( MM/ DD/ YR) NAME AND ADDRESSOF CONTRI BUTORRELATI ONSHI PTO CANDI DATE' ( I t a p p l i c a b l e )

DESCRI PTI ONOF I N K I NDCONTRI BUTI ON

ESTI MATEDF AI R MARKETVALUE

J I F FORFUND- RAI SERCONTRI BUTI ON0 0 7 3t i ' ? I Q ~

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17/17

COMMI TTEE NAME( Mus t b e wi n e a s wi S t a t e me n t o f Or g a n i z a t i o n)l l o v c , f ' . s AC- 1 1 - F o r -

- - 5 ft ( f - ~o r t i s

NOTE T h i s s c h e d u l e r e p o r t s money l o a ne d t o t h e c o mmi t t e e wh i c h i s d e p o s i t e d i n t h e c o mmi t t e e a c c ou n tTOTAL UNPAI D LOANS FROMLAST REPORTI NG PERI OD $PART - MONETARY LOANS RECEI VED_THI S REPORTI NG PERI OD( O r i g i n a l s o u r c e o f l o a n , s u c h a s a b a n k , must b e s h own i f a t h i r d p a r t y i si n v o l v e d I n c l u d e l o a n s f r o m c a n d i d a t e ' s p e r s o n a l f u n d s . ) _

TOTAL ( PART / )

. 2 ob o

' 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 ema 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 must b e s hown t o t h e t h i r d d e g r e e o fc 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 y m a r r i a g e ) ( S e e Page 2 of f o r msp a c k e t . ) I t 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 no t e m p l e tr 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 when i t a p p l i e s

TOTAL CASH REPAYMENTS ( PART H )

F r o m S c h e d ul e E - - TOTAL LOANS FORGI VENTOTAL OUTSTANDI NG LOANS ENDOF REPORT PERI OD

SCHEDULEF LOANS( R ev 0 8 / 9 6 ) RECEI VED6 REPAI DQCHECK T H I S BOX I FAMENDI NG FORM

PART 1 1 - MONETARY LOAN REPAYMENTS MADE HI REPORTI NG PERI OD( L o a n s f o r g i v e n must b e r e p o r t e d o n S c h e du l e E - - I n - k i n d C o n t r i b u t i o n s . )

Page / o f( f o r S c h e d u l e F )

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DATERECE I VED( MM/ DD/ Y%

NAME AND ADDRESS OF LENDER( I n c l u d e E n d o r s e r ' s Name , I f A p p l i c a b l e ) RELATI ONSH I PTO CANDI DATEI f A f i c a b l e '

AMOUNTOF LOAN -

C r i ! ~ ~ f o ~ e r s ~ . r (P a r k R i v a l .

S r ` o r t . > C C l f ~ ; 1 1 4 S" 1 1 o ?~s ame lPe r~u~ds

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DATE PAI D( MM/ DD/ YR) NAME AND ADDRESS OF LENDER- ( i n c l u d e En d o r s e r s Name, I f A p p l i c a b l e ) RELATI ONSHI PTO CANDI DATE'I I A l i c a b l e

AMOUNTREPAI Ds

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