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FOR I NSTRUCTI ONS, SEE BACK _ , = FORM

DI SCLOSURESUMMARYPAGE SAN 2 2 2 0 0 2

COMMI EE NAME ( Mu s t b e s a r n a s o n St a t e me n t o f Or g a ni z a t i on)

1 t r e G~ Z / Z t i ; - r , 3 / L - -

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.

( 1 ) S t a t e w i d e / L e g i s l a d v e C a n d i d a t e ( 2 ) S t a t e w i d e PAC ( 3 ) S t a t e P a r t y ( 4 ) C o u n t y l L o c a l C a n d i d a t e( 5 ) 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 mmi t t e e( 8 ) S u p p o r t S l a t e o f C a n d i d a t e s

SI GNATURE OF TREASURER ( o r p e r s on f i l i n g t h i s r e p o r t ) TELEPHONE DATE S I GNED

Rou t i ne 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 or t s R a n g e f r om $ 2 0 t o $ 8 0 0

SEE I NSTRUCTI ONS ON BACKANDCOMPLETEETHE FOLLOWI NGSENTENCE :

I AM F I L I NGA - ~AWv wl ~ c - 1 19, - L 0 0 , 2 == REPORT FOR A N/ A ( 1 ) EL E CT I O N / ( 2 ) NON- EL ECT I ON YEAR

1 - 7 - 1 1

( r e p o r t d a t e ) I n d i c a t e o n e

FI CHECK I F AMENDMENT TOREPORT DATED 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

F ~ C 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 nd 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 or 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 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 HAND

CASH 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 l

o f a l l moni e s h e l d b y t h e c o mmi t t e e . T h i s amoun t MUST b e t h es am 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 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 HI S PERI OD

Sc h e du 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 Sc h e du l e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sc h e du 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 du l e H : T o t a l Sa l e s o f Ca mp a i g n P r o p e r t y ( A t t a c h Sc h e du l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h ed u l e H a p p l i e s t o Ca nd i d a t e s ' Commi t t e e s On l y )

SUB- TOTAL . . . . . $

SUBTRACT TOTAL MONEYSPENT T HI S PERI OD

Sc h e du 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 du l e B ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e du l e F : L o an Re p a y me n t s t o t a l ( A t t a c h Sc h e du 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 mus tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

UNPA I D BI L L S ( F r o m Sc h e d u l e D - A t t a c h S c h e d u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . _ . . . . . . $

I N K I ND CONTRI BUT I ONS ( F r o m Sc h e d u l e E - A t t a c h Sc h e du l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

OUTSTANDI NG LOANS ( F r o m Sc h ed u l e F - A t t a c h Sc h e du l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

CANDI DATE COMMI TTEES ONLY :CONSULTANT BREAKDOWN ( Sc h ed u l e G A t t a c h e d ? )

VALUEOF CAMPAI GN PROPERTY ( F r o m S c h e d u l e H - A t t a c h S c h e d u l e H) $

FORM

DR- 2

( Re v . 0 1 / 9 8 )

F o r O f f i c e Us e O n l y _

Comm .I n d e x e d

A u d i t e d

Co mp u t e r

/ h - 1 4- 1 ) - 4

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 nw h i c h E l e c t i o n i s h e l d

%3, 6 F S 6 - 3 9

DI SCLOS

REPO

Y=S k . ,

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Fo r I n s t r u c t i o n s , Se e Ba c k o f Fo r m

CONTRI 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 be same a s on St a t e me n t o f Or g a n i z a t i on )

I V i 1 Z~ r . J - / V&

STATE CANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROM A STATEPAC ( POL I T I CA L ACTI ON COMMI TTEE) , L I ST THE PACI DENTI F I CAT I ON

NUMBER ANDTHE PACCHECK NUMBER I N THE DESI GNATED COLUMN. A L I S T OF I D NUMBERS I S A VA I L A BL E FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .

CAUTI ON : S e c t i o n 6 8B . 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 op i e d f r om 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

f o r a n y c omme r c i a l p u r p o s e b y an y 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 e s .

SUB- TOTAL I e-131. ( oTOTAL ( i f l a s t page o f t h i s

s c h ed u l e ) $ y3 ~~ 5D 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 e

c o mm i t t e e . R e l a t i o n s h i p mu s t b e sh 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 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 ) ( S e e Pag e 2 o f f o r ms p a c k e t . ) . I f s umame 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 g e-Lo 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 umn . ( f o r Sc h e d u l e A )

SCHEDULE

A MONETARY

( R e v . 0 6 / 9 7 ) RECEI PTS

CHECK THI S BOX I

AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT v IRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FU( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RA

NUMBER I N

I D#

CK#' 9 0 1 0

/ o0 a vI D #

CK#l ~ ~ - ~ ~ J f L z I L l a l f 1-) 7 c i SZ1 , c ~ U

I D # Cn / l I ; o A c I , T t , L ; + Z - 4 , T7 o n ) - --k ' I . / A d e , 4U; AS

CK#6 0 g , ( a - - I - yo

Gf i r ~ ' s i t D~~s l l 7 a l , ~ , ~ s 5zl vS̀ ( ~ 1 1 , v v

I D #

v / u )CK# 9 r 6 , d f e c

i ) y s

va s -

~ ~ ~Nr z s S~3/ 7 / G , c c )

I D# . .

- -v " v l 7 7 i l ~ l l GD ~ ' D l v ? " i C l / 3 u T l o t i S

D#

CK#

I D#

CK#

I D # 1CK#

I D #

CK#

D#

CK#

1 } 1 f 1 1

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T HI S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY:

Pu 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 m u s t a l s o b e i n v e n t o r i e d o n Sc h e d u l e H . ( R e f e r t o Sc 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 mu s t a l s o b e d e t a i l i t e m i z e d o nSc 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 ma 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 mmi t t e e . ( R e f e r t oSc h e d u l e G i n s t r u c t i o n s a n d I o wa Co d e 5 6 . 6 ( 3 ) ( i ) . )

( f n r Cr h . Hi d c R)

FOR I NSTRUCT I ONS, SEE BACKOF FORM SCHEDULE

EXPENDI TURES B MONETARY- MONEY SPENT FROMCOMMI TT EE ACCOUNT

( Re v . 0 9 / 9 7 ) EXPENDI TURE

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUT I ONS MADE TO STATEWI DE OR LEGI SLAT I V ECANDI DATES, L I S T THE CANDI DATE I DENT I F I CAT I ON NUMBER I N THE DESI GNATED COLUMN AND THE CHECK T HI S BOX I FP AC CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA AMENDI NG FORMETHI CS & CAMPA I GN DI SCLOSURE BOARD.

COMMI TT EE NAME ( M u 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 )

) 6 4 9 r Wr z " J 4 V l L G34V -CANDI DATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED

EXPENDED ( 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 PAC

CHECK

NUMBER

l~

&

I D# P l t l o &

l v i CK# U. l ~ a X $ - ' ( m i l R, Wi i ~ Di T Uk E_ ~2-$ j p ~~ 3p

CaDf f & i t s -, Sa&f 3 AVDuc7kAl < f L r _ U1 Cr a l

I D#( , ~ ' / { - L , ~ 2 l l ~ L ? ~ " N t ~ c l ( ~ S C~/ i C r c a m+ ! w7i . - . S

l r l b l o l 31W= ~' - s T v l t y w d t iI t 1 ~N

ECK#

Sa / Ov 5 ' 0 , 3 3

% / i r r / d l - I D # a. ) / WS . 4 o i ~ ~ T - r r ~ A , ~ ! r 4

/ - ? / ' k " . Sr "~r L v i Ur = f S

m - l r i / o / CK# , 3 Q

I D#

CK#

I D#

CK#

I D#

CK#

I D #

CK#

I D #

CK#

SUB- TOTAL $ 93

TOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) $1. ~

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