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FOR I N STRUCT I ONS, SEEBACK OF FORMDI S C LOSURE SUMMARY PAGE R e s e t Fo r mCOMMI TT EE NAME ( M u s t b e s am e 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 b y # , t s r p e o f c o mmi 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 a t e ( 8 ) 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 ( 8 ) C i t y PAC ( 1 0 ) 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 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

OCHECK I F AMENDMENT TO REPORT DATED0 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 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 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 DR- 3 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 o t a l o f a l l f u n d s h e l d b y t h ec o mm i t t e e . T h i s a m o u n t MUST b e t h e s am e 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . y

ADDTOTAL MONEY TAKEN I N T HI S PER I 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 ) ( * a l s o s e e i n - k i n d b e l o w ) . . . . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n s R e c e i v e d t o t a l ( A t t a c h S c 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 Ca mp a 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( S c h e d u l e H a t a o l ( e s t o C a n d i d a t e s ' Co mmi t t e e s O r r h r )SUB- TOTAL . . . . . . . . . . . . . _

SUBTRACT TOTAL MONEY SPENT T HI S PER I ODS c 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 S c 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 ) . . . . . . . . . . .S c h e d u l e F : L o a n R e p a y m e n t s t o t a l ( A t t a c h S c 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 m u s tb e z e r o ) ( A t t a c h D R - 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

FORMDR - 2 DI SCLOSURE( R e v . 1 2 1 2 0 0 5 ) REPORTF o r O f f i c e Us e O n l yComm . #L o g g e d IS c a n n e dC o mp u t e rA u d i t e d

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 C o d e s e c t i o n ( 3 8 8. 3_a n d t h e c h a i r p e r s ~ g n , f o r a n y o t h e r t y p e o f k n 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 j b l e f o r f i l i e g t i m e l y a n d a c c u r a t e r e p o r t s .

REPORT FOR ( 1 ) ELECT I ON / ( 2 ) N ON - E LEC TI ON YEAR .I n d i c a t e b y # 9 1

" UNP AI D B I L L S ( F r o m S c h e d u l e D - A t t a c h S c h e d u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 i* I N KI ND CONTRI BU T 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . 3* * OU T S TANDI NG LOANS ( F r o m S c h e d u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . y _CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? )

- YES - NOCANDI DATE COMMI TT EES ONLY :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 ) $STATE COMMI TT EES : S u b mi t a r e c o n c i l e d c a m p 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 .

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 nC 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


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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 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 TT EE NAME ( M u s t b e same * o n S t a t e me n t o f O r g a n i z a t i o n )_Z9v&He_-kwa~&&S TA TE C A N DI D A T E S NOTE : I F A C ON T RI 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 OMMI T T E E ) , L I S T T H E PAC I DE NT I F I CA TI O NNUMBER ANDT HE P A C CHECK NUMBER I N T HE D E S I G N A T ED COLUMN . A L I S T OF I D NUMBERS I S A V AI 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 CL O S U R E BOARDf 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 sCAUTI 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 r

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 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 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 ) ( S e e P a g e 2 o f f o r m s p a c k e t . ) . 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 am e 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 mn . P a g e_o f( f o r S c h e d u l e A )

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

CHECK T HI S BOX I FAMENDI NG FORM

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

I D# / "KE t ~ . ' i N ' 1 ~ F . 1 Cn ~5

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

( I n d u d r 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 )

R c s z l F _ o t m

STATE CANL1 f DATES NOTE : I F A CONTRI BUT I ON I S RECE I VEDFROM A STATE PAC ( P O L I T I C AL ACTI ON C O MMI 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 V A I L A B L E FROM THE I OWA E T H I C S AND CAMPAI GNDI SCLOSURE BOARDC AUT 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 mmi t t e e s .

SUB- TOTALTOTAL ( 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 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 wn 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 k ) 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 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 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 mn . ( f o r S c h e d u l e A

SCHEDULEA MONETARY( R e v - 0 7 / 0 3 ) RECEI P T SQCHECK T HI S BOX I FAMENDI NG FORM

DATE PA C 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-( MM/ D D / Y R ) AND PAC CHECK ( i f a p p l i c a b l e ) R AI S ERNUMBER I NCOME0 1 ; 2~16 (0 I D # $CK# ~ 5 a bI D# SI , e V 'S , j ; 1 < f_ , r " AI b 5 1 A1W t ' 2 , E , 5 r -CK# ' ~3I C I { , q' i 5w, + ' : R - Yb s .1 Z Z ~ ~ I D# pa~+t Td I ~ F, n '; ( l 'I p " I ECK# 0 ~ ~ , SI f s s ~L 1 sI D # ~ > l a . ' a r , ~ 1 1~ ' 5 Z v r , - r v

CK# Ar 1 j Yl + A+Acc 7 y - _ E E Ia f ) ~ 7I D# u. ) i t . AAw3 ~A)CK# ~C; ~ S ~ Ah ' . t y M9 v L

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g l ~ l n ~ &oO _ L 0 % 1 _ ' jzL _ ~ *~.CK# . - 5s~Wev~~, I ~ tL u t i - r V - -A , - r j 1 - 3I ' i b

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Fo r I n s t r u c t i on 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 )

STATE CAND I DATES NOTE : I F A CONTRI BUTI ON I S R EC k i ] V ED FROM A STATE PA C ( P O L I T I C A L ACTI ON C OMMI T T E E ) , L I S T T HE P AC I D EN T I F I C A T I O NNUMBER AND T HE PA C CHECK NUMBER I N THE DESI 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 HI C S AND CAMPAI GNDI SCLOSURE BOARD .CAU T I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Co 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 ommi 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 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 wn 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 ) ( S e e P a g e 2 o f f o r m s p a c k e t . ) . 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 , 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 mn .

SCHEDULEA MONETARY( Re v . 0 6 / 9 7 ) RECE I P T SI ~ CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTR I B UTOR RE LAT I ONSHI P AMOUNT J I F FORRECE I VED( MMI DDI YR ) ( i f a p p l i c a b l e )A ND P A C CHECK T O CAND I DATE '( i f a p p l i c a b l e ) RECE I VED FUND-R AI S ERNUMBER I NCOME

CK# a 1 4 3 ~ . a t 5~ _STS z. ~z . $ ~ 6 0 ` n 'I D# _~ G d WM r c I f C i F I ~ 1 4 ' / JCK# aI D# W-M L k A I U, 4 ~ ' W ( ,' Wi t ~' t r w ~ r U I l 1 ~ TCK# 1 _ ~ . I r e1 1 4 ST , o,I D# VHZLCK# V4 4 X3~ l l b ~ i ( 4 ) L ~ - - a T

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3 1 0 - ~, 1 - Pa ( a I


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Fo r I n s t r u c t i on s , See 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 a s on a l e me a n i z a f on )

f o r a n y c omme 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 es .

R e s e t F ' o r n i

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PAC ( P OL I T I C AL ACT I ON C O MMI T T E E ) , L I S T T HE P AC 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 V AI L A B L E FROM THE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARDCAU 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 r

SUB- TOTALTOTAL ( 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 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 r n a me o f c o n t r i b u t o r i s t h e same a s c a n d i d a t e , b u t t h e r e i s n o Page4o 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( Re v . 0 7 / 0 3 ) RECE I PTSCHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTR I B UTOR RELAT I ONSHI P AMOUNT , I I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' R ECEI VED FUND-( MM/ DD/ YR ) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER , I NCOME~ l Z b C S ~ ' I l ~ I L ~AQCI ' L a $ C J I ; 1o. CK # ( 4 4 1 7 - ) x 3 ' 7 / b i ! a,

J ' z I D# Ne -A 0 4CK # - 70~ V' 3 E x t


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T HI S BOX APPL I ES T O 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 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 ns 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 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 Code 5 6 . 6 ( 3 ) ( 1 ) . ) -

Page o f

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

r - - O H I NS 1 RUCTI ONS, SEE BACK OF FORM SCHEDULEEXPENDI T URES B MONETARY- - MONEY SPENT FROM COMMI T T EE ACCOUNT ( R e v . 0 9 / 9 7 ) EXPENDI T URES

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI 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 T HE DESI GNATED COLUMN AND T HE 0CHECK 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 FROM T HE I OWA AMENDI NG FORME THI CS & 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 r g a n i z a t i_ 9 6 V t f l W&- - t c fCANDI DATE NAME AND ADDRESS TO WHOM 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 me n t ) WAS MADE( MM/ DD/ YR) AND PAC

CHECKNUMBERI D # wNJ~ i QP146 J 7 V , , ( j \ j f Wf J j . ' i ~ Q~It

Y / ( S CK #l ~ q k D # V ~V~ ~ ~l ? I Y~ ~~S Y C C: LC P v w n i ~CK I ( 3 33I D # _

/ 034D #1 \ 9 3 . )

l C1 b C K # 7~ ) u 4 d ~ 1 u e T ~ r wA , r v t v CI 1 4n SI D # VS V f ( I j CCL ~ ~ n u x l - 3 9

l 0 CK - II D # wi h r f i t Ca t AWE,~ l Z ~ ~ o V C , i r ( f f ~C

SUB- TOTAL $ 35TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) $


7/10

T HI S BOX APPL I ES TO CANDI DATES' COMMf 1TEES 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 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 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 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 r d 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 mm 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 Co d e 6 8 A . 4 0 2 ( 3 ) ( ) . ) ,

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

FOR I NSTRUCTI ONS, SEEBACK OF FORM 1 , R0 3 0 Fm SCHEDULEEXPENDI TURES B MONETARY- MONEY SPENT FROM COMMI T T EE ACCOUNT ( R e v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI DATES, L I S T THE CANDI DATE I D E NT I F I C A T I O N NUMBER I N THE DESI GNATEDCOLUMN AND THE D 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 FROM THE I OWA AMENDI NG FORME THI CS 8 CAMPAI GN DI SCLOSURE BOARD .COMMI TTEE NAME ( Mu s t b e s a m e a s o n St a t e me n t o f Or g a n i l i o n )

ZE YmC ~ o C c - ~ wCANDI DATE NAME AND ADDRESS 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 me n t ) WAS MADE( MM/ DD/ YR) AND PACCHECKNUMBER

I D# I S 1 , C~ 4 s r 3 7 - 1 3CKJOUj

CVr j. - 6WA P a l A - ~ f $

CKI D# 6- v P k e I J ( * I , T r v ~CK# I M Mw. Fv l v c ~ . ~~u~~ l w~ 0000 t Q 1

J a ' ~ l d l CK#

I / n 4 4 I D# T ~ I A ' t . , a F. t l J i ~ l f Y NC ~/ . ~ ' S p ~ rCK 1 f j ~ Uf i ~ i ( l y L ~ , 4 ' l t l r ~rg Z I D# K~~~L1~ch~(w~wl i t i y ~J yt ~ - ~i l U f I i w

~ lI D# v E t3ww"rE( ' 1. j ' cccu Al 2 l w~_ 3 ` 7 , 3

SUB - T OT AL $TOTAL ( f f l a s t p a g e o f t h i s s c h e du l e ) $


8/10

T HI S BOX A PP L I E S TO CANDI DATES ' COMMI TTEES ONLY :P ur 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 Sc 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 l 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 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 r d 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 wa Code 5 6 . 6 ( 3 ) ( i ) . )4 L 1 3 014cu~ SF11 61W01* ( - 4 - ~ i ~ t l ~ r

P a g e 3-o f( f o r S c h e d u l e B )

FOR I NSTRUCTI ONS , SEE BACK OFFORM SCHEDULEEXPEND I TURES B MONETARY- - MONEY SPENT FROM COMMI TTE E ACCOUNT ( R e v . 0 9 / 9 7 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L EGI S L AT I V E ! ~ CHECK THI S BOXCANDI DATES, USTTHE CANDI DATE I DE NT I F I CA T I O N NUMBER I N THE DESI GNATED COLUMNAND THE I FPAC CHECK NUMBER FOR EACH EXPEND I TURE A L I S T OF I D NUMBERS I S AVAI L ABL E FROMTHE I OWA AMENDI NG FORMETHI CS & CAMPA I GN D I SCLOSURE BOARD . -COMMI TTEE NAME ( Mu s t b e s ame a s o n - t e me n t o f O r g a n i z a t i o n )

CANDDDAEE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPEND I TURE ( D ESCR I BE TRANSACT 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( MMI DDI YR) AND PAC- CHECKNUMBER/ ~ I D# ~ ~ i r , ~ l ~ ~ x ! 1

pi Nk

l o L 1 7l Y~ r4k` d V - 4 , r ~- c ~ n 1

r ( ~~ F4,oY 36" )CK#q

I D# C r l ~ ~ w dCK# ' ~n~

I L L7 JU -~(~~Ni A

cK# 1 u~k~ . r r r r 3 . t 9 ` ~I D# - CEC- Axuw~' e b CK# OCT/ 1",I D# ~ . y 1 1 I C S ' L k 1 . Lo' ~ TI ! ! v 3 3( 9 l f . AAf AoJT*~ ,5 Wam r l i c t ~ J - 1 i f ~TEL Z - - wr" i w ~ rSUB- TOTAL

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 ) $


9/10

T HI S SOX A PP L I E S T O CANDI DATES ' COMMI TT EES 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 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 . )

P a g e

E x p e n d i t u r e s t o p e r s o n s i 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 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 l 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 Co d e 5 6 . 6 ( 3 ) ( 1 ) . ) q L - - o f -y( f o r S c h e d u l e B )

FOR I NSTRUCT I ONS, SEE BACK OF FORM SCHEDULEEXPENDI TURES B MONETARY- - MONEY SPENT FROMCOMMI T TE E ACCOUNT ( R e v _ 0 9 / 9 7 ) EXPENDI TURES

S TA TE PA C COMMI TT EES : NOTE . FOR CONT RI B U T I ONS MADE TO STATEWI DE OR L E G I S L A T I V EC A ND I D A T E S , 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 ANDTHE CHECK T HI S BOX I FPA C CHECK NUMBER FOR EACH EXPENDI TURE A L I S T OF I D NUMBERS I S A VA I L A B L E FROM T HE I OWA AMENDI NG FORME T H I C S & CAMPAI GN DI SCLOSURE BOARD . -COMMI TT EE NAME ( Mu s t b e s am e a s o n men t o f O r g a n i z a t i o n )

CANDI DATE NAME AND ADDRESS T OWHOM 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 me n t ) WAS MADE( MM I D DI Y R ) A ND P A CCHECKNUMBER

0- 2 1i / S ~G 1 0 0CK#. e I D#

CK#

CK #D#CK#1 D#CK #D#CK#I D #CK#

SUB- TOTAL $g . aTOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e ) $


10/10

FOR I NSTRUCT I ONS , SEE BACK OF FORMCOMMI TT EE NAME ( M u s t b e s ame a s o n S t a t n t o f Or g ' o n )

NOTE : e b t s p r e Ou s l y r e p o r t e d t h a t r e ma i n u n p a i d mu s t b e i n c l u d e d o n t h i sS c h e d u l e , a s w e l l a s a n y n e w o b l i g a t i o n s i n c u r r e d i n t h i s p e r i o d .

DEBTS / OBL I GAT I ONS REMAI N I NG T HI S REPORTI NG PERI OD( DO NOT I NCLUDE L OANS - - SHOW LOANS ON SCHEDULE F )

SCHEDULED I NCURRED( R e v . 0 8 / 9 8 ) 1 I NDEBTEDNESSO CHECK T HI S BOXI F AMENDI NGFORM

An " i n c u r r e d d e b t " i s a d e b t f o rg o o d s o r s e r v i c e s o r d e r e d o rr e c e i v e d , b u t n o t p a i d f o r b y t h ee n d o f t h e r e p o r t i n g p e r i o d . ,r e g a r d l e s s o f w h e t h e r a n i n v o i c eh a s b e en r e c e i v e d

* I f a c t u a l f i g u r e i s u n k n o w n , s h o w " e s t i m a t e d " b e s i d e t h e f i g u r e . Pa ge~~of ~( f d r S c h e d u l e d )CANDI DATE COMMI TT EES NOTE :* I n c u r r e d i n d e b t e d n e s s a l s o i n c l u d e s e a c h p e r s o n / e n t i t y w i t h whom t h e c a n d i d a t e ' s c o mm i t t e e h a s e n t e r e d i n t o a c o n t r a c t d u r i n g t h e r e p o r t i n g p e r i o d f o r f u t u r eo r c o n t i n u i n g p e r f o r m a n c e . E n t e r t h e name o f t h e c o n s u l t a n t wh o p r o v i d e s o r p r o c u r e s s e r v i c e s f o r i t e m s s u c h a s 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

..

DATEI NCURRED( MM/ DD/ YR) NAME AND ADDRESS OF PERSONTO WHOM DEBT OR OBL I GAT I ON I S OWEDDESCRI PT I ON OF GOODS ORSERVI CES PROVI DED ORPURCHASED

BALANCE OWED ATCLOSE OFREPORTI NGPERI OD*1 5

l ~ %n r? I U_

r ~Cn r s T TL k F . n t cSBZyt i r h 1

1 ~Mr dl E-E

v

$ a ~ f i g , 6 0v

SUB- TOTAL $

TOTAL DEBTS OWED BY COMMI TT EE AT T HE END OF THI S REPORTI NG PERI OD $

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