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FOR I NSTRUCTI ONS . SEE BACKOF FORMDISCLOSURESUMMARYPAGECOMMI TTHE NAME ( j W u s t b e s ame a s o n St a t e me n t o r Or g a ni z a t i o n)

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 ar e r e p or t i n g f o r :I ( 1 ) S t a t e w i d e l L e g i s l a t i v e Ca nd i d a t e ( 2 ) S t a t e w r i d e PAC ( 3 ) S t a t e Par t y ( 4 ) Co u nt y / L o c al Ca nd i d a t e( 5 ) Co u nt y PAC ( o ) B a l l o t I s su e / F r a nc h i s e Co mmi t t e e ( 7 ) C o u n t y / C i t y Ce n t r a l Co mmi t t e e( 8 ) Su p p or t S l a t e o f Ca nd i d a t e sCANDI DATE COMMI TTEES ONL Y :C a n d i d a t e Name P o l i t i c a l P a r t y

O f f i c e S o u g h t D i s t r i c t ( i f S e n a t e o r H o u s e )

SI GNATURE OF TREASURER ( o r p e r s o n t i l i n g t h i s r e p o r t ) TEL EPHONE DATE SI GNEDR o u t i n e P e n a l t i e s Cue F o r L at e F i l e d Re p or t s Ran ge f r o m $ 2 0 t o $ 8 0 0

SEE I N STRUCTI ONSON BACKANDCOMPLETE THE FOLLOWI NGSENTENCE :I AM F I L I N G A REPORT F OR AN/ A ( 1 ) ELECTI ON / ( 2 ) NON- ELECT I ON YEAR

( r e p o r t d a t e )DCHECK I F AMENDMENT TO REPORT DATED 6 ' - t ,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 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 HAND

I n d i c a t e o n e

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 mo n i e s h e l db y t h e c o m m i t t e e . T h i s a m o u n t MUST b e t h e same a s t h e c a s h o n h a n d a t t h e e ndo f t h e l a s t r e p o r t i n g p e r i o d , o r mu s t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . $ADD TOTAL MONEY TAKEN I N T HI 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 ) ( ' a l s o s e e i n - l d 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 Campa i g n P r o p e r t y ( A t t a c h S c h e d u l e H ) . . . . . . . . . . . . . . . . . . . . . . . . .( S c h e d u l e H a p p l i e s t o C a n d i d a t e s ' Commi t t e e s O n l v l

F ORMDI SCLOSURE

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L o c a l Co mmi t t e e s , e nt e r Da t e o f E l e c t i o n

Co u n t y & L o c a l Co mmi t t e e s , e nt e r Co u n t y i nwh i c h E l e c t i o n i s h e l d

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/ 3 : , / ' ~,L, ~ . ( - ;

." OUTSTAND I NG L OANS Fr om S c h e d u l e F - A t t a c h S c h e d u l eCANDI DATE COMMI TT EES ONL Y :CONSUL TANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) YES NOVALUE OF 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) $ 1 ( , - 77, ' _; ( C

SUB- TOTAL- _$SUBTRACT TOTAL MONEY SPENT THI S PERI 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 and l o a n s b e l o w ) . . .S c h e d u l e F L o a n Re p a y me 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 137, ~ j

" 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $" I N KI ND CONTRI BUTI 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ '


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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 TTEE NAME ( Mu s t b e s a me a s o n S t a t e me n t o f O r g a n i z a t i o n )Che t Cu l v e r Co mmi t t e e

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STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I CA L ACTI ON COMMI TTEE) , L I S T THE PAC I DENTI FI CATI ON NUMBAND 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 CSAND CAMPAI GN DI SCLOSUBOARD .CAUTI ON : Se c t i o n 68B . 3 2 A ( 6 ) , I o w a Co d e , p r o h i b i t s t he u s e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s a n 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 nt r i bu t i o ns f o r a n y c o mme r c i a l p u r p o s e b yp e r s o n o t he 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 .

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` D i s c l o s ur 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 he 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 . Re l a t i o n s hi p s mus t b e shown t o t he t h i r d d e g r e e o f c o n sa n gu i n i t y ( b l o o d r e l a t i v e ) 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 P a g e 2 o f f o r ms p a c ke t ) I f s u r n a me o f c on t r i b u t o r i s t h e s ame a s c a nd i d a t e , bu t t h e r e i s n o f a m i l i a l Page ~~ofr e l a t i o n s h i p , e nt e r " n ot a pp 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 Sc h e d u l e A)

Da t e PAC I D n u mbe r Na me a n d Ad d r e s s o f C o n t r i b u t o r R e l a t i o n s h i p Amou n t V i f f o r F u nRe c e i v e d i f a p p l i c a b l e ) t b Ca n d i da t e ' Re c e i v e d r a i s e r( MM/ DD/ YR) a n d PACCh e c k ( i f a p p l i c a b l e ) I n c omenu mbe rI D # Wi l l i a m H. Ap p l e ga t e1 1 / 3 0 / 0 1 1 7 2 4W. Ab i n g d o n Dr i v e # 1 0 1 $ 1 0 0 . 0 0

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1 1 / 3 0 / 0 1 7 0 7 S . L e e S t r e e t $ 1 0 0 . 0 0CK # A l e x a n d r i a , VA 2 2 3 1 4


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FORI NSTRUCTI ONS, SEEBACKOFFORM

I COMMl 3' TEE NAME ; Mu s t b e s ame a s o n S t a t eme n t o f Or g ani z a t i o n)

CHECKTHI S BOXI FAMENDI NGFORM

' Di s c l o su r e l aw r e q u i r e s c a nd i d at e s t o d i s c l os e t h e r e l a t i o n s h i p o f any r e l a t i v e ma k i n g a n i n k i n d c o n t r i b u t i o n t o t h e Pa g e o f Ic o mmi t t e e . Re l a t i o ns hi p mus t b e shown t o t h e t h i r d d e g r e e o f c o ns an gu i n i t y ( b l o o d r e l a t i v e s ) an d a f f i n i t y ( r e l a t i v e s ( f o r Sc h e d u l e E)by ma r r i a g e) . ( Se e Pa g e 2 o f f o r ms p a c k e t . ) I f su r name o f c o n t r i b u t o r i s t h e s ame as c a n di d a t e , bu 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 nt e r ' n o t a pp 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 .

DATERECE I VED NAME AND ADDRESS RELAT I ONSHI PTO CANDI DATE DESCR I PT I ONOF I N KI ND EST I MATEDF AI R MARKET , i I F FORFUND - RA I S( MMDD / YR) OF CONTRI BUTOR ( i f a p p l i c a b l e ) CONTR I BUT I ON VALUE CONTR I BUT It , c j aA 5 t r ~c o r a~r &-n 5o f - d g - 0 1 / Lie ._ f 0 ' ' f W~ r 4 i s e , 3 0 , 0 6

: 1 ~ l t ~ n~~ f Xc o - r u . ~ i a - sQt - ~ . S- D I y l ` 7 n - Oxt t A -- / 1 5 } r ~ f i _ a n d F o o d f r i e s oD

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FOR ) , A J ST 1 7 , UCT ) ONS . SEEBACKOF FORD/DISCLOSURESUMMARYPAGE

COMMI TT EH NAME ( 7 U u s t d e same a s on St a t e me n t o r Or g a ni z a t i o n)~ v e w C ~ . ~mml - H - e e

I MPORTANT : I nd 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 or t i ng f o r :1 ( 1 ) S t a t e w i d e / L e g i s l a t i v e Ca nd 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 ) Co u nt y / L o c a l Ca nd i d a t er 5 ) Co u nt y PAC ( o ) B a l l o t I s s ue / F r a nc h i s e Co mmi t t e e ( 7 ) C o u n t y i C i t y Ce n t r a l Co mmi t t e e( 8 ) Su p p or t S l a t e o f Ca nd i d a t e sCANDI DATE COMMI TTEES ONLY :

SI GNATUREOF 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 )

SUBTRACT TOTAL MONEY SPENT T HI S PERI OD

P o l i t i c a l P a r r yL ~ r r r n

D i s t r i c t ( i f Se n at e o r Hou s e )

Rou t i ne Pena l t i e s Due F a r L a t e F i l e d Re p or t s Range f r o m $ 2 0 t o $ 8 0 0SEE I NSTRUCTI CNSON BACKAND COMPL ETE THE FOLLOWI NG SENTENCE:I AM F I L I NG A i j - f ~ ' ~ 3 l , , U t i l REPORT FOR AN/ A ( 1 ) E L E CT I ON / ( 2 ) NON- E L ECT I ON YEAR .

( r e p o r t d a t e ) I - I q 4DCHECK 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 mi n a t i o n ) r e p o r t and 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 must 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

I n d i c a t e one

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 mon i e s h e l db y t h e c o mmi t t e e . T h i s amount MUST b e t h e s ame a s t h e c a s h on h and a t t h e e ndo f t h e l a s t r e p o r t i n g p e r i o d , o r must b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d .ADD TOTAL MONEY TAKEN I N T HI S PERI ODSc h e d u l e A: Cas h C o n t r i b u t i o n s t o t a l ( A t t a c h Sc h e d u l e A ) ( * a l s o s e e i n - k i n d b e l o w) . . . . . . . . .Sc h e d u l e F : L o a n s Re c e i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d u l e H : T o t a l Sa l e s o f Camp a i g n P r o p e r t y ( A t t a c h Sc h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .( Sc h e du l e H a p p l i e s t o Ca nd i d a t e s ' Co mmi t t e e s On i v )

SUB- TOTAL . . . . . $

Sc h e d u l e B : E x p e n d i t u r e s t o t a l ( A t t a c h Sc h e d u l e B ) ( " a l s o s e e d e b t s a nd l o a n s b e l o w ) . . .Sc h e d u l e F : L o a n Re p a y me n t s t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON HAND a t t h e e nd 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 nc e mus tb e z e r o ) ( A t t a c h DR- 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* * UNPAI D BI L L S ( F r o m Sc h e d u l e D - A t t a c h Sc h e d u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . _ . . . , $* I N K I ND CONTRI BUTI ONS ( F r o m Sc h e d u l e E - A t t a c h Sc h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . $" OUTSTANDI NG LOANS ( F r om Sc h e d u l e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . $CANDI DATE COMMI TTEES ONLY :CONSULTANT BREAKDOWN ( S c h e d u l e GA t t a c h e d ? )VALUEOF CAMPAI GN PROPERTY ( F r o m Sc h e du l e H - A t t a c h Sc h e d u l e H) $

FORMDR-2 DI SCLOSURE

( Re v . 0 1 1 2 0 0 1 ) REPORTFo r Of f i c e Us e On l yComm. # ' K 3I n de x e dAu d i t e dC omp u t e r

` 5 1 _-~- , _ - ) y L / , 51G7 / - 17- 6%~TELEPHONE DATE S I GNED

L o c a l Co mmi t t e e s , e nt e r Da t e o f E l e c t i o n

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. 3 7

/ 3 - 7 , C9 &,y, . 3 4 o/ t 53 , c oVYES NO- G - - 7 - y , C1


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FCR I i " 1STRUC' 70W SEE BACK OF FORM0~ %SCLCSURESUPYI NI ARYPAGE

COMMI -1 1 E _ NAME { i Wu s t be 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 )C , ~ 0 1 - i t ) V~ r -C0mmI ( v c 'I MPORTANT: I n d i c a t e t y p e o f c o mmi t t e e y o u a r e r e p or t i n g f o r :( 1 ) S t a t e w i d e i L e g i s l a t i v e Ca nd i d at e ( 2 ) S t a t e wi d e PAC ( 3 ) S t a t e P a r t y ( 4 ) Co un t y i L ac a i Ca n d i d a t e5 ) Co u nt y PAC ( o ) B a l l o t I s su e i F r a n c hi s e Co mmi t t e e ( 7 ) Co u n t v i C3 y Ca n t r a i Co mmi t t e e( 8 ; S up p or t S l a t e o f Ca n di d a t e sCANDI DATE COMMI TTEESONLY:Ca n di d a t e NameC y j e f Cu VCY 'Of f i c e Sough t5 e c r e f f &r * o f S f -a f i '

P o l i t i c a l Pa r t ybemOGi - c u t -

5 1 5 , _ " ~ q y ' - / , 5 - 1 S - /S I GN ( ~ r URE 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 ) TELEPHONERo u t i n e P e n a l t i e s Cu e F o r L a t e F i l e d Re po r t s Ra n g e f r o m $ 2 0 t o $ 8 0 0

S EE I N STRUCTI ONS ONSACK AND COMPLETE THE FOLLOWI NG SENTENCE :AM F I L I NG A T d n a c c / - I C e G P a b r r r 3 1 - q OO 1 REPORT FOR ANI A ( 1 ) ELECT I ON / ( 2 ) NCN- EL ECT I ON YEAR1 1 -OCHECKI FAMENDMENTTOREPORTDATED

( r e p o r t d at e ) _/- ~" - ' ' I n di c at e o n e

Check i f t h i s i s f i n a l ( t e r mi n at i o n ) r e p o r t a n d a t t a c h No t i c e o f Di s so l u t i o n Fo r m DR- 3 .( Y ou mus t c o n t i n u e t o f i l e r e p or t s u n t i l a No t i c e o f Di s so l u t i o n i s f i l e d . )

STATEMENTOFCASHONHANDCASHONHANDa t t h e b eg i n ni n g o f t he r e p or 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 mon i e s h e l dby t h e c ommi t t e e . T h i s amou nt MUST be t h e s ame a s t h e ca sh o n ha nd a t t he en do f t h e l a st r e po 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADDTOTALMONEYTAKENI N THI S PERI ODSche d u l e A: Cash Co n t r i b u t i o n s t o t a l ( A t t a c h Sc h e du l e A) ( * a l s o s ee i n - i d nd b e l o w) . . . . . . . . . lSc h e d u l e F : L o a n s Re c ei v e d t o t a l ( A t t a c h Sc h e du l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sche d u l e H: T i i 6 a l Sa l e s o f Campa i gn Pr 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 pp l i es t o Ca n di d a t e s ' Commi t t e e s On l y )SUBTOTAL. . . . . . $

SUBTRACTTOTALMONEYSPENTTHI S PERI ODSche du l e B: Ex 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) ( * * a l s o s e e d eb t s a n d l o an s b e l o w) . . .Sche du l e F : Loa n Repa ymen t s t o t a l ( A t t a c h Sche d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CONSULTANTBREAKDOWN( Sc h ed u l e GAt t a c h e d? )VALUEOFCAMPAIGNPROPERTY ( F r o m Sc h e du l e H- At t a c h Sc h e du l e H) $

IFo r Of f i c e Us e On iComm. #

i I n d e xe d Si 2Au d i t e dCo mp u t e r C

L o c a l C ommi t t e e s , e n t e r Da t e o f E l e c t i o n

Co u n t y & L o c a l C ommi t t e e s , e n t e r Co u n t y i nwh i c h S e c t i o n i s h e l d

- 7 q, sa- 3 . 5-; ~

_V/ YES NOG: - 7 7, - qQ

CASHONHANDa t t he en d o f t h i s r e p o r t i n g p e r i o d ( i t f i n a l r e p or t , b al a n ce mus tb e /37, Q96, Zo0z e r o ) ( A t t a c h DR- 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

* * UNPAI D BI L LS ( Fr o mSc h e du l e D - At t a c h Sc h e du l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5,~_o7. .3~* I N KI ND CONTRI BUTI ONS ( Fr o m Sche d u l e E- At t a c h Sc h e du l e E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1 ' 53("' 00* * OUTSTANDI NG LOANS( F r o m Sc h e du l e F- At t a c h Sc h e du l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDIDATECOMMI TTEESONLY:


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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 b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )C h e t C u l v e r Commi t t e e

SCHEDULEA Mo n e t a r y( R e v . 0 6 / 9 7 ) Re c e i p t s

0C h e c k t h i s b o x i fa me n d i n g f o r mSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PA C ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D E NT I F I C AT I O N NUMBERAND 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 GN DI SCLOSUREBOARD .CAUTI ON : S e c t i o n 6 6 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 f o r a n y c o mme r c i a l p u r p o s e b y a np 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- TOTAL

TOTAL ( i f l a s t p a g e o ft h i s s c h e d u l e )

$ 8 ' 5 5 , 00

* 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 s 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 ) 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 same a s c a n d i d a t e , b u t t h e r e i s n o f a m i l i a l Pa ge f o fr 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 Sc h e d u l e A)

D a t e PA C I D n u m b e r Name a n d A d d r e s s o f C o n t r i b u t o r R e l a t i o n s h i p A m o u n t V i f f o r F u n d -R e c e i v e d i f a p p l i c a b l e ) t o C a n d i d a t e * R e c e i v e d r a i s e r( MM/ D D/ Y R ) a n d PAC C h e c k ( i f a p p l i c a b l e ) I n c o m en u m b e rI D # D a v i d M E r i c k s o n1 / 1 2 / 0 1 8 0 9 3 7 t h S t $ 1 3 5 . 0 0 , /CK # We s t De s Mo i n e s , I A 5 0 2 6 5I D # R o b e r t E J o s t e n1 / 1 2 / 0 1 8 0 1 Gr a n d Av e . , S u i t e 3 9 0 0 $ 1 3 5 . 0 0 1CK # De s Mo i n e s , I A 5 0 3 0 9I D # B r i a n L a u r e n z o

1 / 1 2 / 0 1 5 5 0 8 G a r r i s o n S t r e e t $ 1 3 5 . 0 0CK # J o h n s t o n , I A 5 0 1 3 1I D # J o y c e P e r k i n s1 / 1 2 / 0 1 6 6 1 - 6 3 r d S t r e e t $ 1 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # To m S l o c k e t t1 / 1 3 / 0 1 6 2 9 Br ow n S t $ 1 3 5 . 0 0CK # I o wa C i t y , I A 5 2 2 4 5I D # Me r l i n Ac k e r s o n1 / 1 7 / 0 1 1 7 0 7 P a r k v i e w H e i g h t s $ 2 5 . 0 0CK # K e o k u k , I A 5 2 6 3 2I D # Gl e n n B u h r1 / 1 7 / 0 1 4 1 2 7 3 0 t h S t $ 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 0I D # Ga r y L Came r o n1 / 1 7 / 0 1 1 1 9 N Co u r t $ 3 5 . 0 0 VCK # F a i r f i e l d , I A 5 2 5 5 6I D # Si mon Ca s a d y1 / 1 7 / 0 1 1 3 3 3 L o o mi s Av e $ 5 0 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 5I D # J e a n n e n e Co c h r a n1 / 1 7 / 0 1 4 8 3 7 - 8 6 t h S t r e e t # 7 $ 3 5 . 0 0CK # U r b a n d a l e , I A 5 0 3 2 2


8/110

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 TTEENAME ( Mu s t b e s ame as o n S t a t eme n t o f Or g a n i z a t i o n )C h e t C u l v e r Commi t t e eSTATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECE I VED FROM A STATE PAC ( P OL I T I C A L ACT I ON COMMI TTEE) , L I S T THE PA C I D E NT I F I C A T I O N NUMBEAND 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 CAMPA I GN DI SCLOSUREBOARD .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 f o r a n y c o m m e r c i a l p u r p o s e b y ap e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o m m i t t e e s .

SUB- TOTA LTOTAL ( i f l a s t p a g e o ft 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 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 s 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 ) 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 Pa 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 ame a s c a n d i d a t e , b u t t h e r e i s n o f a m i l i a lr 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 .

SCHEDULEA Mo n e t a r y( R e v . 0 6 / 9 7 ) Re c ei p t s

UC h e c k t h i s b o x i fa m e n d i n g f o r m

Page 0~ o f( f o r Sc h e du l e A )

D a t e PAC I D n um b e r Name a n d A d d r e s s o f C o n t r i b u t o r R e l a t i o n s h i p Am o u n t V i f f o r F u n d -R e c e i v e d i f a p p l i c a b l e ) t o Ca n d i d a t e * R e c e i v e d r a i s e r( MM / D D/ Y R ) a n d PAC C h e c k ( i f a p p l i c a b l e ) I n c o m en u m b e rI D # J ames L . Co f f e y1 / 1 7 / 0 1 3 1 0 8 S i x t h S t . $ 1 3 5 . 0 0CK # Emme t s b u r g , I A 5 0 5 3 6I D # E u g e n e T. C r ame r1 / 1 7 / 0 1 2 9 8 9 1 10 t h S t r e e t $ 1 0 . 0 0CK # T ho r , I A 5 05 9 1I D # L l o y d Dume n i l

1 / 1 7 / 0 1 3 0 9 N. F r a n k l i n Av e . $ 3 5 . 0 0CK # Ames , I A 5 0 0 1 0I D # Ra n do l p h D u n c a n1 / 1 7 / 0 1 4 9 2 4 Co un t r y C l u b B l v d . $ 1 3 5 . 0 0CK# De s Mo i n e s , I A 5 0 3 1 2I D # Dav i d Ga r s t1 / 1 7 / 0 1 4 0 9 Ma i n S t . $ 7 0 . 0 0CK# C o o n Ra p i d s , I A 5 0 0 5 8I D # J a y n e Ha ns e n - L i p p s1 / 1 7 / 0 1 P. O . B o x 5 $ 7 0 . 0 0CK # Al g o n a, I A 5 05 1 1I D # Dal e J ue r g en s1 / 1 7 / 0 1 PO Box 1 5 4 $ 1 0 . 0 0CK # Cl ea f e l d , I A 5 0 8 4 0I D # J u l i eWKa y - L ewi s

1 / 1 7 / 0 1 1 8 1 6 E . 2 2 n d S t . $ 1 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 7I D # J . P . Ke l l o gg1 / 1 7 / 0 1 4 0 2W. Mi s s i o n $ 2 5 . 0 0CK # St r awbe r r y P o i n t , I A 5 2 0 7 6I D # Mi k e K u l i s k y

1 / 1 7 / 0 1 2 7 3 0 2 60 t h S t . $ 3 5 . 0 0 ( /CK # Wa s h i n g t o n , I A 5 2 3 5 3


9/110

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 b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )Chet Cu l v e r Co mmi t t e e


OC h e c k t h i s b o x i fa me n d i n g f o r mSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D EN T I F I C AT I O N NUMBEAND 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 GN DI SCLOSURBOARD .CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r 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 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 f o r a n y c o mme r c i a l p u r p o s e b y ap e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

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

$ 555 , v 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 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 . Re l a t i o n s h i p s 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 ) 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 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 same a s c a n d i d a t e , b u t t h e r e i s n o f a m i l i a l Page 3 o fr 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 Sc h e d u l e A )

D a t e PAC I D n u m b e r Name a n d A d d r e s s o f C o n t r i b u t o r R e l a t i o n s h i p A m o u n t J i f f o r F u n dR e c e i v e d i f a p p l i c a b l e ) t o C a n d i d a t e ' R e c e i v e d r a i s e r( MM / D D/ Y R ) a n d PAC C h e c k ( i f a p p l i c a b l e ) I n c o men u m b e rI D # P a u l e e L i p sma n1 / 1 7 / 0 1 2 8 8 0 Gr a nd AV # 1 0 6 $ 1 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # J a c k i e McCa r t y1 / 1 7 / 0 1 1 1 7 8 H a r d i n g A v e n u e $ 1 0 . 0 0CK # Roc k R a p i d s , I A 5 1 2 4 6I D # Wi l l i a m J Men ne r1 / 1 7 / 0 1 1 4 0 3 Su mme r S t r e e t $ 3 5 . 0 0CK # G r i n n e l l , I A 5 0 1 1 2I D # Ramud u K Mu r t h y1 / 1 7 / 0 1 3 9 2 1 Sp r u c e H i l l s D r i v e $ 3 5 . 0 0CK # Ceda r F a l l s , I A 5 0 6 1 3I D # D o r i s J e a n N e w l i n1 / 1 7 / 0 1 3 3 1 5 4 8 t h P l a c e $ 3 5 . 0 0 t ,CK # De s Mo i n e s , I A 5 0 3 1 0I D # K a t h l e e n Ov e r ma n1 / 1 7 / 0 1 2 1 1 8 Mo r t o n $ 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 7 - 3 5 4 0I D # Wa l l a c e P a r r i s h1 / 1 7 / 0 1 PO Bo x 8 5 $ 3 5 . 0 0CK # Wa t e r l o o , I A 5 0 7 0 4I D # E mi l P a v i c h1 / 1 7 / 0 1 1 7 0 6 - 1 5 t h A v e n u e $ 3 5 . 0 0CK # C o u n c i l B l u f f s , I A 5 1 5 0 1I D # Ro x a n n Ryan1 / 1 7 / 0 1 7 1 0 5 Sun se t T e r r a c e $ 1 0 0 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 1I D # Ru t h S c h a b e n1 / 1 7 / 0 1 1 1 0 4 Ucon A v e n u e $ 1 0 0 . 0 0CK # D u n l a p , I A 5 1 5 2 9


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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 b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )Che t Cu l v e r Co mmi t t e eSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D EN T I F I C AT I O N NUMBEAND THE PAC CHECK NUMBER I N TH E DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM TH E I OWA ETHI CS AND CAMPAI GN DI SCLOSUREBOARDCAUTI 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 f o r a n y c o mme r c i a l p u r p o s e b y ap 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- TOTAL $ ~ I O, OOTOTAL ( i f l a s t p a g e o ft h i s s c h e d u l e )

SCHEDULEA Mo n e t a r y( R e v . 0 6 / 9 7 ) Re c e i p t s0 C h e c k t h i s b o x i fa me n d i n g f o r m

` 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 s 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 ) 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 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 same a s c a n d i d a t e , b u t t h e r e i s n o f a m i l i a lr 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 Sc h e d u l e A)Pa ge

D a t e PAC I D n u m b e r Name a n d A d d r e s s o f C o n t r i b u t o r R e l a t i o n s h i p Amount . / i f f o r F u n d -R e c e i v e d i f a p p l i c a b l e ) t o C a n d i d a t e ` R e c e i v e d r a i s e r( MM / D D/ Y R ) a n d PAC C h e c k ( i f a p p l i c a b l e ) I n c o m en u m b e rI D # Tom Sc h o e l e r ma n1 / 1 7 / 0 1 3 3 0 5 EP T r u e Pkwy # 1 2 0 2 $ 3 5 . 0 0CK # We s t De s Mo i n e s , I A 5 0 2 6 5 - 7 6 0 9I D # Tammi e Sc h r o e d e r1 / 1 7 / 0 1 5 8 6 5 E a s t Oakwood Dr $ 7 0 . 0 0CK # P l e a s a n t H i l l , I A 5 0 3 1 7I D # C h a r l e s S h e r i d a n

1 / 1 7 / 0 1 P . O Bo x 2 7 $ 1 3 5 . 0 0CK # De Wi t t , I A 5 2 7 4 2I D # D e l o r e s S t u r g e o n1 / 1 7 / 0 1 2 3 6 2 Wes t 1 s t S t r e e t $ 1 0 . 0 0CK # S i o u x C i t y , I A 5 1 1 0 3I D # Ro d n e y S u l l i v a n1 / 1 7 / 0 1 2 3 2 6 E C o u r t S t r e e t $ 5 0 . 0 0CK # I o w a C i t y , I A 5 2 2 4 5I D # Sean Swee ne y1 / 1 7 / 0 1 3 2 0 I n s u r a n c e E x c h a n g e B l d g $ 1 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 0 9I D # J o a n n e T h i n n e s f Y ) O f h e + ' -1 / 1 7 / 0 1 1 8 3 5 2 5 t h Av e $ 1 3 5 . 0 0CK # Ma r i o n , I A 5 2 3 0 2 - 1 1 3 1 i n I , Q ~I D # D e r i t h R Vog t1 / 1 7 / 0 1 1 2 3 1 8 Ma d i s o n Road $ 7 0 . 0 0CK # Ce n t e r J u n c t i o n , I A 5 2 2 1 2I D # H a r r y We i s s1 / 1 7 / 0 1 2 5 2 9 No r t h wo o d Dr $ 3 5 . 0 0 ( /CK # Ames , I A 5 0 0 1 0I D # J o h n P Whee l e r1 / 1 7 / 0 1 5 3 Mea d o wb r o o k C i r c l e $ 1 3 5 . 0 0 t /CK # Cummi ng , I A 5 0 0 6 1


11/110

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 TTEENAME ( Mu s t b e s ame as o n S t a t eme n t o f O r g a n i z a t i o n )Che t C u l v e r Commi t t e e

SCHEDULEA Mo n e t a r y( R e v . 0 6 1 9 7 ) Re c ei p t s

0C h e c k t h i s b o x i fa m e n d i n g f o r mSTATE CANDI D ATES NOTE : I F A CONTRI BUT I ON I S RECE I VED FROM A STATE PA C ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D E NT I F I C A T I ON NUMBEAND THE PA C CHECK NUMBER I N THE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN D I SCLOSURBOARD .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 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 f o r a n y c o mme r c i a l p u r p o s e b yp 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 .

SUB - TOTA L $ ba0, 00TOTAL ( 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 mm i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e R e l a t i o n s h i p s 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 ) 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 ame a s c a n d i d a t e , b u t t h e r e i s n o f a m i l i a lr 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 Sc h e d ul e A)Page

Da t eR e c e i v e d PA C I D n um b e ri f a p p l i c a b l e ) Name a n d A d d r e s s o f C o n t r i b u t o r R e l a t i o n s h i p Am o u n t V i f f o r F u n d( MM/ D D/ Y R ) a n d PA C C h e c k t o C a n d i d a t e '( i f a p p l i c a b l e ) R e c e i v e d r a i s e rI n c o m en u m b e rI D # J . P o r t e r Wi l l i ams1 / 1 7 / 0 1 5 3 8 0 NW7 1 s t Pl ac e $ 2 5 . 0 0 , /CK # J o hn s t o n , I A 5 0 1 3 1I D # M. C o r r i n e Wi l l i ams1 / 1 7 / 0 1 2 8 7 3 1 0 2 n d S t . $ 2 5 . 0 0CK # V i l l i s c a , I A 5 0 8 6 4I D # Do r o t h y Woods

1 / 1 7 / 0 1 1 1 0 1 P r a i r i e V i e w Dr i v e $ 1 3 5 . 0 0CK # Wes t De s Mo i n e s , I A 5 0 26 6 - 7 2 1 0I D # B r e n t A p p e l1 / 1 9 / 0 1 1 0 8 7 - 1 8 0t h S t r e e t $ 1 3 5 . 0 0 , /CK# Ac k wo r t h , I A 5 0 0 0 1I D # Ki m Bi s i g nan o1 / 1 9 / 0 1 2 6 1 8 Ea s t L e a c h $ 3 5 . 0 0 , /CK# Des Mo i n e s , I A 5 0 3 2 0I D # Hon . Ma r y P . Bu k t a1 / 1 9 / 0 1 6 0 4 S . 3 2 n d S t r e e t $ 3 5 . 0 0 , /CK # C l i n t o n , I A 5 2 7 3 2I D # J e r r y D o d d s1 / 1 9 / 0 1 2 6 8 0 Re na i s s a n c e $ 3 5 . 0 0CK # D u b u q u e , I A 5200 1I D # Ma r i l y n F a r r1 / 1 9 / 0 1 3 9 3 0 Gr a n d Ave . , Ap t . 409 $ 1 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 0I D # G l o r i a G o l l

1 / 1 9 / 0 1 24 0 5 1 60 t h S t . $ 2 5 . 0 0CK # K l emme, I A 5 0 4 4 9I D # Hon . Mi c h a e l Gr o n s t a l1 / 1 9 / 0 1 2 2 0 B en n e t t $ 3 5 . 0 0 ~/CK # Co u nc i l B l u f f s , I A 5 1 5 0 3


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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 TT EE NAME ( Must be s ame as on St at ement o f Or g an i z a t i o n)C h e t C u l v e r Commi t t e eSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PA C I D E NT I F I C A T I O N NUMBEAND 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 GN DI SCLOSURBOARD .CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r 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 f o r a n y c o m m e r c i a l p u r p o s e b yp 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 .

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

SCHEDUL EA Mone t a r y( R e v . 0 6 / 9 7 ) Re c e i p t s0C h e c k t h i s b o x i fa m e n d i n g f o r m

$ 9 / 0 - 0 0

' 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 s 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 ) 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 a m e a s c a n d i d a t e , b u t t h e r e i s n o f a m i l i a lr 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 Sc h e d u l e A)

D a t e PAC I D n u m b e r Name a n d A d d r e s s o f Co n t r i b u t o r R e l a t i o n s h i p A m o u n t , / i f f o r F uR e c e i v e d( MM I D DI Y R ) i f a p p l i c a b l e )a n d PAC C h e c k t o C a n d i d a t e '( i f a p p l i c a b l e ) R e c e i v e d r a i s e rI n c o m en u m b e rI D # K a t h l e e n H a l l o r a n1 / 1 9 / 0 1 2 1 0 - 1 NWGe o r g e t o wn B l v d $ 1 3 5 . 0 0CK # A n k e n y , I A 5 0 0 2 1 , ~I D # L i l e a h H a r r i s1 / 1 9 / 0 1 3 6 2 6 Bea v e r AV SE $ 3 5 . 0 0CK # Cedar R a p i d s , I A 5 2 4 0 3I D # A n g e l i n e J a c o b s o n

1 / 1 9 / 0 1 7 4 0 Ri d g e Road $ 2 5 . 0 0CK # D e c o r a h , I A 5 2 1 0 1I D # S t e v e n Kr anz1 / 1 9 / 0 1 2 7 3 2 - 6 7 t h S t r e e t $ 1 0 0 . 0 0CK # N e w h a l l , I A 5 2 3 1 5I D # R i c h a r d K r u e g e r1 / 1 9 / 0 1 5 9 9 7 Wap s i A v e n u e SE $ 1 3 5 . 0 0CK # Lone T r e e , I A 5 2 7 5 5I D # E i v e n d L i l l e h o j1 / 1 9 / 0 1 PO Box 2 2 $ 1 3 5 . 0 0CK # K i m b a l t o n , I A 5 1 5 4 3I D # G e r a r d D Neugen t1 / 1 9 / 0 1 5 0 0 0 We s t o wn P k w y , S t e 1 0 0 $ 1 3 5 . 0 0CK # We s t De s Mo i n e s , I A 5 0 2 6 6I D # J a n e t Oj a1 / 1 9 / 0 1 2 0 5 3 B A v e n u e NE $ 5 0 . 0 0CK # Cedar R a p i d s , I A 5 2 4 0 2I D # O H S t a l h e i m1 / 1 9 / 0 1 1 9 1 8 Ge o r g e A l l e n D r i v e $ 3 5 . 0 0CK # Ame s , I A 5 0 0 1 0I D # L i n d a S t e e n s l a n d1 / 1 9 / 0 1 1 9 3 5 1 Monument Rd . $ 2 5 . 0 0 ~/CK # C o u n c i l B l u f f s , I A 5 1 5 0 3


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CONTRI BUTI ONS - MONEY TAKEN I N( I n c l u di n g c a nd 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 same a s on S t a t e me n t o f O r g a n i z a t i o n )C h e t C u l v e r Commi t t e eSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CA L ACTI ON COMMI TTEE) , L I S T THE PAC I DENTI FI CATI ON NUMBEAND 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 GN DI SCLOSURBOARD .CAUTI ON : Se c t 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 s e o f i n f o r ma t i on c o pi e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i on s f o r a n y c omme r c i a l p u r p o s e b yp 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- TOTAL $ &L1 0 , 0 0TOTAL ( i f l a s t page o f

t h i s s c h e d u l e )' Di s c l o s ur e l aw r e q ui r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o se t h e r e l a t i o ns 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 . Re l a t i o ns h i p s mus t b e s h own t o t h e t h i r d d e g r e e o f c on s an g u i n i t y ( b l o od r e l a t i v e ) 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) ( Se e Page 2 o f f o r ms p a c k et ) . I f s u r n a me o f c on t r i b u t o r i s t h e s ame a s c a n di d a t e , b u t t h e r e i s n o f a mi l i a lr e l a t i o n s h i p , e n t e r " n o t a pp 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 .

SCHEDULEMo n e t a r y

( Re v 0 6 / 9 7 ) Re c ei p t s0 Chec k t h i s b o x i fa me n d i n g f o r m

Page I o f( f o r Sc h e d ul e A )

D at e PAC I D number Name a n d Ad d r e s s o f Con t r i b u t o r Re l a t i on s h i p Amou nt , / i f f o r F u n dRe c e i v e d i f a pp l i c a b l e ) t o Ca n d i d a t e ` Re c e i v e d r a i s e r( MM/ DD/ YR) a n d PAC C h e c k ( i f a pp l i c a b l e ) I n c o men u m b e rI D # Di a n e Todd - Br own1 / 1 9 / 0 1 5 5 0 5 Ro b e r t s o n D r i v e $ 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # J o h n J We r t z b e r g e r1 / 1 9 / 0 1 3 4 0 1 N F a i r f a x Dr $ 1 3 5 . 0 0CK # A r l i n g t o n , VA 2 2 2 0 1 - 4 4 9 8I D # J i m A u t r y

1 / 2 2 / 0 1 5007 Wo od l a n d $ 1 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # Ma r i e C a l l a s1 / 2 2 / 0 1 4 7 1 2 Tama r a La ne $ 3 5 . 0 0CK # West De s Mo i n e s , I A 5 0 2 6 5I D # A r v i n d Da n d e k a r

1 / 2 2 / 0 1 2 7 3 1 2 8 t h Av e $ 7 5 . 0 0CK # Ma r i o n , I A 5 2 3 0 2I D # G e r t r u d e F o g a r t y

1 / 2 2 / 0 1 R R Bo x A5 $ 2 0 . 0 0CK # C y l i n d e r , I A 5 0 5 2 8I D # Mi c h a e l Ke r sman1 / 2 2 / 0 1 2 6 Wh i s p e r i n g Woods $ 3 5 . 0 0CK # H o l l a n d , MI 4 9 4 2 4I D # D a n i e l J Mc Gu i r e1 / 2 2 / 0 1 1 0 0 3 7 t h S t $ 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 31 2 - 4 3 0 4I D # Ma r i l y n Mon r oe1 / 2 2 / 0 1 4 8 3 7 8 6 t h NW# 9 P l umwood $ 1 0 0 . 0 0CK # U r b a n d a l e , I A 5 0 3 2 2I D # Ron St opa k

1 / 2 2 / 0 1 4 1 6 - 1 s t Avenue NE $ 3 5 . 0 0CK # L e Ma r s , I A 5 1 0 3 1


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CONTRI BUTI ONS - MONEY TAKEN I N( I n c l u di n g c an d i d at e ' s p e r s on a l f u n ds )

COMMI TTEE NAME ( M u s t b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )C h e t C u l v e r Commi t t e eSCHEDULEA Mone t a r y( Re v . 0 6 / 9 7 ) Re c ei p t s0Check t h i s b o x i f

a me n d i n g f o r mSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CA L ACTI ON COMMI TTEE) , L I ST THE PAC I DENTI FI CATI ON NUMBEANDT HE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN DI SCLOSURBOARD .CAUTI ON : Se c t 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 s e 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 a n d s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i on s f o r a n y c omme r c i a l p u r p o s e b yp e r s o n ot 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 $ / , 3 / o - o OTOTAL ( i f l a s t page o f $

t h i s s c h e d u l e )* D i s c l o su r e l a w r e q u i r e s c a n di d at e c o mmi t t e e s t o d i s c l o se 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 on t r i b u t i o n t o t h ec o mmi t t e e Re l a t i o ns h i p s mus t be 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 ns an g ui n i t y ( b l o od r e l a t i v e ) 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 ee Pa g e 2 o f f o r ms p a c k et ) . I f s u r n a me o f c on t r i b u t o r i s t h e s ame a s c a nd i d at e , b u t t h e r e i s n o f a mi l i a lr e l a t i o n s h i p , e nt e r " n o t a pp l i c a bl 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 Sc h e d ul e A)

D at e PAC I D n umbe r Name a nd Ad d r e s s o f Co nt r i b ut o r Re l a t i o ns h i p Amount J i f f o r F u n dRe c e i v e d i f a pp l i c a b l e ) t o Ca n d i d a t e * Re c e i v e d r a i s e r( MM/ DDNR) a n d PAC Check ( i f a pp l i c a b l e ) I n c o menumberI D # T r a c y R . V a n c e

1 / 2 2 / 0 1 1 1 2 3 - 4 8 t h S t # 1 4 $ 1 3 5 . 0 0CK # F o r t Ma d i s o n , I A 5 2 6 2 7I D # O l i v a A Wr i g h t

1 / 2 2 / 0 1 1 4 1 4 Ma i n S t r e e t $ 5 0 . 0 0CK # G r i n n e l l , I A 5 0 1 1 2I D # B r e n t Wy n j a1 / 2 2 / 0 1 1 0 1 2 H u n z i k e r D r i v e $ 1 3 5 . 0 0CK # Ames, I A 5 0 0 1 0I D # S u z a n n e B l o u i n1 / 2 3 / 0 1 3 0 0 Wa l n u t # 1 2 $ 1 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 0 9I D # D a v i d Br own1 / 2 3 / 0 1 8 0 3 F l e mi n g B u i l d i n g $ 1 0 0 . 0 0CK # De s Mo i n e s , I A 5 0 3 0 9I D # Ho n . M a r c e l l a F r e v e r t1 / 2 3 / 0 1 Box 3 2 4 $ 5 0 . 0 0CK # Emme t sbu r g , I A 5 0 5 3 6I D # M i c h a e l G a r t n e r1 / 2 3 / 0 1 5 3 1 5 Wa t e r b u r y Rd $ 5 0 0 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # S t e p h a n i e Gl e n n Te c h a u1 / 2 3 / 0 1 5 9 2 1 Wa t e r b u r y C i r c l e $ 1 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # J a y H Go l d M . D1 / 2 3 / 0 1 5 3 1 0 S h r i v e r Ave n u e $ 5 0 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # Ma r y Pa t Gr e g e r s o n

1 / 2 3 / 0 1 6 9 3 2 4 - 7 3 0 t h S t r e e t $ 2 0 . 0 0 t/CK # Massena , I A 5 0 8 5 3


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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 ( Must be samea s o n St a t e men t o f Or g an i z a t i o n)Chet Cu l v e r Commi t t e eSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C AL ACTI ON COMMI TTEE) , L I S T THE PAC I D E N T I F I C A T I O N NUMBEAND 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 GN DI SCLOSUREBOARD .CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r 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 f o r a n y c o mm e r c i a l p u r p o s e b y ap 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 .

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 )* 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 s 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 ) 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 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 ame a s c a n d i d a t e , b u t t h e r e i s n o f a m i l i a lr 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

SCHEDULEMonet a r y( R e v . 0 6 / 9 7 ) Re c ei p t s

0 C h e c k t h i s b o x i fa m e n d i n g f o r m

SUB- TOTAL $ - 9 7 0 OO

Page q o f( f o r Sc h e d u l e A )

D a t e PAC I D n u m b e r Name a n d A d d r e s s o f C o n t r i b u t o r R e l a t i o n s h i p Amount J i f f o r F u n d -R e c e i v e d i f a p p l i c a b l e ) t o C a n d i d a t e * R e c e i v e d r a i s e r( MM / D D/ Y R ) a n d PAC C h e c k ( i f a p p l i c a b l e ) I n c o m en u m b e rI D # B r u c e Hann1 / 2 3 / 0 1 9 0 0 5 B o s t o n Av e $ 2 5 . 0 0CK # U r b a n d a l e , I A 5 0 3 2 2

I D # Max i ne He nr y1 / 2 3 / 0 1 2 4 9 0 - 5 0 t h Avenue $ 3 5 . 0 0CK # New V i r g i n i a , I A 5 0 2 1 0I D # Ma r g a r e t John son

1 / 2 3 / 0 1 6 0 8 Hodge Avenue $ 3 5 . 0 0CK # Ames , I A 5 0 0 1 0I D # L i n d a J u n k i n s1 / 2 3 / 0 1 1 8 1 8 De s Mo i ne s S t $ 1 0 0 . 0 0CK # De s Mo i n e s , I A 5 0 3 0 9I D # D a v i d K r u i d e n i e r1 / 2 3 / 0 1 3 4 0 9 S o u t h e r n H i l l s Dr $ 5 0 0 . 0 0CK # De s Mo i n e s , I A 5 0 3 2 1I D # O r v i l l e K L a r s o n1 / 2 3 / 0 1 1 5 1 9 Gr and Av e #A 1 0 6 $ 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 0 9I D # K a t h r y n WMc Cos h1 / 2 3 / 0 1 7 0 1 W. C e n t r a l Av e $ 2 0 . 0 0CK # W i n f i e l d , I A 5 2 6 5 9I D # Mi c h a e l C Th i e l mann1 / 2 3 / 0 1 5 0 2 E Re n o , A p t . 1 C $ 5 0 . 0 0CK # K n o x v i l l e , I A 5 0 1 3 8I D # K a t h r y n Wag ne r Wa l l ac e1 / 2 3 / 0 1 6 3 9 5 7 t h S t $ 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2 - 1 2 4 7I D # F r e d We i t z1 / 2 3 / 0 1 1 2 4 5 B r o w n ' s Woo d s Dr $ 1 3 5 . 0 0CK # Wes t De s Mo i n e s , I A 5 0 2 6 5


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CONTRI BUTI ONS - MONEYTAKEN I N( I n c l u di n g c a nd i d at e ' s p e r s o n a l f u n ds )

COMMI TTEE NAME ( Mu s t b e s ame a s on St a t eme nt o f O r g a n i z a t i o n )Che t Cu l v e r Co mmi t t e eSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( POL I T I C A LACTI ON COMMI TTEE) , L I S T THE PAC I DENTI FI CATI ON NUMBEAND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GN DI SCLOSURBOARD .CAUTI ON : S ec t i o n 68B . 3 2 A ( 6 ) , I o wa C od e , p r o h i b i t s t h e u s e o f i n f o r ma t i on c o pi e d f r o m r e p o r t s a n 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 f o r a n y c o mme r c i a l p u r p o s e b yp e r s o n ot 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 of

t h i s s c h e d ul e )

SCHEDULEA M o n e t a r y

( Re v . t o s / 9 7 ) R e c e i p t sa C h e c k t h i s box i fa me n d i n g f o r m

' Di s c l o s ur e l a w r e q ui r e s c a nd i d at e c o mmi t t e e s t o d i s c l o se t h e r e l a t i o ns 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 . Re l a t i o ns h i p s mu s t be shown t o t h e t h i r d d e g r e e o f c o ns an g ui n i t y ( b l o od r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s byma r r i a g e ) ( S ee Page 2 o f f o r ms p a c k et ) . 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 sa me a s c a nd i d at e , b ut t h e r e i s n o f a m i l i a lr e l a t i o n s h i p , e nt e r " n ot a pp l i c a bl 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 )

D at e PAC I D n um b e r Name a nd Ad d r e s s o f Co nt r i b ut o r Re l a t i o ns h i p Amou nt / i f f o r F u n dRe c e i v e d i f a p p l i c a b l e ) t o C an d i d a t e ' Re c e i v e d r a i s e r( MM/ DD/ YR) a n d PAC Check ( i f a p p l i c a b l e ) I n c o menumberI D # Da v i d Cl a y p oo l1 / 2 4 / 0 1 5 7 5 4 Ga l l e r y Co u r t $ 1 3 5 . 0 0CK # We s t Des Mo i n e s , I A 5 0 2 6 6I D # Br e n d a n Co mi t o1 / 2 4 / 0 1 4 5 16 Wa v e l a n d Co u r t $ 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 2I D # Sl o an Co wn i e

1 / 2 4 / 0 1 1 9 1 5 Gr a n d A v e n u e $ 1 0 0 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 2I D # Pe t e D' Al e s sa nd r o1 / 2 4 / 0 1 3 2 3 5 S . Ri d g el a nd $ 1 3 5 . 0 0CK # Be r wy n , I L 6 0 4 0 2I D # Hon . Wi l l i am A. Do t z l e r1 / 2 4 / 0 1 2 83 7 Ce d ar T e r r a c e D r i v e $ 4 0 . 0 0CK # Wa t e r l o o, I A 5 0 7 0 2I D # B r e t A. Du bl i n sk e1 / 2 4 / 0 1 4 5 2 - 5 2 n d Co u r t $ 5 0 . 0 0CK # We s t De s Mo i n e s , I A 5 0 2 6 5I D # St e ph e n E c kl e y1 / 2 4 / 0 1 5 2 9 Wa t e r b u r y C i r c l e $ 2 5 0 . 0 0CK# Des Mo i n e s , I A 5 0 3 1 2I D # Hon . St e v e n L . Fa l c k1 / 2 4 / 0 1 1 0 7 3 6 - 1 0 t h S t r e e t $35 . 0 0 JCK # S t a n l e y , I A 5 0 6 7 1I D # Go r d o n F i s c h er

1 / 2 4 / 0 1 1 4 0 7 4 1 s t $ 1 3 5 . 0 0 ,jCK # Des Mo i n e s , I A 5 0 3 1 1I D # Ti mo t h y J . Gannon1 / 2 4 / 0 1 Box 1 6 7 $ 3 6 . 0 0CK # Mi n g o , I A 5 0 1 6 8


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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 TTEENAME ( Mu s t b e s ame as o n S t a t e me n t o f O r g a n i z a t i o n )C h e t C u l v e r Commi t t e e

SCHEDULEMo ne t a r y( R e v . 0 6 / 9 7 ) R e c e i p t s

0 C h e c k t h i s b o x i fa me n d i n g f o r mS TATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECE I VED FROM A STATE PA C ( P OL I T I C AL ACT I ON COMMI TTEE) , L I S T T HE PAC I D EN T I F I C AT I ON NUMBEAND T HE PAC CHECK NUMBER I N THE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPA I GN D I SCLOSURBOARDCAUT 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 ma 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 f o r a n y c o mme r c i a l p u r p o s e b yp 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 .

SU B- TOTA L $ E 1 Z IqO. OOTOTAL ( i f l a s t p a g e o f $ ,t h i s s c h e d u l e )

* D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e R e l a t i o n s h i p s 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 ) 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 ame a s c a n d i d a t e , b u t t h e r e i s n o f a m i l i a l Page~~o fr e l a t i o n s h i p , e n t e r " n o t ap p l i c ab 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 )

D a t e PA C I D n um b e r Name a n d A d d r e s s o f Co n t r i b u t o r R e l a t i o n s h i p Am o u n t V i f f o r F u n dR e c e i v e d i f a p p l i c a b l e ) t o Ca n d i d a t e * R e c e i v e d r a i s e r( MM / D D/ Y R ) a n d PA C C h e c k ( i f a p p l i c a b l e ) I n c o m en u m b e rI D # Mi c h a e l A. Gi u d i c e s s i1 / 2 4 / 0 1 9 4 1 0 Gr e e nb e l t Dr i v e $ 5 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 2 2I D # Br e n t B . Gr e e n1 / 2 4 / 0 1 7 - 34 t h S t r e e t $ 2 5 0 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 2I D # Hon . J a n e Gr e i ma n n

1 / 2 4 / 0 1 1 5 1 8 1 3 t h S t $ 3 5 . 0 0CK # Ame s , I A 5 0 0 1 0I D # Howa r d O. Ha g e n1 / 2 4 / 0 1 1 1 5 0 - 2 8 t h S t r e e t $ 1 3 5 . 0 0CK # We s t Des Mo i n e s , I A 5 0 2 6 6I D # A nd r e w D . H a l l1 / 2 4 / 0 1 5 0 8 - 58 t h $ 7 0 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 2I D # A ar o n Hamr oc k

1 / 2 4 / 0 1 8 3 5 0 Hi c k man Ro ad # 14 $ 1 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 2 5I D # Tom He n d e r s o n

1 / 2 4 / 0 1 6 2 3 9 N Wi nwood Dr i v e $ 1 3 5 . 0 0CK # J o h ns t o n, I A 5 0 1 3 1I D # Ann Ho l d e n Ke n de l l

1 / 2 4 / 0 1 3 0 0 Wa l n u t # 7 1 $ 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 0 9I D # De n ni s J o h n s o n1 / 2 4 / 0 1 5 2 1 0 We l k e r $ 7 0 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 2I D # Mi c h a e l J . Ki e r n an

1 / 2 4 / 0 1 8 3 9 - 4 1 s t S t r e e t $ 4 0 . 0 0 LjCK # Des Mo i n e s , I A 5 0 3 1 2


19/110

CONTRI BUTI ONS - MONEY TAKEN I N( i n c l u d i n g c a nd i d at e ' s p e r s o n a l f u n d s )

COMMI TTEE NAME ( Mu s t b e same a s on S t a t e me n t o f O r g a n i z a t i o n )C h e t C u l v e r Commi t t e eSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( POL I T I CA L ACTI ON COMMI TTEE) , L I ST THE PAC I DENT I F I CATI ON NUMBEAND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN A L I ST OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GN DI SCLOSUREBOARD .CAUTI ON : Se c t 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 s e o f i n f o r ma 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 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 f o r a n y c o mme r c i a l p ur p o s e b y ap e r s o n ot 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 oft h i s s c h e du l e )

SCHEDULEA Mo n e t a r y

( Re v . 0 6 1 9 7 ) Re c ei p t s0 C h e c k t h i s b o x i fa me n d i n g f o r m

$ 4 9 1 5 , 0 0

' Di s c l o s ur e l a w r e q u i r e s c a n di d at e c o mmi t t e e s t o d i s c l o se 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 on t r i b u t i o n t o t h ec o mmi t t e e . Re l a t i o ns h i p s mus t b e shown t o t h e t h i r d d e g r e e o f c on s an g u i n i t y ( b l o od r e l a t i v e ) 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 ) ( Se e Pa g e 2 o f f o r ms p ac k e t ) I f s u r n a me o f c on t r i b u t o r i s t h e s ame a s c a n di d a t e , b u t t h er e i s n o f a mi l i a l Pageo f 6 1 9 ,r e l a t i o n s h i p , e n t e r " n o t a pp 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 Sc h e d ul e A)

Da t e PAC I D numbe r Name and Ad d r e s s o f Co nt r i b u t o r Re l a t i o ns h i p Amou nt V i f f o r F u n d -Re c e i v e d i f a pp l i c a bl e ) t o Can d i da t e ' Re c e i ve d r a i s e r( MM/ DDNR) a n d PAC C h e c k ( i f a pp l i c a b l e ) I n c o men umbe rI D # Todd K r u e g e r1 / 2 4 / 0 1 6 8 0 0 M i l l Pond D r i v e $ 7 0 . 0 0CK # U r b a n d a l e , I A 5 0 3 2 2I D # G e r a l d Kueh n1 / 2 4 / 0 1 4 1 0 6 Ph o e n i x S t $ 1 3 5 . 0 0CK # Ames, I A 5 0 0 1 4I D # De n i s e Ku h n

1 / 2 4 / 0 1 2 6 6 7 - 2 4 0 t h S t r e e t $ 3 5 . 0 0CK # C h a r l e s C i t y , I A 5 0 6 1 6I D # Sa r a h L eon a r d1 / 2 4 / 0 1 5 6 6 1 F l e u r D r i v e $ 3 5 . 0 0CK # Des M o i n e s , I A 5 0 3 2 1I D # J a s o n L e t c h e r

1 / 2 4 / 0 1 3 3 3 3 Gr a n d A v e n u e $ 3 5 . 0 0CK # Des M o i n e s , I A 5 0 3 1 2I D # Sha r o n M a l h e i r o1 / 2 4 / 0 1 35 1 4 SW3 3 r d S t r e e t $ 3 5 . 0 0CK # Des M o i n e s , I A 5 0 3 2 1I D # Dr Ro b e r t C Ma r geas1 / 2 4 / 0 1 1 0 5 6 P o l k B l v d $ 3 5 . 0 0CK # Des M o i n e s , I A 5 0 3 1 1I D # Ho n Mar y Masc he r1 / 2 4 / 0 1 40 Gr y n Ct $ 3 5 . 0 0CK # I o wa C i t y , I A 52 24 6I D # J o h n McDo n a l d1 / 2 4 / 0 1 1 1 4 3 P i n e h u r s t C i r c l e $ 3 5 . 0 0CK # N o r w a l k , I A 5 0 2 1 1 UI D # B r i a n J Meyer1 / 2 4 / 0 1 6 7 8 - 3 8 t h S t r e e t $ 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 2


20/110

CONTRI BUTI ONS - MONEY TAKEN I N( I n c l u di n g c an d i d at e ' s p e r s o n a l f u n ds )

COMMI TTEENAME ( Mu s t b e s ame a s on S t a t e me n t o f O r g a n i z a t i o n )C h e t C u l v e r Commi t t e eSCHEDULEA Mone t a r y( Re v . 0 6 / 9 7 ) Re c e i p t sO C h e c k t h i s box i famend i ng f o r m

STATECANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VEDFROMA STATE PAC ( POL I T I C A L ACTI ON COMMI TTEE) , L I S TTHE PAC I DENT I F I C AT I ON NUMBERAND THE PAC CHECK NUMBER I N THE DESI GNATEDCOLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GN DI SCLOSUREBOARDCAUTI ON: S ec t i o n 68B . 3 2 A ( 6 ) , I o wa C od e , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o pi e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns f o r a n y c o mme r c i a l p u r p o s e b y a np 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 e s .

SUB- TOTAL $ 1 , 1 q0 00TOTAL ( i f l a s t page o f $ ,

t h i s s c h ed u l e )' Di s c l o s ur e l aw r e q ui r e s c a nd i d at e c o mmi t t e e s t o d i s c l o se t he r e l a t i o ns h i p o f a n y r e l a t i v e ma k i n g a c on t r i b u t i o n t o t h ec o mmi t t e e . Re l a t i o ns hi p s mu s t b e s h own t o t he t h i r d d e g r e e o f c on s an gu i n i t y ( b l o od r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s byma r r i a g e) ( S ee Pa g e 2 o f f o r ms p a c k et ) . I f s u r n a me o f c on t r i b u t o r i s t he sa me as c a nd i d a t e , b u t t h e r e i s n o f a m i l i a l Page o fr e l a t i o n s h i p , e n t e r " n o t a pp 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 Sc h e d u l e A )

Da t e PAC I D n um b e r Name a nd Ad d r e s s o f Con t r i bu t or Re l a t i on s hi p Amount V i f f o r F u n d -Re c e i v e d i f a pp l i c a b l e ) t o Ca n di d a t e ' Re c e i v e d r a i s e r( MM/ DD/ YR) a n d PAC C h e c k ( i f a pp l i c a bl e ) I n c o men um b e r

I D # J ames M i l l e r1 / 2 4 / 0 1 1 3 5 0 NW7 0 t h A v e n u e $ 3 5 . 0 0CK # A n k e n y , I A 5 0 0 2 1I D # J e a n i M. Mu r r a y

1 / 2 4 / 0 1 4 4 0 0 Pa r k A v e n u e #6 2 $ 1 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 2 1I D # Hon . Ri c h ar d E. My e r s

1 / 2 4 / 0 1 P . O . Bo x 5 6 0 8 $ 5 0 0 . 0 0CK # C o r a l v i l l e , I A 5 2 2 4 11D# Hon . Da v i d Na g l e1 / 2 4 / 0 1 P . O . Bo x 7 9 2 $ 7 0 . 0 0 c / ,CK # Wa t e r l o o, I A 5 0 7 0 4I D # Hon . Robe r t J . Os t e r h au s1 / 2 4 / 0 1 2 1 6 Au s t i n $ 7 0 . 0 0 ~/CK # Ma q u o k e t a , I A 5 2 0 6 0I D # Ma t t h ew J . Pau l

1 / 2 4 / 0 1 4 0 1 0 U n i v e r s i t y A v e n u e # 1 4 $ 2 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 1I D # Cy nd i Pe d er s o n

1 / 2 4 / 0 1 1 0 7 5 - 4 4t h S t r e e t $ 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 2I D # Da v i d P e r r e t1 / 2 4 / 0 1 5 3 2 1 Sh r i v e r Ave . $ 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 2I D # Hon . J a n e t Pe t e r s e n

1 / 2 4 / 0 1 1 3 4 6 47 t h S t r e e t $ 1 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 1I D # Ro s e Ma r y V . P r a t t1 / 2 4 / 0 1 4411 46 t h S t r e e t $ 1 0 0 . 0 0 I /CK # Des Mo i n e s , I A 5 0 3 1 0


21/110

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 ( M u s t b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )Chet Cu l v e r Co mmi t t e e


0C h e c k t h i s b o x i fa me n d i n g f o r mSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C AL ACTI ON COMMI TTEE) , L I S T THE PAC I D E N T I F I C A T I O N NUMBEAND 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 GN DI SCLOSUREBOARD .CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r 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 f o r a n y c o mme r c i a l p u r p o s e b y ap 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- TOTAL $ I , ( P&, S , OOTOTAL ( i f l a s t p a g e o ft h i s s c h e d u l e )

* D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p s 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 ) 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 Pa 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 same a s c a n d i d a t e , b u t t h e r e i s n o f a m i l i a lr 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 Sc h e d u l e A)

D a t e PAC I D n um b e r Name a n d A d d r e s s o f C o n t r i b u t o r R e l a t i o n s h i p Am o u n t V i f f o r F u n d -R e c e i v e d( MM / D DI Y R ) i f a p p l i c a b l e )a n d PAC C h e c k t o C a n d i d a t e *( i f a p p l i c a b l e ) R e c e i v e d r a i s e rI n c o men u m b e rI D # Ho n B r i a n Q u i r k1 / 2 4 / 0 1 4 1 5 N . C h e s t n u t A v e n u e $ 1 4 0 . 0 0CK # Ne w Hamp t o n , I A 5 0 6 5 9I D # B r u c e R a s t e t t e r1 / 2 4 / 0 1 1 5 4 9 1 Hwy 9 4 1 $ 2 5 0 . 0 0CK # A l d e n , I A 5 0 0 0 6I D # D a v i d Repp

1 / 2 4 / 0 1 6 2 1 - 4 1 s t S t r e e t $ 5 0 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # S h e i l a M Ri g g s1 / 2 4 / 0 1 4 0 5 S Wi l mo t h $ 3 5 . 0 0CK # Ames , I A 5 0 0 1 4I D # Do n a l d P Rowen1 / 2 4 / 0 1 3 4 0 7 C r o c k e r $ 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # Ho n P a u l J Sc h e r r ma n1 / 2 4 / 0 1 1 0 4 Mi c h i g a n A v e n u e $ 3 5 . 0 0CK # F a r l e y , I A 5 2 0 4 6I D # Ed S k i n n e r1 / 2 4 / 0 1 Bo x 3 6 7 $ 1 , 0 0 0 . 0 0 ,CK # A l t o o n a , I A 5 0 0 0 9I D # R o b e r t T S o u k u p1 / 2 4 / 0 1 4 2 3 0 I n g e r s o l l , # 5 $ 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # Do n a l d D S t a n l e y1 / 2 4 / 0 1 9 7 2 5 A u r o r a A v e n u e $ 5 0 . 0 0CK # U r b a n d a l e , I A 5 0 3 2 2I D # Ho n Gr e g S t e v e n s1 / 2 4 / 0 1 2 3 4 3 8 - 2 2 1 s t S t r e e t $ 3 5 . 0 0CK # M i l f o r d , I A 5 0 3 5 1


22/110

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 ( M u s t b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )C h e t C u l v e r Commi t t e e

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 )


0 C h e c k t h i s b o x i fa me n d i n g f o r mSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C AL ACTI ON COMMI TTEE) , L I S T THE PAC I D EN T I F I C AT I O N NUMBEAND THE PA C 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 CSAND CAMPAI GN DI SCLOSUREBOARDCAUTI 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 f o r a n y c o mme r c i a l p u r p o s e b y ap 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- TOTAL $ b 1 5 , 0 0

' 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 s mu 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 ) 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 Pa 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 same a s c a n d i d a t e , b u t t h e r e i s n o f a m i l i a l P a g e!~o fr 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 Sc h e d u l e A )

D a t e PAC I D n u m b e r Name a n d A d d r e s s o f C o n t r i b u t o r R e l a t i o n s h i p Am o u n t / i f f o r F u n d -R e c e i v e d i f a p p l i c a b l e ) t o Ca n d i d a t e ' R e c e i v e d r a i s e r( MM I D D/ Y R ) a n d PA C C h e c k ( i f a p p l i c a b l e ) I n c o m en um b e rI D # Ho n To m V i l s a c k1 / 2 4 / 0 1 2 3 00 Gr a n d Av e n u e $ 3 5 . 0 0

CK # Moun t P l e a s a n t , I A 5 2 6 4 1I D # C a r l V o s s

1 / 2 4 / 0 1 4 8 1 1 Gr a nd Av e n u e $ 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # C l a u d i a Wea v e r

1 / 2 4 / 0 1 1 3 0 9 2 C l a r k S t r e e t $ 2 0 . 0 0CK # C l i v e , I A 5 0 3 2 5I D # M a r g a r e t We i s s1 / 2 4 / 0 1 4 8 1 9 Wa t e r b u r y Road $ 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 21 D# A l i s o n Wh a l l

1 / 2 4 / 0 1 5 8 2 0 Ki n gma n $ 3 5 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 1I D # R o b e r t An d e r s o n1 / 2 5 / 0 1 1 2 1 4 I r o n S t r e e t $ 5 0 . 0 0CK # K e l l o g g , I A 5 0 1 3 5I D # Fa y e F r a i s e1 / 2 5 / 0 1 1 6 9 9 - 2 8 0 t h A v e n u e $ 3 5 . 0 0CK # F o r t Ma d i s o n , I A 5 2 6 2 7I D # G D a v i d Hu r d

1 / 2 5 / 0 1 3 9 3 0 Gr a n d A v e n u e , # 4 0 6 $ 3 0 0 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2- 3 5 2 3I D # Ho n D e l o r e s M e r t z1 / 2 5 / 0 1 1 0 0 2 - 7 0 t h A v e n u e $ 3 5 . 0 0 t /CK # O t t o s e n , I A 5 0 5 7 0I D # An d r a L A t t e b e r r y1 / 2 6 / 0 1 1 0 3 4 Sh e r ma n A v e n u e $ 3 5 . 0 0 i ,CK # M a n c h e s t e r , I A 5 2 0 5 7


23/110

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 TTEENAME ( Mu s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n )

Che t Cu l v e r Co mmi t t e e


0 C h e c k t h i s b o x i fa me n d i n g f o r mSTATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PA C ( P OL I T I C AL ACT I ON COMMI TTEE) , L I S T T HE PAC I D EN T I F I C A T I O N NUMBEAND T HE PAC CHECK NUMBER I N THE DES I GNATED COL UMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN DI SCLOSURBOARDCAUTI 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 f o r a n y c o mme r c i a l p u r p o s e b y ap 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- TOTAL $ l , ~ O 60TOTAL ( i f l a s t p a g e o f $ ,t h i s s c h e d u l e )

' D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p s 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 ) 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 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 same a s c a n d i d a t e , b u t t h e r e i s n o f a m i l i a l Pa g e Ofr 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 he d u l e A)

D a t e PA C I D n u m b e r Name a n d A d d r e s s o f C o n t r i b u t o r R e l a t i o n s h i p Am o u n t , / i f f o r F u n dR e c e i v e d i f a p p l i c a b l e ) t o C a n d i d a t e ` R e c e i v e d r a i s e r( MM/ D D/ Y R ) a n d PAC C h e c k ( i f a p p l i c a b l e ) I n c o m en um b e rI D # Gr e g o r y R. B r o wn1 / 2 6 / 0 1 5 21 3 Wo o d l a n d A v e n u e $ 2 0 0 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 2I D # Ru s s e l lW. Cu r r i e r

1 / 2 6 / 0 1 1 8 6 4 NW151 s t Ct . $ 2 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 2 5I D # M. Ru t h Sc h u l l e r

1 / 2 6 / 0 1 6 2 1 T i f f a n y Dr i v e $ 3 5 . 0 0CK # C e d a r Ra p i d s , I A 5 2 4 0 2I D # P a t r i c k M. Ca r p e n t e r

1 / 2 9 / 0 1 3 0 0 Wa l n u t , Su i t e 2 7 0 $ 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 0 9I D # Hon . Ro b e r t E. Dv o r s k y

1 / 2 9 / 0 1 4 1 2 6 t h A v e n u e $ 3 5 . 0 0CK # C o r a l v i l l e , I A 5 2 2 4 1I D # L i n n A. H a l l

1 / 2 9 / 0 1 4 4 1 5 Bu c k wa l t e r $ 3 5 . 0 0CK # S i o u x C i t y , I A 5 1 1 0 8I D # Mi c h a e l A. J o n e s1 / 2 9 / 0 1 9 3 2 V i r g i n i a A v e n u e $ 3 5 . 0 0CK # V i r g i n i a B e a c h , VA 2 3 4 5 1I D # Wi l l i a m C . K n a p p I I1 / 2 9 / 0 1 5 0 0 0 Wes t own Pkwy , S t e 1 0 0 $ 2 5 0 . 0 0CK # We s t Des Mo i n e s , I A 5 0 2 6 6I D # Ma r j o r i e Kn o t t

1 / 2 9 / 0 1 1503 B i r c h A v e n u e $ 3 5 . 0 0CK # C a r r o l l , I A 5 1 4 0 1I D # Ho n . Ri c h ar d L . L a r k i n

1 / 2 9 / 0 1 1 3 0 4 A v e n u e B $ 3 5 . 0 0CK # F o r t Ma d i s o n , I A 5 2 6 2 7


24/110


25/110

CONTRI BUTI ONS - MONEY TAKEN I N( I n c l u di n g c an di d at e ' s p e r s o n al f u n ds )

COMMI TTEE NAME ( Mu s t b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )C h e t C u l v e r Commi t t e eSCHEDULEA Mone t a r y( Re v . 0 6 1 9 7 ) Re c ei p t s0Che c k t h i s b o x i fa me n d i n g f o r m

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( POL I T I CA L ACTI ON COMMI TTEE) , L I ST THE PAC I DENTI FI CATI ON NUMBEAND THE PAC CHECK NUMBER I N THE DESI GNATEDCOLUMN . A L I ST OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GN DI SCLOSURBOARD .CAUTI ON : Se c t i o n 68B . 3 2 A ( 6 ) , I o wa Co d e , p r o h i b i t s t he u s e 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 a n 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 f o r a n y c omme r c i a l p ur p o s e b y ap 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 e s .

SUB-TOTAL

TOTAL ( i f l a s t page o ft h i s s c h ed u l e )

` D i s c l o su r e l aw r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o se t he 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 . Re l a t i o n sh i p s mus t b e shown t o t he t h i r d d e g r e e o f c o ns a ng u i n i t y ( b l o od r e l a t i v e ) 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 ) ( Se e Page 2 o f f o r ms p ac 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 sa me as c a n di d a t e , b u t t h e r e i s n o f a mi l i a l Page ' 9 of 9r 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 Sc h ed u l e A)

D at e PAC I D n u m b e r Name a nd Ad d r e s s o f Co nt r i b u t o r Re l a t i o ns hi p Amount / i f f o r F u n dRe c e i v e d i f a p p l i c a b l e ) t o Ca n d i d a t e ' Re c e i v e d r a i s e r( MM/ DD/ YR) a n d PAC Check ( i f a p p l i c a b l e ) I n c o men u m b e rI D # R o b e r t J Mo t t e t2 / 2 / 0 1 5 0 6 E An g u s C t . $ 2 5 . 0 0CK # Maquoke t a , I A 5 2 0 6 0

I D # J i m Nahas2 / 2 / 0 1 3 7 0 8 Wa l c o t t $ 2 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 2 1I D # J o n a t h an Neunabe r

2 / 2 / 0 1 1 7 2 7 9 1 8 0 t h S t $ 5 . 0 0CK # A k r o n , I A 5 1 0 0 1I D # Thoma s Wa l t o n2 / 2 / 0 1 9 5 1 4 A l p i n e D r i v e $ 1 3 5 . 0 0CK # U r b a n d a l e , I A 5 0 3 2 2I D # J o h n P B i c k e l2 / 6 / 0 1 2 1 1 5 - 1 s t Avenue SE # 2 2 2 7 $ 1 0 0 . 0 0CK # Cedar R a p i d s , I A 5 2 4 0 2I D # Doug McRe y n o l d s2 / 6 / 0 1 P 0 Box 6 0 5 $ 3 5 . 0 0CK # F a y e t t e , I A 5 2 1 4 2D # B e t t y E Bower s2 / 1 2 / 0 1 4 0 2 - 3 r d Ave n u e $ 2 5 . 0 0CK # Ma r i o n , I A 5 2 3 0 2

I D # J o a n n a C o u r t e a u2 / 1 2 / 0 1 1 1 2 0 G a r f i e l d Av e $ 3 5 . 0 0CK # Ames, I A 5 0 0 1 4I D # Thoma s S c o v i l l e2 / 1 2 / 0 1 3 6 3 7 Ve az e y S t r e e t NW $ 5 0 0 . 0 0CK # Wa s h i n g t o n , DC 2 0 0 0 8I D # J ames G Thomas2 / 1 2 / 0 1 1 0 2 N F o r d S t r e e t , Box 7 7 $ 3 5 . 0 0 /CK # Anamosa, I A 5 2 2 0 5


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COMMI TTEE NAME ( M u s t b e same a s on S t a t e me n t o f O r g a n i z a t i o n )Chet Cu l v e r Commi t t e e

TOTAL ( i f l a s t page o ft h i s s c h ed u l e )

Page

SCHEDULEA Mone t a r y( Re v . 0 6 / 9 7 ) Re c ei p t s0 C he c k t h i s b o x i f

amend i ng f o r mSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VEDFROMA STATE PAC ( P OL I T I CAL ACTI ON COMMI TTEE) , L I ST THE PAC I DENT I F I CATI ON NUMBEAND THE PAC CHECK NUMBER I N THE DESI GNATEDCOLUMN . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN DI SCLOSUREBOARD.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 ma 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 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 f o r a n y c o mme r c i a l p ur p o s e b y a np 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 e s

SUB- TOTAL $ I , 7 ( aO . OO

* Di s c l o s ur e l a w r e q u i r e s c a nd i d at e c o mmi t t e e s t o d i s c l o se 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 . Re l a t i o ns h i p s must b e shown t o t h e t h i r d d e g r e e o f c on s an g ui n i t y ( b l o o d r e l a t i v e ) 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 ) ( Se e Pag e 2 o f f o r ms p a c k et ) . 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 sa me a s c a nd i d a t e , b u t t h er e i s no f a mi l i a lr 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 Sc h e d u l e A)o f

8 a

Da t eRe c e i v e d

PAC I D numberi f a p p l i c a b l e ) Name and Ad d r e s s o f Co nt r i b u t o r Re l a t i o n sh i p Amount . / i f f o r Fu n d -

( MM/ DD/ YR) a n d PAC C he c k t o Ca n d i d a t e *( i f a p p l i c a b l e ) Re c e i v e d r a i s e rI n c o men umbe rI D # Roger L Wh i t e2 / 1 2 / 0 1 2 3 0 3 Gr ee nwood Av e $ 3 5 . 0 0CK # Cedar F a l l s , I A 5 0 6 1 3I D # J ayme Wh i t e h e a d - J a c o b i2 / 1 2 / 0 1 3 4 2 0 S a i n t J o h n s Road $ 7 0 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 2 - 4 5 1 3I D # R o b e r t Wh i t t e n b u r g

2 / 1 2 / 0 1 2 0 5 E 2 n d S t r e e t $ 3 5 . 0 0CK # S p e n c e r , I A 5 1 3 0 1I D # T h e l ma B e l l v i l l e2 / 2 7 / 0 1 2 0 6 1 NE 5 8 t h A v e n u e $ 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 3I D # P a u l F r a n z e n b u r g2 / 2 7 / 0 1 6 8 2 6 2 n d S t $ 1 5 . 0 0 V'CK # Des Mo i n e s , I A 5 0 3 1 2I D # Dwayne McAn i n c h2 / 2 7 / 0 1 6 8 0 0 La k e Dr . , S t e 1 2 5 $ 1 , 0 0 0 . 0 0CK # West Des Mo i n e s , I A 5 0 2 6 6I D # James Cown i e3 / 1 9 / 0 1 1 4 1 - 3 7 t h S t $ 5 0 0 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 2I D # Nor een McMahon Ba r k ema3 / 1 9 / 0 1 1 1 0 8 Manor D r i v e $ 1 0 . 0 0CK # Mason C i t y , I A 5 0 4 0 1I D # B a r b a r a D o o l i t t l e4 / 1 7 / 0 1 1 0 1 3 1 - 5 1 0 t h A v e n u e $ 2 5 . 0 0 t jCK # S t o r y C i t y , I A 5 0 2 4 8I D # James F F o s t e r4 / 1 7 / 0 1 2 8 0 0 Ri d g e $ 3 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 2


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CONTRI BUTI ONS - MONEYTAKEN I N( i n c l u d i n g c a nd i d at e ' s p e r s o n a l f u n d s)

COMMI TTEE NAME ( Mu s t b e same as o n S t a t eme n t o f O r g a n i z a t i o n )Che t Cu l v e r Commi t t e eSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VEDFROM A STATE PAC ( P OL I T I CA L ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ON NUMBERAND 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 GN DI SCLOSUREBOARDCAUTI ON : S ec t 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 s e 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 a n d s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns f o r a n y c o mme r c i a l p u r p o s e b y a np 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 ommi t t e e s .

SUB- TOTALTOTAL ( i f l a s t p a g e o f

t h i s s c h e du l e )

SCHEDULEM o n e t a r y

( Re v . 0 6 / 9 7 ) Re c ei p t s0Ch e c k t h i s b o x i f

ame n d i n g f o r m

* Di s c l o su r e l aw r e q ui r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o se t he 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 . Re l a t i o ns h i p s mus t b e s h own t o t h e t h i r d d e g r e e o f c on sa ng ui n i t y ( b l ood r e l a t i v e ) 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 ee Page 2 o f f o r ms p a c ke t ) . I f s u r n a me o f c on t r i b u t o r i s t h e s ame a s c a nd i d a t e , b u t t h e r e i s n o f a m i l i a lr e l a t i o n s h i p , e n t e r " n o t a pp l i c a bl 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 Sc h e d u l e A)

Da t e PAC I D n u mbe r Name a n d Ad d r e s s o f Co n t r i b u t o r Re l a t i o n sh i p Amount V i f f o r F u n d -Re c e i v e d( MM/ DD/ YR) i f a pp l i c a b l e )a n d PAC Ch e c k t o Ca n d i d a t e *( i f a pp l i c a bl e ) Re c e i v e d r a i s e rI n c o men u mbe rI D # Pau l R. Kn a p p4 / 1 7 / 0 1 3 2 1 9 NW1 4 2 n d $ 5 0 0 . 0 0CK # Ur b a n d al e , I A 5 0 3 2 2I D # P a t t y L i n k4 / 1 7 / 0 1 4 1 2 9 Fo r es t A v e n u e $ 1 0 0 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 11D# S u s a n F Pamp e r i n

5 / 2 3 / 0 1 2 7 1 8 Co l l e ge $ 3 5 . 0 0CK # Da v e n p or t , I A 5 2 8 0 3I D # J e r r y D. Kar b e l i n g5 / 3 0 / 0 1 3 3 5 J u l i a na Cou r t $ 3 5 . 0 0CK # Po l k C i t y , I A 5 0 2 2 6I D # Robe r tW. B a r r i e7 / 2 / 0 1 1 6 6 6 K S t r e e t NW, St e 5 0 0 $ 5 0 0 . 0 0CK # Wa s hi n g t o n , DC 2 0 0 0 6I D # J a n e Nagy7 / 2 / 0 1 1 0 4 Su n l a nd Co u r t $ 2 5 . 0 0CK # Fo r es t C i t y , I A 5 0 4 3 6I D # Br e n t Appe l7 / 1 1 / 0 1 1 0 8 7 - 1 80 t h S t r e e t $ 1, 0 0 0 . 0 0CK # Ac k wo r t h , I A 5 0 0 0 1I D # Ke n n e t h Br o o k s7 / 1 1 / 0 1 1 0 3 4 0 5 60 t h Ave . $ 6 0 . 0 0CK # S t o r y C i t y , I A 5 0 2 4 8I D # Da v i d M. Er i c k s on7 / 1 1 / 0 1 8 0 9 37 t h S t . $ 1, 0 0 0 . 0 0 t /CK # We s t De s Mo i n e s , I A 5 0 2 6 5I D # Roge r Ri e s7 / 1 1 / 0 1 4 0 8 - 1 8 t h S t r e e t $ 2 5 . 0 0 > . /CK # We s t Des Mo i n e s , I A 5 0 2 6 5

$ 3 , 1 ; ( 3 0 00$ ,

Page ~ o f


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CONTRI BUTI ONS - MONEY TAKEN I N( i n c l u d i n g c an di d at e ' s p e r s o n al f u n ds )

COMMI TTEENAME ( Mu s t b e same a s o n St a t e me nt o f O r g a n i z a t i o n )Che t Cu l v e r Commi t t e e

SCHEDULEA M o n e t a r y( R e v . 0 6 1 9 7 ) R e c e i p t s

UChec k t h i s b o x i fa me n d i n g f o r m

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I CA L ACTI ON COMMI TTEE) , L I S T THE PAC I DENTI FI CATI ON NUMBEAND THE PAC CHECK NUMBER I N THE DESI GNATEDCOLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GN DI SCLOSURBOARDCAUTI ON: S ec t i o n 68B . 3 2 A ( 6 ) , I o wa Cod e , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o pi e d f r o m r e p o r t s a n 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 ut i o ns f o r a n y c o mme r c i a l p u r p os e b yp 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 .

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t h i s s c h e du l e )* Di s c l o s ur e l a w r e q u i r e s c a n di d a t e c o mmi t t e e s t o d i s c l o se t he r e l a t i o ns 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 . Re l a t i o ns h i p s mus t b e s h own t o t h e t h i r d d e g r e e o f c o ns an g u i n i t y ( b l o od r e l a t i v e ) 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 ee Page 2 o f f o r ms p a c k et ) . I f s u r n a me o f c on t r i b u t o r i s t h e sa me a s c a n di d a t e , b u t t h er e i s n o f a m i l i a l Pager e l a t i o n s h i p , e n t e r " n o t a pp 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 .

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CK # St or y C i t y , I A 5 0 2 4 8I D # Pa u l e e L i p sma n7 / 1 2 / 0 1 28 8 0 Gr a n d AV # 1 0 6 $ 1 0 0 . 0 0 i /CK # Des Mo i n e s , I A 5 0 3 1 2I D # Ti mo t h y J . Wa l k e r

7 / 1 2 / 0 1 3 1 7 6 t h Ave . , Su i t e 1 2 0 0 $ 1 0 0 . 0 0CK # Des Mo i n e s , I A 5 0 3 0 9I D # J e f f r e y F a r r e l l7 / 1 3 / 0 1 6 2 1 5 Ro b i n Dr i v e $ 2 5 . 0 0CK # Des Mo i n e s , I A 5 0 3 2 2I D # H a r r y Ku n k l e

7 / 1 3 / 0 1 1 2 4 6 Be n t wo o d Co u r t $ 1 0 . 0 0CK # A l t o o n a , I A 5 0 0 0 9I D # S t e p he n R e n o7 / 1 3 / 0 1 1 6 1 5 NWNo r t h wo o d Dr i v e $2 5 . 0 0CK # A n k e n y , I A 5 0 0 2 1I D # Gl e n n Buh r

7 / 1 7 / 0 1 4 1 2 7 3 0t h S t $ 5 0 . 0 0CK # De s Mo i n e s , I A 5 0 3 1 0I D # Tho mas D. J o h n s o n7 / 2 4 / 0 1 5 4 0 4 Be ec h t r e e Dr i v e $ 1 2 5 . 0 0CK # We s t Des Mo i n e s , I A 5 0 2 6 6I D # Ge r a r d D. N e u g e n t7 / 2 4 / 0 1 5 0 0 0 Wes t own Pkwy , St e 1 0 0 $ 5 0 . 0 0CK # We s t Des Mo i n e s , I A 5 0 2 6 6I D # Do r i s J e a n Ne wl i n

7 / 2 4 / 0 1 3 3 1 5 4 8 t h Pl a c e $ 5 0 . 0 0CK # Des Mo i n e s , I A 5 0 3 1 0


29/110


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STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I CA L ACTI ON COMMI TTEE) , L I ST THE PAC I DENTI FI CATI ON NUMBAND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN. A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN DI SCLOSUBOARD .CAUTI ON : Se c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa C ode , 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 pi e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i on s f o r a n y c omme r c i a l p u r p o s e b yp 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 e s .

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* Di s c l o s ur e l aw r e q ui r e s c a nd i d at e c o mmi t t e e s t o d i s c l o se t he 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 . Re l a t i o ns h i p s mus t be s hown t o t he t h i r d d e g r e e o f c on s an g ui n i t y ( b l o od r e l a t i v e ) 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 ee Page 2 o f f o r ms p a c k et ) . 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 sa me a s c a nd i d at e , b u t t h e r e i s n o f a m i l i a lr e l a t i o n s h i p , e n t e r " n o t a pp l i c a bl 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 )3 o f $ a

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