gus. - webapp.iecdb.iowa.gov · ll-/5=c)(q datesigned local committees, enterdateofelection...

FORINSTRUCTIONS, SEEBACK OF FORM

DISCLOSURE SUMMARY PAGECOMMITTEE NAME (Must be same as on Statement of Organization)

AO, SJe.4`IMPORTANT: Indicate by # type of committee you are reporting for: I

I

I( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party( 4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board orOtherPolitical Subdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 10 )School Board or Other PoliticalSubdivision PAC ( 11 )Local Ballot Issue

GUS".-

SIGNATURE OF PERSON FILING REPORT

I AM FILING A

Cey:'

\'I(report date)

[CHECK IF AMENDMENT TO REPORT DATED

Political Party (if applicable)

District (if Senate or House)saln e - 37

515-cf(1-1_1)~TELEPHONE

C Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 .(You must continue to file reports until a DR-3 is filed .)

REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .Indicate by #

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period. (Total of all funds held by thecommittee . This amount MUST be the same as the cash on hand at the endof the last reporting period or must be zero if this is first report filed .) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADD TOTAL MONEY TAKEN IN THIS PERIODSchedule A: Cash Contributions total (Attach Schedule A) (*also see in-kind below) . . . . . . . . . .Schedule F :

Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Schedule H : Total Sales of Campaign Property (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(Schedule H applies to Candidates' Committees Only)SUB-TOTAL . .. . . $

SUBTRACT TOTAL MONEY SPENT THIS PERIODSchedule B : Expenditures total (Attach Schedule B) (**also see debts and loans below) . . . .

Schedule F : Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON HAND at the end of this reporting period (if final report balance mustbe zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. . $

**UNPAID BILLS (From Schedule D - Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . .. . . . .. . $

*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . . .. . . . .. . .. . . . .. . . . .. .. . .. .. . . . . . . .. . . . .. . $"'OUTSTANDING LOANS (From Schedule F -Attach Schedule F) . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$CONSULTANT BREAKDOWN (Schedule G Attached?)CANDIDATE COMMITTEES ONLY:VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)

FORMDR-2

I DISCLOSURE(Rev . 07/2004)

REPORT

Comm . #Logged

_

ScannedComputerAudited

Late reports are subject topossible civil and criminalpenalties .

LL-/5=c)(QDATE SIGNED

Local Committees, enter Date of Election

County & Local Committees, enter County inwhich Election is held

1, qa

~ ~ 44a

~.w

3 3 /o

YES V~NO

For im°tructions, SeeBack of Form

CONTRIBUTIONS -MONEY TAKEN IN(Including candidate's personal funds)

COMMITTEE NAIVE (Must be Same as on Statement ofOrganization)

STATE CANDIDATES NOTE: IFACONTRIBUTIONIS RECEIVED FROM ASTATE PAC (POLITICAL ACTION COMMrCfEE), LIST THE PAC IDENTIFICATION .NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LISTOF ID NUMBERS IS AVAILABLE FROM THE iowA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person otherthan statutory political committees.

' Disclosure law requires candidatecommittees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must beshown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . Ifsumame of .contributor is the same as candidate, but there is nofamilial relationship, enter'not applicable` in the relationship column .

SUB-TOTAL o0

TOTAL (iffastpage of Upis schedule)

Page / of(for Schedule A)

SCHEDULEA MONETARY

(Rev. 07/03) RECEIPTS

CHECK THIS BOX IFAMENDING FORM

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MNVDD(YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# ("-01777rn;~ay~ $clcID# R"C-ly all,f

-7 - IS-C6 CK# 1 too Nr h O 00 E:1ID# ~u~e p~cK~

TQ-C~ cK# 0° E].e

ID# ,r,;e r~r~X11CK# 3t31 -1ex .~ ~.k . . 70~..qp )Co. 66 EJ

aID# ~ect sZ ~~~~~oan

66 E]C,ID# 1e ~n. ti`'1 a E:1ID# QLN,iCy

"I -C(o CK# P.O. Qlr-Al M+-~ Lj

ID#~Iome' M~ks

-1 -r~Co-O(o CK# 1NOa ~11,e~r~e. t.SV/bc

no

-

ID#

CIC# P.O. \(DS0, E:1

ID# CC~~~ c~rv~ ~r~ ~ OO

CK# 13 ,1 ~esS`'lo ; r1pS ~fr 5031+`1 E:1

For !Instructions, See Back of Forth

CONTRIBUTIONS - MONEY TAKEN IN(Induding candidate's personal itrrds)

COMMITTEE NAME (Must be same as on Statement ofOrganization)

STATE CANDIDATES NOTE : IF A CONTRIBUTION1S RECEIVEDFROM A STATE PAC (POLITICAL ACTION COMMITTEE), USTTHE PAC IDENTIFICATION .NLJMBER ANDTHE PAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF IDNUMBERS ISAVAILABLE FROMTHE IOWA EtHCS AND CAMPAIGNDISCLOSURE BOARD.

CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees .

SUB-TOTAL

TOTAL (if last page of this schedule)

Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If surname ofcontributor is the same as candidate, but there is no

paw O~-offamilial relationship, enter'not applicable' in the relationship column .

(forSchedule A)

SCHEDULEA MONETARY



DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(11AM/DD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# damesCK# rRvn

ID# I M~CK# 3R 1a~a .

CQr~~'f .̀`gli~~crnL.Jf\r1ZMrZed-

ID#

CK#Calu(Y~ll`~ICtI

/GO, E:1Fjl ; zR s) s

ID# Cle&~~ ~~~%w, t_

.31-No

I

CK# P.o. ~,~ 1oN~ 7:Go

oo~I3 O~ S~'Ia,nPs~ ~~.

C ©Oa~~~~1J ~" .C. Kssr. ,

ID#y-a -~ CK# . > sk.

ID# ,~y g~hKq-a-O166 CK# E:1C

mc.f1e5,--~+1T S?~3i2.

-3-0~

lD#

CK# ~36~, rr 5 . E:1ID#

~- -Co C lsv3 N8'" . 00

For Instructions, See Back of Form

CONTRIBUTIONS -MONEYTAKEN IN(Including candidate's personal finds)


STATE CANDIDATES NOTE: IF ACONTRIBUTION IS RECEIVEDFROM A STATE PAC (POLITICAL ACTION COMMITTEE), USTTHE PAC IDENTIFICATIONNUMBER AND THE PAC CHECKNUMBER IN THEDESIGNATED COLUMN. A LIST OF ID NUMBERS ISAVAILABLE FROMTHE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

` Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) .

tfsumanleofcontributor is the some as candidate, butthere is nofamilial relationship, enter not applicable` in the relationship column .

Page

r

ofj(for Schedule A)

SCHEDULEA MONETARY

(Rev. 07103) RECEIPTS


DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (d applicable) RAISER

NUMBER INCOMEID# R~r: vk1~Q.

CK# oJ-S -OCo

ID# ~l h _n h ElCK#~ SO

ID# nrte. ~r

~-S-OCfl CK#

ID#

S-bCo CK# 31 3 3 ~. oz~

ID# cJh;~S- CK# 101 ~-e Rd.

~.cy-

ID#9mnm (CIO

S-O(o CK# 11CrkiI4 Lcxc2s 9adce

ID#'`~,R ac.R S

_,.-AID#

4> --~5-U C

ID#

CK#nco4\ IRX~ rrnsPo SZ

Od

I r,I-WWt,9K W-1I_ ~C,

For Instnrctions, See Back of Fonn

CONTRIBUTIONS - MONEY TAKEN IN(including candidae's personal Aeds)


r -~ .

STATECANDIDATES NOTE: IF ACONTRIBUTION IS RECEIVEDFROM ASTATE PAC (POLITICAL ACTION COMMITTED, LISTTHEPAC IDENTIFICATIONNUMBERANDTHEPACCHECKNUMBER IN THEDESIGNATED COLUMN. ALIST OF IDNUMBERS ISAVAILABLE FROMTHEIOWAETHICSANDCAMPAIGNDISCLOSURE BOARD.

CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees .

Disclosure law requires candidate committees to disclose the relationship ofany relative making a oontriburion to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . Ifsumame of contributor is the same as candidate, but there is no .

Page

-of5famifial relationship, enter `not applicable" in the relationship column . (for Schedule A)

SCHEDULEA MONETARY


0 CHECK THIS BOX IFAMENDING FORM

DATE PAC ID NUMBER 'NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-(MNIIDDIYR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# Q 777e7-~

1 6' 3 \ 5S'~. cx%sr,C~,ctr~\G~~ ~~

ID# U<,,A-em o'-wo 1 . -17 IZICK#

ID#

CK# ~~~ ~~ ~. 0110.00

ID# q (e-fo f~~1 ~rner.cc; PRC E:1ID#

CK# 4~, ~x I~i-f7 S . ElID# wce 1 `

60 E:1ID# Cece\

QK',r i:n

CK#

ID# (~ ?1 1 PRcCK#jgN9

,q Mo.n~s` - .:S=t

Sam.ID#

he/~ l ~~ Y>

CK# ~S S. o1.a ~F. ~~` ao~:n~~ ~O1~T3

ID# bran ~~ne.

CK# 3 15` -l-.~nc ln c~~s~nes r~- ~~

ForInstructions, See Back of Form

CONTRIBUTIONS -MONEYTAKEN IN(Including candidate's personal hinds)

COMMITTEE NAME (Must be same as on StatementofOrganization)

STATE CANDIDATES NOTE: IFA CONTRIBUTION IS RECEIVEDFROM A STATE PAC (POLIt1CAL ACTION COMMlT EE), UST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECKNUMBER IN THEDESIGNATED COLUMN . A LISTOF ID NUMBERS ISAVAILABLE FROMTHE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees . .

Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee . Relationship must be shown to the third degreedfconsanguinity (blood relatives) and affinity (relatives bymaniage) .

If sumame ofcontributor is the same as candidate, but there is no

.

Page

offamilial relationship, enter not applicable' in the relationship column .

(for Schedule A)

SCHEDULEA MONETARY


© CHECK THIS BOX IFAMENDING FORM

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# ~cxtlL~i~ne

owl O~-. $ 60CK#

ID# ~~ S',o .~a m v~S'~31awtt5'h`Ve. Re'~te, rs'sno 00 EJCK#

0)W3 S`i1~,~s,si4 S

ID# ~g99- We\\ Pcx. .CK ,SN,

.

ID# ~rra 1. '~ecan

a3-~ CK# 0~1~ r -c /~~ to.rves ~~r 503ia1

ID# M

~s Mo;nes~ X316ID# qj ~~,~ l ocal 3N7

a~-C(O CK#aq1ytr sue.

~'~)es vnes . R5031ID#

h9 Sin g(~-~ OCp CK# 5 r l C~r~l C~

'a-)MMt -S ,.yes S1~CoSr

ID# ~~ht^11

n

CK#_Zk~%cxr%AQ --v} ~1b1~

ID# 1:JI~z.ub ~n COf'tl--

9,0l'4 -CG CK# SAO C 00

ID#

q-o l -E CK# flscu~'4h .(

\.J.~ 1 1Gn~ -y. ~ '

ForInshuctions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN IN(Including candidaws personal funds)


J~~fKi~C.

STATE CANDIDATES NOTE: IF ACONTRIBUTION ISRECEIVEDFROM A STATE PAC (POLITICAL ACTION COMMITTEE), USTTHE PAC IDENnFICATION .NUMBERANDTHE PAC CHECKI.JMBER IN THE DESIGNATED COLUMN . A LIST OF IDNUMBERSISAVAILABLE FROMTHE IOWAETHICSAND CAMPAIGNDISCLOSURE BOARD.


' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to theCommittee. Relationship mustbe shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If surname ofcontributor is the same as candidate, but there is no

.

, .

Page(_ offamilial relationship, enter"not applicable` in the relationship column.

(for Schedule A)

SCHEDULEA MONETARY


CJ CHECK THIS BOX IFAMENDING FORM

DATE ' PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MHVDD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# }~~e~n 'teams

~J10 CK#

ID# rc~nCC)

-owl-C(o CK# 4.0 . ~ M-T /oaID#

CK# 00

iD#oe

1

Mr- An,r4C CK# Q,0. I'~~~

ID# CM' 7Z8AjN

CK# 4 a 3. -QaKs C~- .re.

ID# Cam,

CK# 00

rID#

e% el ,ZS' J'~o CK# t3 '- ~Q .

~s r'~,rlesID# ''% cUtUN~PACCIC# .~3 1~13s WE

AmenID# ~'ecL.SR rrtrl~.an

aa- .o CK# kxix IZIID#

C ~1(aI7 CQme Qc:/00- a5 Elo6 ~s .

For Instructions, SeeBack of Form

CONTRIBUTIONS - MONEY TAKEN IN(Including candidate's personal funds)


STATECANDIDATES NOTE : IF ACONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBERANDTHE PAC CHECKNUMBER IN THE DESIGNATED COLUMN . A LIST OF IDNUMBERS ISAVAILABLE FROM THE IQWA ETHICSAND CAMPAIGNDISCLOSURE BOARD.


Disclosure law requires candidate committees to disclose the relationship ofanyrelative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If sumame of contributor is the same as candidate, but there is no

Page~^offamilial relationship, enter' not applicable` in the relationship column.

(for Schedule A)

SCHEDULEA MONETARY



DATE PAC ID NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (Ifapplicable) TO CANDIDATE" RECEIVED FUND-(MM/DDYR) ANDPACCHECK (if applicable) RAISER

NUMBER INCOMEID# ~~n No~.lecK

-SSO6 CK# rr-fl-5

ID# 1~e. arts'

ID#

CK# / 0Manes~- ~ID#

CK#sa c;a t,~~K El

ID#

LUCKA-ee,ID#

CK# 16A 1 PAC flve .

ID# ~.;n~ ~en~crn-,j-~ CK# ~i~o Slk> ~ P14~y . CIO El

~fwes~ ~ID#

S`'l~o;rles ~f~ID#

(Q CK#

ID# (Q,KV ---!'r1 f\ tom,-hS~sl.~cal

tJ~ ~.oi(Ies ~A- Sa3~3

ForInstructions, See Back of Form

CONTRIBUTIONS -MONEYTAKEN INpndudimg candidate's personalfunds)

COMMI7TEE NAME (Mustbe same as on Statement ofOrganization)

STATE CANDIDATES NOTE: IF A CONTRIBUTION ISRECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBERAND THEPAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF IDNUMBERS ISAVAILABLE FROMTHE IOWAETHICSANDCAMPAIGNDISCLOSURE BOARD.


* Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must beshown to the third degreeof consanguinity (blood relatives) and affinity (relatives by

15-familialmarriage) . Ifsumame of contributor is the same as candidate, but there is no

Page~-ofrelationship, enter'not applicable' in the relationship column . (for Schedule A)

SCHEDULEA MONETARY


O CHECK THIS BOX IFAMENDING FORM

DATE PAC ID NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (ifapplicable) TO CANDIDATE* RECEIVED FUND-(NtNVDD1YR) ANDPAC CHECK (if applicable) RAISER

NUMBER INCOMEID# ~t~c-~-~ ~nc~evv~ctn

S CK# Cdr U . Ono

Q-S--C)(Q 'ID#

CK# Glo ' . loo `0 Q-\,ID# Q

_j6,, 5 ~S -1uF \"vm~

c llao,rc ~ve .,

tol3ID# e-

119`-S o CK# 3L31 F1~^,

,ob

,

ID# C -by~,-5- cK# ,~~3,

CK#

ID#\ ~ICA

~m iII J iID#

-'r oo

ID#

21_~

ID#

_

FE-~OCo CK#,Qr~~ -

ForInshuctions, See Back of Form

CONTRIBUTIONS -MONEYTAKEN IN(Ir>dudngcane's personal funds)

COMMITTEE NAME (Must be same as on StatementofOrganization) .

~e

STATECANDIDATES NOTE: IFACONTRIBUTION IS RECEIVED FROM ASTATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER ANDTHEPAC CHECKNUMBER IN THEDESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THEIOWA ETHICS ANDCAMPAIGNDISCLOSURE BOARD.

CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orforany commercial purpose by any person other than statutory political committees.

* Disclosure law requires candidate committees to disclose the relationship orany relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . Hsurnameof.contributor is the same as candidate, but there is no

.

Page

of

~~familial relationship, enter'not applicable' in the relationship column .

(for Schedule A)

SCHEDULEA MONETARY


FEW CHECKTHIS BOXIFAMENDING FORM

DATE PACID NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-(MlWDDIYR) AND PACCHECK (if applicable) RAISER

NUMBER INCOMEID#

CK#

~

`&x 7 $ cc

lD#

q- CK# 1ao1,~,c~''

lD# Suit pi n

CK n uo

ID#

sID#

~ h~~ct1 00CK#

G s~ID# I~av,~ SG,

C aCK#~.s ~in sfl~3

ID# Pln-)M-1- Mc.,,e14q~- CK# ~QJ W, cans C a°

... \`ID# l.ltJi_.y Qprntxsa~s

-1y El

q4-c(Q CK# IZIID#

CK# ` ~~a- t~lJiwmS~.

ForIastructions, See Back of Form

CONTRIBUTIONS -MONEYTAKEN IN(Indudmg candidate's personal funds)

COMMITTEENAME (Must be same as on Statement ofOrganization)

STATE CANDIDATES NOTE: IFA CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMrfTEE~, LISTTHE PAC IDENTIFICATIONNUMBERAND THE PAC CHECK NUMBER INTHE DESIGNATED COLUMN . ALISTOF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person otherthan statutory political committees.

SUB-TOTAL

Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must beshown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) .

Ifsumome ofcontributor is the same as candidate, but there is no

Page

offamilial relationship, enter"not applicable' in the relationship column .

(for ScheduleA)

SCHEDULEA MONETARY

(Rev . 07/03) RECEIPTS


DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (f applicable) TO CANDIDATE' RECEIVED FUND-(MhAIDDIYR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# ' 7;77-777 Cam,

CK# b-0ID#

CK# 1 4.. "" ' l tics

ID# ilv:11Q,M e,n

t-Ct -C6p CK# loci Mec C~:_

~ ,ID#

CK# ~d0 ~,~11e,,n Ave.,

ID# ~,Ct3rlcc ~'`er1~

9-1M-CJC~ CK# /

ID# \aM ~M ~\'6Y1

CK# M1o C- er, a q~.

~

ID#

CK#

,-d~ 21~A- 0

ID# Pa`~t~c~a 1~.cKS9'-IS-C CK# 9c~ . C ZI~pc-

ID#

~r1~yvCerto~'r ~- ~1olS

For Instructions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN IN(In

g

date's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATEPAC (POLITICAL ACTION COMMITTEE), LISTTHEPAC IDENTIFICATIONNUMBERANDTHE PAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICSAND CAMPAIGNDISCLOSURE BOARD.

CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statementsfor soliciting contributions orfor any commercial purpose by any person other than statutory political committipes .

Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If sumarne of contributor is the same as candidate, but there is no

Page~_offamilial relationship, enter not applicable' in the relationship column .

(for Schedule A)

SCHEDULEA MONETARY

(Rev . 07103) RECEIPTS

CHECKTHIS BOX IFAMENDING FORM

DATE PAC ID NUMBER NAME ANDADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MMIDDIYR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# an Kos`a.~s

ll~~es ~n S~' :~ID# xllne ~Se~n.~rc.~

G-15'-- CK# i 4 l~ a,, Vi

lD#vo

CK#

lD#

q- 1160-0 CK# Zed %CK\ H640

lD#

CK#Wc_..A ~W 3

lD#

CK# ~ ~ G0I&n \-w OD alD#

CK#JAAem%2e k C-CnA'VN\Z16~CAs ~S El

lD# CJ $.nCK#

_ v .;sci4p

cva-1rar,

~11~ 'KA40RA.

'D") ElC'34 .16* ,

ID# "Zconne ~~

9-1j=0(o CK# lOol"I R 1a~i~~s.»asO: EJID# Nks . x`1 .1. . rvKlrlC, 00

~ Marle's~F~ ssa3 )O ,

For I-wtructions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN INoncftumn9 candid~s personal funds)


STATE CANDIDATES NOTE : IF ACONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICALACTIONCOMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBERANDTHE PAC CHECKNUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS ANDCAMPAIGNDISCLOSURE BOARD .

CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statementsfor soliciting contributions orfor any commercial purpose by any person other than statutory political committees .

Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship mustbe shown to the third degree of consanguinity (blood relativeS) and affinity (relatives bymarriage) . If sumarne ofcontributor is the same as candidate, but there is no

Page~a

of_ Is-familial relationship, enter"'not applicable' in the relationship column.

(for Schedule A)

SCHEDULEA MONETARY



DATE PAC ID NUMBER NAME ANDADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (If applicable) TO CANDIDATE' RECEIVED FUND-(MIINDD(YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOME

O, CK# $~~~~2yw~~~t

sula e-+W/r

ID# C,\\ert t-.L7p

-@O-O& CK# q /per, 0ID#

-~-CL CK# El4 -~

ID#

CK#

-Ito

~1-1_--i M~:-,.~\a-C'm.1 ED10~

ID# ,C . Cler'h~c-~~pCt~`n_"~ CK#

~ r6) WE 00

ID# nes 'VIJC~\ec',00 E]

ID# ~~s n ~ J\ginCK# 331s ~'- Pi . °° ElC~M; z~ So3i~DID# ~CZ1e SchJCK# ~~..~C, ~ID# Cdvm;rle_CK P~1 8\ .

oo

3

'o QID#

CK#

"n t.ca eDCrn%e\1e C~.

lot

ED

ForInsdmctions, See Back of Form

CONTRIBUTIONS -MONEYTAKEN IN(Indudmg candidate's personal funds)


STATECANDIDATES NOTE: IFACONTRIBUTION IS RECEIVED FROM ASTATE PAC (POLITICAL ACTION COMMITTEE), USTTHEPAC IDENnFICATIONNUMBER ANDTHEPAC CHECKNUMBER IN THEDESIGNATED COLUMN . AUSTOF IDNUMBERS ISAVAILABLE FROMTHEIOWAETHICSANDCAMPAIGNDISCLOSURE BOARD.

CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports andstatements forsoliciting contributions orfor any commercial purpose by any person other than statutory political committees .

Disclosure lawrequires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage).Ifsumarne ofcontributor is the same as candidate, but there is no

Page 8 offamilial relationship, enter not applicable` in the relationship column .

(for ScheduleA)

SCHEDULEA MONETARY


CHECKTHIS BOX IFAMENDING FORM

DATE PACID NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (f applicable) TO CANDIDATE' RECEIVED FUND-(MMDD(YR) AND PACCHECK (fapplicable) RAISER

NUMBER INCOMEID# tn Mcz wCK# an

mID#

I CK#I

,n; vnzr~ Ccsn

-`c~ s

~,ao

ID# cam0C)

CK#0~9 i UZ

~ ~ VA~31+~1 Sam .

ElID#

00Boy- (Gel a

ID#

-aa-Co CK# VMhM~zed C a,-, 013p

kD-3-C(oID#

v ElCK#

~0-3--~ CK#@~( /s U, P41 y s\a.,sL;:a'eJ loo 020«~

. ElPMY,er, Sf~ ".: ,

CK# E:1/o-H -OHO

V

CK# +~3 !U .U~. flue-.00

Co3i15 fles ~'1o,nes~

ForInstuct3ons, See Back of Form

CONTRIBUTIONS -MONEYTAKEN IN(Including canddate's personal hinds)


Sena

STATE CANDIDATES NOTE : IF ACONTRIBUTION ISRECEIVEDFROM A STATE PAC (POLrnCALACTIONCOMMITTEE), LIST THE PAC IDENTIFICATIONNUMBERAND THEPAC CHECKNUMBERIN THE DESIGNATED COLUMN. A UST OF ID NUMBERS IS AVAILABLE FROM THE IQWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political commItWes.

Disclosure lawrequires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If surname of contributor is the same as candidate, but there is no

Page

Nof

15familial relationship, enter not applicable' in the relationship column .

(for Schedule A)

SCHEDULEA MONETARY

(Rev . 07/03) RECEIPTS


DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MMIDDfYR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# ( ~ ucc Ccsvwr . Cn -bt~-,CGi JCsrTwn E~F1-.-C~~

~.s Mo,nc~,SR 5J~~1 K

ID# a - P c)o-l4-po CK#

.

S~o1C~ UJes c~Kuza °°o ~, aID# (0a V,0 :MELL) 1 a3 .

IO -~-b(o CK# 1a,57 3-70 Ska"rs " Pra., N.t . /00.~ Ljec'A AS

ID# ('oolq C.LuA ~-~1 -I IICA~0-~4-c7Co CK# 3(o1a w sue, ~OQ. orr~~

Oes~.nes~1~ 5~3~5

r~K~- °aX09

10# &0-1 -7/b -CXo CK# V~H 9151S 5~;, l(c Ejo,r .~R/O-(o -O4o C

°Y`rl1-1 -ZS K Un,~~ cx~ Sw

/O-(D-C(oID# Qa-~ "~

,3~ef0 CoyJlv9ElCK#

ID#

CK# , . a

ID#

CK#900 s,~Aksee \NW

00

For lnstnrctions, See Back of Form

CONTRIBUMNS -MONEYTAKEN IN(Including candidal e's personal funds)


oe1 -,;r Se",~~~

STATE CANDIDATES NOTE: IF ACONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDEN11FICATIONNUMBERANDTHE PAC CHECKNUMBER IN THEDESIGNATEDCOLUMN . A LIST OF IDNUMBERS ISAVAILABLE FROMTHE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.


Disclosure law requires candidate committees to disclose the relationship ofany relativemaking a contribution to thecommittee. Relattonship must be shown to the third degree of consanguinity (bwod relatives) and affinity (relatives bymarriage) . If sumame of contributor is the same as candidate, but there is no

Page

/1-5-

of-15-familial relationship, enter"not applicable` in the relationship column.

(for Schedule A)

SCHEDULE

A MONETARY(Rev. 07103) RECEIPTS


DATE PAC ID NUMBER NAME ANDADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED(MMIDDIYR)

(if applicable)AND PAC CHECK

TO CANDIDATE"(if applicable)

RECEIVED FUND-RAISER

NUMBER INCOMEID# 7e.7C, ~ Q;4- ;,, ( ?,A . 0, 0ID# (DI`7Q(D rL)F FJ14

~o -ion CK# i 1 ao cellr1ec,~C1`\ Rue .,kw 5*.11co °° E:11041 ,O:C .GID# (DISC Urn; vGAe s - v~C.v I-c ~3

k~- I 1-O(o CK#x"17 ia5 SU~.3 ~Qess'1c~r~s~~

y

~3r3

00

ID# <q:5C~q : C~v ~~IC>-11 -C(o CK#

01Ig311 V+~~'v ,

S`'l,n 1~S ~sv

CK# DSC5~ 1- nmAkon Ve zs~. ElRrr ".E,~ 9comID# Rn n &~e'Mne

10-11 -(Yc CK# 90-A R-4f\'~" Os'. oCE]

ID# p~ --~ N1Q~~-

10- 11 -0(0 CK# 1931 Su~ , ~1 CJ~- . oc

c.U n~-~~~ ~aT3

,

ID# ~ey

IC)--Q-0(o CK# loo.

lD#

Cic#00

~s Ma~nessi~ID#

CE:1

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Purchases of certaincampaign property costing 5500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions) .

Expenditures to Personstentities Providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, Purpose, and date of each type ofexpenditure made by the PersWentity on behalf of the candidates committee. (Refer toSchedule G instructions and Iowa Code 68A.402(3)() .)

(for Schedule B)

FOR INSTRUCTIONS, SEEBACK OF FORM SCHEDULE

EXPENDITURES B-MONEY SPENT FROM COMMITTEE ACCOUNT MONETARY(Rev. 07/03) EXPENDITURES

STATE PAC COMMITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS ISAVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD.


1 .-~- Ae,CANDIDATE NAME ANDADDRESS TO V1MOM PURPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDEDEXPENDED (d applicable) (Disbursement) WAS MADE(MM/DD/YR) AND PAC

CHECKNUMBER

ID# %ce, cMarn "Mew -%e

~'ot -1'ao CK#$

o

cK#~,o~nes~,~' sa3~1

ID#

CK#~9~p'"~

ID# m~x'r°.etre~~' r ~~X.i-

00CK# cxxns,~ . . w-c1, ~.s Ot~(p .~C q wcr `, ,rU`

SUB-TOTAL $ OCo

TOTAL (if lastpage ofthis schedule) $

THIS BOXAPPLIES TO CANDIDATES' COMMITTEES ONLY:

Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)

Expenditures to personsfentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule Gby the amount, purpose, and date of each type of expenditure made by the persorderdity on behalf of the candidate's committee . (Refer toSchedule Ginstructions and Iowa Code 66A.402(3)().)

(for Schedule 8)

FORINSTRUCTIONS, SEEBACK OF FORM ` SCHEDULE

EXPENDITURES B- MONEY SPENT FROM COMMITTEE ACCOUNT MONETARY(Rev. 07/03) EXPENDITURES

STATE PAC COWITTEES: NOTE: FOR CONTRIBUTIONS MADE TOSTATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN ANDTHE CHECKTHIS BOX IFPAC CHECK NUMBER FOREACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS 8 CAMPAIGN DISCLOSURE BOARD.

COMMRTEE NAME (Must be same as on Statement of Organization)

CANDIDATE NAME ANDADDRESSTO WHOM PURPOSE AMOUNTDATE9 ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED

EXPENDED (if applicable) (Disbursement) WAS MADE(MMIDDYR) AND PAC

CHECKNUMBER

I 1 -" ~t'"ldUa

I-0(o`~

CK#

ID#~S'75~

~ces ltwvri r~no,r.~~ cx~4,-,-(~(o ~q1~^S~.

CK#~C~Co 3cx~~uno~7~~ SD\~

I-o(p CK# X31 .IcS3`1 ~~~ti~ID# ~S~e. C .zr'n Qav ~s.~

5,

CK#

ID# CJ- °1 ;'evw~a men r Ce.

~-

ID# nrlNvs7~.) 4 S

4s~- ?-co >GS3

CK#

ID# DA55Sis S~-oCo 60

CK#laqSUB-TOTAL $ ~la

TOTAL (fflast page ofthis schedule) $

THIS BOX APPLIES TO CANDIDATES'COMMITTEES ONLY :

Purchases of certain campaign property costing 5500 or more must also be inventoried on Schedule H. (Refer to Schedule H Instructions.)

Expenditures to personslentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule Gby the amount, purpose, and date ofeach type of expenditure made by the persoNentity on behal ofthe candidate's committee. (Refer toSchedule Ginstructions and Iowa Code 68A.402(3)(i).)

(for Schedule B)

FOR INSTRUCTIONS, SEEBACK OF FORM I Fg ~ l~ ! SCHEDULE


STATEPACCOMMITTEES: NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMNANDTHE D CHECKTHIS BOXIFPAC CHECK NUMBER FOR EACH EXPENDITURE. ALISTOF ID NUMBERS ISAVAILABLE FROM THEIOWA AMENDING FORMETHICS &CAMPAIGN DISCLOSURE BOARD.


CANDIDATE NAME ANDADDRESSTO WHOM PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDEDEXPENDED (if applicable) (Disbursement) WASMADE(MWDD/YR) ANDPAC

CHECKNUMBER

IM

Kctirw,e~. : -.1C'A3 dKLrlo~G ~ ~ $$

-i I-OCp cK# w911o'Ilogy s ,U-)'P - Ica

1D#lpcl~

~o 011 W , 1st' flue.CK#5z> I&S-

.

ID# wskC- S- f'~S -LJtO

SC~1 F Q~ ;~.O o CK#

1Cqq grrr,,ol~ h~A ~r

~Itltot,CK# :57.1D# Pv6''h ce "~~ . S rn~t d-f7!o fCK# I~ c2rtOq -tirZ- ~Ia~

SUB-TOTAL

TOTAL (fflast page ofthis schedule) $

THIS BOXAPPLIES TO CANDIDATES'COMMITTEES ONLY:

Purchases of certain campaign property costing $600 or more mustalso be inventoried on Schedule H. (Refer to Schedule H instructions .)

Expenditures to personslentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, arid date ofeach type of expenditure made by the persoNentity on behalf of the candidate's committee. (Refer toSchedule G instructions and Iowa Code 68A.402(3)(i).)

(for Schedule B)

FORINSTRUCTIONS, SEEBACK OF FORM SCHEDULE

EXPENDITURES B-MONEY SPENT FROM COMMITTEEACCOUNT MONETARY(Rev. 07/03) EXPENDITURES

STATEPACCOMIIIITFEES : NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMNANDTHE CHECKTHIS BOX IFPACCHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS &CAMPAIGN DISCLOSURE BOARD.


CANDIDATE NAME ANDADDRESSTOWHOM PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED

EXPENDED (if applicable) (Disbursement) WASMADE(MM/DD/YR) ANDPAC

CHECKNUMBER

ID# Ukt1 V)urvq-N-0(o clc# j5bc ~U ,'fi n 19

1 ~ 1 ~~no~,~ ~~as 13 ,ID#

CK# Q~l0ai yesNb nrs S~ ~_.

ID# ~nc~cenb\a a\ ~ 00Q--W'0( lo1WIIa SW. ae CK# 1103 ;or,c -ZPr 5a~4S .

ID# Oft-CknMjC:~~~ OU

11o~iID#

-uld~C AM, m\oyk" b,3Q <<

q-~-c( CK#zleu-geo -V S

ID# CJ rc.~ aINC1 itcP"W- '

-~-G~ CK#

ID# a vn CIOCK# tsm ~.- - X61-Q"~'' 391\v1 .->. ,zAs~~~ .1D#

190k W."CK# 1 : 1K 1a ; ~~as

SUB-TOTAL $a O~?TOTAL (if last page of this schedule) $


Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions.)

Expenditures to personVentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each type of expenditure made by it* persoNentity on behalf ofthe candidate's committee . (Refer toSchedule G Instructions and Iowa Code 68A.402(3)().)

(for Schedule B)

FORINSTRUCTIONS, SEEBACK OF FORM t SCHEDULE


STATE PAC COMMITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWAETHICS & CAMPAIGN DISCLOSURE

AMENDING FORMBOARD.


DATEEXPENDED

CANDIDATEID NUMBER(d applicable)

NAME ANDADDRESS TO WHOMEXPENDITURE

(Disbursement) WAS MADE

PURPOSE(DESCRIBE TRANSACTION)

AMOUNTEXPENDED

(MMIDDIYR) AND PACCHECKNUMBER

ID#

q-~-o(O CK#11 9

-7u~,;, ,~Rsba~3

ID# c ,«

110 ~~~~A sa1~

q~~- CK# WOOQ1x1 N R 440(oo 9r 0-7

ID#

CK#

C~L° ' I~I ' ~~"_~ Ftx,

re~~ men\ - ,-c ce s,7 hes

ID#~, rY1G~rIG- rye - moCO(I1y oen''T r'

dD

r l 2 XeM6)~says

ID# ,'A,

CK#1~t39 aa-~ta Ave . "'

CDIAJ.

4q CK# Po ecw~(

1D#

SUB-TOTAL $ eTOTAL (iflast page ofthis schedule) $

THIS BOXAPPLIES TO CANDIDATES'COMMITTEES ONLY :

Purchases of certain campaign property costing X500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions.)

Expenditures to personsfentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule Gby the amount, purpose, and date ofeach type of expenditure made bythe peMonlentity on behalf of the candidate's committee. (Refer toSchedule Ginstnxtions and Iowa Code 68A.402(3)()-)

(for Schedule B)

FOR INSTRUCTIONS, SEEBACK OF FORM SCHEDULE

EXPENDITURES B-MONEY SPENT FROM COMMITTEE ACCOUNT MONETARY(Rev . 07/03) EXPENDITURES

STATE PAC CORIIrrTEES: NOSE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMNANDTHE CHECKTHIS BOX IFPACCHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE KNNA AMENDING FORMETHICS &CAMPAIGN DISCLOSURE BOARD.

COMMITTEE NAME (Mustbe same as on Statement of Organization)

1`e

CANDIDATE NAME ANDADDRESSTO 440M PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED

EXPENDED rrf applicable) (Disbursement) WASMADE(MM/DDIYR) ANDPAC

CHECKNUMBER

iD#~~-~IIc,

-.A ~~~ t~~m~osemers;-~ac- a

c(-1o1-fY-fYo C"IC~iol~a

ID# ~crannc. ~.~z ce�,r ,~rh "_i3-CXp CK#

Kax~B'S~~~~~ID# LUC ,~ ~cu~~o ac~S o0

ID# r . ~c :+L~,n CIIc 1t Ca~s,n

C~ '. ~sa3{(oID# ~r~r,rle r,?--u-A1o~ A . se-<- lt-"%n

~f-I~,UCowrelTa~

~" eSt t

CK#a

ID#H3Ica~t

CK#~ ~aa

ID# one. ( ~~°^ ? z2a~Ool-l ~a - r s n vo ~'CK#

ID# -c c~t compn , CA

oaCK#

Z)

' SUB-TOTAL $~ QO

TOTAL (fflast page ofthis schedule) $ '

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY:

Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions.)

Eghenditures to pemonslentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each type ofexpenditure made by the personlentity on behalf of the candidate's committee. (Refer toSchedule G instructions and Iowa Code BaA.402(3)() .)

Page--of-10

(for Schedule B)



STATE PAC CONMETTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATEDCOLUMN AND THE CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWAETHICS

AMENDING FORM& CAMPAIGN DISCLOSURE BOARD.

COMMITTEE NAME (Mustbe same as on Statement of Organization)

DATEEXPENDED(MMIDDIYR)

CANDIDATEID NUMBER(d applicable)AND PAC

NAME ANDADDRESSTO WHOMEXPENDITURE

(Disbursement) WAS MADE

PURPOSE(DESCRIBE TRANSACTION)

AMOUNTEXPENDED

CHECKNUMBER

ID# =o+.~q GJec\Cr~e ~a-. t'. C.an' ~4'~~n -~ one

° CK# l I&SSZoCo~ F ~Lk!

pes S1o 1e5, l

1GC~ c.$30CO,~CYJ

~3-EXp cK#S\C Wcx-K

90"~ID#

CK# 11a_7 ncwano\a 3~ SD1aS

_-

,;,-~tar-

9x6-06ID#

CK#Ila~

Cpr~\S1r'- C\~ly2~erlc~,s~,~~ ~a~1

~~ ..,,~Jog .

O

1D#

CK# tiaqT,~~\onAcl Pie-" -ala.iq° t w. 4"& 1 'E~w.a , ~~~ ads

IS67,

-~--~

ID#

CK# iQ~iWCOAA.t V ~s

o0

l

1D#

-6?-C(P CK#113~

X10 S. ls~ S`~ .C~-\.s~,~~n

C\ I T QAs ~

°o,

ID#

CK#flue.

SUB-TOTAL

TOTAL (iflastpage ofthis schedule) $


Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions_)

Expenditures to personslerffities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each type of expenditure made by the pen oNentity on behaff ofthe candidate's committee. (Refer toSchedule G instnictions and Iowa Code 68A.402(3)(i).)

Page

(for Schedule B)

FORINSTRUCTIONS, SEEBACK OF FORM AS-' SCHEDULE

EXPENDITURES B- MONEY SPENT FROM COMMITTEE ACCOUNT N(Rev. 07/03)

EXPENDITUDfTURES

STATE PAC COMMITTEES: NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LISTTHE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMNANDTHE CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS ISAVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD .


CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED

EXPENDED (if applicable) (Disbursement) WAS MADE(MM/DD/YR) AND PAC

CHECKNUMBER

ID#

10- 1 39 e.as-\ -C eve.CK#

ID# c, ac,ao,bla : ~h ~ae k,~. y, ;/o-o1-Q(o CK# P. C- x 9 r

ID# Lkl~~ Matio-3-o(o CK# C*

3. 90

113(0 ~N1o,~aes~ gJ~ID# ru+iok+ New 1~.

igot <N.~,a aCK#13Y1 S11c~.~'rrb~RhS ' was

ID# Mot %'S"01crr1 f`vu. CIio-J'-(2( CK# 4a cu: C~:1-~-fl~. \ 00

113 ~'rf~~e~,~ X13ID# ~o

104~CK#

1D# CaAsNe C.Vze. OAio-5-off CK#

lab s. wt s`t.neu,--1 s-

1!off,1Mo cQ-a~s~,~A a-7

SUB-TOTAL $ IC)c'1,,~ Ciol..TOTAL (Iflast page ofthis schedule) $


Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)

Expenditures to persons/entities providing consulting, advertising, fund-raising, poling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each tSchedule G instructions and Iowa Code

ype of expenditure made by the persoNentity on behalf of the candidate's committee . (Refer to68A.402(3)f) .)

(for Schedule B)



STATE PAC COMMITTEES: NOTE : FOR CONTRIBUTIONS MADE TOSTATEWIDE OR LEGISLATIVECANDIDATES, LISTTHE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMNANDTHE CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD .


CANDIDATE NAME AND ADDRESSTO WHOM PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED

EXPENDED (if applicable) (Disbursement) WAS MADE(MMIDD/YR) AND PAC

CHECKNUMBER

ID#

CK#Roe . ~ rt~s S

~ 1H 1 ~,~,ob,~~ somasID#

lo-~-C P ©. 8~ NcK#

K5-1-C cK# P.o . ~x Ink, 91

ID#(00

CK#

ID# ' i,tcnrr,Al bless - ;Y,~,Jn1~ s~S* -i-J0°-9'-CXt, CK# ULtARM

ID# e Rea1 3 ~ANY. (VKlt-f(-1-0(o CK# at't~ !1~u3 '' .rasae 1 c~unea' - - , ~°

11 146ID#

mc3rtla ~var~ C'2~rn cam,JO-R-()Co 0`10 { E .Sam' _ ~~ e ~

CK# f'~ .~ ; '"'r~ilol5~ID#

PO. -~gt~( 39cK# u. ~a1

SUB-TOTAL $ 130

TOTAL (fffastpage of this schedule) $

THIS 13OX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Purchases ofcertain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions.)

Expenditures to personslenfties providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each type of expenditure made bythe personlentity on behalf ofthe candidate's committee. (Refer toSchedule G instructions and Iowa Code 68A.402(3)(Q.)

(for Schedule B)


EXPENDITURES B- MONEY SPENT FROM COMMITTEEACCOUNT MONETARY(Rev. 07/03) EXPENDITURES

STATE PAC COIIMIIITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE D CHECKTHIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD.


CANDIDATE NAME ANDADDRESS TO WHOM PURPOSE AMOUNTDATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED

EXPENDED (if applicable) (Disbursement) WAS MADE(MM/DD/YR) AND PAC

CHECKNUMBER

ID# 4cgnne LUtAit'n ~.hMnX men~ f. ! s~.r_

10-13 joa~R'4~-4 C~--11#1)H9$

ID#o

CK#

ID#8 S i.~;.~ S~v;ces lckk^ maa;;ncL Ccl

CK# is7s~ Kim . ~o

1 IS I ~ S,Pr 9~1a.SID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL$v

~ C~OCr"~

TOTAL (iflast page ofthis schedule) $

FOR INSTRUCTIONS, SEE BACK OF FORM

COMMITTEE NAME(Must be same as on Statement of Organization)

fl~i -~Zx- s -- -NOTE : This schedule reports money loaned to the committee which is deposited in the committee account.

cfiTOTAL UNPAID LOANS FROM LAST REPORTING PERIOD $

ADCC),

PART I - MONETARY LOANS RECEIVED THIS REPORTING PERIOD(Original source of loan, such as a bank, must be shown if a third party isinvolved. Include loans from candidate's personal funds.)

TOTAL (PART I)

$

"Disclosure law requires candidate committees to disclose the relationship of any relativemaking a contribution to the committee . Relationship must be shown to the third degree ofconsanguinity (blood relatives) and affinity (relatives by marriage) . If surname of contributor isthe same as candidate, but there Is no familial relationship, enter "not applicable" In therelationship column when it applies .

PART 11- MONETARY LOAN REPAYMENTS MADE THIS REPORTING PERIOD(Loans forgiven must be reported on Schedule E -- In-kind Contributions.)

TOTAL CASH REPAYMENTS (PART ll)

$

l

From Schedule E - TOTAL LOANS FORGIVEN

$

TOTAL OUTSTANDING LOANS END OF REPORT PERIOD

$

Page of(for Schedule F)

SCHEDULE

F LOANS(Rev . 07/03) RECEIVED

REPAID


DATERECEIVEDMM/DD/YR

NAME AND ADDRESS OF LENDER(Include Endorser's Name, If Applicable)

RELATIONSHIPTO CANDIDATE

If Applicable*)

AMOUNTOF LOAN

$

DATE PAID(MM/DD/YR)

NAME AND ADDRESS OF LENDER(Include Endorser's Name, If Applicable)

RELATIONSHIPTO CANDIDATE`

If Applicable)

AMOUNTREPAID

J~G1f:~ ~~ s,*. 1l I~Ve,

$

oC

FOR INSTRUCTIONS. SEEBACK OF FORM

COMRiTTEE NAME (Must besame as on Statement ofOnjanimdon)

SCHEDULE

_ Rev.E IN-KIND.0619 CONTRIBUTIONS

[] CHECK THIS BOX IFAMENDING FORM

-Disclmaue law tequkw cam6daies two

ite relationship ofany refa6ve moMgan in idnd

nto"committee. Rolafmmsldp must beshown totothird degmee of

guidy(blood naistives) and

y (relatives

(forSdmdule E)bY marriag4 (See Page 2 offorms padcel.) Usumeme of car*&ulor isthe somascandidate, butthereis nofamiral relafionsNP, enter "not appWable' in the relationship cok>rnn .

DATERECEIVEDMMDDIYR)

NAME AND ADDRESSOFCONTRIBUTOR

RELATIONSHIPTO CANDIDATE` (if l'!-3"e)

DESCRIPTIONOF IN KIND

CONTRIBUTION

ESTIMATEDFAIR MARKET

VALUE

d IF FORFUND-RAISERCONTRIBUTION

o

v

C-".6,tJt fKe. mw-Slit-6k

~1 ctEVs i~9 aM F-1Cs~n+rac v-1v RIC . ,n5l:RNlce. C~s 00

coFk7l

9D,C~

.p~,~,~Tp\-lf%Z0QK 40-

,nSucu~ee, joy;. C]O~~;r e'ss

P~ ~~~ 0s

oesM~,ns,~R~3a~ c)c F-1

O~ �

FOR INSTRUCTIONS. SEE BACK OFFORM

COYYITTEE NAYS (AAfust be same as on Statement ofOrgarfmOion)

SUB-TOTAL / $

.TOTAL (if last Ipage ofthis Is ue)

SCHEDULEE IN-KIND

(Rev. 06/97M CONTRIBUTIONS

~ CHECKTHIS BOX IFAMENDING FORM

'OW=" la- requkes wrdidales to d

the re4abonship ofany relatNe magng an m Idnd oontrlrdion to the

page Q _of_a_conxniltae. Relationship must be shown to the third degas of oorssanguinily (blood relatives) and atfmity (relatives

(for schedule E)by mairiage~ (See Page 2of farms packet.) Ifswname of oontribubor is the same ascandidaft, butthane is nofamilial relationship, enter "not applicable" in the relationship column.

DATERECEIVEDMM/DDnR)

NAME-- ANDADDRESSOF CONTRIBUTOR

RELATIONSHIPTO CANDIDATE* K f-±able)

DESCRIPTIONOF IN KIND

CONTRIBUTION

ESTIMATEDFAIR MARKET

VALUE

d IF FORFUND-RAISERCONTRIBUTION

$

.`~" a

_ ,_)~9 . 0

F-1

aF-IF-1F]

FOR INSTRUCTIONS, SEE BACK OF FORM

THIS FORM IS USED BY CANDIDATES' COMMITTEES ONLY


PART I - ONGOING INVENTORY OF CAMPAIGN PROPERTY

PART II - SALES OR TRANSFERS OF CAMPAIGN PROPERTY **

TOTAL VALUE CAMPAIGN PROPERTY T

P~~T(TRANSFER TO SUMMARY PAGE) $

* If estimated, show est. beside figure .

SCHEDULE

H CAMPAIGN(Rev . 07/03) I

PROPERTY

ATTACH SCHEDULE H TOEACH REPORT, MAKINGCHANGES AS REQUIRED.


** PROPERTY SALES & TRANSFERS TOTAL

TOTALS

$

$(TRANSFER TO SUMMARY PAGE) $

(Attach Additional Schedules if Needed)

Page

I

- of

I

Pages(For Schedule H)

Date Purchased(Schedule B)

or Date Received(Schedule E)MMIDD/YR

Description of PropertyPurchase

Price or Est .Value WhenAcquired*

CurrentValue at FairMarket This

Report

:YE l~osO.x{I1

C.

Date(MM/DD/YR)

Name and Address of Purchaser/Donee Description of Property Sold?YIN

SalePrice

Value ofDonation

gus. - webapp.iecdb.iowa.gov · ll-/5=c)(q datesigned local committees, enterdateofelection...

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