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F- 9 I NSTRUCTI ONS, SEEBACK OF " RM

DI SCLOSURE SUMMARYPAGE ~ SAN 2 3 2 0 0 2Pm I - z 2- -

COMMI TTEE NAME ( Mu s t b e s ame as o n St a t eme n t o f Or g a nr r a d o

I MPORTANT : I n d i c a t e t y p e o f c o mmi t t e e y ou a r e r e p o r t i n g f o r .( 1 ) S t a t e w i d e / L e g i s l a i v e C a n d i d a t e ( 2 ) S t a t e w i d e PAC ( 3 ) S t a t e P a r t y ( 4 ) C o u n t y / L o c a l C a n d i d a t e( 5 ) C o u n t y PAC ( 6 ) B a l l o t I s s u e l F r a n c h i s e C o mmi t t e e ( 7 ) C o u n t y / C i t y C e n t r a l C o mm i t t e e( 8 ) S u p p o r t S l a t e o f C a n d i d a t e s

I AM F I L I NG A

SI GNATURE OF TREASURER o r p er s o n f i l i n g t h i s r e p o r t ) TELEPHONE

oCc~ . c~CO O~- REPORT FORAN/ A ( 1 ) ELECT I ON / ( 2 ) NON- EL ECT I ON YEAR.( r e p o r t a t e ) I n d i c a t e one F L I

OCHECK I F AMENDMENT TO REPORT DATED

P e n a l t i e s Du e F o r L a t e F i l e d R e p o r t s Range f r o m $ 1 0 t o $ 4 0 0SEE I NSTRUCTI ONS ON BACK ANDCOMPLETE THE FOLLOWI NGSENTENCE :

pChec 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 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 or m DR- 3 .( Yo u m u s t c o n t i n u e t o f i l e r e p o r t s u n t i l a N o t i c e o f D i s s o l u t i o n i s f i l e d . )

STATEMENT OF CASH ON HANDCASH ON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d . ( T h i s i s t h e t o t a lo f a l l mo n i e s h e l d b y t h e c o mmi t t e e . T h i s amoun t MUST b e t h es ame a s t h e c a s h o n han d a t t h e e n d o f t h e l a s t r e p o r t i n g p e r i o d ,o r 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADDTOTAL MONEY TAKEN I N T HI S PERI ODSc h ed u l e A: Cash 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 ed u l e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h ed u l e C : F u n d - r a i s i n g Ev e n t s t o t a l ( A t t a c h Sc h ed u l e C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h ed 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 ed u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h ed 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 ed u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc he d u 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 es On l y )SUB- TOTAL . . . . . $

CASH ON HAND a t t h e end 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 mu s 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 ed u l e D - A t t a c h Sc h ed u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $I N K I ND CONTRI BUTI ONS ( F r o m Sc he du l e E - A t t a c h Sc h ed u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $OUTSTANDI NGLOANS ( F r o m Sc h ed u l e F - A t t a c h Sc h ed u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI TTEES ONLY :CONSULTANT BREAKDOWN ( Sc he d u l eGAt t a ch ed ? )VALUE OF CAMPAI GN PROPERTY ( F r o m Sc h ed u l e H - A t t a c h Sc h ed u l e H) $

FORMDR- 2( R e v . 0 2 / 9 6 )

DI SCL OSUREREPORT

F o r O f f i c e Us e On l yComm . # n1 ` 1I n d e x e d t Z t iA u d i t e dCo mp u t e r GL

L o c a l C o mmi t t e e s , e n t e r Da t e o f E l e c t i o nC o u n t y & L o c a l C o mmi t t e e s , e n t e r C o u n t yw h i c h E l e c t i o n i s h e l d

q ? ' V ? - ( o , - L

SUBTRACT TOTAL MONEY SPENT T HI S PERI ODSc h ed 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 ed u l e B ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I + / 7 - i 7Sc h ed u l e F : Lo a n Re p a yme nt s t o t a l ( A t t a c h Sc h ed u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

, : : ) 70- , 3 /

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2/20

F d r ' I n s t r u c t i o ns , Se e Ba c k o f FonCONTRI 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 A r n d a )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 t z a d o n )

P J ~ q ~ - , s - Fby - ( xSTATE CAND I DATES NOTE : I F A C ON T RI B U T I ON I S R E CE I V E D FROM A S T A T E PAC ( P O L I T I C A L A C T I O N C O MMI T T E E ) . UST THEPAC I D EN T I F I C A T I ONNUMBER AND THEPAC CHECK NUMBER I N THE D E S I GN A T E D COLUMN . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM T HE I O WA E T H I C S AND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON: S e c t i o n 6 8 8 . 3 2 A ( 6 ) . I o wa C o d e . p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s an d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r an y c o m m e r c i a l p u r p o s e b y an y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o m m i t t e e s .

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 o 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 mak kp 1 1 o a l W b u f i o n t o t h ec o m m i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( W o o d r e l a t i v e s ) a n d s f t k d 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 n n 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 b t h e s ame 1 1 1 1 C B Md k i a t e . b u t t o r e i s n of a m i l i a l r e l a t i o n s h i p e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u m n .

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3/20

F o r I n s t r u c t i o n s , Se e B a c k o f F ,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 a me a s o n S t a t e me n t o f O r g a n l z a t l o n )

' C- Or 0 ' t XSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S R E CE I V E D FROM A S TA TE PAC ( P O L I T I C A L A C T I O N C OMMI T T E E ) . UST T HE PAC I D EN T I F I C A T I ONNUMBER AND THEPACCHECK NUMBER I N THE D E S I GN A T E D COL UMN A L I S T OF I D NUMBERS I S A V A I L A B L E FROM T H E I OWA E T H I C S AND CAMPA I GNDI SCLOSURE BOARDCAUT I ON : S e c t i o n 6 8 8 . 3 2 A ( 6 ) . I o wa Code . p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e 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 nf o r a n y c o mm e r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mm i t t e e s .

NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I PTO CANDI DATE'( i f a p p l i c a b l e )

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4/20

F & ' I n s t n u c t i o n s , So * B a c k o f Fo nCONTRI BUT I 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 k x r d s )COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a N z e d o n )

STATE 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) . US T THE PAC I D E N T I F I C A T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARDCAUTI ON : Se c t i o n 6 8 B . 3 2 A ( 6 ) . I o wa Code , p r o h i b i t s t h e u s e o f i n f o r 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 nt s f o r s o l i c i t i n g c o n t r i b u t i o n s of o r a ny c o mme r c i a l p u r p o se b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e es .

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 s l e l e r o t u s k i n g a c a r l r b r f l 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 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 r g l i n i t y ( b l o o d MI a t Ms ) a n da" ( 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 m s p a c k e t . ) . I f s umame o f c o n t r b u t o r i s t h e s am e a s a nd i d a t e . b u t t h e r e i s n of a mi l i a l r e l a t i o n s h i p . e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u mn .

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5/20

F o r ' I n s t r u c t i o n s , See Back o f Fo rCONTRI BUTI ONS - MONEYTAKENI 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 t u n d e )COMMI TTEE NAME ( Mu s t be s ame a s o n St a t e men t o f Or g aNz a t l o n )

STATE 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) . UST THE PAC I D E NT I F I C A T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN. A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se c t i o n 6 8B . 3 2A ( 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 Co p i e d f r o m r e p o r t s an d s t a t e me nt s f o r s o l i c i t i n g c o n t r i b u t i o n s of o r a ny c o mme r c i a l p u r p o s e by an y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e es .

' 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 me" a c o nt r bu f n t o t h ec o mmi t t e e . R e l a t i o n s h i p 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 o o mw r p u i r r i t y ( b l o o d r e t e t i w s ) anda" ( r e t a t l w s b yma r r i a g e ) ( S e e Page 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 bb ut o r b 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 of a mi l i a l r e l a t i o n s h i p . e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l umn .I - tp a g e o f

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

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6/20

F o w' I n s t r u c t i o n s , Se e Ba c k o f Fo r tCONTRI BUTI ONS - MONEY TAKEN I N

( I n c l u d k V 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 h e f f o n )

STATE CANDI DATES NOTE : I F A C ON T RI B U T I ON I S R EC E I V E D FROM A S T A T E PA C ( P OL I T I C A L A C T I ON C OMMI T T E E ) . L I S T T HE PAC I D E NT I F I C A T I O NNUMBER AND THEPAC CHECK NUMBER I N THE D ES I GN A T E D COLUMN . A L I S T OF 1 0 NUMBERS I S A V A I L A B L E FROM T HE I O WA E T H I C S AND CAMPAI GNDI SCLOSURE BOARD .CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Co d e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s of o r a n y c o m m e r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mm i t t e e s .

' 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 n u n i t t e s 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 e o 1 M r f b u t f o n t o t h ee w n m i t t e s . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n p u i n k y ( b l o o d ( e l a 0 w s ) a n d a f l k l i t y ( r W a d v e s b yma r r i a g e ) ( S e e P a p * 2 o f f o r m s p a c k e t . ) . I f s u mame 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 n i s n of a m i l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u m n . P a g e ( f o r S c h e d u l e A )

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7/20

F o i - I n s t r u c t i o n s , Se e B a c k o f F o f TCONTRI 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 l x m 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 b : a 6 o n )

T5 r' ~ -"ds ~ -S T AT E C AN DI D AT E S N OT E I F A C ON T R I B U T I ON I S R E CE I V E D F R O M A S T A T E P A C ( P O L I T I C A L A C T I O N C OM MI T T E E ) . U S T T H E PAC I D EN T I F I C AT I ONNUMBER AND T H E P A C C H E C K NUMBER I N T HE D E S I G NA T E D C O L U M N A L I S T OF I D NUMBERS I S A V A I L A B L E FROM T H E I OWA E T H I C S AND C A MP A I G ND I S C L OS U R E B O A R DCAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o mme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s

' 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 r w r b u f 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 mu s t b e s h o w n t o t h e t h i r d d e f i n e o f o w ma n p j Wt y ( b l o o d r e l a t i v e s ) a n d a" ( r e l a t i v e s b y o fm 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 t sumame o f o o n t r 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 n i s n o P a g e S c h e d u l e A )f a m i l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u mn ( f o r

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8/20

Fo r I n s t r u c t i on s , Se e B a c k o f Fo r tCONTRI BUTI ONS - MONEYTAKEN I N

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I t A / ? d 5T- VY b ' I ~STATE CAND I DATES NOTE : I F A C ON T R I B U T I O N I S R E CE I V E D FROM A S TA TE PAC ( P OL I T I C A L A CT I ON C OMMI T T E E ) . US T T HE P AC I D EN TI F I CA T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DES I GNATED COLUMN . A L I S T OF 1 0 NUMBERS I S A VA I L A BL E FROM T HE I OWA E T H I C S AND CAMPAI GNDI SCLOSURE BOARD .CA UT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s an d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o m m e r c i a l p u r p o s e b y a ny p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o m m i t t e e s .

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 MI ND" m a k i n g a C WMr b u d o n t o t h ee o n x n i t t e e . Re l a d o n s h i p n %A t b e s h o w n t o t h e t h i r d do" o f o a n a n p Wr l l l y ( b l o o d r e l a t i v e s ) a n da" ( r e l a t i v e s b yma r r i a p e ) ( S e e Pa g e 2 o f f o m l s p a c k e t . ) . I f s u mame o f c o n b bu t w b t M Nam" e s c n Wi d s t e , b u t Owe i s n of a m i l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u m n .

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9/20

Fdr i ns. t r u c t i ons , See Back o f Fo r t

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STATECANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE ) . L I ST THEPAC I DENT I F I CAT I ONNUMBER AND THEPACCHECKNUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A VA I L A BL E FROM THE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARDCAUTI ON : Se c t i o n 68B . 3 2A ( 6 ) , I o wa Code, p r o h i b i t s t h e use o f i n f o r ma t i o n c op i e d f r o m r e p or t s an d s t a t e me n t s f o r s o l i c i t i n g c o n t r i bu t i o n s of o r any c o mme r c i a l p u r p o se b y an y p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

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10/20

V0I n s t r u c t i o ns , S e t a Back o f F o n tCONTRI BUTI ONS - MONEYTAKEN I N( I n d u d k V c a n d i d a t e ' s p e r s o n a l A m 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 l r a d o n )Ty - a t 4, - , f 7 o r . ~~ I x

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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 ms k h q a M* budm t o t h ec o mmi t t e e . R e l a t i o n s h i p 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 r n a n g u t r l i l y ( b l o o d r e l a t i v e s ) a n da" ( 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 ame o f e o n b b u t o r i s t h e s c a r . . a s c a n d i d a t e . b u t t wo i s n of a m i l i a l r e l a t i o n s h i p . e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u mn . Pageo f-_

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11/20

F o e I n s t r u c t i o n s , Sa e B a c k o f F o rCONTRI 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 l s a d o n )

S T A T E C ANDI D AT E S NOTE I F A C ON T R I B U T I O N I S R E CE I V E D F R O M A S T A T E P A C ( P O L I T I C A L A C T I O N C O MMI T T E E ) US T T H E P A C I D EN T I F I C A T I O NNUMBER AND T H E P A C CHECK NUMBER I N T H E D E S I G NA T E D C O L U M N A L I S T O F I D NUMBERS I S A V A I L A B L E FROM T HE I OWA E T H I C S AND C A MP A I G ND I S C L O SU R E B O A R DCAUTI ON : S e c t i o n 6 8 8 . 3 2 A ( 6 ) , I o w a Code p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e 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 of o r a n y c o mme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s

' 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 n l s 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 A b u d o n t o t h ec o mmi t t e e R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n da" ( r e l a t i v e s b y ,m 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 sumams o f o o n t r i b u t o r I s t h e i s . 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 p o p I ~-5f a m i l i a l r e l a t i o n s h i p e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u mn ( f o r S c h e d u l e A )

SCHEDULEA MONETARY

( Re v . 0W97 ) RECEI PTSQ CHECK THI S BOX I FAMENDI NG FORM

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

NUMBER I NI D# " i t ~t . r~e h^ ~ r ~ . ~ ,ICK# - 7 0 3 6 4 , U r a t ~ d 1 ." t o ' , v i e s , Y A S 0 3 0 3 _ . . o t P 57s $ . 0 0 , V

I 9 W' DII D# ~ v q b MARL&- ~mc . + u _ Y e c ( PAC-

F r u ~ .U_ o u _ s t h ~

i , + o o b e a v % VCK# 1 ,44 I y e s h ' l 6 i v e s , i A 5d3/ b - 353ki - I D# 6118 t a ~- r - monoa - u ~ a O E , T I Z t C ~ .. S~c~ ~ S) o c K# l ' 7 ( e 4 l o ~ s F - ye s mOn u l l s s , : ' A saa6b. b o a ,

I D # 6 6 73 pwa h e e d : c a ( PACI , A1 - s I DI CK# , 4 b S Sa o f CSK- L n d A n ) e - . Sb~Co~ 1 c ) 6 , 6- 6e s t - b e - 5 t a i n ~ e ~ , Z4I D # 6 , o l o ~ l k T - v l d e , c s h - y PAC V

I d l - , 1 6 1 CK# a4 UJ a l n u + , S U I ' D 0 l 6 G, L `z 1/-e 5 ym, h?s , . T - A S a 3 o 9 3Sd~I D# 0 7 i 7

CK# C a m as +~ ~ cS - 22s ~Mm~v , PS ~A -. Sd 309 153` 3I~

~ I s ' l a r t o oo HsCK# s3 i - 1 - I -- Z>eS v 1 n a , n ~e s %A 5a3bq- a 4 c l a t o , OtI D# ~ , A t l l 1 ' 1 ' t GT ~. d~a Pt y . c , ;

a ~ ~D/ n l CK# ~ ~ 7 t i o ~ q 3 k,aI D #

l a / p o l o 3 o ~s CCK# , s QI D# y - t u - y , z ' , a" ~ F e e - ~ c e . ~ .

I a I / o / a 6 , 6 - t , o~ Sa~Jc K# a3~~' ~ SdL ,SUB- TOTAL

TOTAL ( N l a s t pa g e o f t h i ss c h e d u l e ) $


12/20

Fo r I n s t r u c t i o ns , Se e Ba c k o f Fo r m- CONTRI BUTI ONS - MONEYTAKEN I N

( I n d u d t r q c a n d l d a l e ' s p e r s o n a l l h n d s )I COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a f a ma n t o f Or gaMt r a t b n )STATE CANDI DA TES NOTE : I F A CON T RI B UT I ON 1 3 R E C E I V E D FROM A S T A T E PAC ( P O L I T I C A L A C T I O N C O MM I T T E E ) . UST THE PAC I D E NT I F I C A T I O NNUMBER AND THEPAC CHECK NUMBER I N THE D E S I G N A T E D COLUMN . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM T HE I OWA E T H I C S AND CAMPA I GNDI SCLOSURE BOARDCAUTI ON: S e c t i o n 6 8 B . 3 2 A ( S ) , I o wa Co d e , p r o h i b i t s t h e us 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 nf o r an y c o m m e r c i a l p u r p o s e b y an y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o m m i t t e e s .

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 f t 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 mak kq a c o r l t r b u d c n t o t h ec o m m i t t e e . R e t a b o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f o w a n p u k d t y ( b l o o d r e l a t M s ) a n d a" ( r e l a t i v e s b ym a r d a p e ) ( S e e P a p a 2 o f t o w n s p a c k e t . ) . I f s u me me o f c o n t r i b u t o r b 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 of a m i l i a l r e l a t i o n s h i p . e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u m n .

SCHEDULEMONETAR( R e v . o e / t a 7 ) I RECEI P T

[ ] CHECKT HI S BOXAMENDI NGFORM

Ppe _ o f 1( f o r S c h e d u l e A )

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTR I BUTOR RELAT I ONSHI P AMOUNTRECEI VED ( i t a p p l i c a b l e ) T O CANDI DATE ' RECEI VED( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e )NUMBERI D#CKS . say DI DO

L / 8 1 CK# oaI D# CCK# ~ 1 aY 3 16 s / S O , ~ c . J ~a e s o iI D# c 2 ~l a d e a l a s o a6 u ) . . e ,I D# y u e s ~aa ~

p~a~eCI D#

1 a / 1 0 1 6 1 - 7 , 2CK# , aI D# ~r i c L t ) " 130CKf h8~( l , J Q

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


13/20

F a r I n s t r u c t i o n s , Ss * Ba ck o f Fo nCONTRI BUTI ONS - MONEYTAKENI N

( I r l d u d i n q c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t b e s ame a s o n S f a t e me n f o f Or g a Mr e d o n )

STATE 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) , UST THE PAC I D E NT I F I C A T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A V AI L A B L E FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARDCAUTI ON: S e c t i o n 68 B . 3 2 A ( 6 ) , I o wa Code , p r o h i b i t s t h e u s e o f i n f o r ma t i o n Co 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 o rf o r a ny c omme r c i a l p ur p o se b y a ny p er s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

v SUB- TOTALTOTAL ( I f l a s t page o f t h i s

s c h e du l e )' D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o m m i t t e e s t o d i s d 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 s k k V a Wn t r b u l b n t o f tc o mm i t t e e . R e l a t l o n s l w p mu s t b e s hown t o t h e t h i r d d e p n e o f c o n s s n p u i n l t y ( b l o o d r e l a t l w s ) a n d a" ( r s b d v e s b ym a r r i a g e ) ( Se e Pa p a 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 on t r b ut w I s t h e same a s c o n d i d a t e . b u t t h en i s n of a mi l i a l r e l a t i o n s h i p . e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l umn .

p op / ~ ; ) , o f( f o r Sc h e du l e A)

SCHEDULEA MONETARY( Re v . O f 3 / 9 7 ) RECEI PTSQ CHECK THI S BOX I FAMENDI NG FORM

DATE PACI D NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT IRECEI VED ( i i a p p l i c a b l e ) TOCANDI DATE' RECEI VED FU( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RANUMBER I N

I D# 3CK# s 6G 6s

i J / / 6%I CK# 3 s 9 U A - ~ ~ ,

J a / i ~ l ~ I CK# l a~ o s J S ' D~ c j ~s ('4 &SrI D#

/ 0 / g I CK# ? a s sa~a~ a s hI D#CK# 3- 7 7 . d 3I DN

. I D# wt o / " o / q CK# ' ~ I s / e l d . vs6

I D#CK# a ss - ~g o s6 i /S'7. ( . t

~ Se ~ a~G~ I S 6 k . uI D#CK# 6 3 - S t of f ,~sdl ~ ~5c v t . l 2 ,I D# l > . ~ JCK# a 7 0 7


14/20

Fo r I n s t r u c t i o n s , Se e B a c k o f F o r t hCONTRI BUTI ONS - MONEYT AI %r = N 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 Amds )COMMI TTEE NAME ( Mu s t b e s ame as o n S t a bme r l t o f O r g e A l t e d o n )

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC .POUT I GI L ACT I ON COMMI TT EE) . UST THE PAC I DENTI F I CA T I ONNUMBER AND THE PAC CHECKNUMBER I N THE DESI GNATED COLUMN. A USTOF 1 0 NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON : Se c t i o n 688 . 3 2 A( 6 ) , I o wa Code, p r oh i b i t s t h e us e o f i n f o r mat i o n c o p i e d f r o m r e p o r t s a nd 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 nsf o r any c o mme r c i a l p u r p o s e b y any p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

' Di s c l o s u r e l aw 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 s e f t r e l a t i o n s h i p o f an y r e l a t i v e ma" a o a * b u d c n t o t h ec o mn wt t e e . Re l a t i o n s h i p mu s t b e shown t o t h e t h i r d d e gr 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 s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a ge ) ( Se e Page 2 o f t a 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 b t h e s ame as c n d i d at e , b u t t h em i s n of a mi l i a l r 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 Sc h e d u l e A)

SCHEDULEMONETARY

( Re v . OW97 ) RECEI PT0 CHECKT HI S BOX

AMENDI NGFORM

DATE PAC I D NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT JRECEI VED ( i f a pp l i c a bl e ) TO CANDI DATE' RECEI VED( MMI DD/ YR) ANDPACCHECK ( i t ap p l i c ab l e ) R

NUMBER II DS

$CK#I DN

1 , V1 6 1 6 1 CK# "6 3 3a o - ~ a d ' n16 s-. : mo d ! QI DS

s n S r ~ _ ~ -a~u~ ~ . s a ~ ~ s.!I D#1 4 1 6CK# 60 4I DS oI a l 1 6 1b l CK# , a - 3 a vCKS

. I DS

) a i b ~a l CK# - 3r d Aue~ . `Q f 1 7 ~X27 ( o~5 ~I D# -c K# , OT) 1~ c a.I D#

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15/20

F o r I n s t r u c t i o n s , So * B a c k o f F o r m. CONTRI BUT I ONS - MONEY TAKt N I N

( I n c l u d i r q c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( M u s t b e s ame a s o n S h t l a ms n t o f O r p a r l l r s d o n )

S T A T E CAND I DATES NOTE: I F A C ON T RI B U T I O N I S R EC E I V E D FROMA S T A T E P A C ( P O L I " f I C A L A CT I O N C O MM I T T E E ) U S T T H E P A C I D EN TI F I C AT I O NNUMBER AND T HE P AC C H E C K NUMBER I N T H E D E S I G NA T E D C O L U M N A L I S T O F 1 0 NUMBERS I S A V AI L A B L E FROM T H E I O WA E T HI C S AND C A MP A I G ND I S C L O S UR E BOARDCAUTI ON : S e c t i o n 6 8 8 . 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 sf o r a n y c o mme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mm i t t e e s .

' 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 1 M 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 MWN a c o n f r b u l i o n t o t h ec o mmi t t e e R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e c r e e o f c o n s a r q u i r * ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( M i a t h r e s b yM a r r i a g e ) ( S e e P a g e 2 o f f o n n s p a c k e t . ) I f s u r n a m e o f c o n b i b u t o r a t h e s a m e a c a n d i d a t e b u t t h e n i s n of a m i l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u mn .

SCHEDULEI Mo NETAR( R e v o d g 7 ) RECEI PT

QCHECK T H I S BOXAMENDI NG F ORM

P a g e ( f o r S c h e d u l e A )

DATE P AC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNTRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED( MMI DDf YR) AND P AC CHECK ( i f a p p l i c a b l e )NUMBER II D# - TX" 4 _, , 6 - u . - a - ~) a ~ l D~ p l CK# I 0 x 391 s ' ~ 4 1 ~ , S 6 6

I D NCK# 3$~s S ~ ~ F - s oI D S ( 0 1 07 u~esf 1 Pf dG ~ ; .' a I I DJ o ICK# 3 ~ , 3 ' + q as

~ ' ~ ' Y S91 J e s YvL o . e s i T A I - S . D 3 8 4

I D S ( p 0 S7 a . T" / ' . c - 0 wl v r t u . n t c a _ F- i b a g f f - s s o c ,l a l l ~ l ~ I CKS / 1 3 5 5 r 4 , o I - - X a ) i d s t l Z x t ; I ( e , 05WT ,W2 . ~ -~t _ s MmI r t e s A C A ~ ' o. a6 ~ l 5 0 . d 8 r

I D # 6 ~ as ' , a 0- a. k 4 o v - s P4a- ? J / n / o l CKS 1 9 38 / S7o i ) w r / ' ~ t +h . ) #~~ as 6 , d- 1 0 L0 _ ) A / e = ' A S ' 1 7 3Q- 5 "I D S ( , O l 0 7 J : : , 4 l e a l s c h

p4G -L -tCKS 73 - 1 7 - 5 - 6 l ~ ~ , d z ~t . l es I ' 1 ' I D~ a s FA, S` d mi l . I DS ~i Cu c b e Y '

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~aJ ) d / b I CK# 1 a I a ( , ~ owx pG~Sa m , aa , o - c ) I~v r - Ke r Sb u ~' >~ . S' ai o~5I D S ~ . Jl a b / ~ I CK# ~, 2 . 5 Y ~ 9 - ~ - e a c ~ 4 5B 3O. ~ ~8 ~I D #al a 6/ a I CK#

SUB- TOTAL a0f 5 '$TOTAL O f l a s t p a g e o f t h i ss c h e d u l e ) $


16/20

Fo r I n s t r u c t i o ns , Se e Ba c k o f Fo r mCONTRI BUTI ONS - MONEYTAKt NI N

( I n du dk v c a n d i d a t e ' s p e r s o n a l f i r r l d a )COMMI TTEE NAME ( Mu s t b e s ame a s o n Sb bf n e r # o f Or WI h8 Bon)

STATE CANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I C AL ACTI ON COMMI TTEE) . UST THE PAC I D ENT I F I CA T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A UST OF 1 0 NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON: S e c t i o n 6 88 . 3 2 A ( 6 ) , l o v e r s 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 o m r e p o r t s an d s t a t e me nt s f o r s o l i c i t i n g c o n t r i b u t i o n sf o r a ny c o mme r c i a l p u r p o s e by an y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e es .

D i s c l o s u r e l o w r e q u i r e s C a n d i d a t e Commi t t e es t o d i s d oa t h e r e l a t i o n s h i p o f a n y *AMn r a k t n p a =wbudon t o t h ec a n m i l t e e . R e l a t i o n s h i p 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 r n s r g Awl y ( b l o o d N l e t l v e s ) an da" ( N I OWes b yma r r l s p e ) ( S e e Po pe 2 o f f o r m s p a c k e t . ) . I f s u r n a me o f eo nt f t d o r b t h e s ame a s c a n d i d a t e . b u t I r e i s n of a mi l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u mn .

SCHEDULEMONETARY( Re v . ow 9 7 ) RECE I PTS

QCHECK T HI S BOXAMENDI NG FORM

p a g e o f( f o r Sc h e d u l e A )

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNTRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE' RECE I VED( MM/ DDI YR) ANDPACCHECK ( i f a p p l i c a b l e ) RNUMBER I

I D#

C L l 4 1 -3 5? )I D# Su K ` ~CK# ~? e s a k e~

/ , O d a , I I V2: v b 4 - 4 1I D# YY1 r ~P~A2 . Q I n n ~~CKS 3 o o Vi a - , 6 0 -6I DS t ; 7 ~ ~ e i ( PAC' - ~ C , . - ~ 6 2 ) 7CK# 6 7 - v o t i d AA~- e. , f - e, i - 7 07. S u , - - , ~ 5T , c r y

mY r t e 1 ~ - , , ? - A S6 3 o 7I DS &I O ( V - y \ , c , t - p e , ~` a r r i F v - 5 F AcCKSJ J S c l p . a . l n I ~ s - r - -W- P S M u k - ~ 7 SL : ' .TA. V t S~~1 i l F. ~ ~ Sc 3c 1~I DS ~ - ~~ I v " ~. b a I d c v s Ai 5 0 C k 1 Ac .

~ ~I I F S~ GIL

- .

. I DS P ' 4 v y I I v s - Ke i pCKE S~ 5a c : i b0 1 1~5I DS ( , ~ o ~SSc~ C ~- - e t ~r a l t C~ ' m` ~ ac - t o r s L ~ ~ Z d u r . ~ . L ,

a i l y ( ~,A c ,

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s c h ed u l e ) $


17/20

T HI S BOX APPL I E S TO CANDI DATES' COMMI T TEE S ONLY :P u r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H . ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g . o r g a n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l i t e mi z e d o nS c h e d u l e G b y t h e a m o u n t . p u r p o s e . a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o N e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e r tS c h e d u l e G I n s t r u c t i o n s a n d I o w a Code 5 6 . 8 ( 3 ) ( 1 ) . )

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

. ROR I NSTRUCT I ONS, SEE BACK OF, f M SCHEDULEEXPENDI TURES B- MONEY SPENT FROM COMMI T TEE ACCOUNT MONET ARY( R e v . 0 9 t 9 7 ) EXPENDI TURES

STATE PAC COMMI TT EES : NOTE : FORCONTRI BUTI ONS MADE TOSTATEWI DE OR L E G I S L A T I V E 0 CHECK T HI SCANDI DATES . L I S T THE CANDI DATE I D E N T I F I C AT I ON NUMBER I N THE DESI GNATED COLUMN AND THE BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE. A US T OF 1 0 NUMBERS I S A VA I L A B L E FROMTHE I OWA AMENDI NG FORME T HI C S 3 CAMPAI GN DI SCLOSURE BOARD.COMMI TTEE NAME ( M u s t b e s am e a s o n S t a t e me n t o f Or g a n i z a t i o n )

CANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( MM/ DD/ YR) AND PACCHECKNUMBER

6 - 7 / 0I D # Tz a u . P a e 4 - ~ a ~

z r b~ CI A+ Ib 5 a D a .t a t

I D # ~uJ i c a . S60 , QZ J' ) - 7 1 I ) , c K# 5 1 a - - 57QI -3"~Y' 4 mi V L O- s 1 X I 4 , _ X30(I D # (6- f &+- ` ~ Qct h Du . $ s ~ e a s` j q3 t o ~~~x n K v C j a v e r ~ . 1 l C> SdCK# Q~ F ' 4 5a&77I D # ' ~ 2 e o - e pe C o' - 1 , p i - D i 5 r l 0 ': L ~ d v f r ' I i ~ t

d7l e j coSc ~ Po . I 3 o n 3 7 0 , A I 9 N , end 5 1 ; &v ~ - c o w- l c c ' ' ~ ~Up l _ _ s P S f1 5 ~ l Oe o ) ~ - : f - A 5oW3~

4 1 I D #CK# yS Rp , Q~x as > C e t v k ~ . , . U v p o s e s I f s aCl' 3 1 - o o R ' I n SA wal lI D # 59 CP s - V ~ - i - ~ o ~ - z e e ,

CAe , ~ ~ .I D #

,s t e ~ v ~ ~

CK# a a ~ y s f - . . 5h ~ A u e . r I . 5 6 0 7 7i

a CAnu~CK# p . p . B O Y - s y( X ; c ~ v e r I . ~ ~ Q( c 2 7 ` .SUB- TOTAL $ 3 3 7 1 D , g

TOTAL ( i f l as t ~ o f t h i s s c h e d u l e ) $


18/20

FOR I NSTRUCT I ONS, SEE BACKOF . r RMEXPENDI TURES - MONEY SPENT FROM COMMI TT EE ACCOUNT

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUT I ONS MADE TO STATEWI DE OR L EGI S L AT I VECANDI DATES, L I ST THE CANDI DATE I DENT I F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBERFOREACH EXPENDI TURE . A UST OF I D NUMBERS I S AVAI LABLE FROM THE I OWAETHI CS & CAMPAI GN DI SCL OSURE BOARD .COMMI TT EE NAME ( Mu s t b e same a s o n St a t eme n t o f O r g a n i z a t i o n )

DATEEXPENDED( MM/ DD/ YR)

7/ ( 31a

I D#7 1 t CK# ( 0 0 0

CANDI DATEI D NUMBER

( i f a p p l i c a b l e )AND PACCHECKNUMBER

co sa7I D#CK# 5a 9

CK# ~ % t . > 3I D#CK# 60qI D#CK# X05

NAME AND ADDRESS TOWHOMEXPENDI TURE( D i s b u m e r n e r r t ) WAS MADE

?Do F ~~ ( ' ( a ~a s av i f S I L .A060A ~s7~vooKl ul r ~, .: L~ . S t e a l I

x a S71 3 v ' o a K ( L t v - , , : EA S . ) 2 . L I

. u : 61 r c c ~ y r p c Y~ c k" b e s 1 ' K 1 n ; ~ .2s ~ ' r ASo 3oF

- I D# - _l ob F-( , k ) 0, U2N i b r a- ' ~ l a s

S3 ' ~ Ta - C~ au~ ' r " A . S i r m( G a a I as tCK# 6 , - Y Y ( m , s , , . S03

' : ~ 1 &c Lc XO .

1 0- Q Y t i l . ~ - J 5v a qJ ~

_ s y Yl m vas , : ~A Sc 3 c 9

PURPOSE( DESCR I BE TRANSACTI ON) AMOUNTEXPENDED

~CS V 2 Y ' " E t S w 1

) ( Ayu < < .x v- Pc l ` r ~a

&nom, b a - - h ' 6 r 1

TOTAL ( 1 f l a s t page o f t h i s s c h ed ul e ) $

l i bQ~ , , d Z 9

1 1 p c h v . ( ~

pGba~cS~

~. - 01~, 9i - s i ,

SUB- TOTAL ' $

THI S BOX APPLI ESTO CANDI DATES' COMMI TT EES ONLY :Pu r c h a s e s o f c e r t a i n c amp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n S c he d u l e H . ( R e f e r t o Sc h e d ul e H i n s t r u c t i o n s . )Ex p e n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g . man a g i n g , o r g a n i z i n g s e r v i c e s must a l s o b e d e t a i l i t e m i z e d o nSc h e du l e G b y t h e amoun t , p u r p o s e , an d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o Ne n t i y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e r tSc h e du l e G I n s t r u c t i o n s an d I o wa Code 5 8 . 8 ( 3 ) ( 1 ) . )

Page

( f o r Sc h e du l e B )

SCHEDULEB MONET ARY( Re v . 0 9 1 9 7 ) EXPENDI TUREQCHECK T HI S BOX I FAMENDI NG FORM


19/20

T HI S BOX APP L I E S TO CANDI DATES ' COMMI T T EES ONLY :P u r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e m u s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H . ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o 1 1 t , ma n a g i n g , o r g a n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l i t e m i z e d o nS c h e d u l e G b y t h e a mo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o N e n t i t y o n b e h a l f o f t h e c a n d ' i d a t e ' s c o mm i t t e e . ( R e f e r t oS c h e d u l e G I n s t r u c t i o n s a n d I o w a Code 5 6 . 6 ( 3 ) ( 1 ) . )

P a g e 3 o f 3

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

FORI NSTRUCTI ONS, SEEBACK OF f . . r ? M SCHEDULEEXPEND I T URES B MONET ARY- MONEY SPENT FROMCOMMI TTEE ACCOUNT ( R e v . 0 9 / 9 7 ) EXPENDI T URES

STATE PAC COMMI TT EES : NOTE : FORCONTRI BUTI ONS MADE TO STATEWI DE OR L E G I S L A T I V ECANDI DATES, L I S T T HE CANDI DATE I D E N T I F I C A T I ON NUMBER I N THE DESI GNATED COLUMN AND THE CHECK T HI S BOX I FPAC CHECK NUMBER FOREACH EXPENDI TURE. A UST OF I D NUMBERS I S A V A I L A B L E FROM T HE I OWA AMENDI NGFORMET HI CS & CAMPAI GN DI SCLOSURE BOARD.COMMI TTEE NAME ( Mu s t b e s a m e a s o n S t a t e me n t o f O r g a n i z a t i o n )

' CANDI DA TE NAME ANDADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( d a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( MM/ DD/ YR) AND PACCHECKNUMBERI D #CK # S ' ; ~ + c a s t 1 - a = yt ' ~ . , . . r 1 , 6W6 - DI D#CK #I D#CK#I D #CK#I D #CK#I D #CK#I NCK#I D #CK#

SUB - TOTAL $ 1 0 GG11Y71TOTAL ( N l e s t p i g r o f t h i s s c h e du l e ) $ 11


20/20

FOR I NSTRUCT I ONS, SEE BACK OF FORMCOMMI TTEE NAME ( Mu s t b e same 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 )

I t An d_3

j ~ - t r I ~ e C i v ~ ' ~ L k - ~q - CZ-- . SUB- TOTALTOTAL ( i f l a s tp a g e o f t h i ss c h e du l e )

SCHEDULEE I N K I ND( Re v . 0 6 / 9 7 ) 1 CONTRI BUT I ONSQCHECK T HI S BOX I F

AMENDI NG FORM

' 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 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 n i n k i n d c o n t r i b u t i o n t o t h e Pag e - 4 ( f - , r o fc o mmi t t e e . R e l a t i o n s h i p mus t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) 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 )b y m a r r i a g e ) ( Se e Pag e 2 o f f o r ms p a c k e t . ) I f s u r n ame 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 of a m i l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn .

DATERECEI VED( MM/ DD/ YR)

NAME AND ADDRESSOF CONTRI BUTOR

RELAT I ONSH I PTO CAND I DATE` ( i f a p p l i c a b l e )DESCR I PT I ONOF I N K I NDCONTRI BUT I ON

EST I MATEDF AI R MARKET

VALUEJ I F F ORFUND- RAI SERCONTRI BUT I O

1 1 1` 1 510G'

r Ca r r i e - r 5 ~ O t ~ f - , r a Q . ~*bN C8 YNM1 .a 1 4 a s ' r~wo " I G, 9 SMf i a ?i ~ . BOX C o l ,~e5 r n m; r e s =ASa309 h 'l ~ ~ ' e 4 r ~17" YQ C

~- r i u . r + ,Y n p { o - h - o nSOC- r V . X _ V_

I S~ . g I

~al a~o~3111 Z7XPO o o 2L~s r , e L L i ~ , V_ l

'd i daf ~ p o r , - ~ n , l a e. ~ n u j o ~e y g?~o

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