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FOR I NSTRUCTI ONS . SEE BACK OF FORM

DI SCLOSURE SUMMARYPAGECOMMI 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 )I RON WORKERS LOCAL 6 7 PAC COMMI TT EE

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 o r t i n g f o r :( t ) S t a t e w i d e / L e g i s l a t 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 , ) S a l l o t I s s u e / F r a n c h i s e C o mm i 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 po r t S l a t e o f fya n c j o a t e s

SI GNATURE OF TREASURER{ * f p e r s o n f i l i n g t h i s r e p o r t ) TELEPHONE DATE SI GNEDRo u t i n e P e n a l t i e s Du e F o r L a t e F i l e d Rep o r t s Ran g e f r o m !

SEE I NSTRUCT I ONS ON BACK AND COMPL ET E THE FOLLOWI NG SENTENCE :J u l 1 5 2 0 0 4 t o Oc t 1 4 , 2 0 0 4AM F I L I NG A Y > > REPORT FORAN/ A ( 1 ) ELECT I ON / ( 2 1 1 0 N - E L E C T I C N O N YEAR .

( r e p o r t d a t e ) I n d i c a tC3CHECK I F AMENDMENT TO REPORT DATED

0 Ch ec 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 an 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 OR- 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 . )

CONSULTANT BREAKDOWN ( S c h e d u l e - G A t t a c h e d ? ) .VALUE 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 ) $

FORMDR- 2 DI SCLOSURE( R e v . 0 1 / 9 8 1 REPORT

F o r O f f i c e Us e O n l yComm. aI n d e x e dA u d i t e dC o mp u t e r

Xf 1 8 2 0 0 4

L o c a l C o mmi t t e e s , e n t e r D a t e o f E l e c t r o n

C o u n t y i L o c a l C o mmi t t e e s , e n t e r C o u n t y i nw h i c h E l e c t i o n i s h e l d

CANDI DATE COMMI T T EES ONL Y :YES NO

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 ommi t t e e . T h i s amou n t MUST b e t h esame a s t h e c a s h o n hand a t t h e en 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 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S 2 , 1 48 . 4 2

ADD TOTAL MONEY TAKEN I N THI 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 S c h e d u i e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 , 9 64 . 7 8Sc 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 S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h ed 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc he du l e H a p p l i e s t o Ca n d i d a t e s ' Commi t t e e s On l y )SUB- TOTAL . . . . . . S 1 4 , 1 1 3 . 2 0

SUBTRACT TOTAL MONEY SPENT THI S PERI ODSc h ed u l e 8 : 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 8 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 , 4 90 . 0 0Sc h ed 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 mu s tb e z e r o ) ( A t t a c h OR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S 1 1 , 6 23 . 2 0

UNPA I D BI L L S ( F r o m S c h e d u l e 0 - A t t a c h S c h e d u l e 0 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SI N KI ND CONTRI BUTI ONS ( F r o m Sc h ed u l e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SOUTSTANDI NG LOANS ( F r o m Sc hed u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S

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F o r I n s t r u c t i o n s , Se e Ba c k o f Fo r mCONTRI BUTI ONS - MONEY TAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TT EE NAME ( Mu s t b e 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 )

I RON WORKERS LOCAL 6 7 PAC COMMI TT EESTATE CANDI 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 THE PAC I DENT I F I CATI ONNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF 1 0 NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .

CAUTI 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 op i e d f r o m r e p o r 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 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 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 ommi t t e e s .

O i s c l o s u r e l a w r e q u i r e s C a n d i d a t e c o m m i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e m a k i n g a c o n t r i b u t i o n t o t h ec o m m i 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 ) a n d a f f i n i t y ( r e l a t i v e s o ym a r r i a g e ) ( S e e P a g e 2 o f f o r m s p a c k e t ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o P a g e 1 o f1f 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 . ( f o r S c n e d u l e A )

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

SCHEDULEA MONETARY

( R e v . 0 6 1 9 7 ) RECEI PTSQ CHECK THI S BOX I FAMENDI NG FORM

DATE - PAC 1 0 NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT t i I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MMl DO/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME10 # Un i t e mi z e d c o n t r i b u t i o n s l e s s t h a7 / 2 3 / 0 4 $ 2 5 . 0 0 r e c e i p t f r o m e a c h u n i o n MEmber 1 1, 9 6 4 . 7CK# f r o m emp l o y e r c h e c ko f f s h e e t s .I D #CK#

1 0 #CK#I O #CK#1 0 #CK#1 0 # -CK# .

I D #CK# 1 0 #CK#

10 #CK#C#CK#

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S BOXAPP L I E S T O CANDI DATES ' COMMr i 7EES ONLY :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 n d i t u r e s t o p e r s o n s l e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s 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 ne d u l e Gb y t h e a mo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n l e n t i t y o n b e h a l f o f t h e c a nd i d a t e ' s c o mmi t t e e . ( R e f e r t oe d u l e Gi n s t r u c t i o n s a n d I o w a Code 5 6 . 6 ( 3 ) 0 . )

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

OR I NS TRUCT I ONS , SEE BACK OF FORM SCHEDULEEXPENDI TURES B MONET ARY- MONEY SPENT FROM COMMI TTEE ACCOUNT ( R e v . 0 9 1 9 7 ) EXPENDI TURESPAC COMMI T T EES : NOT E : FORCONTRI BUTI ONS MADE T O STATEWI DE OR L E GI S L AT I V EI DATES, UST T HE CANDI DATE I D EN T I F I C AT I ON NUMBER I N T HE DESI GNATED COLUMN ANDTHE 0 CHECK T HI S BOX I FC CHECK NUMBER FOR EACH EXPENDI TURE A US T OF I D : NUMBERS I S A VA I L A B L E FROMTHE I OWA AMENDI NG FORMI C S & CAMPAI GN DI SCLOSURE BOARD.

MMI T T EE NAME ( Mu s t b e s am e a s o n S t a t e me n t o f O r g a n i z a t i o n )I RON WORKERS LOCAL 6 7 PAC COMMI T T EECANDI DATE NAME ANDADDRESS T OWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADEMI DD1 YR) AND PAC _CHECK

NUMBER1 D# A n d e r s o n f o r Sh e r i f f Co n t r i b u t i o n 4 9 0 . 005 6 6 1 F l e u r Dr i v e/ 3 0/ 0 4 CK# 5 6 3 De s Mo i n e s , I A 5 0 3 2 1 $I D# I o wa De mo c r a t i c Pa r t y Co n t r i b u t i o n 1 , 0 00 . 005 6 6 1 F l e u r Dr i v e8 / 1 6 / 0 CK# 5 6 4 De s Mo i n e s , I A 5 0 3 2 1I D# Ci t i z e n s f o r Ha r k i n Co n t r i b u t i o n 5 00 . 0 05 6 6 1 F l e u r Dr i v e8 / 2 4 / 0 CK# 5 6 6 De s Mo i n e s , I A 5 0 3 2 1I D# Che t Cu l v e r C6 mmi t t e e Co n t r i b u t i o n 5 00 . 0 0

5 6 6 1 F l e u r Dr i v e2 5 / 0 4 CK# 5 6 5 De s Mo i n e s , I A 5 0 - 3 2 1I D#CK#

1 0#CK#

1 0 # -CK#I D#CK#

SUB - TOT A L $ 2 , 4 90 . 0 0TOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) $ 2 , 4 90 . 0 0