seiu local 199 cope fund6492scanned

8/7/2019 SEIU Local 199 COPE Fund__6492__scanned

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OCT - 1 9 - 2 0 0 4 0 8 : 5 3

DI SCLOSURESUMMARYPAGE

COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e me nt o f Or g a n i z a t i o n )

SETU( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n) L oc a l 1 9 9 COPE Fo l d

I MPORTANT : I n d i c a t e t y p e o f c o mm i t t e e y o u a r e r e p o r t i n g f o r . 1 2( 1 ) 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 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 / F r a n c h i s e C o mm i t t e e ( 7 ) C o u n t y l g i t y C e n t r a l C o mmi 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

D i s t r i c t ( i f Sena t e o r Hou s e )

Ac c o u n t a n t ( 3 19 ) - 3 41 - 0 1 1 2 1 0 - 1 8 = 2 0 0 4

SI GNATURE OF TREASURER ( o r p e r s o n f i l i n g t h i s r e p o r t ) TEL EPHONE DATE S I GNED

Rou t i ne P e n a l t i e s Du e For L a t e F i l e d Re po r t s Ran g e f r o m $ 20 t o $ 800

SEE I NSTRUCTI ONS ON BACK ANDCOMPL ETE THE FOLL OWI NG SENTENCE :

I AM FI L I NG A 7/ 15/ 04- 10/ 14/ 04 REPORT FORA N/ A ( 1 ) ELECTI ON / ( 2 ) NON- ELECT I ON YEAR_

( r e p o r t d a t e ) I n d i c a t e one 7 1

[ J CHECK I F AMENDMENT TO REPORT DATED

[ 3 Check i f t h i s i s f i n a l ( t e r m i n a t i o n ) r e p o r t a nd a t t a c h N o t i c e o f D i s s o l u t i o n F o r m DR- 3 .( Y o u mus t c o n t i n u e t o f i l e r e p o r t s u n t i l a N o t i c e o f D i s s o l u t i o n i s f i l e d . )

STATEMENT OF CASH ON HAND

P . 02

DR- 2 DI SCLOSURE

( R e v . 0 5 / 2 0 1 3 2 ) REPORT

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

C o u n t y & l o c a l C o mm i 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

CASH ON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d . ( T h i s i s t h e t o t a l o f a l l mon i es h e l d

b y t h e c ommi t t e e . T h i s amoun t MUST b e t h e s ame a s t h e c a s h o n h and a t t h e endo 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 mus t be 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 . ) . . . . . . . , . , . . . . , . . . . . . . . . , . . $ 909 . 2 - 1.

ADDTOTAL MONEYTAKEN I N THI S PERI OD

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be z e r o ) ( A t t a c h DR- 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . $

" UNPAI D BI L L S ( F r o m S ch e du l e D - A t t a c h Sc h e du l e D ) . . . . . _ _ . . . . . . . . . . , . . , . , . . . , . . . . , . . . . . . . . , . . . . . . . . _ _ . . . . . . _ . . . . . $

` I N KI ND CONTR I BUT I ONS ( Fr o m Sc h ed u l e E - A t t a c h S ch e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

" ' ` OUTSTANDI NG LOANS ( F r o m S ch e du l e F - A t t a c h S ch e du l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

CANDI DATE COMMI TT EES ONLY :

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

VALUE OF CAMPAI GN PROPERTY ( Fr o m S ch e du l e H - A t t a c h S c h e d u l e H ) $

YES - x NO

r

S ch e du 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 ch e du l e A ) ( ' a l s o s ee i n - k i n d b e l o w ) . . . . . . . . . -,

S ch e du 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 Camp a i g n P r o p e r t y ( A t t a c h S ch e du l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc hed u l e H a p p l i e s t o Ca n d i d t e s ' Commi t t e es On l y )

3.i53.00

- r

SUB- TOTAL . . . . . . S 4 , 0 55 . 2 3SUBTRACT TOTAL MONEY SPENT THI S PERI OD

Sc 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 e du l e B ) ( " ' a l s o s ee d e b t s a nd l o a n s b e l o w ) . . . 2 . 4 2 4 . 7 5

S c h e d u l e F : L o a n Repaymen t s t o t a l ( A t t a c h S ch e du l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .



OCT- 19 - 2 004 08 : 5 4

T HI S BOX APPL I ES TO CANDI DATES' COMMI TTEES ONLY :

P . 03

Pu 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 $500 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n Sc he d u l e H . ( R e f e r t o Sc h e d u l e H i n s t r u c t i o n s . )

E x p e n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mu s t a l s o b e d e t a i l i t e m i z e d o n

Sc 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 m a d e b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e r t o

Sc h e d u l e G i n s t r u c t i o n s a nd I o wa Co d e 5 8 . 6 ( 3 ) ( 1 ) . )

Pa g e _ . _ , _L _ _ - o f 1

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

FOR I NSTRUC71 0NS, SEE BACK OF FORM SCHEDULE

B MONETARY

EXPENDI TURES - - MONEY SPENT FROM COMMI TTEE ACCOUNT( R e v , 0 9 1 9 1 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECHECK THI S BOX I F

CANDI DATES, L I ST THE CANDI DATE I DENT I F I CAT I ON NUMBER I N THE DESI GNATED COLUMN AND THE

PAC CHECK NUMBERFOR EACH EXPENDI TURE . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NG FORM

ETHI CS & CAMPAI GN DI SCLOSURE BOARD .

COMMI TTEE NAME ( Mu s t b e s o m e a s o n St a t e me n t o f Or g a n i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 1 9 9 COPE F u n d

CANDI DATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE I D NUMBER EXPENDI TURE ( D ESCRI BE TRANSACTI ON) EXPENDED

EXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADE

( MM/ DD / YR) ANDPAC

CHECKNUMBER

7 / 3 1 / 0 , 4 I D # SEI U ( I n t ' 1 Of f i c e ) Mo n t h l y c o n t r i b u t i o n 7 1 2 . 50

CK # 1 0 6 4 Wa s h i n g t o n DC 20005

8 / 2 5/ 04 I D # SEI U ( I n t ' 1 Of f i c e ) Mo n t h l y c o n t r i b u t i o n 8 2 6 . 7 5

CK # 1065 Wa s h i n g t o n DC 2 0 005

9 / 21 / 04D#

SEI U ( I n t ' l Of f i c e ) Mo n t h l y c o n t r i b u t i o n 8 8 5 . 5 0

CK # 1066 Wash i ng t on DC 20005

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CK #

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OCT - 1 9 - 2 0 0 4 08 : 5 4 P . 0 4

F o r I n s t r u c t i o n s , Se e B a c k o f F o r m

CONTRI BUTI ONS - MONEY TAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )

COMMI TTEE NAME ( M u s t b e 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 )

SEI U( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 199 C PE Fu n d

JUD- I v 1 ^ ~

SCHEDULE

TOTAL ( i f l a s t page o f t h i s s c h e du l e )

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK T HI S BOX I F

AMENDI NGFORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ON

NUMBERANDTHE PACCHECK NUMBER I N THE DESI GNATED COLUMN. A L I ST OF I D NUMBERS I S AVA I LAB LE FROMTHE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B. 3 2A( 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 ma t i o n c o pi 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 nt r i b u t i o ns o r

f 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 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 a w r e q u i r e s c a nd i d at e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 of c o n sa n gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e Pa g e 2 o r l o an s p ac k et . ) . i f su r name o f c o n t r i h u t o r i s t h e s ame a s c a nd i d a t e , b u t t h e r e i s n o P s g e / o f

f a m i l i a l r e l a t i o n s h i p , e nt e r " n ot a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn . ( f o r Sc h e d ul e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FO

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND.

( MMI OD / YR1 AND " AG CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

7 / 2 3 / 2 0 0 4 B r i a n P F l a h e r t y 3 . 0 0

D i r e c t D e p o s i t 1122 So Se v e n t h Av e I C I A 52245

7 / 2 3 / 2 0 0 4 Annd G t r i t i t = A r c ~ i e r " - - 5 . 0 0

D i r e c t D e p o s i t 1744 - 1 1 5 t h S t We s t L i b e r I A 5 2 7 7 6

7 / 2 3 / 2 0 0 4 Ca t h y S i n g e r Gl a s s o n 1 5 . 0 0

D i r e c t D e p o s i t 1920 - 2n d Av e SE CR I A 52403

7 / 2 3 / 2 0 0 4 Ma t t N L o e b 2 . 5 0

D i r e c t D e p o s i t 47 0 H a w a i i Ct I C I A 52246

7 / 2 3 / 2 0 0 4 - D a v i d C Me g g e r s 5 . 0 0

D i r e c t D e p o s i t 3 3 7 1 O z z i e D r i v e NE S o l o n I A 5 2 3 3 3

7 / 2 3 / 2 0 0 4 D e v i n P Me h a f f e y 2 . 5 0

D i r e c t D e p o s i t 8 6 5 Camb u r n C t SE CR I A 52403

7 / 2 3 / 2 0 0 4 K i m R M i l l e r 1 0 . 0 0

D i r e c t D e p o s i t 8 0 5 S p e n c e r D r I C I A 52246

7 / 2 3 / 2 0 0 4 Do u g l a s L P e t e r s 2 . 5 0

D i r e c t D e p o s i t 7 0 E C h e s t n u t NL I A 52 31 7

7 1 2 3 1 2 0 0 4 J e n n i f e r M P o l a n d 2 , 5 0

D i r e c t D e p o s i t 2040 Gl a s s Rd NE # 1 0 1 CR I A 52402

7 / 2 3 1 2 0 0 4 K i r s t e n A Ru n n i n g 2 . 5 0

D i r e c t D e p o s i t 1210 H i g h l a n d Av e I C I A 52240



OCT - 1 9 - 2 0 0 4 0 8 : 5 5 P . 0 5


CONTRI 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 al f u n d s )

COMMI TTE E NAME ( M u s t b e same a s o n St at ement o f Or g a ni z a t i o n)

S E I U( S e r v i c e Emp l o y e e s I n t ' l Un i o n ) Loca l 1 9 9 C PE F u n d


AMENDI NGFORM

SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

STATE CANDI DATES NOTE I F A CONTRI BUT I ON I S RECE I VED FROMA STATEPAC ( POL I T I CAL ACT I ON COMMI TTEE ) , L I S T T HE PAC I DENT I F I CAT I ON

NUMBERANDTHEPACCHECK NUMBER I N THE DES I GNATED COLUMN. A L I S T OF I D NUMBERS I S AVA I L AB L E FROMTHE I OWA ETHI CS ANDCAMPA I GN

DI SCLOSURE BOARD.

CAUTI ON, S e c t i o n 6BB. 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 a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r

f o r a n y c o m m e r c i a l p u r p o s e by a n 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 mm i t t e e s

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

- D i s c l o s u r e l a w r e q u i r e s c a nd 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 ny r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mmi t t e e R e l a t i o n s h i p must 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 ns a ng u i n i t y ( b l o o d r e l a t i v e s ) a nd a f f i n i t y ( r e l a t i v e s by

ma r r i a g e) ( S e e Pag e 2 o f f o r ms p a c k e t . ) . I f sur name o f c o n t r i b u t o r i s t h e same a s c an d i d at e , b u t t h e r e i s no

f a m i l i a l r e l a t i o n s h i p , e nt e r ' no t a p p l i c a b l e " i n t h e i e l a t i o n s h i p c o l u mn .

Pa g e v, o f

( f u r S c h e du l e A)

OAT" PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FO

RECEI VED o f a pp l i c a b l e ) I TO CANDI DATE - RECEI VED FUND-

( MMI DD/ YF i ) AND" A ( ' CHECK ( i f a pp l i c a bl e ) RAI SER

f i t I MF I E R I NCOME

7 / 2 3 / 2 0 0 4 R i t a J S t e r l e r 5 . 0 0

D i r e c t D e p o s i t 2 1 3 1 P l a e n Vi e w Dr I C I A 5 2 2 4 6

7 / 2 3 / 2 0 0 4 - S a r a i I C S w i s n e r 4 0 _ 0 0

D i r e c t D e p o s i t 9 1 7 Bowe S t I C I A 5 2 2 4 0

7 / 2 3 / 2 0 0 4 Tawny L Wi l s o n 7 . 5 0

D i r e c t D e p o s i t 1 1 1 0 C o n k l i n S t I C I A 5 2 2 4 5

7 1 3 0 / 2 0 0 4 R u s s e l l A C l a r k ( CR S c h ) 5 _ 0 0

1 0 2 6 5 0 4 0 4 5 Ch i c k a d e e L n Hi a wa t h a I A 5 2 2 3 3

` 7 / 3 0 / 2 0 0 4 H a r l e s s S Cl emo n s ( CR S c h ) 1 0 . 0 0

1 0 2 6 5 0 5 0 5 S i x t h S t SE CR I A 5 2 4 0 1

7 / 3 0 / 2 0 0 4 Ma r s h a l l R Cl emo n s ( CR S c h ) 5 _ 0 0

1 0 2 6 5 0 5 0 5 S i x t h S t SE CR I A 5 2 4 0 1

7 / 3 0 / 2 0 0 4 WmA F i a c c o ( CR S c h ) 3 . 0 0

1 0 2 6 5 0 4 1 3 3 - 2 2 nd Av e SWCR I A 5 2 4 0 4

7 1 3 0 1 2 0 0 4 J e f f L F o s t e r ( CR S c h ) 5 . 0 0

1 0 2 6 5 0 3 2 0 9 T ama r a Dr SWCR I A 5 2 4 0 4

7 / 3 0 / 2 0 0 4 Ke n D G r o u t ( CR S c h ) 2 . 0 0

1 0 2 6 5 0 1 0 3 7 C l i f t o n S t NE CR I A 5 2 4 0 2

7 1 3 0 / 2 0 0 4 Go r d o n K a l t e n b a c h ( CR S c h ) 6 . 0 0

1 0 2 6 5 0 2 2 7 - 1 1 t h S t N WCR I A 5 2 4 0 5



OCT - 1 9 - 2 0 0 4 0 8 " 5 5 P . 0 6

F o r I n s t r u c t i o n s , Se e B a c k o f Fo r m J SCHEDULE



COMMI TT EE NAME ( M u s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Emp l o y e es I n t e l Un i o n ) L o c a l 1 9 9 C~ PE Fu n d

A MONET ARY

( Re v . 0 6 / 9 7 ) RECEI PTS

QCHECK T HI S BOX I F

AMENDI NG FORM

STATE CANDI DATES NOT E : I F A CONTRI BUT I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMMI TTEE) , L I S T THE PAC I DENT I F I C AT I ON

NUMBER ANDTHEPA C CHECK NUMBER I N THE DESI GNATED COLUMN A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD

CAUTI ON . Se c t i o n 6 8B . 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 ma t i o n c op i e d f r om r e po 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 omme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h 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 .

D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 own t o t h e t h i r d d e g r e e o f c o ns a n gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( S ee P a g e 2 o f f o r ms p a c k e t . ) . I f s u r n a r n e o f c o n t r i b u t o r i s t h e s ame a s c a n di d at e , b u t t h er e i s n o

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 .P a g e

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

DATE PA C I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORECEI VED ( i f a p p l i c a b l e ) T O CANDI DATE' RECEI VED FUND-

( MM/ DDI Yf i 1 AND ' - ' A C CHECK ( H a pp l i c a b l e ) RAI SER

NUMBER I NCOM

7 / 3 0 / 2 0 0 4 J o y c e E L u c a s ( CR S c h ) 4 . 0 0

1 0 2 6 5 0 1 4 0 1 B Av e V i n t o n I A 5 2 3 4 9

7 / 3 0 1 2 0 0 4 D a v e L M a r t ( CR S c h ) 5 . 0 0

1 0 2 6 5 0 9 2 6 - 1 5 t h Av e SWCR I A 5 2 4 0 4

7 / 3 0 1 2 0 0 4 C h r i s McLe e s ( CR S c h ) 5 . 0 0

1 0 2 6 5 0 4 1 1 - 2 7 t h S t NE CR I A 5 2 4 0 2

7 / 3 0 / 2 0 0 4 T i m J Ne wc omb ( CR S c h ) 5 . 0 0

1 0 2 6 5 0 7 2 6 E Av e NWCR 1 A 5 2 4 0 5

7 / 3 0 / 2 0 0 4 Cha s A P e r r y ( CR S c h ) 1 0 . 0 0

1 0 2 6 5 0 1 4 7 9 Mi a mi Dr NE CR I A 5 2 4 0 2

7 / 3 0 1 2 0 0 4 AL J P o s p i s i l ( CR S c h ) 1 . 0 0

1 0 2 6 5 0 1 6 1 9 A r i z o n a Av e NE CR I A 5 2 4 0 2

7 / 3 0 / 2 0 0 4 T e r r y A S l i c k t y ( CR S c h ) 2 . 5 0

1 0 2 6 5 0 1 1 2 8 B r own Av e NE CR I A 5 2 4 0 2

7 / 3 0 / 2 0 0 4 L o i s J B a s s e t t ( CR S c h ) 3 . 0 0

1 0 2 6 5 1 1 0 0 2 E a s t e r n Dr SE CR I A 5 2 4 0 3

7 / 3 0 / 2 0 0 4 S t e p h a n i e J L e w i s ( CR S c h ) 5 . 0 0

1 0 2 6 5 1 1 6 0 1 - 3 0 t h S t NW# 1 2 CR I A 5 2 4 0 5

7 / 3 0 / 2 0 0 4 Do n a l d J B i n e g a r J r ( I C S c h ) 1 . 5 0

2 2 7 6 8 1 P O Bo x 3 7 3 N E n g l i s h I A 5 2 3 1 6JVv , v , nw

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



OCT - 1 9 - 2 0 0 4 0 8 : 5 6 P . 0 7

F o r I n s t r u c t i o n s , Se e B a c k o f Fo r m ( SCHEDULE



COMMI TT EE NAME ( M u s t b e s ame a s o n St a t eme n t o f Or g a ni z a t i o n)

SEI U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 1 9 9 COPE Fun d

A I MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NGFORM

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECE I VED FROMA STATE PAC ( POL I T I CAL ACT I ON COMMI T TEE ) . L I S T THE PAC I DENT I F I CAT I ON

NUMBERANDTHEPAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS AND CAMPAI GN

D I SCLOSURE BOARD

CAUTI ON : Se c t i o n 6 8B, 3 2A( 6 ) , I o wa C o d e , pr o h i b i t s t h e us e o f i n f o r ma t i o n c o pi e d f r o m r e po 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 nt r i b ut i o ns o r

f o r an y c o mme r c i a l p u r p o s e b y a ny pe 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 nd 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 ny r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 ns a ng ui n i t y ( b l o od r e l a t i v e s ) a nd a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S ee P a g e 2 o f f o r ms p a c k e t ) , I f s u r n ame o f c on t r i b u t o r i s t h e s ame a s c a nd i d a t e , b u t t h er e i s no p a g e o f

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 pp l i c ab l e ' i n t h e r e l a t i o n s h i p c o l u mn . ( f o r S c h e d ul e A)

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FO

RECEI VED ( i f a pp l i c a b l e )

ITO CANDI DATE'

IRECEI VED FUND-

( MM/ DDI Yk ) AND" AC CHECK ( i f a p p l i c a b l e )

NUMBER I NCOME

7 / 3 0 / 2 0 0 4 K u r t h T Boy c e ( I C S c h ) 1 . 5 0

2 2 7 6 8 1 4 8 7 6 - 1 2 0 S t NE S o l o n I A 5 2 3 3 3

7 / 3 0 / 2 0 0 4 Ri d h a r d ' Ha n na n ( I C S c h ) 1 . 5 0

2 2 7 6 8 1 P 0 Bo x 3 2 8 1 I o w a C i t y I A 5 2 2 4 4

7 / 3 0 / 2 0 0 4 J o h n Ho a r d ( I C S c h ) 1 - 2 5

2 2 7 6 8 1 Bo x 4 6 6 H i l l s I A 5 2 2 3 5

7 / 3 0 / 2 0 0 4 Ron J e n s e n ( I C S c h ) 1 . 0 0

2 2 7 6 8 1 4 2 5 - 3 2 0 t h S t WL i b e r t y I A 5 2 7 7 6

7 / 3 0 1 2 0 0 4 B r a d K u e s t e r ( I C S c h ) 1 . 5 0

2 2 7 6 8 1 2 8 2 1 S R i v e r s i d e Dr I o w a C i t y I A 5 2 2 4 6

7 / 3 0 / 2 0 0 4 J o n L a l l e ( I C S c h ) 2 . 5 0

2 2 7 6 8 1 6 0 1 Oa k l a n d Av e I o w a C i t y I A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 B r i a n J Meyer ( I C S c h ) 1 . 5 0

2 2 7 6 8 1 1 6 M e t r i c Road I o w a C i t y I A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 M i c h e l Mur phy ( I C S c h ) 2 _ 6 0

2 2 7 6 8 1 3 1 5 E l l i s Av e # 1 I o w a C i t y I A 5 2 2 4 6

7 / 3 0 1 2 0 0 4 Randy Nguyen ( I C S c h ) 1 - 5 0

2 2 7 6 8 1 4 8 Amber L a n e I o w a C i t y I A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 M i c h a e l O' Conno r ( I C S c h ) 1 . 5 0

2 2 7 6 8 1 2 9 0 El m R i d g e D r i v e N o r t h L i b e r t y I A 5 2 3 1 7

$ I l D 4 1-000 )

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



OCT - 1 9 - 2 0 0 4 0 8 : 5 6 P . 0 8

F o r I n s t r u c t i o n s , Se e B a c k o f Fo r m SCHEDULE

CONTRI BUT I ONS - MONEY TAKEN I NA MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


COMMI TT EE NAME ( M u 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 )

SEI U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 1 9 9 C~PE F u n d


AMENDI NGFORM

STATE CANDI DATES NOTE! I F A CONTR I BUT I ON I S RECEI VED FROMA STATEPAC ( P OL I T I CA L . ACT I ON COMMI TTEE ) , L I S T THE PAC I DENT I F I CAT I ON

NUMBERAND THE PAC CHECK NUMBER I N THE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD.

CAUTI ON: Se 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 us e o f i n f o r ma t i o n c o pi e d f r o m. r e po r t s and s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o r

f o r an y c o mme 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 mmi t t e e s .

' Di s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e _c 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 Co ns a n gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( Se e Page 2 o f f o r ma p a c k e t . ) . I f s u r r i 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 nd i d at e , b u t t h e r e i s n o P a g e o f ^f a m i l i a l r e l a t i o n s h i p , e nt e r " n o t a pp l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn .

( f o r S c h ed u l e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT J I F FORECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE ' RECEI VED FUND-( MMI DD / YR) AND " AC CHECK ( i f a p p l i c a b l e ) RA I SE

NUMBER I NCOM

7 1 3 0 / 2 0 0 4 Rodne y Pe r d u e ( I C S c h ) 2 . 5 0

2 2 7 6 8 1 6 0 3 WP a r i s S t WL i b e r t I A 5 2 7 7 6

7 1 3 0 1 2 0 0 4 71

- WmS a l a s b e r r y ( I C S c h ) 1 . 5 0

2 2 7 6 8 1 1 1 1 9 P i n e S t I o wa C i t y I A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 K i m b e r l y Sc h l a b a c h ( I C S c h ) 1 . 5 0

2 2 7 6 8 1 5 2 7 2 O a k c r e s t H i l l Rd R i v e r s i d e I A 5 2 2 4 6

7 / 3 0 / 2 0 0 4 Ge r a l d V o n s t e i n ( I C S c h )2 , 5 0

2 2 7 6 8 1 5 0 4 8 - 2 1 0 t h S t NE S o l o n I A 5 2 3 3 3

7 / 3 0 / 2 0 0 4 Da l e Wei r ( I C S c h )1 - 5 0

2 2 7 6 8 1 2 1 4 5 P a l me r C i r c l e I o w a C i I A 5 2 2 4 0

7 / 3 0 1 2 0 0 4 J e r o me Wi e deme i r ( I C S c h ) 1 . 5 0

2 2 7 6 8 1 2 5 0 6 F r i e n d s h i p S t I C I A 5 2 2 4 5

7 / 3 0 / 2 0 0 4 D a r y l L e wi s ( I C S c h )5 _ 0 0

2 2 7 6 8 1 2 1 6 Da r t mo u t h I o w a C i t I A 5 2 2 4 5

7 / 3 0 / 2 0 0 4 Ma r s h a An d e r s o n ( U I H C ) 5 . 0 0

1 2 7 6 0 8 6 1 9 7 5 So Ri d e Dr C o r a l v i l l e I A 5 2 2 4 1

7 1 3 0 / 2 0 0 4 Sa n d r a A n f i n s o n ( UI HC)2 . 0 0

1 2 7 6 0 8 6 3 0 2 N o r t h F o u r t h S t WB r a n c h I A 5 2 3 5 8

7 1 3 0 / 2 0 0 4 Ma t t B a h l ( U I H C )5 . 0 0

1 2 7 6 0 8 6 2 4 5 H i c k o r y S t N L i b e r t y I A 5 2 3 5 8

TOTAL ( i f l a s t p ag e o f t h i s s c h e du l e )



OCT - 1 9 - 2 0 0 4 0 8 " 5 6 P . 0 9

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 m



COMMI TT EE NAME ( M u s t b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Emp l o ye es I n t ; ' l Un i o n ) Loca l 1 9 9 CTPE Fund

SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) I RECEI PTS


AMENDI NG FORM

STATE CANDI DATES NOTE: I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMMI T TEE) , L I S T THEPAC I DENT I F I CAT I ON

NUMBERANDTHE PAC CHECKNUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS ANDCAMPAI GNDI SCL OSURE BOARD.

CAUTI ON : Se 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 us 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 po r t s and s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o r

f o r a ny 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 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 i o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mmi t t e e R e l a t i o n s h i p mu l l be s h o w n t o t r e 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 e t l v e f b y

ma r r i a g e) ( Se e P a g e 2 o f f o r ms p a c k e t . ) . I ( 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 an d i d a t e , b ut t h e r e i s n o

f a m i l i a l r e l a t i o n s h i p , e nt e r " n o t a pp l i c 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 .p a t e l L / , o f


DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT q I F FORECEI VED ( i f a p p l i c a b l e ) T O CANDI DATE' RECEI VED F UND-( MM/ DDNR. ) AND " AC C HE CK- ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

7 / 3 0 / 2 0 0 4 M i c h e l l e B a r g r e n ( UI HC) 5 - 0 0

1 2 7 6 0 8 6 7 0 2 Ho d e S t N o r t h L i b e r t y I A 5 2 3 1 7

7 / 3 0 / 2 0 0 4 ' J a n i o b S a r r i e s ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 1 0 2 1 - 2 0 t h Av e CV I A 5 2 2 4 1

7 1 3 0 / 2 0 0 4 Ra c ha e l B a r r o w ( UI HC) 1 0 . 0 0

1 2 7 6 0 8 6 3 5 1 3 D u n h a m Dr SWCR I A 5 2 4 0 4

7 / 3 0 / 2 0 0 4 De b B e n f e r ( UI HC) 3 . 0 0

1 2 7 5 0 8 6 1 6 8 3 Hemi n wa L a n e I C I A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 De b Be n n e r - Ha h n ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 1 2 3 2 E C o l l e e S t I C I A 5 2 2 4 5

7 / 3 0 / 2 0 0 4 Ma r t h a B r a d b u l y ( U I H C ) 2 . 0 0

1 2 7 6 0 8 6 1 1 1 6 WI d e Gr e e n Rd I C I A 5 2 2 4 6

7 / 3 0 / 2 0 0 4 J a n a B u r k h o l d e r ( UI HC) 1 . 0 0

1 2 7 6 0 8 6 6 0 4 Ki mb e d d e S t T i f f i n I A 5 2 3 4 0

7 1 3 0 / 2 0 0 4 He i d e B u r s c h ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 9 7 O b e r l i n I C I A 5 2 2 4 5

7 1 3 0 1 2 0 0 4 B a r r y Bu s c h e l ma n ( U I H C ) 5 . 0 0

1 2 7 6 0 8 6 7 8 0 F a i r v i e w L n N o r t h L i b e r t y I A 5 2 3 1 7

7 / 3 0 / 2 0 0 4

1 3 0 2

An n By r n e ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 Oa k S t B u f f a l o I A 5 2 7 2 8i ~ t u u a

~ - - c~r_~~g




OCT - 1 9 - 2 0 0 4 0 8 : 5 7 P . 1 0

F o r I n s t r u c t i o n s , Se e B a c k o f Fo r m

CONTRI BUT I ONS - MONEY TAKEN I N


COMMI TT EE NAME ( M u s t b e s ame a s o n St a t e me n t o f Or g a n i z a t i o n )

SE I U( Se r v i c e Empl o y e e s I n t ' l Un i o n ) L o c a l 1 9 9 C PE F u n d

S TAT E CANDI DAT ES NOTE ; I F A CONTRI BUTI ON i $ RECEI VED FROM A STATE PAC ( P OL I T I C A L ACT I ON COMMI T T E E ) , L I S T T HE PAC I D E N T I F I C A T I O NNUMBER AND THE PAC CHECK NUMBER I N T HE DESI GNATED COL UMN . A L I S T OF 1 0 NUMBERS I S AVAI LABLE FROM T HE I OWA ETMI CS AND CAMPAI GN

0I SCLO$URE BOARD.

CAUTI ON : Se c t i o n 6 8 B . 3 2 A ( B ) , 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 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 r

f o r a n y c o mme r c i a l p u r p os e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c ommi t t e e s .

D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mm i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 hown t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) ( S e e P a g e 2 o f f o r m s p a c k e t . ) . I f s u r n a me o f c o n t r i b u t o r i s t h e same a s c a n d i d a t e , b u t t h e r e i s n o P a g e _ o f

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 umn . ( f o r Sc h e d ul e A )

SCHEDULE

A MONETARY

( R e v . 0 6 / 9 7 ) RECE I PTS


AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT d I F FO

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE RECEI VED FUND-

( MM/ DD/ YR) ANO . ' - ' A C CHECK ( i f a p p l i r a b l e ) RAI SE

NUMBER . , I NCOM

7 / 3 0 1 2 0 0 4 M a r j i e C a r u t h ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 8 0 1 A l p i n e Dr I C I A 5 2 2 4 5

7 / 3 0 / 2 0 0 4 Be v C l e a h T i a n ' ( U 1 HC ) 5 . 0 0

1 2 7 60 8 6 1 0 0 7 E i g h t h S t C o r a l v i l l e I A 5 2 2 4 1

7 / 3 0 / 2 0 0 4 L y n e t t e Coope r ( U I H C ) 2 . 5 0

1 2 7 6 0 8 6 2 4 0 1 Hwy 6 E # 1 2 1 0 I C I A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 J u l i e D a v i s ( U I H C ) 5 , 0 0

1 2 7 6 0 8 6 3 3 7 No r man d y Dr I C I A 5 2 2 4 6

7 / 3 0 / 2 0 0 4 Ca t h y D o s t a l ( U I H C ) 2 . 0 0

1 2 7 60 8 6 1 9 8 5 So u t h Ri d e D r CV I A 5 2 2 4 1

7 / 3 0 / 2 0 0 4 An g e l a Duwa ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 2 5 1 9 J Av e Wi l l i a ms b u r g I A 5 2 3 6 1

7 1 3 0 / 2 0 0 4 C a r o l y n E l l i o t t ( UI HC) 1 0 . 0 0

1 2 7 6 0 8 6 1 1 0 F l o r i d a Av e SWCR I A 5 2 4 0 4

7 / 3 0 / 2 0 0 4 S h e l l e y Engman ( UI HC) 5 . 0 0

1 2 7 60 8 6 7 1 7 R u n d e l l S t I C I A 5 2 2 4 0

7 1 3 0 / 2 0 0 4 E l i z a b e t h F i s h e r ( U I H C ) 2 . 5 0

1 2 7 60 8 6 1 3 0 7 C a r r o l l S t I C I A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 A n i t a F i t e ( UI HC) 5 . 0 0

1 2 7 6 0 6 6 1 3 3 H i l l s i d e Dr E l d r i d e I A 5 2 7 4 81 J ~L ' J t l ~ / h /

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



OCT - 1 9 - 2 0 0 4 08 : 5 7

Fo r I n s t r u c t i o n s , Se e Bac k o f F o r m



COMMI TTEENAME ( 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 )

S EI U( S e r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 199 C PE Fu n d

- D i s c l o s u r e l a w r e q u i r e s c an d i d at 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 an y r e l a t i v e mak i n g a c o n t r i b u t i o n t o t h e

c ommi t t e e R e l a t i o n s h i p must b e s h ow n t o t h e t h i r d d e gr e e o f c o n s an g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e Pag e 2 o f f o r ms p a c k e t . ) . I l s u r n ame o f c o n t r i b u t o r i s t h e s ame as c an d i d at e , b i l l t h e r e i s n o

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 .

P . 1 1

CHECK THI S BOX I F

AMENDI NG FORM

SCHEDULE

A MONETARY

( R e v , 0 6 1 9 7 ) I RECEI PTS

STATECANDI DATES NOTE : I F ACONTRI BUTI ON I S RECEI VED FROMA STATEPAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THEPAC I DENTI F I CATI ON

NUMBER ANDTHE PACCHECK NUMBER I N THE DESI GNATED COLUMN A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHEI OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD

CAUTI ON : S e c t i o n 6 8B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r

f o r a n y c o m m e r c i a l p u r p o s e b y 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 .

Pag e o f

( f o r S c he d u l e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FOR

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-

( MM/ DD/ Y k ) AND - AC CHECK i ( i f a p p l i c a b l e ) RAI SERBI NCOME

7 / 3 0/ 2 00 4 Kar l e n e F u l l e r ( UI HC) 3 . 0 0

1 2 7 6 0 8 6 1611 - 1 3 t h S t r e e t CV I A 5 2241

7 1 3 0 / 2 0 04 Ci n d y i i u i ' i k . ( u i H C ) 3 . 0 0

1 2 7 6 0 8 6 1231 S a n d u s k Ave I C I A 5 2 2 4 0

7 / 3 0/ 2 00 4 J o e G a l b r a i t h ( UI HC) 10 . 0 0

1 2 7 6 0 8 6 3021 Rave n S t I C I A 5 2 2 4 5

7 1 3 0 / 2 0 04 Nancy Genoa r ( UI HC) 5 . 0 0

12 7 6 0 8 6 125 2 C o l l Dr I C I A 5 2 2 4 6

7 1 3 0 / 2 0 04 Tr i s ha Go d a r d S h e ph e r d ( UI HC) 2 . 5 0

12 7 6 0 8 6 93 0 223 r d Av e Apt CC o r a l v i l l e I A 52241

7 1 3 0 / 2 0 04 L y n d a Gr e e n ( UI HC) 10 . 0 0

1 2 7 6 0 8 6 2 0 7 5 Me l r o s e Av e I C I A 5 2 2 4 6

7 1 3 0 / 2 0 04 M e l i s s i a Gr e i n e r ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 2 6 4 3 6 - 3 05 t h A v e n u e Ke o t a I A 5 2 2 4 8

7 / 3 0 / 2 00 4 Dan Gr i n s t e ad ( UI HC) 7 . 5 0

12 7 6 0 8 6 121 8 As h S t I C I A 5 2 2 4 0

7 / 3 0 1 20 0 4 Ma r c i a Hahn ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 2281 S u g a r Bo t t o m Rd S ol o n I A 5 2 3 3 3

7 / 3 0/ 2 00 4 Te r r y Hami l t o n ( UI HC) 3 . 0 0

1 2 7 6 0 8 6 7 1 5 N Van Bu r e n S t I C I A 5 2 2 4 5

$ 5 , ' I I ITOTAL ( i f l a s t p a g e o f t h i s s c he d u l e )



OCT - 1 9 - 2 0 0 4 0 8 : 5 8 P . 1 2



( I n c l u d i n g c a nd i d a t e ' s p e r s o n a l f u n d s )

COMMI TT EE NAME ( M u 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 )

SEI U( Se t v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 1 9 9 C~PE Fu n d

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROMA STATE PAC ( POL I T I CAL ACT I ON COMMI T TEE) , L I S T THEPAC I DENT I F I CAT I ONNUMBER ANDTHEPACCHECK NUMBER I N THE DESI GNATED COLUMN, A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD,

CAUTI ON S e c t i o n 6 9 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 or 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 .

! ~- r J t 3 - 7 -pFA- 5S~$ rTOTAL ( i f l a s t page o f t h i s s c h e d u l e )

' D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mmi t t e e . R e l a t i o n s h i p must b e s h own t o t h e t r l l r d d e g r e e 0 ( Co n s an g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

m a r r i a g e ) ( S e e P a g e 7 o f f o r ms p ac k e r . ) . I f s u r n ame o f c o n t r i b u t o r 1 5 t h e same a s c a n d i d at e , b u t t h e r e i s n o P a c e

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 pp 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 .

SCHEDULE

A MONETARY( Re v , 0 6 / 9 7 ) R EC E I P T S

a CHECK T HI S BOX I F

AMENDI NG FORM

9 o f

( f o r Sc Fi c d u l e A)

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT d I F FORECEI VED ( i f a pp l i c a bl e ) TO CANDI DATE' RECEI VED FUND-

( MM/ DD/ Y k ) AND " AC CHECK ( i f a p p l i c a b l e ) RAI SENUMBER I NCOM

7 / 3 0 1 2 0 0 4 L y n n Ha n k e ( UI HC) 5 _ 0 0

1 2 7 5 0 8 6 1 0 0 1 M e m o r i a l Dr SE CR I A 5 2 4 0 3

7 / 3 0 / 2 0 0 4 Sa r a h H e l l e ( UI HC) - 5 . 0 0

1 2 7 6 0 8 6 1 3 3 0 Up pe r O l d H 6 O x f o r d I A 5 2 3 2 2

7 / 3 0 / 2 0 0 4 Sh a r o n H i c k s ( UI HC) 2 . 0 0

1 2 7 6 0 8 6 2 6 3 9 - 1 4 0 t h S t r e e t NWSwi s h e r I A 5 2 3 3 8

7 / 3 0 / 2 0 0 4 Me l o d y H o b e r t - M e l l e c k e r ( U I H C ) 5 . 0 0

1 2 7 6 0 8 6 3 0 0 Ma i n S t H i l l s I A 5 2 2 3 5

7 / 3 0 / 2 0 0 4 C l a i r e Ho c k l e y ( UI HC) 7 . 5 0

1 2 7 6 0 8 6 2 6 4 7 Newpor t Rd NE I C I A 5 2 2 4 0

7 / 3 0 1 2 0 0 4 De b R e y n o l d s Hu b b a r d ( UI HC) 3 . 0 0

1 2 7 6 0 8 6 1 4 6 8 V a l l e y Vi e w D r i v e CV I A 5 2 2 4 1

7 / 3 0 / 2 0 0 4 S h e l l e y J a c o b u s ( UI HC) 1 . 0 0

1 2 7 6 0 8 6 6 5 0 7 Boxwood L n NE CR I A 5 2 4 0 2

7 / 3 0 / 2 00 4 J e n n i f e r J u n g e n ( U I H C ) 5 . 0 0

1 2 7 6 0 8 6 P 0 Bo x 5 8 8 N o r t h L i b e r t y I A 5 2 3 1 7

7 / 3 0 / 2 0 0 4 Nor man K a l v i g ( UI HC) 2 0 _ 0 0

1 2 7 6 0 8 6 1 9 4 5 Pa r k Av e SE CR I A 5 2 4 0 3

7 1 3 0 1 2 0 0 4 V a l e r i e K e f f a l a ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 1 1 0 9 P r a i r i e DuChi e n Rd I C I A 5 2 2 4 5



OCT - 1 9 - 2 0 0 4 0 8 " 5 8




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

SEI U( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 199 C PE F u n d

SCHEDULE

P 1 3


AMENDI NGFORM

A MONETARY

( Re v . 06 197 ) RECEI PTS

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATEPAC ( POL I T I C AL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ON

NUMBERAND THE PACCHECK NUMBER I N THE DES I GNATEDCOLUMN A L I ST OF I D NUMBERS I S A VA I L A B L E FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD

CAUTI ON , S e c t i o n 68B. 3 2A( B ) , I o wa Co d e , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c op i e d f r 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 on t r i b ut i o n s o r

f 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 er 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 .

' D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e R e l a t i o n s h i p mi n t b e s h o wn t o t h e t h i r d d e g r e e o f c o n s a ng 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 l i v e s b y

ma r r i a ge ) ( S e e P a g e 2 o f f o r ms p a c k e t . ) . I f s u r n a r n e o f c on t r i b u t o r i s t h e s ame a s c an d i d at e , b u t t h e r e i s n o P a g e o f

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 Sc h e d ul e A)



( MMI DDI Yk ) AND- AC CHECK ( i f a pp l i c a b l e ) RAI SER

NUMBER I NCOM

7 / 3 0 1 2 0 0 4 Te r e s a A K i n g d o n ( UI HC) 2 . 5 0

127 6 086 2113 N o r c o r A v e A p t 4 CV I A 5 2 2 4 1

7 / 3 0 / 2 0 0 4 K a t h e r i n K i t e l n o w ( OI HC) - -' 5 . 0 0

127 6 086 3 3 3 3 Ph e a s a n t Ct NE N o r t h L i b e r t y I A 52 3 1 7

7 / 3 0 1 2 0 0 4 A r l e n e K l e s n e r ( UI HC) 1 . 0 0

127 608 6 1901 Ea r l Roa d I C I A 52246

7 / 3 0 / 2 0 0 4 AmyKr u s e ( UI HC) 5 . 0 0

127 608 6 203 F i f t h S t # 1 C o r a l v i l l e I A 5 2 2 4 1

7 / 3 0 / 2 0 0 4 L i n d a K r u t s i n g e r ( U I H C ) 1 0 . 0 0

127 6 086 2147 P l a e n Vi e w Dr I C I A 52246

7 1 3 0 / 2 0 0 4 C y n t h i a L ar e w ( UI HC) 1 , 0 0

127 608 6 P 0 Bo x 4 4 1 L o n e T r e e I A 52755

7 / 3 0 / 2 0 0 4 P a u l a L a u b e ( U I H C ) 7 . 5 0

1276086 7 12 Wa l n u t S t I C I A 52240

7 / 3 0 1 2 0 0 4 Ra el e n e L en o c h ( UI HC) 1 , 0 0

127 6 086 213 Br o a d wa y S t WB r a n c h I A 52358

7 1 3 0 / 2 0 0 4 L u a n n e L i n k ( UI HC) 5 . 0 0

1276086 2215 H i c k o r y C o u r t I C I A 52240

7 1 3 0 / 2 0 0 4 M i c h a e l L o u c k s ( UI HC) 5 . 0 0

1276086 1495 F a l c o n Av e S w i s h e r I A 5 2 3 3 8

S




OCT - 1 9 - 2 0 0 4 0 8 : 5 9




COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g a n i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 199 C PE F u n d

SCHEDULE

TOTAL, ( i f l a s t page o f t h i s s c h e du l e )

P . 1 4

A MONETARY

( R e v , 0 6 1 9 7 ) RECEI PTS

©CHECK T HI S BOX I F

AMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI v EO FROM A STATE PAC ( P O L I T I C A L ACTI ON COMMI TTEE) , L I S T TH E PAC I D EN T I F I C A T I O N

NUMBER AND THE PAC CHECK NUMBER I N TH E DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM TH E I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD

CAUTI ON : S e c t i o n 6 8B . 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 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 r

f o r a n y c omme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c ommi 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 os e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y } Ima r r i a g e ) ( S e e P a g e 2 o f f o r m s p a c k e t . ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s a r n 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 a g e o f

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

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSH I P AMOUNT J I F FOR

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE - RECEI VED FUND-

( MMI DD1Yk ) AND " AC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

7 / 3 0 / 2 0 0 4 Wi l ma Ma c a l a l a g ( UI HC) 5 . 0 0

127 608 6 8 2 8 Au gu s t a C i r c l e N o r t h L i b e r t y I A 52 31 7

7 / 3 0 1 2 0 0 4 J u n e - M a s b r t h : ; h ( U I H ( ; ) 5 _ 0 0

127 6 086 23 87 - 3 4 0 t h S t SWT i f f i n I A 52 340

7 / 3 0 / 2 0 0 4 An n Mason ( U I H C ) 3 . 0 0

1276086 1 0 3 2 O a k c r e s t S t I C I A 52246

7 / 3 0 1 2 0 0 4 Ru t h McKeeve r ( U I H C ) 5 . 0 0

127 6 086 3 02 Wa l n u t S t T i t o n I A 5 2 7 7 2

7 1 3 0 / 2 0 0 4 Ma r y Mc Ki n n e y ( UI HC) 3 . 0 0

127 608 6 5 06 We s t Se v e n t h S t T i t o n I A 5 2 7 7 2

7 1 3 0 / 2 0 0 4 Mar y J o Me g g e r s ( UI HC) 5 . 0 0

127 608 6 3 3 7 1 Oa i e Dr S o l o n I A 5 2 3 3 3

7 1 3 0 1 2 0 0 4 T e r r i Me n g l e r ( UI HC) 7 . 5 0

127 608 6 2 21 5 Se c o n d St SWCR I A 52404

7 / 3 0 / 2 0 0 4 J e a n M i l l e r ( UI HC) 5 . 0 0

127 5 086 3 7 5 5 C o t t a g e Re s e r v e Rd NE S o l o n I A 5 2 3 3 3

7 / 3 0 1 2 0 0 4 T a r a M i l l e r ( UI HC) 2 . 5 0

1276086 3 3 3 C a r t e r S t NWCR I A 52405

7 / 3 0 1 2 0 0 4 R o b e r t M i l n e ( U I H C ) 3 , 0 0

1276086 417 C a r t e r S t NWCR I A 52405



OCT - 1 9 - 2 0 0 4 0 8 : 5 9 P . 1 5





SETU( Se r v i c e Emp l o y ee s Yn t ' l Un i o n ) Loca l 1 9 9 C PE Fund

SCHEDULE

A MONETARY

( Re v . 0 6 1 9 7 ) RECEI PTS


AMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATEPAC ( POL I T I CAL ACT I ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ONNUMBERAND THEPAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I 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 C o d e , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c op i e d f r o m r e p o r t s and s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o r

f o r any c o mme r c i a l p ur p o s e b y a n 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 .

D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t l o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mml t t e c 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 eg r e e o f c on s an gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) ( Se e P a g e 2 o f f o r ms p a c k e t . ) . I f su r name o f c o n t r i b u t o r i s t h e same a s c an d i d at e , b u t t h e r e i s n o P a g ef 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 du l e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT q I F FORECEI VED ( i f a pp l i c a bl e ) TOCANDI DATE RECEI VED FUNO-( MMI DDI YR) AND' ' AC CHECK ( i f a p p l i c a b l e ) RAI SE

NUMBER I NCOM

7 / 3 0 / 2 0 0 4 M e l i n d a My e r s ( UI HC) 2 0 . 0 0

1 2 7 6 0 8 6 1 1 1 6 A Av e NWCR I A 5 2 4 0 5

7 / 3 0 / 2 0 0 4 J a n Ni e b e s CPC) " 5 . 0 0

1 2 7 6 0 8 6 1 7 2 7 4 - 1 5 t h Av e Ke y s t o n e I A 5 2 2 4 9

7 / 3 0 / 2 0 0 4 L i n d a P e t e r s e n ( UI HC) 2 . 5 0

1 2 7 6 0 8 6 9 0 7 N G i l b e r t S t I C I A 5 2. 2 4 5

7 / 3 0 1 2 0 0 4 M a r g a r e t Mar y P i n g ( U I H C ) 3 . 0 0

1 2 7 6 0 8 5 1 1 0 Sa r e r t Dr We s t B r a n c h I A 5 2 3 5 8

7 / 3 0 / 2 0 0 4 B e c k y P o t t o r f f - L e a v e n ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 1 1 4 9 H u n t e r ' s Run I C I A 5 2 2 4 6

7 / 3 0 / 2 0 0 4 Mar y R e i d y ( UI HC) 3 . 0 0

1 2 7 6 0 8 6 2 3 3 1 E a s t Wa s h i n g t o n S t I C I A 5 2 2 4 5

7 / 3 0 / 2 0 0 4 J e f f r e y Rupe ( UI HC) 3 . 0 0

1 2 7 6 0 8 6 P O Bo x 2 18 N o r t h L i b e r t y I A 5 2 3 1 7

7 / 3 0 / 2 0 0 4 Nancy Sa nds t r o m ( UI HC) 7 . 5 0

1 2 7 6 0 8 6 6 0 D a v i d Le e C o u r t N o r t h L i b e r t y I A 5 2 3 1 7

7 / 3 0 / 2 0 0 4 D o r o t h y S a t a r i a n o ( UI HC) 3 . 0 0

1 2 7 6 0 8 6 3 2 2 2 S h a s t a Ct NECR I A 5 2 4 0 2

7 1 3 0 1 2 0 0 4 C h e r y l S c h i l d ( UI HC) 3 . 0 0

1 2 7 6 0 8 6 9 1 4 - 1 2 t h Av e CV I A 5 2 2 4 1: 7VOw V W" L

$~




OCT - 1 9 - 2 0 0 4 0 9 " 0 0 P . 1 6




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 Or g a n i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 1 9 9 C PE F u n d

SCHEDULE

A ~ MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK T HI S BOX I FAMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACT I ON C OMMr F F E E ) , L I S T THE PAC I D EN T I F I C A T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF 1 0 NUMBERS I $ AVAI LABLE FROMT HE I OWA E T HI C S AND CAMPA I GNDI SCLOSURE BOARD .

CAUTI ON : S e c t i o n 6 B8 . 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 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 n s o rf o r a ny c o mme 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 ommi 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 r e l a t l v e ma k i n g a c o n t r i b u t i o n t o t h ec o 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 own t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) ( 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 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 Page o f

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

DATE PACI D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT J I F FORECEI VED( MM/ DO/ YR)

( i f a p p l i c a b l e )A ND' - A C CHECK

O CANDI DATE'( i f a p p l i c a b l e )

RECEI VED FUND-RAI SER

NUMBER I NCOM

7 / 3 0 / 2 0 0 4 Ma r y S c h l i c h t e ( UI HC) 1 0 _ 0 0

1 2 7 60 86 4 4 9 0 We s t o v e r Rd SE CR I A 5 2 4 0 3

7 ( 3 0 / 2 0 0 4 ' J o y c e S C K u i t z ( U 1 H l : ) 3 . 0 0

1 2 7 6 0 8 6 1 3 0 2 3 R a d c l i f f e A v e n u e I C I A 5 2 2 4 5

7 / 3 0 / 2 0 0 4 S h a n n a S e i g e l ( UI HC) 5 . 0 0

1 2 7 6 086 2 8 2 0 U A v e n u e P a r n e l l I A 5 2 3 2 5

7 / 3 0 / 2 0 0 4 J e a n n e S h e e t z ( U I H C ) 5 . 0 0

1 2 7 6 0 8 6 1 2 0 T a r t a n O r N o r t h L i b e r t y I A 5 2 3 1 7

7 1 3 0 1 2 0 0 4 K a r e n S h i c k e l l ( UI HC) 1 0 . 0 0

1 2 7 6 086 8 2 7 D o v e r S t r e e t I C I A 5 2 2 4 5

7 / 3 0 / 2 0 0 4 An t h o n y S h r a d e r ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 1 5 6 0 - 7 t h Av e SE CR I A 5 2 4 0 3

7 / 3 0 1 2 0 0 4 V i c k i S i e f e r s ( UI HC) 3 . 0 0

1 2 7 6 0 8 6 1 5 B r o wn Deer K n o l l CV I A 5 2 2 4 1

7 / 3 0 / 2 0 0 4 Pa m S i mons ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 1 3 1 0 F r a n k l i n S t I C I A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 T e r r y S i mon s ( UI HC) 5 . 0 0

1 2 7 6 086 5 1 0 K i m b e r l i t e S t T i f f i n I A 5 2 3 4 0

7 / 3 0 / 2 0 0 4 C h r i s S l a t e r ( UI HC) 5 . 0 0

1 2 7 6 086 2 7 6 0 T u r k e y Cr e e k L n NE I C I A 5 2 2 4 0

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



OCT - 1 9 - 2 0 0 4 0 9 : 0 0 P . 1 7





SEI U( S e r v i c e Emp l o y e e s I n t ; ' l Un i o n ) L o c a l 1 9 9 C 1 ' E F u n d

SCHEDULE

A( R e v . 0 6 / 9 7 )


AMENDI NG FORM

STATE CANDI DATES NOTE! I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI T T E E ) , L I S 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 FROMTHE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD .

CAUTI ON : S e c t i o n 6 8 B . 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 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 r

f o r a n y c omme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e 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 r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e , R e l a t i o n s h i p mu s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) ( S e e Pa ge 2 o f l o r m s 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 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 o f

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 S c he d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT , I I F FORECEI VED( MM/ DD/ YR)

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

AND ' ' A C CHECKT O CANDI DATE '

( i f a p p l i c a b l e )RECEI VED FUND-

RA I SERNUMBER I NCOM

7 1 3 0 1 2 0 0 4 Ma r y S t e s s ma n ( UI HC) 1 . 0 0

1 2 7 6 0 8 6 3 7 8 8 S un a u r a D r i v e NE I C I A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 Su e 5 we &i h g e n ( UI HC) ." 5 . 0 0

1 2 7 6 0 8 6 4 2 2 M e l r o s e C t I C I A 5 2 2 4 6

7 / 3 0 / 2 0 0 4 Wand a T h a c k e r y ( UI HC) 1 _ 0 0

1 2 7 6 0 8 6 6 0 4 F i r s t Av e So Mount Ve r n o n I A 5 2 3 1 4

7 / 3 0 1 2 0 0 4 T r i s h a T u r n i s ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 4 5 1 9 Wa l k e r S t NE CR I A 5 2 4 0 2

7 / 3 0 / 2 0 0 4 Di a n e Va n E r s v e l d e ( UI HC) 1 . 0 0

1 2 7 6 0 8 6 3 0 5 1 Me a d o w Rd NE N o r t h L i b e l I A 5 2 3 1 7

7 / 3 0 / 2 0 0 4 J o V on d e r h a a r ( UI HC) 3 . 0 0

1 2 7 6 0 8 6 1 0 2 3 Ma r c S t r e e t I C I A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 An g e l a We r n k e T r e n k amp ( UI HC) 1 0 , 0 0

1 2 7 6 0 8 6 3 6 1 Camden Rd I C I A 5 2 2 4 5

7 / 3 0 1 2 0 0 4 P a t s y Wh e e l e r ( UI HC) 7 . 5 0

1 2 7 6 0 8 6 2 7 6 1 R h i n e Cr e e k Way NW O x f o r d I A 5 2 3 2 2

7 1 3 0 1 2 0 0 4 S h e r r y Wh e t s t o n e ( UI HC) 5 . 0 0

1 2 7 6 0 8 6 1 1 0 S w i s h e r V i e w D r SW S w i s h e r I A 5 2 3 3 8

7 / 3 0 / 2 0 0 4 P a t Wol f ( UI HC) 1 . 0 0

1 2 7 6 0 8 6 1 4 0 9 We s t e r n C o l l e g e CR I A 5 2 4 0 4J UD- I V 1 / 1 L i I "

c̀~ l




OCT - 1 9 - 2 0 0 4 0 9 : 0 1 P 1 8


A MONETARYCONTRI BUT I ONS - - MONEY TAKEN I N


COMMI TT EE NAME ( M u s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 1 9 9 C PE F u n d

( Re v . 0 6 / 9 7 ) RECEI PTS

0 CHECK THI S BOX I F

AMENDI NG FORM

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 TT EE) . L I S T THE PAC I D E N T I F I C AT 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 E T HI C S ANO CAMPAI GNDI SCLOSURE BOARD .

CAUTI ON : S e c t i o n 6 8B . 3 2 A ( B ) . I o wa Co de , 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 oRs 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 n y c o mme r c i a l p ur p o s e b y a n y pe r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c ommi t t e e s .

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 l r l e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mm i t t e e R e l a t i o n s h i p m u s t b e s h ow n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) ( S e a 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 c o n t r i b u t o r i s t h e same a s c a n d i d a t e , b u t t h e r e i s n o P a g e I o ff a m i l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " I n t h e r e l a t i o n s h i p c o l umn . ( f o r S c h e d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT J I F FORRECE I V ED ( i f a p p l i c a b l e ) TO CANDI DATE ' RECE I VED FUND-( MM/ DDI YR) AND " AC CHECK ( i f a p p l i c a b l e ) RA I SER

N i I l y t g F RI NCOME

7 / 3 0 / 2 0 0 4 J o a n Comer Wr i g h t ( UI HC) 3 . 0 0

1 2 7 6 0 8 6 1 6 5 9 P o l k Avenue NE S o l o n I A 5 2 3 3 3

7 / 3 0 / 2 0 0 4 M a r i s a Y o d e r ' ( t 1 1 H C ) - - - 7 , 5 0 11 2 7 6 0 8 6 P 0 Bo x 1 3 0 K a l o n a I A 5 2 2 4 7


2 2 7 7 7 1 P 0 Bo x 3 7 3 N E n g l i s h 1 A 5 2 3 1 6

7 / 3 0 / 2 0 0 4 K u r t h T Boy c e ( I C S c h ) 1 . 5 0

2 2 7 7 7 1 4 8 7 6- 1 2 0 S t NE S o l o n I A 5 2 3 3 3

7 / 3 0 / 2 0 0 4 R i c h a r d H a n n a n ( I C S c h ) 1 . 5 0

2 2 7 7 7 1 P 0 Bo x 3 2 8 1 I o w a C i t y I A 5 2 2 4 4

7 / 3 0 / 2 0 0 4 J o h n Ho a r d ( I C S c h ) 1 . 2 5

2 2 7 7 7 1 Bo x 4 66 H i l l s I A 5 2 2 3 5

7 1 3 0 / 2 0 0 4 Ro n J e n s e n ( I C S c h ) 1 . 0 0

2 2 7 7 7 1 4 2 5 - 3 2 0 t h S t WL i b e r t y I A 5 2 7 7 6

7 / 3 0 / 2 0 0 4 B r a d K u e s t e r ( I C S c h ) 1 . 5 0

2 2 7 7 7 1 2 8 2 1 S R i v e r s i d e Dr I o w a C i t y l A 5 2 2 4 6

7 / 3 0 / 2 0 0 4 J o n L a l l a ( I C S c h ) 2 . 5 0

2 2 7 7 7 1 6 0 1 Oa k l a n d Av e I o wa C t I A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 B r i a n J Mey er ( I C S c h ) 1 . 5 0


$ a s " 1 5TOTAL ( i f l a s t p a g e o f t h i s s c h e d ul e )



OCT - 1 9 - 2 8 0 4 0 9 : 01 P . 19


CONTRI BUTI ONS - - MONEY TAKEN I N


COMMI TTEE NAME ( M u s t b e s ame a s o n S t a t e m e n t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 1 9 9 COPE F u n d

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON 1 5 RECEI VED FROM A STATE PAC ( P O L I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D E N T I F I C AT I O NNUMBER AND TH E PAC CHECK NUMBER I N TH E DESI GNATED COWMN A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .

CAUTI ON ; S e c t i o n 6 8B . 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 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 omme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e 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 r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o 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 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 t e t i v e s b y

ma r r i a g e ) ( S e e Page 2 o r f o r m s 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 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 Page~~~o f Gf 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 umn . ( f o r Sc h e d u l e A )

SCHEDUL E

A MONET ARY

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


AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT q I F FORECEI VED ( i f a p p l i c a b l e ) T O CANDI DATE' RECEI VED FUND-( MMI DDI YR) AND ' ' A C CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

7 / 3 0 / 2 0 0 4 M i c h e l Mu r p h y ( I C S c h ) 2 . 5 0

2 2 7 7 7 1 3 15 E l l i s Av e # 1 I o wa C i t y I A 52246

7 / 3 0 / 2 0 0 4 - Randy - N g u y e r f ( I G S c h ) - 1 . 5 0

2 2 7 7 7 1 1 4 8 Ambe r L a n e I o w a C i t y I A 52240

7 / 3 0 / 2 0 0 4 M i c h a e l O' Conno r ( I C S c h ) 1 . 5 0

2 2 7 7 7 1 290 E l m Ri d g e D r i v e N o r t h L i b e r t y I A 5 2 3 1 7

7 1 3 0 / 2 0 0 4 Rodn e y Pe r d u e ( I C S c h ) 2 . 5 0

2 2 7 7 7 1 6 0 3 WP a r i s S t WL i b e r t y J A 5 2 7 7 6

7 / 3 0 / 2 0 0 4 WmS a l a s b e r r y ( I C S c h ) 1 . 5 0

2 2 7 7 7 1 1119 P i n e S t I o w a C i t y 1 A 5 2 2 4 0

7 / 3 0 / 2 0 0 4 K i m b e r l y Sc h l a b a c h ( I C S c h ) 1 . 5 0

2 2 7 7 7 1 5 2 7 2 O a k c r e s t H i l l Rd R i v e r s i d e I A 52246

7 / 3 0 / 2 0 0 4 G e r a l d V o n s t e i n ( I C S c h ) 2 . 5 0

2 2 7 7 7 1 5 0 4 8 - 2 1 0 t h S t NE S o l o n 1 A 5 2 3 3 3

7 / 3 0 / 2 0 0 4 D a l e We i r ( I C S c h ) 1 . 5 0

2 2 7 7 7 1 2145 P a l me r C i r c l e I o w a C i t y I A 52240

7 / 3 0 / 2 0 0 4 J e r o me Wi e d e me i r ( I C S c h ) 1 - 5 0

2 2 7 7 7 1 25 06 F r i e n d s h i p S t I C I A 52245

7 1 3 0 1 2 0 0 4 Da r y l L e w i s ( I C S c h ) 5 _ 0 0

2 2 7 7 7 1 2 1 6 Da r t mo u t h I o w a C i t y I A 52245" 1 ~ 1 9 1 " 1 ) ~ a r




OCT- 19 - 2004 09 : 0 1



( I n c l u d i n g c a n d i d a l e ' s p e r s o n a l f u n d s )

COMMI TTEE NAME ( Mu s t b e same a s o n St at ement o f Or g a ni z a t i o n)

SEI U( Ser v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 1 9 9 COPE F un d

CHECK THI S BOX I F

AMENDI NG FORM

SCHEDULE

P . 2 0

A ( MONETARY

( Ra y . 06 197 ) RECEI PTS

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( POLI T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENTI F I CATI ON

NUMBERANDTHE PAC CHECK NUMBER I N THE DESI GNATED COLUMN. A L I ST OF 1 0 NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 6 B B , 3 2 A ( 6 ) , I o wa Code, pr o h i bi t s t h e u s e o f i n f o r ma t i o n c o pi e d f r o m r e p or 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 nt r i bu t i o ns o r

f 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

Di s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a ny r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mmi t t e e . R e l a t i o n s h i p must be s h o w n t o t h e t h i r d d eg r f o f c o ns a ng ui n i t y ( b l o o d r e l a t i v e s ) a nd a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( Se e Page 2 o f f o r ms p a c k e t . ) I f sur name o f c o n t r i b u t o r i s t h e same a s c an d i d a t e , b ut t h e r e i s n o P a g e~_o f

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 S c h e du l e A)


RECEI VED ( i f a p p l i c a b l e ) 0CANDI DATE' RECEI VED FUND-

( MM/ DDI Y k ) AND ' ' AC CHECK I ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

8 / 6 / 2 0 0 4 B r i a n F l a h e r t y 3 . 0 0

D i r e c t D e p o s i t 1122 So Se v e n t h Av e I C I A 52 2 4 5

8 / 6 / 2 0 0 4 A n h i f G e n t i l = A f c h e r - 5 . 0 0

D i r e c t D e p o s i t 1 7 4 4 - 1 1 5 t h S t We s t L i b e r t y I A 5 2 7 7 6

8 / 6 / 2 0 0 4 Ca t h y S i n g e r Gl a s s o n 1 5 . 0 0

D i r e c t D e p o s i t 1920 - 2nd Av e SE CR I A 52 40 3

8 / 6 / 2 0 0 4 M i c k e n z i e J e n s e n 2 . 5 0

D i r e c t D e p o s i t 2 31 3 K e l l y S t SWCR I A 52 40 4

8 / 6 / 2 0 0 4 Ma t t L o e b 2 . 5 0

D i r e c t D e p o s i t 4 7 0 H a w a i i C t I C I A 5 2 2 4 6

8 / 6 / 2 0 0 4 D a v i d C Megge r s 5 . 0 0

D i r e c t D e p o s i t 3 3 7 1 Oz z i e D r i v e NE S o l o n I A 5 2 3 3 3

8 / 6 / 2 0 0 4 D e v i n P Me h a f f e y 2 . 5 0

D i r e c t D e p o s i t 8 6 5 Cambu r n C t SE CR I A 52 40 3

8 / 6 1 2 0 0 4 K i m R M i l l e r 1 0 . 0 0

D i r e c t D e p o s i t 8 05 Spence r D r I C I A 5 2 2 4 6

8 / 6 / 2 0 0 4 Do u g l a s L P e t e r s 2 _ 5 0

D i r e c t D e p o s i t 7 0 E C h e s t n u t NL I A 52 31 7

8 / 6 / 2 0 0 4 J e n n i f e r P o l a n d 2 _ 5 0

D i r e c t D e p o s i t 20 40 Gl a s s Rd NE # 1 0 1 CR I A 5 2 4 0 2

TOTAL ( i f l a s t page o f t h i s s c h e d ul e )



OCT - 1 9 - 2 0 0 4 09 : 02 P . 21

Fo r I n s t r u c t i o n s , Se e Ba c k o f F o r m I SCHEDULE



COMMI TTEE NAME ( Mu s t b e s ame as o n St a t e me n t o f Or g a n i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 199 C PE F u n d

J UCS- I VI ML

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

QCHECK T HI S BOX I F

AMENDI NG FORM

A MONETARY

( Re v . 0 6 / 9 7 ) I RECEI PTS

STATE CANDI DATES NOTE : I F ACONTRI BUTI ON I S RECE I VED FROMA STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THEPAC I DENT I F I CATI ON

NUMBER ANDTHE PAC CHECKNUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS 1 5 AVA I LABLE FROMTHE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r mat i o n c o p i e d f r o m . r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r

f o r an y c o mme r c i a l p u r p os 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 aw r e q u i r e s c a nd i d at e c o mmi t t e es t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( S e e Page 2 o f f o r ms p a c k e r . ) . I f su r name o f c o n t r i b u t o r i s t h e s ame a s c a n d i d at e , b u t t h er e i s n o Page o f~_

f a m i l i a l r e l a t i o n 5 h i p , e n t e r ` n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u mn ( f o r Sc h e d u l e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT d I F FO

RECEI VED ( I f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-

( MMI DONR) AND " AC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

8 / 6 / 2004 K i r s t e n A Ru n n i n g 2 . 5 0

D i r e c t De po s i t 1210 Hi h l an d Ave I C I A 5 2240

8 / 6 / 2004 R i t a S t 6 i l e r 5 . 0 0

D i r e c t D e p o s i t 2 1 3 1 P l a e n Vi e w Dr I C f A 52246

8 / 6 / 2 0 0 4 S a r a h C S w i s h e r 4 0 . 0 0

D i r e c t De po s i t 9 17 Bowe S t I C I A 5 2 - 2 4 0

8 / 6 / 2 0 0 4 Tawn y L Wi l s o n 7 . 5 0

D i r e c t De po s i t 1110 C o n k l i n S t I C I A 52245

8 / 18 / 2 004 Ru s s e l l ACl a r k ( CR Sc h ) 5 . 0 0

1 0 3 8 0 3 4045 Ch i c k a d e e L n Hi a wa t h a I A 5 2 2 3 3

8 / 1 8 / 2 0 0 4 H a r l e s s S Cl emon s ( CR S c h ) 1 0 . 0 0

1 0 3 8 0 3 505 S i x t h S t SE CR I A 52401

8 / 1 8 1 2 0 0 4 Mar s h a l l R Cl emo n s ( CR Sc h ) 5 . 0 0

1 0 3 8 0 3 5 05 S i x t h S t SE CR I A 5 2 4 0 1

8 / 18 / 2 004 WmAF i a c c o ( CR S c h ) 3 . 0 0

1 0 3 8 0 3 4133 - 22nd Av e SWCR I A 52404

8 1 1 8 / 2 0 0 4 J e f f L F o s t e r ( CR S c h ) 5 . 0 0

103803 3 209 Tama r a Dr SWCR I A 5 2404

L8 / 1 8 12 00 4 Ken D G r o u t ( CR Sc h ) 2 . 0 0

103803 1 0 3 7 C l i f t o n S t NE CR I A 5 2402



OCT- 19- 2004 09 : 02 P . 22

F o r I n s t r u c t i o n s , Se e B a c k o f Fo r m I SCHEDULE




SE I U( S e r v i c e E mp l o y e e s I n t ' l Un i o n ) L o c a l 1 9 9 C I T , PE Fun d


c 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 n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e Pa ge 2 o f f o r m s p a c k e t . ) .I f su r n ame 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

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 umn .

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

©CHECK THI S BOX I F

AMENDI NG FORM

STATE CAND I DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P O L I T I C A L ACTI ON COMMI T T E E ) , L I S T THE PAC I D EN T I F I C AT I O N

NUK48ER AND THE PAC CHECK NUMBER I NTHEDESI GNATE0 COLUMN A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA E T HI C S ANOCAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : S e c t i o n 6 8 B . 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 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 r

f o r a ny c o mme r c i a l p ur p os 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 ommi t t e e s .

o f( f o r S c he d ul e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT 1 I F FOR

RECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE ' RECEI VED FUND-

( MM1DD/ YR) AND ' ' A C CHECK ( i f a p p l i c a b l e ) RA I SER

N ! l r ' i L L A " I NCOME

8 / 1 8 1 2 0 0 4 Go r don K a l t e n b a c h ( CR S c h ) 6 . 0 0

1 0 3 8 0 3 2 2 7 - 1 1 t h S t NWCR I A 5 2 4 0 5

8 / 1 8 / 2 0 0 4 J o y c e L LD c a s ( CR S c h ) 4 . 0 0

1 0 3 8 0 3 1 4 0 1 B Av e V i n t o n I A 5 2 3 4 9

8 / 1 8 1 2 0 0 4 Dave L M a r t ( CR S c h ) 5 . 0 0

1 0 3 8 0 3 9 2 6 - 1 5 t h Av e 1 3 WCR I A 5 2 4 0 4

8 / 1 8 / 2 0 0 4 C h r i s Mc L e e s ( CR S c h ) 5 . 0 0

1 0 3 8 0 3 4 1 1 - 2 7 t h S t NE CR I A 5 2 4 0 2

8 / 1 8 / 2 0 0 4 Ti m J Ne wc omb ( CR S c h ) 5 . 0 0

1 0 3 8 0 3 7 2 6 E Av e NWCR I A 5 2 4 0 5

8 / 1 8 / 2 0 0 4 Chas A P e r r y ( CR S c h ) 1 0 _ 0 0

1 0 3 8 0 3 1 4 7 9 Mi a mi Dr NE CR I A 5 2 4 0 2

8 / 1 8 / 2 0 0 4 AL J P o s p i s i l ( CR S c h ) 1 . 0 0

1 0 3 8 0 3 1 61 9 A r i z o n a Av e NE CR I A 5 2 4 0 2

8 / 1 8 / 2 0 0 4 T e r r y A S l i c k t y ( CR S c h ) 2 - 5 0

1 0 3 8 0 3 1 1 2 8 B r own Av e NE CR I A 5 2 4 0 2


1 0 3 8 0 4 1 0 0 2 E 6 s t e r n Dr SE CR I A 5 2 4 0 3

8 / 1 8 / 2 0 0 4 S t e p h a n i e J L e w i s ( CR S c h ) 5 . 0 0

1 0 3 8 0 4 1 6 0 1 - 3 0 t h S t NW# 1 2 CR I A 5 2 4 0 5




OCT - 1 9 - 2 0 0 4 0 9 : 0 3 P . 2 3

F o r I n s t r u c t i o n s , Se e B a c k o f F o r m { SCHEDULE



COMMI TT EE NAME ( Mus t b e s ame a s o n St at ement o f Or g an i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I n t r l Un i o n ) L o c a l 1 9 9 C PE F u n d

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NG FORM

STATE CANDI DATES NOTE: I F A CONTR I BUT I ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ON

NUMBERANDTHE PAC CHECK NUMBER I N THEDESI GNATED COLUMN. A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD

CAUTI ON: Se c t i o n 685 . 3 2 A ( 6 ) , I o wa C o d e , p r o hi bi 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 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 nt r i bu t i o ns o rf 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

D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a ny r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mmi t t e e R e l a t i o n s h i p must b e s h o w n t o t h e t h i r d d e gr e e o f c o n sa n gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e Pag e 2 o f l o r ms 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 nd i d a t e , b u t t h e r e i s nof 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 pp l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn .

rnP a g e . ( K o f

( f o r S c h e du l e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FO

RECEI VED ( f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-

( MM/ DD/ YR) AND ' ' AC CHECK ( i f a pp l i c a b l e ) RAI SER

NUMBER I NCOME

8 / 1 8 / 2 0 0 4 S t a c y K i n g ( HACAP) 2 0 , 0 0

c a s h 2 12 3 Bu c k i ng ha m Dr NW# 4 CR I A 5 2 4 0 5

8 1 1 8/ 2 0 0 4 Do n a l d J B i h e g a r J r ( I C S c h ) 1 - 5 0 ,

2 2 8 0 7 0 P 0 Bo x 3 7 3 N E n g l i s h I A 5 2 3 1 6

8 / 1 8 / 2 0 0 4 K u r t h T B o y c e ( I C S c h ) 1 . 5 0

2 2 8 0 7 0 4 8 7 6 - 1 2 0 S t NE S o l o n I A 5 2 3 3 3

8 / 1 8 / 2 0 0 4 R i c h a r d Hannan ( I C S c h ) 1 , 5 0

2 2 8 0 7 0 P 0 Bo x 3 2 8 1 I o wa C i t y I A 5 2 2 4 4

8 / 1 8 / 2 0 0 4 J o h n Ho a r d ( I C S c h ) 1 . 2 5

2 2 8 0 7 0 Bo x 4 6 6 H i l l s I A 5 2 2 3 5

8 / 1 8 / 2 0 0 4 Ro n J e n s e n ( I C S c h ) 1 - 0 0

2 2 8 0 7 0 4 2 5 - 3 2 0 t h S t WL i b e r t y I A 5 2 7 7 6


2 2 8 0 7 0 2 8 2 1 S R i v e r s i d e Dr I o w a C ' I A 5 2 2 4 6

8 / 1 8 / 2 0 0 4 J o n L a l l a ( I C S c h ) 2 . 5 0

2 2 8 0 7 0 6 0 1 Oa k l a nd Av e I o w a C i t y I A 5 2 2 4 0

8 / 1 8 1 2 0 0 4 B r i a n J Meye r ( I C S c h ) 1 , 5 0


8 1 1 8 1 2 0 0 4 Mi c h e l Mu r p h y ( I C S c h ) 2 . 5 0

2 2 8 0 7 0 3 1 5 E l l i s Av e # 1 I o w a C i t y I A 5 2 2 4 6l J : r t v vFW- _




OCT - 1 9 - 2 0 0 4 0 9 0 3





SEI U( S e r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 1 9 9 C PE F u n d

D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mmi t t e e . R e l a t i o n s h i p mu s t b e s how 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 ) r i n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) ( S e e Page 2 o f f o r m s p a c k e t . ) I f sumame 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 ( h e r e i s n of a m i l i a l r e l a t i o n s h i p . e n t e r " n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn

P . 2 4

SCHEDULE

A MONETARY

( R e v , 0 6 / 9 7 ) RECEI PTS

CHECK THI S BOX I F

AMENDI NG FORM

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 ACT I ON COMMI TT EE) .L I S T THE PAC I D EN T I F I C A T I O N

NUMBER 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 E T HI C S AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON ; S e c t i o n 6 8 B, 3 2 A( 6 ) , I o wa Co de , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r


Page ~ 4 _ o f( f o r S c h e d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT 4 I F FORRECEI VED ( i f a p p l i c a b l e ) T O CANDI DATE- RECEI VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RA I SER

NUMBER I NCOME

8 / 1 8 / 2 0 0 4 Randy Nguyen ( I C S c h ) 1 . 5 0

2 2 8 0 7 0 4 8 Amber L a n e I o w a C i t y I A 5 2 2 4 0

8 / 1 8 / 2 0 0 4 M i c h a e l O' Co h n b e ( I C S c h ) 1 . 5 0

2 2 8 0 7 0 2 9 0 E l m Ri d e D r i v e N o r t h L i b e r t y I A 5 2 3 1 7

8 / 1 8 / 2 0 0 4 Rodn ey Pe r d u e ( I C S c h ) 2 . 5 0

2 2 8 0 7 0 6 0 3WP a r i s S t WL i b e r t y I A 5 2 7 7 6


2 2 8 0 7 0 1 1 1 9 P i n e S t I o w a C i t y I A 5 2 2 4 0

8 / 1 8 / 2 0 0 4 K i mb e r l y S c h l a b a c h ( I C S c h ) 1 - 5 0


8 / 1 8 / 2 0 0 4 G e r a l d V o n s t e i n ( I C S c h ) 2 _ 5 0

2 2 8 0 7 0 5 0 4 8 - 2 1 0 t h S t NE S o l o n I A 5 2 3 3 3

8 / 1 8 / 2 0 0 4 D a l e We i r ( I C S c h ) 1 . 5 0

2 2 8 0 7 0 2 1 4 5 Pa l me r C i r c l e I o w a C i t y I A 5 2 2 4 0

8 1 1 8 / 2 0 0 4 J e r o me Wi e de me i r ( I C S c h ) 1 . 5 0


8 / 1 8 / 2 0 0 4 D a r y l L e w i s ( I C S c h ) 5 . 0 0

2 2 8 0 7 0 2 1 6 D a r t m o u t h I o wa C i t y I A 5 2 2 4 5

8 / 1 8 / 2 0 0 4 Ma r s h a An d e r s o n ( U I H C ) 5 , 0 0

1 2 8 5 8 4 5 1 9 7 5 So R i d e Dr C o r a l v i l l e I A 5 2 2 4 1JUD- r v r L

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



OCT- 19 - 2004 09 : 0 4 P . 2 5




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 i z a t i o n)

SEI U( Se r v i c e Emp l o ye es I n t ' l Un i on ) Loc a l 1 9 9 C

D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma 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 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 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 .

SCHEDULE

A( R e v . 0 6 / 9 7 )

MONETARY

RECEI PTS

CHECK T H I S B OX I FAMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI 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 ACTI ON COMMI TTEE) . L I S T 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 FROM THE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD .

CAUTI 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 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 o mmi t t e e s .

Page o f b 5( F o r S c he d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSH I P AMOUNT + l I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE" RECEI VED FUND-( MMI DOI YR) AND PAC CHECK ( i f a pp l i c a bl e ) RAI SER

NUMBER I NCOM

8 / 1 8 / 2 0 0 4 Sa n d r a A n f i n s o n ( UI HC) 2 , 0 0

1285845 3 0 2 N o r t h F o u r t h S t WB r a n c h I A 52358

8 / 1 8 / 2 0 0 4 Ma t t 8 a h l ( U CH C) - 5 . 0 0

1285845 2 4 , 5 H i c k o r y S t N L i b e r t y I A 52358

8 / 1 8 / 2 0 0 4 M i c h e l l e B a r g r e n ( UI HC) 5 . 0 0

1285845 7 0 2 H o d g e S t N o r t h L i b e r t y I A 52317

8 1 1 8 / 2 0 0 4 J a n i c e B a r n e s ( UI HC) 5 . 0 0

1285845 1 0 2 1 - 2 0 t h Av e CV I A 5 2 2 4 1

8 / 1 8 / 2 0 0 4 Ra c h a e l B a r r o w ( UI HC) 1 0 . 0 0

128 58 45 3 513 D u n h a m Dr SWCR I A 52404

8 / 1 8 / 2 0 0 4 De b B e n f e r ( UI HC) 3 . 0 0

128 58 45 16 8 3 Hemi n a L a n e I C I A 52240

8 / 1 8 / 2 0 0 4 De b Be n f e r - Ha h n ( UI HC) 5 . 0 0

128 58 45 123 2 E C o l l e g e S t I C I A 52245

8 1 1 8 / 2 0 0 4 Ma r t h a B r a d b u r y ( UI HC) 2 . 0 0

128 58 45 1116WI d e Gr e e n Rd I C I A 52246

8 / 1 8 / 2 0 0 4 J a n a B u r k h o l d e r ( UI HC) 1 , 0 0

1285845 6 0 4 K i m b e r l i t e S t T i f f i n I A 52340

8 / 1 8 1 2 0 0 4

THe i d e B u r s c h ( UI HC) 5 . 0 0

1285845 9 7 O b e r l i n I C t o 52245

J Ul S - I V t HL .




OCT- 19 - 2004 09 : 04

Fo r I n s t r u c t i o n s , See Bac k o f Fo r m

CONTRI BUTI ONS - - MONEYTAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o na l f u n ds )

COMMI TTEE NAME ( Mu s t b e s ame a s on St a t e me n t of O r g a n i z a t i o n )

SEI U( Se r v i c e E mp l o y e e s I n t ; ' l Un i o n ) Loca l 1 9 9 C PE F u n d

SCHEDULE

P . 2 6

A MONETARY

( R ev . 0 6/ 9 7 ) RECEI PTS


AMENDI NGFORM

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECE I VED FROMASTATE PAC ( POL I T I C A L ACT I ON COMMI TTEE ) , L I S T THEPAC I OENT I F I CA 7 1ON

NUMBER ANDTHE PACCHECKNUMBER I N THEDES I GNATED COLUMN. A L I S T OF I D NUMBERS I S A VA I L A B L E FROM THEI OWA ETHI CS AND CAMPA I GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B, 3ZA( 6 ) , I owa C o d e , p r o h i b i t s t h e u s e o f i n f o r ma t i on c o pi e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c on t r i bu t i on s o r

f o r a n y c o mme r c i a l p u r p os e by an 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 o mmi t t e e s .

Di 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 es t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t c t h e _

Commi t 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 on s an g ui 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 by ` - r

ma r f i a g e ) ( S ee Pa ge 2 o f f a r ms 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 di d at e , bu t t h e r e i s n o f a g s ~ o f

f a r r f f 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 du l e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT + I I F FOR

RECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE' RECEI VED FUND-

( MMI DOI Y R) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

Ww n y - ~ , - I NCOME

B/ 1 8 / 2 00 4 B a r r y Bu s c h e l ma n ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 7 80 F a i r v i e w L n N o r t h L i b e r t y I A 52317

8 / 1 8 1 2 0 0 4 - A f r o l 8 y f r s e ( U CH C ) ' - 5 . 0 0

1285845 3 02 Oa k S t Bu f f a l o I A 52728

8 / 1 8/ 2 00 4 Ma r j i e Ca r u t h ( UI HC) 5 . 0 0

1285845 80 1 A l p i n e Dr I C I A 52245

8 / 1 8/ 2 00 4 Bev Cl e a r ma n ( UI HC) 5 . 0 0

1285845 1007 E i g h t h S t C o r a l v i l l e I A 5 2 2 4 1

8 / 1 8 12 0 04 L y n e t t e Cooper ( UI HC) 2 . 5 0

1285845 2 4 0 1 Hw 6 E #1210 I C I A 52240

8 118 12004 J u l i e D a v i s ( U I H C ) 5 . 0 0

- 1285845 3 3 7 No r man dy D r I C I A 52246

8 1 1 8 1 2 0 0 4 Ca t h y D o s t a l ( UI HC) 2 , 0 0

1285845 1985 S o u t h Ri d e Dr CV I A 5 2 2 4 1

8 1 18 / 2 0 04 A n g e l a Du wa ( UI HC) 5 - 0 0

1285845 2519 J Av e Wi l l i a ms b u r I A 5 2 3 6 1

8 / 1 8 / 2 0 0 4 C a r o l y n E l l i o t t ( UI HC) 1 0 - 0 0

1285845 110 F l o r i d a Ave SWCR I A 52404

8 118 12004 I S h e l l e y Engman ( UI HC) 5 . 0 0

1285845 7 1 7 R u n d e l l S t I C I A 52240

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



OCT- 19- 2004 09 : 05

Fo r I n st r u c t i on s , See Bac k o f Form

CONTRI BUTI ONS- MONEYTAKENI N


COMMI TT EE NAME ( M u s t b e s ame a s o n S t a t e m e n t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Emp l oyees I n t ' 1 Un i on ) Loc al 1 9 9 C PE Fund


c o mm i t t e e . R e l a t i o n s h i p m t i s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma 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 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 .


AMENDI NG FORM

SCHEDULE

P. 27

A MONETARY

( Re v . 0 6 / 9 7 ) RECE I PTS

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) , L I S T THE PAC I D EN T I F I C A T I O N

NUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LAB LE FROM THE I OWA E T HI C S AND CAMPAI GN

D I SCLOSURE BOARD .

CAUT I ON- S e 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 m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r

f 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 on 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 .

o f ( ' 0 5( f o r S c h e d u l e A )


RECE I VED i f a p p l i c a b l e ) TOCANDI DATE ' RECE I VED FUND-

( MMI DDI YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

8 1 1 8 / 2 0 0 4 E l i z a b e t h F i s h e r ( UI HC) 2 . 5 0

1 2 8 5 8 4 5 1 3 0 7 C a r r o l l S t I C I A 5 2 2 4 0

8 1 1 8 / 2 0 0 4 - ' A r d i a F i t e ( UI HC) 5 . 0 0 1

1 2 8 5 8 4 5 133 Hi l l s i d e Dr El d r i d e I A 5 2 7 4 8

8 / 1 8 / 2 0 0 4 K a r l e n e F u l l e r ( U I H C ) 3 . 0 0

1 2 8 5 8 4 5 1 6 1 1 - 1 3 t h S t r e e t CV 1 A 5 2 2 4 1

8 / 1 8 / 2 0 0 4 Ci n d y Fu n k ( UI HC) 3 . 0 0

1 2 8 5 8 4 5 1 2 3 1 S a n d u s k Av e I C I A 5 2 2 4 0

8 / 1 8 / 2 0 0 4 J oe G a l b r a i t h ( UI HC) 1 0 _ 0 0

1 2 8 5 8 4 5 3 0 2 1 Rave n S t I C I A 5 2 2 4 5

8 / 1 8 / 2 0 0 4 Na n c y Genoar ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 1 2 5 2 C o l l Or I C I A 5 2 2 4 6

8 1 1 8 / 2 0 0 4 T r i s h a God a r d Shephe r d ( UI HC) 2 . 5 0

1 2 8 5 8 4 5 9 3 0 - 2 3 r d Av e Ap t C C o r a l v i l l e I A 5 2 2 4 1

8 / 1 8 / 2 0 0 4 L y n d a Gr e e n ( UI HC) 1 0 , 0 0

1 2 8 5 8 4 5 2 0 7 5 M e l r o s e Av e I C I A 5 2 2 4 6

8 / 1 8 / 2 0 0 4 M e l i s s i a Gr e i n e r ( UI HC) 5 , 0 0

1 2 8 5 8 4 5 2 6 4 3 6 - 3 0 5 t h A v e n u e Ke o t a I A 5 2 2 4 8

8 / 1 8 / 2 0 0 4 Da n G r i n s t e a d ( UI HC) 7 _ 5 0

1 2 8 5 8 4 5 1 2 1 8 As h S t I C I A 5 2 2 4 0

.




OCT- 19 - 2004 09 : 0 5




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 an i z a t i o n )

SEI U( Se r v i c e Emp l o ye es I n t ' l Un i on ) Loc a l 1 9 9 C~PE Fund

SCHEDULE

P . 2 8

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK THI S BOX I F

AMENDI NG FORM

STATE 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 S T THE PAC I DENT I F I CATI ON

NUMBER ANDTHE PAC CHECK NUMBER I N THEDESI GNATED COLUMN, A L I ST OF I D NUMBERS I S AVA I L A B L E FROM THE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD

CAUTI 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 us 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 a n d s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o r

f o r a n y 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 mm i t t e e s

Di s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p 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 ns an g ui n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e Page 2 o f f o r ms 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 di d at e , b u t t h e r e i s n o P a g e - o f ~~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 ot a pp l i c ab l e ' i n t h e r e l a t i o n s h i p c o l u mn . ( f o r S c he d u l e A)

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT q I F FOR


( MMI DD I YR) ANDPAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

8 / 1 8 / 2 0 0 4 Ma r c i a Hahn ( UI HC) 5 . 0 0

1285845 2 2 8 1 S u g a r B o t t o m Rd S o l o n I A 52 3 3 3

8 / 1 8 / 2 0 0 4 . 1 T e r r y H a mi l i o n ( UI HC) 3 . 0 0

1285845 7 1 5 N Va n B u r e n S t I C I A 52245

8 / 1 8 / 2 0 0 4 L y n n Hanke ( UI HC) 5 _ 0 0

1285845 1 0 0 1 Me mo r i a l D r SE CR I A 52403

8 / 1 8 1 2 0 0 4 S a r a h H e l l e ( UI HC) 5 . 0 0

1285845 1 3 3 0 U p p e r O l d H 6 O x f o r d I A 52322

8 / 1 8 / 2 0 0 4 S h a r o n H i c k s ( UI HC) 2 . 0 0

12858 45 2 6 3 9 - 1 4 0 t h S t r e e t NWS wi s h e r I A 52 3 38

8 / 1 8 / 2 0 0 4 Me l o d y H o b e r t - Me l l e c k e r ( UI HC) 5 . 0 0

1285845 3 0 0 Ma i n S t H i l l s I A 52235


128584 5 26 4 7 Ne w p o r t Rd NE I C I A 52240

8 / 1 8 / 2 0 0 4 De b R e y n o l d s Hu b b a r d ( UI HC) 3 . 0 0

128584 5 14 6 8 V a l l e y Vi e w D r i v e CV I A 5 2 2 4 1

8 1 1 8 / 2 0 0 4 S h e l l e y J a c o b u s ( UI HC) 1 , 0 0

1285845 6507 B o xw o o d L n NE CR I A 52402

8 / 1 8 / 2 0 0 4 J e n n i f e r J u n g e n ( U I H C ) 5 . 0 0

1285845 P 0 Bo x 5 8 8 N o r t h L i b e r t y I A 52317S UB

_- TOTAL


Es



OCT- 19- 2004 09 : 05




COMMI TTEE NAME ( M u s t b e s ame a s o n St a t emen t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Emp l o y ees I n t ' l Un i o n ) Loca l 1 9 9 C PE Fund

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THEPAC I DENT I F I CAT I ON

NUMBER ANDTHE PACCHECK NUMBER I N THEDESI GNATED COLUMN, A L I S T OF I D NUMBERS I S AVA I LAB LE FROM THE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD

CAUTI ON : S e 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 m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r

f 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 .

- Di s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 ns a ng u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S ee P a g e 2 o f f o r ms p a c k et . ) .I f s u r n a r n e o f c o n t r i b u t o r i s t h e same a s c a n di d a t e , b u t t h e r e i s n o

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 pp 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 .

SCHEDULE

( Re v . 0 6 / 9 7 )

CHECK THI S BOX I F

AMENDI NG FORM

P a g e

P . 29

MONETARY

RECEI PTS

o f G5( f o r S c he d u l e A)

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT - 4 I F FOR

RECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE' RECEI VED FUND-( MM/ DDYR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

8 / 1 8 / 2 0 0 4 No r ma n K a l v i g ( UI HC) 2 0 . 0 0

1 2 8 5 8 4 5 1 9 4 5 Pa r k Av e SE CR 1 A 5 2 4 0 3

8 / 1 8 / 2 0 0 4 V a l e r i e K e f f a l a ( U I H C) 5 - 0 0

1 2 8 5 8 4 5 11 09 P r a i r i e DuCh i e n Rd I C I A 5 2 2 4 5

8 / 1 8 / 2 0 0 4 Te r e s a A K i n g d o n ( UI HC) 2 . 5 0

1 2 8 5 8 4 5 2 11 3 N o r c o r Av e Ap t 4 CV I A 5 2 2 4 1

8 / 1 8 / 2 0 0 4 K a t h e r i n e K l e i n o w ( UI HC) 5 . 0 0

12 8 58 4 5 3 3 3 3 P h e a s a n t Ct NE N o r t h L i b e r t y I A 5 2 31 7

8 / 1 8 / 2 0 0 4 A r l e n e K l e s n e r ( UI HC) 1 . 0 0

1 2 8 5 8 4 5 1 9 0 1 E a r l Road I C I A 5 2 2 4 6

8 / 1 8 / 2 0 0 4 Amy K r u s e ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 2 0 3 F i f t h S t 4 1 C o r a l v i l l e I A 5 2 2 4 1

8 / 1 8 1 2 0 0 4 L i n d a K r u t s i n g e r ( UI HC) 1 0 . 0 0

1 2 8 5 8 4 5 2 1 4 7 P l a e n Vi e w Dr I C I A 5 2 2 4 6

8 / 1 8 / 2 0 0 4 C y n t h i a L a r e w ( UI HC) 1 . 0 0

1 2 8 5 8 4 5 P 0 Bo x 4 4 1 L o n e T r e e I A 5 2 7 5 5

8 / 1 8 / 2 0 0 4 Pa u l a L a u b e ( UI HC) 7 . 5 0

1 2 8 5 8 4 5 7 12 Wa l n u t S t I C I A 5 2 2 4 0

8 / 1 8 / 2 0 0 4 Ra e l e n e L e n o c h ( U I H C ) 1 . 0 0

1 2 8 5 8 4 5 2 13 Br o a d wa y S t WB r a n c h I A 5 2 35 8




OCT - 1 9 - 2 0 0 4 0 9 : 0 6Fo r I n s t r u c t i o n s , Se e Back o f Fo r m



COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t eme n t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Empl oy ees I n t ' l Un i on ) Loc a l 1 9 9 C PE Fund

P . 3 0

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI T T E E ) , L I S T THE PAC I D EN T I F I C A T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COL UMN, A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD,

CAUTI ON : S e c t i o n 68 B . 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 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 commer c i a l p u r p o s e b y an 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 .

D i s c l o s u r e l a w r e q u i r e s C a n d i d a t e c o mm i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a C o n t r i b u t i o n t o t h ec o 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 wn t o t h e l n l f d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) ( Se e P a g 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 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 Page o f 65f 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 umn . ( f o r Sc h e d u l e A )

SCHEDULE

A MONETARY

( R e v , 0 6 1 9 7 ) RECEI PTS

L J CHECK THI S BOX I F

AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT - 4 I F FORECE I VED( MMI DDf YR)

( i f a p p l i c a b l e )AND PAC CHECK

TO CANDI DATE'( i f a p p l i c a b l e )

RECE I VED FUND-RAI SER

NUMBER I NCOM

8 / 1 8/ 2 00 4 L u a n n e L i n k ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 2215 H i c k o r y C o u r t I C I A 52240

8 / 1 8 12 0 04 Mi c ha e l L o u c k s - ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 1495 Fa l c o n Av e Swi s h e r I A 5 2 3 3 8

8 / 1 8/ 2 00 4 Wi l ma Ma ca l a l a g ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 8 2 8 Au g u s t a C i r c l e No r t h L i b e r t y I A 5 2 3 1 7

8 / 1 8/ 2 00 4 J u n e Ma s b r u c h ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 2 3 8 7 - 3 40 t h S t SW T i f f i n I A 5 2 3 4 0

8 / 1 8 / 2 0 0 4 Ann Mason ( UI HC) 3 . 0 0

1285 845 1 03 2 Oa kc r e s t S t I C 1A5 2 2 4 6

8 / 1 8/ 2 00 4 Ru t h McKeeve r ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 3 0 2 Wa l n u t S t T i t o n I A 5 2 7 7 2

8 / 1 8/ 2 00 4 Mar y Mc Ki n n e y ( UI HC) 3 . 0 0

1 2 8 5 8 4 5 5 06 Wes t Se v en t h S t T i t o n I A 5 2 7 7 2

8 / 1 8/ 2 00 4 Mar y J o Me g g e r s ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 3371 Oz z i e Dr So l o n I A 5 2 3 3 3

8 / 1 8/ 2 00 4 T e r r i Me n g l e r ( UI HC) 7 . 5 0

1 2 8 5 8 4 5 2215 Se c o n d S t SWCR 1 A 5 2 4 0 4

8 / 1 8/ 2 00 4 Jea n M i l l e r ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 3 7 5 5 Co t t ag e Re s e r v e Rd NE So l o n I A 5 2 3 3 3




OCT - 1 9 - 2 0 0 4 0 9 : 0 6




COMMI TT EE NAME ( M u s t b e s ame a s o n St a t e me n t o f Or g a n i z a t i on )

SEI U( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 1 9 9 C PE Fu n d

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D E N T I F I C A T I O N

NUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COL UMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE 90AR0 .

CAUTI ON : S e 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 m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r

f 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 mm i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o 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 y

ma r r i a g e ) ( S e e Pa g e 2 o f l o r m s 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 s ame a s c a n d i d a t e , b u t t h e r e i s n o

f a 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

SCHEDULE

( Re v . 0 6) 9 0

P . 3 1

MONETARY

RECE I PTS

0 CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT J I F FOR

RECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE` RECE I VED FUND-

( MM/ OD/ YR) I AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERN t I MRFR I NCOME

8 1 1 8 / 2 0 0 4 T a r a M i l l e r ( UI HC) 2 . 5 0

1 2 8 5 8 4 5 3 3 3 C a r t e r S t NWCR I A 5 2 4 0 5

8 / 1 8 / 2 0 0 4 - ' ` ., . 4 . . R ' 6 t r e r t Wr i e ( UI HC) " - " " 3 . 0 G

1 2 8 5 8 4 5 4 1 7 C a r t e r S t NWCR I A 5 2 4 0 5

8 1 1 8 / 2 0 0 4 M e l i n d a Mye r s ( UI HC) 2 0 _ 0 0

1 2 8 5 8 4 5 1 1 1 6 A Av e NWCR I A 5 2 4 0 5

8 1 1 8 / 2 0 0 4 J a n N i e b e s ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 7 2 7 4 - 1 5 t h Av e Ke y s t o n e I A 5 2 2 4 9

8 / 1 8 1 2 0 0 4 L i n d a P e t e r s e n ( UI HC) 2 . 5 0

1 2 8 5 8 4 5 9 0 7 N G i l b e r t S t I C 1 A 5 2 2 4 5

8 / 1 8 1 2 0 0 4 M a r g a r e t Mar y P i n g ( UI HC) 3 . 0 0

1 2 8 5 8 4 5 1 1 0 Sa r e r t Dr We s t B r a n c h I A 5 2 3 5 8

8 1 1 8 1 2 0 0 4 B e c k y P o t t o r f f - L e a v e n ( U I H C ) 5 . 0 0

1 2 8 5 8 4 5 1 1 4 9 H u n t e r ' s Ru n I C I A 5 2 2 4 6

8 / 1 8 / 2 0 0 4 J e f f r e y Rupe ( UI HC) 3 . 0 0

1 2 8 5 8 4 5 P O Box 2 18 N o r t h L i b e r t y I A 5 2 3 1 7

8 / 1 8 / 2 0 0 4 Na n c y Sa n ds t r o m ( UI HC) 7 . 5 0

1 2 8 5 8 4 5 6 0 D a v i d L e e C o u r t N o r t h L i b e r t y I A 5 2 3 1 7

8 / 1 8 1 2 0 0 4 D o r o t h y S a t a r i a n o ( UI HC) 3 . 0 0

1 2 8 5 8 4 5 3 2 2 2 Sh a s t a Ct NE CR I A 5 2 4 0 2



OCT- 19- 2004 09 : 07



( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n ds )


SEIU(Servi ce Emp l o y e e s I n t ' 1 U n i o n ) L o c a l 199 C~PEFund

" D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 ns a ng u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( Se e P a g e 2 o f f o r ms 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 nd i d at e , b u t t h e r e I c n o

f a m i l i a l r e l a t i o n s h i p , i 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 .

SCHEDULE

P . 32


AMENDI NG FORM

A MONETARY

( Re v 0 6 1 9 7 ) l RECEI PTS

STATE 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 S T THE PAC I DENT I F I CATI ON

NUMBER ANDTHE PACCHECK NUMBER I N THE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE 80ARD

CAUTI ON : Se c t i o n 6 B B_ 3 2 A( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o r

f 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

P a g e f i t _ o f- ! r . . ) ~

( i o r S c he d u l e A)

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FOR

RECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE' RECEI VED FUND-

( MMI DDf YR) ANDPACCHECK ( i f a pp l i c a b l e ) RAI SER

NUMBER I NCOME

8 / 1 8 / 2 0 0 4 C h e r y l S c h i l d ( U I H C ) 3 . 0 0

1 2 8 5 8 4 5 9 1 4 - 1 2 t h Av e CV I A 5 2 2 4 1

8 / 1 8 i 2 0 0 4 N i a r y S c h l i c h t e ' ( U I H C ) r- 1 o . b d "

1 2 8 5 8 4 5 4 4 9 0 We s t o v e r Rd SE CR I A 5 2 4 0 3

8 / 1 8 / 2 0 0 4 J o y c e S c h u l t z ( UI HC) 3 . 0 0

1 2 8 5 8 4 5 3 0 2 3 R a d c l i f f e A v e n u e I C I A 5 2 2 4 5

8 / 1 8 / 2 0 0 4 S h a n n a Sei g e l ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 2 8 2 0 U A v e n u e P a r n e l l I A 5 2 3 2 5

8 / 1 8 / 2 0 0 4 J e a n n e Sh e e t z ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 1 2 0 T a r t a n D r N o r t h L i b e r t y I A 5 2 3 1 7

8 / 1 8 / 2 0 0 4 K a r e n S h i c k e l l ( U I H C ) 1 0 . 0 0

1 2 8 5 8 4 5 8 2 7 Dove r S t r e e t I C I A 5 2 2 4 5

8 / 1 8 / 2 0 0 4 An t h o n y S h r a d e r ( U I H C ) 5 _ 0 0

1 2 8 5 8 4 5 1 5 6 0 - 7 t h Av e SE CR I A 5 2 4 0 3

8 / 1 8 / 2 0 0 4 V i c k i S i e f e r s ( UI HC) 3 . 0 0

1 2 8 5 8 4 5 1 5 B r o wn Dee r K n o l l CV I A 5 2 2 4 1

8 / 1 8 / 2 0 0 4 Pa m S i mo n s ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 1 3 1 0 F r a n k l i n S t I C I A 5 2 2 4 0

8 / 1 8 / 2 0 0 4 T e r r y S i mo n s ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 5 1 0 K i m b e r l i t e S t T i f f i n I A 5 2 3 4 0- 1 ML r ' - I

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



OCT - 1 9 - 2 0 0 4 0 9 : 0 71 - o r i n s t r u c t i o n s , a e e t s a c K Dr t u r n !



COMMI TT EE NAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g a n i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 1 9 9 C ( PE F u n d



c 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 n g u i n i t y ( b l o o d r e l a t i v e s ) F i n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e P a g 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 s ame a s c a n d i d a t e , b u t t h e r e i s n o

f a m i l i a l 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 .

a ut o - I V I h L -

o " . n c v %J L . cP . 3 3

D CHECK T HI S BOX I F

AMENDI NG FORM

A MONETARY

( R e v , 0 61 9 7 ) RECE I PTS

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T T HE PAC I D E N T I F I C A T I O N

NUMBER AND T HE PAC CHECK NUMBER I N THE DESI GNATED COL UMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON . S e c t i o n 6 8 a . 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 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 o r

f o r a n y c o mme r c i a l p ur 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 .

Pa ge ~ J O o f

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


RECEI VED ( I f a p p l i c a b l e ) TO CANDI DATE' RECE I VED FUND-

( MMI DDI YR) AND PAC CHECK ( I f a p p l i c a b l e ) RAI SERI NCOME


1 2 8 5 8 4 5 2 7 6 0 T ur k e y Cr e e k L n NE I C I A 5 2 2 4 0

8 / 1 1 1 1 ? 0 0 4 , Ma r y St e s s ma n - ( UI HC)

1 2 8 5 8 4 5 37 88Sun au r a D r i v e NE I C

I A5 2 2 4 0

8 / 1 8 / 2 0 0 4 Su e Swe a r i n g e n ( U I H C ) 5 . 0 0

1 2 8 5 8 4 5 4 2 2 Me l r o s e C t I C 1 A 5 2 2 4 6

8 / 1 8 / 2 0 0 4 Wanda T ha c k e r y ( UI HC) 1 . 0 0

1 2 8 5 8 4 5 6 0 4 F i r s t Av e So Mount Ve r n o n I A 5 2 3 1 4

8 1 1 8 1 2 0 0 4 T r i s h a T u r n i s ( UI HC) 5 . 0 0

1 2 8 5 8 4 5 4 5 1 9 Wa l k e r S t NE CR I A 5 2 4 0 2

8 / 1 8 / 2 0 0 4 Di a n e Va n E r s v e l d e ( UI HC) 1 . 0 0

1 2 8 5 8 4 5 3 0 5 1 Me a d o w Rd NE N o r t h L i b e r t y I A 5 2 3 1 7

8 / 1 8 / 2 0 0 4 J o Vo n d e r h a a r ( UI HC) 3 . 0 0

1 2 8 5 8 4 5 1 0 2 3 Ma r c S t r e e t I C I A 5 2 2 4 0

8 / 1 8 / 2 0 0 4 An g e l a We r n k e T r e n k a r n p ( UI HC) 1 0 . 0 0

1 2 8 5 8 4 5 3 5 1 Camden Rd I C I A 5 2 2 4 5

8 / 1 8 / 2 0 0 4 P a t s y Whe e l e r ( UI HC) 7 . 5 0

1 2 8 5 8 4 5 2 7 6 1 R h i n e Cr e e k Way NW O x f o r d I A 5 2 3 2 2

8 1 1 8 1 2 0 0 4 S h e r r y Wh e t s t o n e ( U I H C ) 5 . 0 0

1 2 8 5 8 4 6 1 1 0 S w i s h e r Vi e w Dr SWSwi s h e r I A 5 2 3 3 8



OCT- 19- 2004 09 : 08

Fo r I n s t r u c t i o n s , See Back o f Fo r m



COMMI TTEENAME ( Mu s t b e same a s o n St at ement o f Or g a n i z a t i o n)

SEI D( Ser v i c e Emp l o y ees I n t ' 1 Un i o n) L o ca l 1 9 9 C PE Fund

D i s c l o s u r e l a w r e q u i r e s c an di d at e c ommi 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 any r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c ommi t t e e R e l a t i o n s h i p must b e shown t o t h e t h i r d d e g r e e o f c o ns a ng u i n i t y ( b l o o d r e l a t i v e s ) and a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( Se e Pa ge 2 o f f o r ms p a c k e r . ) . I f sur name o f c o n t r i b u t o r i s t h e same as c an d i d a t e , bu t t h e r e i s no

f a m i l i a l r e l a t i o n s h i p , e nt e r " n o t a pp l i c a b l e " i n t he r e l a t i o n s h i p c o l u mn .

Q CHECK THI S BOX I F

AMENDI NG FORM

SCHEDULE

P . 34

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

STATE 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 ON

NUMBER ANDTHE PACCHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF 1 0 NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD,

CAUTI ON : Se c t i o n 688 . 3 2 A( 6 ) . I o w a Code , p r o h i b i t s t he us e o f i nf or ma t i on c op i e d f r om r e p or 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 on t r i b ut i o ns o r

f o r an y c omme 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 mm i t t e e s .

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

DATE PAC I D NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FOR


( MMI DDI YR) ANDPACCHECK I ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

8 / 1 8 / 2 0 0 4 P a t Wo l f ( U I HC) 1 . 0 0

1 2 8 5 8 4 5 1 4 0 9 Wes t e r n C o l l e g e CR I A 5 2 4 0 4

8 / 1 - 8 / 2 0 0 4 - " ' - "- J o a n Cbmbr Wr i g h t ( UI HC) 3 . 0 0

1 2 8 5 8 4 5 1 6 5 9 P o l k Avenue NE S o l o n I A 5 2 3 3 3

8 / 1 8 / 2 0 0 4 M a r i e t t a Yoder ( U I H C ) 7 . 5 0

1 2 8 5 8 4 5 P 0 Box 1 3 0 K a l o n a I A 5 2 2 4 7

8 / 2 0 / 2 0 0 4 Deb B e n f e r ( UI HC) 3 . 0 0

D i r e c t D e p o s i t 1 6 8 3 Hemi n wa Lane I C I A 5 2 2 4 0

8 / 2 0 / 2 0 0 4 B r i a n F l a h e r t y 3 . 0 0

D i r e c t D e p o s i t 1 1 2 2 So Se v e n t h Av e I C I A 5 2 2 4 5

8 / 2 0 / 2 0 0 4 Anne G e n t i l - A r c h e r 5 . 0 0

D i r e c t D e p o s i t 1 7 4 4 - 1 1 5 t h S t Wes t L i b e r t y I A 5 2 7 7 6

8 / 2 0 / 2 0 0 4 Ca t h y S i n g e r Gl a s s o n 1 5 , 0 0

D i r e c t D e p o s i t 1 9 2 0 - 2 nd Av e SE CR I A 5 2 4 0 3

8 / 2 0 / 2 0 0 4 L i n d a L Hagen 1 0 . 0 0

D i r e c t D e p o s i t 3 7 5 Mor mon T r e k B l v d # 7 I C I A 5 2 2 4 6

8 / 2 0 / 2 0 0 4 M i c k e n z i e Jensen 2 _ 5 0

D i r e c t D e p o s i t 2 3 1 3 K e l l y S t SWCR I A 5 2 4 0 4

8 / 2 0 1 2 0 0 4 D a v i d C Megger s 5 . 0 0

D i r e c t D e p o s i t 3 3 7 1 Oz z i e D r i v e NE S o l o n I A 5 2 3 3 3

$ 5 6 11

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



OCT - 1 9 - 2 0 0 4 0 9 0 8

F o r I n s t r u c t i o n s , Se e t 3 a c k o T r o r m


( i n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n ds )

COMMI TT EE : NAME ( M u s t b e same a s o n St a t ement o f Or g a n i z a t i o n )

SEI U( S e r v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 1 9 9 C PE F u n d

Jk_ f 1 t UULC

P . 3 5


AMENDI NGFORM

A MONETARY

( Re v . 0 6 / 9 7 ) I RECEI PTS

STATE CANDI DATES NOTE : I F A CONTR I BUTI ON I S RECE I VEDFROMA STATE PAC ( P OL I T I CAL ACT I ON COMMI TTEE ) , L I S T THE PAC I DENT I F I CAT I ON

NUMBER AND THE PACCHECK NUMBER I N THE DESI GNATED COWMN. A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI C S AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 6 8 B, 3 2A( 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 ma 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 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 r

f o r a n y c o mme 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 mmi t t e e s .

Di s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o n t m l i t e e R e l a t i o n s h i p mus t b e s h o wn t o t h e t h i r d d e gr e e o r c o n s an gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( Se e P a g e 2 o f f o r ms p a c k e t . ) . I f s u r n a me o f c o n t r i b u t o r i s t h e same a s c a nd i d a t e , b u t t h e r e i s n o

f a m i l i a l 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 he d u l e A)P a g e~~~ o f~~

DATE PAC 1 0 NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FOR


( MMI DDI YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

8 / 2 0 / 2 0 0 4 D e v i n P Me ha f f e y 2 - 5 0

D i r e c t D e p o s i t 8 6 5 Camb u r n C t SE CR I A 5 2 4 0 3

' s i 2 O/ 2 0 0 4 1;.K i m PC I V i i l r e r " - " ' r U . O U

D i r e c t D e p o s i t 8 0 5 S p e n c e r Dr I C I A 5 2 2 4 6

8 / 2 0 / 2 0 0 4 Do u g l a s L P e t e r s 2 . 5 0

D i r e c t D e p o s i t 7 0 E C h e s t n u t N I L I A 5 2 3 1 7

8 / 2 0 / 2 0 0 4 J e n n i f e r P o l a n d 2 . 5 0

D i r e c t D e p o s i t 2 0 4 0 Gl a s s Rd NE # 1 0 1 CR I A 5 2 4 0 2

8 / 2 0 / 2 0 0 4 K i r s t e n A Ru n n i n g 2 . 5 0

D i r e c t D e p o s i t 1 2 1 0 H i g h l a n d Av e I C I A 5 2 2 4 0

8 / 2 0 / 2 0 0 4 S a r a h D S i mp s o n 1 0 . 0 0

D i r e c t D e p o s i t 3 0 2 5 Hi d d e n M e a d o w Dr R i v e r s i d e I A 5 2 3 2 7

8 / 2 0 / 2 0 0 4 Ga r y D S m i t h 2 - 5 0


8 / 2 0 / 2 0 0 4 R i t a S t e r l e r 5 . 0 0

D i r e c t D e p o s i t 2 1 3 1 P l a e n Vi e w D r I C I A 5 2 2 4 6

8 / 2 0 / 2 0 0 4 S a r a h C Swi s h e r 4 0 , 0 0

D i r e c t D e p o s i t 9 1 7 Bowe S t I C I A 52240

8 1 2 0 1 2 0 0 4 T aw n y L Wi l s o n 7 . 5 0

D i r e c t D e p o s i t 1 1 1 0 C o n k l i n S t I C I A 52 245

SUM- I f I AL

TOTAL ( i f l a s t p a g e o f t h i s s c h ed ul e )



OCT- 1 9 - 2 00 4 0 9 : 0 9




COMMI TT EE NAME ( Mus t be s ame a s o n St a t emen t o f Or g a ni z a t i o n )

SEI U( Se r v i c e Empl oyees I n t ' 1 Un i on ) Local 199 C PE Fund

" D i s c l o s u r e t a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

Commh l e e R e l a t i o n s h i p mus t b e s ho wn t o t h e t h i r d d e gr e e o f c o ns a ng ul n l t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( Se e Pa g e 2 o f f o r ms p a c k e t . ) . I f s ur name o r c o n t r i b u t o r i s t h e Same a s c an d i d a t e , b ut t h e r e i s n o

t 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 ,

SCHEDULE

P . 3 6

CHECK THI S BOX I F

AMENDI NG FORM

A MONETARY

( Re v . 06 197 ) RECEI PTS

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( POL I T ICAL ACTI ON COMMI TTEE) , L I ST THE PAC I DENT I F I CAT I ON

NUMBERANDTHE PAC CHECK NUMBER I N THEDESI GNATED COLUMN, A L I S T OF I D NUMBERS I S AVA I L A B L E FROMTHE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD

CAUTI 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 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 on t r i b ut i o ns o r

f o r a n y c o mme 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 mmi t t e e s .

Pa g e o f ' «- - J

( f o r Sc he d ul e A )


RECEI VED ( ' i f a pp l i c a b l e ) TOCANDI DATE' RECEI VED FUND-

( MMI DDI YR) AND PAC CHECK I ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 3 / 2 0 0 4 De b B e n f e r ( U I H C ) 3 . 0 0

D i r e c t D e p o s i t 1 6 8 3 Hemi n a L a n e I C I A 52240

9 / 3 / 2 0 0 4 - B r i a n F i a h e r t y t 3 _ 0 0

D i r e c t De " ! o s i t 1122 So Se v e n t h Av e I C I A 5 224 5

9 / 3 / 2 0 0 4 A n n e G e n t i l - A r c h e r 5 . 0 0


9 / 3 / 2 0 0 4 Ca t h y S i n g e r Gl a s s o n 1 5 . 0 0

D i r e c t D e p o s i t 1 9 2 0 - 2 n d Av e SE CR I A 5 240 3

9 / 3 / 2 0 0 4 L i n d a L Hage n 1 0 . 0 0

D i r e c t D e p o s i t 3 7 5 Mor mon T r e k B l v d # 7 I C I A 5 224 6

9 / 3 / 2 0 0 4 Da v i d C Me g g e r s 5 . 0 0

D i r e c t D e p o s i t 3 3 7 1 Oz : z i e D r i v e NE S o l o n I A 5 2 3 3 3

9 / 3 / 2 0 0 4 D e v i n P Me h a f f e y 2 . 5 0

D i r e c t D e p o s i t 8 6 5 Cambu r n Ct SE CR I A 5 240 3

9 / 3 / 2 0 0 4 K i m R M i l l e r 1 0 . 0 0

D i r e c t D e p o s i t 8 05 S p e n c e r Dr I C I A 52246

9 / 3 / 2 0 0 4 M i c h e l Mu r ph y ( I C S c h ) 2 . 5 0

D i r e c t De o s i t 3 1 5 E l l i s Av e # 1 I o w a Ci t I A 52246

9 1 3 1 2 0 0 4 Do u g l a s L P e t e r s 2 . 5 0

D i r e c t D e p o s i t 7 0 E C h e s t n u t NL I A 5 2 3 1 7




OCT - 1 9 - 2 0 0 4 0 9 : 0 9




COMMI TTEENAME ( Mus t be s ame a s o n St a t ement o f Or g a ni z a t i o n)

SEI U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 1 9 9 C PE Fu nd


c o mmi t t e e . R e l a t i o n s h i p must 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 an g u ) n i t y ( b l o o d r e l a t i v e s ) a nd a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( Se e P a g e 2 o f f o r ms p a c k e t . ) . I f su r name o f c o n t r i b u t o r i s t h e s ame a s c a nd i d a t e , bu t t h e r e i s no

f a m i l i a l r e l a t i o n s h i p , e nt e r " n o t a 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 ,

SCHEDULE

P . 3 7

A MONETARY

( R e v . 0 6 1 9 7 ) I RECEI P TS


AMENDI NGFORM

STATE CANDI DATES NOTE ; I F A CONTRI BUT I ON I S RECE I VED FROMA STATE PAC ( P OL I T I CA L A C T I ON COMMI TTEE) , L I ST THEPAC I DENT I F I C A TI ON

NUMBER AND THE PACCHECK NUMBER I N THEDES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I L A B L E FROMTHE I OWA ETH I CS AND CAMPA I GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 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 ma 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 me nt s f o r s o l i c i t i n g c ont r i bu t i o ns o r

f 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 an 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

P a g e _ o f ~ ,


DATE PAC I d NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FOR


( MM1DD/ YR) ANDPACCHECK ( i f a pp l i c a b l e ) RAI SER

NUMBER I NCOME

9 1 3 / 2 0 0 4 K i r s t e n A Ru n n i n g 2 . 5 0

D i r e c t D e p o s i t 1 2 1 0 H i h l a n d Av e I C I A 5 2 2 4 0

9 / 3 / 2 0 0 4 S h a h D S i r h p s o n"

1 6 1 0 0

D i r e c t D e p o s i t 3 0 2 5 Hi d d e n Me a d o w Dr R i v e r s i d e I A 5 2 3 2 7

9 / 3 1 2 0 0 4 Ga r y D Smi t h 2 . 5 0

D i r e c t D e p o s i t 9 1 7 Bowe r y S t I C I A 5 2 2 4 0

9 / 3 / 2 0 0 4 R i t a S t e r l e r 5 . 0 0


9 1 3 / 2 0 0 4 Sa r a h C S w i s h e r 4 0 . 0 0

D i r e c t D e p o s i t 9 1 7 Bower S t I C I A 5 2 2 4 0

9 / 3 / 2 0 0 4 Tawny L Wi l s o n 7 _ 5 0


9 / 1 6 1 2 0 0 4 Ru s s e l l A C l a r k ( CR S c h ) 5 . 0 0

1 0 4 3 8 9 4 0 4 5 Ch i c k a d e e L n Hi a wa t h a I A 5 2 2 3 3

9 / 1 6 1 2 0 0 4 H a r l e s s S Cl emons ( CR S c h ) 1 0 . 0 0

1 0 4 3 8 9 5 0 5 S i x t h S t SE CR I A 5 2 4 0 1

9 / 1 6 / 2 0 0 4 Ma r s h a l l R Cl emons ( CR S c h ) 5 . 0 0

1 0 4 38 9 5 0 5 S i x t h S t SE CR I A 5 2 4 0 1

9 1 1 6 / 2 0 0 4 WmA F i a c c o ( CR S c h ) 3 . 0 0

1 0 4 3 8 9 4 1 3 3 - 2 2nd Av e SWCR I A 5 2 4 0 4

r~DTOTAL ( i f l a st page o f t h i s Sc h e du l e ) Ei$-



OCT - 1 9 - 2 0 0 4 0 9 1 0



( i n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )

COMMI TTEE NAME ( Mu s t b e s ame 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 )

SEI U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 1 9 9C ' T "

PE F u n d

SCHEDULEA( Re v . 0 6 / 9 7 )

P . 38

MONET ARY

RECEI PTSDCHECK T HI S BOX I F

AMENDI NGFORM

STATE CANDI DATES NOTE ; I F A CONTRI BUT I ON I S RECEI VED FROMA STATE PAC ( P OL I T I CA L A C T I ON COMMI TTEE ) , L I S T THE PAC I DENT I F I C AT I ON

NUMBER ANDTHE PACCHECK NUMBER I N THEDES I GNATED COLUMN. A L I ST OF I D NUMBERS I S A VA I L A BL E FROMTHE I OWA ETHI CS AND CAMPA I GN

DI SCLOSURE BOARD

CAUTI ON: Se c t i o n 68B . 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 ma t i o n c o p i e d f r o m r e po r t s a nd s t a t e me nt s f o r s o l i c i t i n g c o nt r i b ut i o ns o r

f o r a ny 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 .


c 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 ns a ng u i n i t y ( b l o o d n = _ I a t i v L s ) a nd a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( S ee P a g e 2 o f f o r ms 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 nd i d a t e , b u t t h e r e i s no

f a m i l i a l r e l a t i o n s h i p , e nt e r " n o t a pp l i c 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 .


P a g e _. o f

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

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FOR


( MM/ DD1YR) AND PAC CHECK ( i f a pp l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 1 6 / 2 0 0 4 J e f f L F o s t e r ( CR S c h ) 5 . 0 0

1 0 4 3 8 9 3 2 0 9 T ama r a Dr SWCR I A 5 2 4 0 4

9 / 1 6 1 2 0 0 4 Ke n D G r o u t ( CR S c h ) 2 - . 0 0


9 1 1 6 / 2 0 0 4 Go r d o n K a l t e n b a c h ( CR S c h ) 6 . 0 0

1 0 4 3 8 9 2 2 7 - 1 1 t h S t NWCR I A 5 2 4 0 5

9 / 1 6 / 2 0 0 4 J o y c e E L u c a s ( CR S c h ) 4 . 0 0

1 0 4 3 8 9 1 4 0 1 B Av e V i n t o n I A 5 2 3 4 9

9 / 1 6 / 2 0 0 4 Dave L M a r t ( CR S c h ) 5 . 0 0

1 0 4 3 8 9 9 2 6 - 1 5 t h Av e SWCR I A 5 2 4 0 4

9 / 1 6 / 2 0 0 4 C h r i s McLe e s ( CR Sc h ) 5 . 0 0

1 0 4 3 8 9 4 1 1 - 2 7 t h S t NECR I A 5 2 4 0 2

9 / 1 6 / 2 0 0 4 T i m J Ne wc o mb ( CR S c h ) 5 . 0 0

1 0 4 3 8 9 7 2 6 E Av e NWCR I A 5 2 4 0 5

9 / 1 6 / 2 0 0 4 Chas A P e r r y ( CR S c h ) 1 0 _ 0 0

1 0 4 3 8 9 1 4 7 9 Mi a mi Dr NECR I A 5 2 4 0 2

9 / 1 6 / 2 0 0 4 A L J P o s p i s i l ( CR S c h ) 1 . 0 0


9 / 1 6 / 2 0 0 4 T e r r y A S l i c k t y ( CR S c h ) 2 . 5 0

1 0 4 3 8 9 1 1 2 8 Br own A v e NE CR I A 5 2 4 0 2



OCT - 1 9 - 2 0 0 4 0 9 : 1 0




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 Or g a n i z a t i o n)

SEI U( Se r v i c e Emp l o y e e s I n t ' l Uni on) Lo c a l 1 9 9 C PE F u n d

SCHEDULE

P . 3 9

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NGFORM

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECE I VED FROM A STATE PAC ( P OL I T I CA L AC T I ON COMMI TTEE ) , L I S T THEPAC I DENT I F I C AT I ON

NUMBERANDTHE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF 1 0 NUMBERS I S AVA I L A B L E FROMTHE I OWA ETHI CS AND CAMPA I GN

DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 66B. 3 2A ( 6 ) , I o wa Code, pr o h i b i t s t h e us e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o r

f o r a n y c o mme 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 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 a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 ns a ng u l n l t y ( b l o o d r e l a t i v es ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( Se e P a g e 2 o f f o r ms pa c ke 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 an di d a t e , b ut t h e r e i s n o

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 ,

P a g e o f




( MMI DD/ YR) ANDPAC CHECK

I( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME



9 / 1 6 / 2 0 0 4 ( S t e p h a n i e J L e wi s ( CRS c h ) 5 : 0 0

1 0 4 3 9 0 1 6 0 1 - 3 0 t h S t NW# 1 2 CR 1 A 5 2 4 0 5


2 2 8 1 5 6 P 0 Bo x 3 7 3 N E n g l i s h I A 5 2 3 1 6

9 / 1 6 / 2 0 0 4 K u r t h T Boyce ( I C S c h ) 1 . 5 0

2 2 8 1 5 6 4 8 7 6 - 1 2 0 S t NE S o l o n I A 5 2 3 3 3

9 / 1 6 / 2 0 0 4 R i c h a r d Han n a n ( I C S c h ) 1 . 5 0

2 2 8 1 5 6 P 0 Bo x 3 2 8 1 I o wa C i t y 1 A 5 2 2 4 4

9 / 1 6 / 2 0 0 4 J o h n Ho a r d ( I C S c h )1 . 2 5

2 2 8 1 5 6 Bo x 4 6 6 H i l l s I A 5 2 2 3 5

9 / 1 6 / 2 0 0 4 Ron J e n s e n ( I C S c h ) 1 . 0 0

2 2 8 1 5 6 4 2 5 - 3 2 0 t h S t WL i b e r t y I A 5 2 7 7 6


2 2 8 1 5 6 2 8 2 1 S R i v e r s i d e Dr I o wa C i t y I A 5 2 2 4 6

9 / 1 6 / 2 0 0 4 J o n L a l l a ( I C S c h ) 2 _ 5 0

2 2 8 1 5 6 6 0 1 Oa k l a n d Av e I o wa C i t y I A 5 2 2 4 0

9 / 1 6 / 2 0 0 4 B r i a n J Meyer ( I C S c h ) 1 . 5 0

2 2 8 1 5 6 1 6 M e t r i c Road I o w a C i t I A 5 2 2 4 0

67TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) 1



OCT- 19- 2004 09 : 10




COMMI TTEENAME ( Mus t be s ame a s on St a t ement o f Or g an i z a t i o n )

SEI U( S e r v i c e Emp l o y e e s I n t ' l Un i o n ) Local 199 PE F u n d

SCHEDULE

P. 40


AMENDI NG FORM

A MONETARY

( Re v . W97) RECEI PTS

STATECANDI DATES NOTE : I F A CONTRI BUTI ON 1 5 RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I ST THE PAC I DENT I F I CATI ON

NUMBERANDTHE PACCHECKNUMBER I N THE DESI GNATED COLUMN, A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD

CAUTI ON : Se c t i o n 68B. 3 2 A( 6 ) , I o w a Cod e, p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o 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 ut i o ns o r

f o r an y c o mme 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 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 di d at e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 sa n gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( S e e P a g e 2 o f f o r ms p ac k et . ) I f s u r n a r n e o f c o n t r i b u t o r i s t h e s ame a s c an d i d at e , b u t t h e r e i s n o

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 pp l i c ab l e " i n t h e r e l a t i o n s h i p c o l u mn , ( f o r S c he du l e A)P a g e

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FOR


( MMl DDI YR) ANDPACCHECK ( i f a pp l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 1 6 / 2 0 0 4 Randy Nguy e n ( I C S c h ) 1 . 5 0

2 2 8 1 5 6 4 8 Ambe r L a n e I o w a C i t y I A 5 2 2 4 0

9 / 1 6 i 2 0 0 4 M i c h a e l U' Co n n o r ( I C S c h ) 1 . 5 0 J

2 2 8 1 5 6 2 9 0 El m Ri d e D r i v e N o r t h L i b e r t y I A 5 2 3 1 7

9 / 1 6 / 2 0 0 4 Rod n e y Pe r d u e ( I C S c h ) 2 _ 5 0

2 2 8 1 5 6 6 0 3 W P a r i s S t WL i b e r t y I A 5 2 7 7 6

9 1 1 6 / 2 0 0 4 WmS a l a s b e r r y ( I C S c h ) 1 . 5 0

2 2 8 1 5 6 1 1 1 9 P i n e S t I o wa C i t y I A 5 2 2 4 0

9 / 1 6 / 2 0 0 4 K i m b e r l y Sc h l a b ac h ( I C S c h ) 1 . 5 0


9 / 1 5 / 2 0 0 4 Ge r a l d V o n s t e i n ( I C S c h ) 2 _ 5 0

2 2 8 1 5 6 5 0 4 8 - 2 1 0 t h S t NE S o l o n I A 5 2 3 3 3

9 / 1 6 1 2 0 0 4 Da l e Wei r ( I C S c h ) 1 . 5 0

2 2 8 1 5 6 2 1 4 5 Pa l me r C i r c l e I o wa C i t y I A 5 2 2 4 0

9 / 1 6 / 2 0 0 4 J e r o me Wi e d eme i r ( I C S c h ) 1 . 5 0


9 / 1 6 / 2 0 0 4 D a r y l L e w e s ( I C S c h ) 5 . 0 0

2 2 8 1 5 6 2 1 6 Da r t mo u t h I o w a C i t y I A 5 2 2 4 5

9 1 1 6 / 2 0 0 4 Do n a l d J B i n e g a r J r ( I C S c h ) 1 . 5 0

2 2 8 5 1 5 P 0 Bo x 3 7 3 N E n g l i s h 1 A 5 2 3 1 6




OCT- 19- 2004 09 : 11

Fo r I n s t r u c t i o n s , See Back of Form

CONTRI BUTI ONS-MONEYTAKEN I N


COMMI TTEE NAME ( Mu s t b e same as o n St at ement o f Or g a ni z a t i o n)

SEI U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n) L o c a l 1 9 9 C PE Fund

6 L ; Hl z UUL t _

P . 41

CHECK T HI S 1 3 0 X I F

AMENDI NG FORM

A MONETARY

( R e v . 0 6 1 9 7 ) RECE I P TS

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TT EE) , L I S T T HE P AC I D EN T I F I C A T I O N

NUMBER AND T HE PAC CHECK NUMBER I N T HE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM T HE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON: Se c t i o n 68B. 3 2 A ( 6 ) , I o wa Code . p r o h i b i t s t h e use 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 or t s and 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 r

f o r a ny c omme 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 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 mm i t t e e s t o d i s c l o s e t i r e r e l a t i o n s h i p o 9 a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o wn t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

m a ( 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 sur name o f c o n t r i b u t o r i s t h e same a s c a n d i d a t e , b u t t h e r e i s n o Page ~~o f

f a m i l i a l r e l a t i o n s h i p , e n i 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 co l umn . ( t o r , S c h e d u l e A) +

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT J I F FOR

RECE I VED ( I f a p p l i c a b l e ) T O CANDI DATE ' RECE I VED FUND-

( MMI DDI YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

9/ 16 / 2004 K u r t h T Boyc e ( I C S c h ) 1 - 5 0

2 2 8 5 1 5 4 8 7 6- 1 2 0 S t NE S o l o n I A 5 2 3 3 3

9/ 16 / 2004I . Ri c h a r 6 ' H a n n a n ( I C S c h ) ' 1 : 5 0

228515 P 0 Box 3 2 8 1 I o w a C i t y I A 52244

9/ 16 / 2004 J o h n Hoa r d ( I C S c h ) 1 . 25

228515 Box 466 Hi l l s I A 52235

9/ 16 / 2004 Ron Jensen ( I C Sch) 1 . 0 0

228515 4 2 5 - 3 2 0 t h S t WL i b e r t y I A 52776

9/ 16 / 2004 B r a d K u e s t e r ( I C S c h ) 1 . 5 0

228515 2821 S R i v e r s i d e Dr I o wa C i t y I A 52246

9/ 16 / 2004 J on L a l l a ( I C Sch) 2_50

2 2 8 5 1 5 6 0 1 Oa k l a nd Av e I o wa C i I A 5 2 2 4 0

9/ 16 / 2004 B r i a n J Meye r ( I C S c h ) 1 . 5 0

2 2 8 5 1 5 1 6 M e t r i c Road I o wa C i t y t o 5 2 2 4 0

9/ 16 / 2004 Randy Nguyen ( I C Sch) 1 . 5 0

2 2 8 5 1 5 48 Amber Lane I owa C i t y I A 52240

9/ 1 6/ 2004 M i c h a e l O' Connor ( I C S c h ) 1 . 5 0

228515 2 9 0 El m Ri d e D r i v e No r t h L i b e r t y I A 52317

9 / 16/ 2004 Rodney P e r d u e ( I C S c h ) 2 . 5 0

228515 603WP a r i s S t WL i b e r t y I A 52776~ - 1 V I AL

TOTAL . ( i f l a s t p a g e o f t h i s s c h ed ul e ) r -



OCT - 1 9 - 2 0 0 4 0 9 : 1 1

F o r I n s t r u c t i o n s , Se e BACK o f c o r m


( I n c l u d i n g c a n d i d at e ' s p e r s o na l f u n ds )

COMMI TTEE NAME ( Mu s t b e same a s o n S t a t e m e n t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 199 C PE F u n d

- b Ur l e u UL t

P . 4 2

7 J CHECK T HI S BOX I F

AMENDI NG FORM

A MONET ARY

( Re v , 0 5 1 9 7 ) RECEI PTS

STATE CANDI DATES NOT E : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTE E) . L I ST T HE PAC I DENT I F I CAT I ON

NUMBER AND THE PAC CHECK NUMBER I N T HE DESI GNATED COL UMN . A L I S T OF I D NUMBERS 1 5 AVA I L A B L E FROM THE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c on t r i b ut i o ns o r


D i 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 t h e 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 k i n g a c o n t r i b u t i o n t o I mc o mmi t t e e . R e l a t i o n s h i p must 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 ns a ng u i n l f y ( b l o o d r e l a t i v e s ) a n d a f f n i l y ( r e l a t i v e s b y

ma r r i a g e ) ( S ee Pag e 2 o f f o r ms p a c k e t . ) . I f s u r n a me o f c o n t r i b u t o r i s t h e same as c a nd i d at e , b u t t h e r e i s n o F a g e39o f 6 sf a m i l i a l r e l a t i o n s h i p , e nt e r " n o t a pp l i c 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 du l e A )

DATE PA C I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FOR

RECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE' RECEI VED FUND-

( MMI DDI YR) AND PA C CHECK ( i f a pp l i c a b l e ) RAI SER

NUMBER I NCOME


2 2 8 5 1 5 1119 P i n e S t I o w a C' I A 52240

` 9 / 1 6 f 2 00 4 K i mb e r l y S c h l a b a c h ( I C S c h ) ` 1 _ b 0

228 5 15 5 27 2 O a k c r e s t H i l l Rd R i v e r s i d e I A 5224 6

9 / 1 6 / 2 00 4 Ge r a l d Vo ns t e i n ( I C Sc h ) 2 . 5 0

2 2 8 5 1 5 5 0 48 - 2 10 t h S t NE So l o n I A 5 2 3 3 3

9 / 1 6 / 2 00 4 D a l e Wei r ( I C S c h ) 1 . 5 0

228 5 15 2145 Pa l me r C i r c l e I o w a C i t y I A 52240

9 / 1 6 / 2 0 0 4 J e r o me Wi e deme i r ( I C S c h ) 1 . 5 0

228 5 15 25 06 F r i e n d s h i p S t I C I A 52245

9 / 1 6 / 2 0 0 4 D a r y l L e w i s ( I C S c h ) 5 . 0 0

228 5 15 216 Da r t mo u t h I o w a C i t y I A 5224 5

9 / 1 6 / 2 0 0 4 Ma r s h a A nd e r s o n ( UI HC) 5 . 0 0

1305260 197 5 So Ri d e Dr C o r a l v i l l e I A 5 2 2 4 1

9 / 1 6 / 2 0 0 4 Sa n dr a A n f i n s o n ( UI HC) 2 _ 0 0

1305260 3 0 2 N o r t h F o u r t h S t WB r a n c h I A 5 23 5 8

9 / 1 6 / 2 0 0 4 Ma t t Bah l ( UI HC) 5 . 0 0

1305260 2 4 5 Hi c k o r y S t N L i b e r t y I A 5 23 5 8

9 1 1 6 1 2 0 0 4

LM i c h e l l e B a r g r e n ( UI HC) 5 . 0 0

1305260 7 0 2 Ho d e S t N o r t h L i b e r t y I A 52317J Uo - i L J I ML




OCT- 19- 2004 09 : 1 2



( I n c l u d l n g c a n d i d a t e ' s p e r s o n a l f u n ds )

COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t emen t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Emp l oyee s I n t ' 1 Un i on ) LoCa l 199 C PE F u n d

J C. Ht UUL t

P . 4 3


AMENDI NGFORM

A MONETARY

( Re v . 0 6 / 9 7 ) I RECEI PTS

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I C AL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ON

NUMBERANDTHE PAC CHECK NUMBER I N THE DES I GNATED COLUMN A L I S T OF I O NUMBERS I S A VA I L A B L E FROM T Hf i I OWA ETHI CS AND CAMPAI GN

DI SCL OSURE BOARD.

CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) . I o w a C o d e , p r oh i b i t s t h e us 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 and s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o n s o r

f o r a n y 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 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 di d at e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e _

Commi 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 ns a n gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( Se e P a g e 2 o f f o r ms p a c k e t . ) . I f su r name o f c o n t r i b u t o r i s t h e s a me a s c a n di d at e . b u t t h e r e i s n o P a g e Oo f _

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 pp l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn . ( f o r Sc h e du l e A )



( MM/ D0 1 YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 1 6 / 2 0 0 4 J a n i c e Ba r n e s ( U I H C ) 5 . 0 0

13 0 5 2 6 0 1 0 2 1 - 2 0 t h Av e CV I A 5 2 2 4 1

9 / 1 6 / 2 0 0 4 F t a c h a e l B a r r o w ( UI HC) 1 - 0 . 0 0

1305260 3513 D u n h a m Dr SWCR I A 5 2 4 04

9 / 1 6 / 2 0 0 4 De b B e n n er - Ha h n ( U I H C ) 5 . 0 0

13 0 5 2 6 0 1232 E C o l l e g e S t I C I A 52245

9 / 1 6 / 2 0 0 4 Ma r t h a B r a d b u r y ( UI HC) 2 . 0 0

1305260 1116WI d s Gr e e n Rd I C I A 5 224 6

9 / 1 6 1 2 0 0 4 J a n a B u r k h o l d e r ( U I H C ) 1 . 0 0

1305260 6 0 4 K i m b e r l i t e S t T i f f i n I A 52340

9 / 16 / 2 0 0 4 He i d e B u r s c h ( UI HC) 5 _ 0 0

13 0 5 2 6 0 9 7 O b e r l i n I C I A 52245

9 / 1 6 / 2 0 0 4 B a r r y B us c h e l ma n ( UI HC) 5 . 0 0

1305260 7 8 0 F a i r v i e w L n N o r t h L i b e r t y I A 5 2 3 1 7

9 / 1 6 / 2 0 0 4 A n n B y r n e ( U I H C ) 5 . 0 0

13 0 5 2 6 0 30 2 Oa k S t B u f f a l o I A 5 2 72 8

9 / 1 6 / 2 0 0 4 Ma r j i e C a r u t h ( UI HC) 5 . 0 0

1305260 8 0 1 A l p i n e Dr I C I A 52245

9 1 1 6 1 2 0 0 4 B e v Cl e a r ma n ( UI HC) 5 _ 0 0

1 3 0 5 2 6 0 1 0 0 7 E i g h t h S t C o r a l v i l l e I A 5 2 2 4 1

ouo- I U 1 A L _ v

TOTAL ( i f l a s t page o f t h i s s c he d u l e )



OCT- 19 - 2004 09 : 1 2 P . 4 4

Fo r I n s t r u c t i on s , See Back o f Fo r m I SCHEDULE

CONTRI BUTI ONS - - MONEYTAKEN I 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 A L ACTI ON COMMI TTEE) . L I S T THE PAC I D EN T I F I C A T I O N

NUMBER 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 GN

DI SCLOSURE BOARD .

CAUTI ON: S e 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 m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r

f o r a n y c omme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h an 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

QUO- r v I r u .


CHECK THI S BOX I F

AMENDI NG FORM

A MONETARY

( Re v . G6 / 9 7 ) I RECEI PTS

- D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 own t o t h e t h i r d d e g r e e o f c on s an g ui n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e Pa g e 2 o f f o r ms p a c k e t . ) I f s u r n a me o f c o nt r i b u t o r i s t h e s ame a s c a nd i d a t e , b u t t h e r e i s n o

f a m i l i a l r e l a t i o n s h i p , e nt e r " n o t a p p l i c a b l e " i n t h e f 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)

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT 4 I F FOR

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECE I VED FUNO-

( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 1 6 1 2 0 0 4 L y n e t t e Cooper ( UI HC) 2 . 5 0

1 3 0 5 2 6 0 2 4 0 1 H 6 E # 1 2 1 0 I C I A 5 2 2 4 0

9 / i 6 1 2 0 0 4 ' J u l i e D a v i s ( UI HC) - 5 , O i y

1 3 0 5 2 6 0 3 3 7 No r ma n d y D r I C I A 5 2 2 4 6

9 / 1 6 / 2 0 0 4 Ca t h y D o s t a l ( UI HC) 2 _ 0 0

1 3 0 5 2 6 0 1 9 8 5 S o u t h Ri d e Dr CV I A 5 2 2 4 1

9 / 1 6 / 2 0 0 4 An g e l a Duwa ( UI HC) 5 . 0 0

1 3 0 5 2 6 0 2 5 1 9 J Av e Wi l l i a ms b u r g I A 5 2 3 6 1

9 / 1 6 / 2 0 0 4 C a r o l y n E l l i o t t ( UI HC) 1 0 . 0 0


9 / 1 6 / 2 0 0 4S h e l l e y En gma n ( U I H C ) 5 . 0 0

1 3 0 5 2 6 0 7 1 7 R u n d e l l S t I C I A 5 2 2 4 0

9 / 1 6 1 2 0 0 4 E l i z a b e t h F i s h e r ( UI HC) 2 . 5 0

1 3 0 5 2 6 0 1 3 0 7 C a r r o l l S t I C I A 5 2 2 4 0

9 / 1 6 / 2 0 0 4 A n i t a F i t e ( UI HC) 5 . 0 0

1 3 0 5 2 6 0 1 3 3 H i l l s i d e D r E l d r i d e I A 5 2 7 4 8

9 / 1 6 / 2 0 0 4 K a r l e n e F u l l e r ( UI HC) 3 . 0 0

1 3 0 5 2 6 0 1 6 1 1 - 1 3 t h S t r e e t CV 1 A 5 2 2 4 1

9 1 1 6 1 2 0 0 4 C i n d y Fu n k ( U I H C ) 3 . 0 0

1 3 0 5 2 6 0 1 2 3 1 Sa n du sk Av e I C I A 5 2 2 4 0



OCT-19-2004 09 : 13


CONTRI BUTI ONS - -MONEY TAKEN I N

( i n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )

COMMI TT EE NAME ( Mu s t b e same 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 )

SEZU( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 1 9 9 C PE F u n d

S [ , ; Ht UUL t

P. 45

CHECK THI S BOX I F

AMENDI NG FORM

A MONET ARY

( Re v . 0 6 / 9 7 ) I RECEI PTS

STATE CAND I DATES NOT E I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P O L I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D E NT I F I C A T I O N

NUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN A L I S T OF I D NUMBERS I S AVAI LABLE F ROM THE I OWA ETHI CS ANO CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON : Se c t i o n 6 i 3 B . 3 2 A ( 6 ) , I o wa Co de , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r



c 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 own t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e P a g e 2 o f f o r ms p a c k e t . ) I f s u r n a me o f c o n t r i b u t o r i s t h e same a s c a n d i d a t e , b u t t h e r e i s n o P a g eq~o f l o sf 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 Sc h e d u l e A )

DATE PAC 1 0 NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT I F FOR

RECE I VED ( i f a p p l i c a b l e ) T O CANDI DATE' RECE I VED FUND-

( MMI DDNR)I

A ND P A C CHECK

I( i f a p p l i c a b l e ) RA I SER

NUMBER I NCOME

9 / 1 6 / 2 0 04 J o e G a l b r a i t h ( UI HC) 1 0 . 0 0

1 3 0 5 2 6 0 302 1 R a v e n S t I C I A 5 2 2 4 5

" " 9 / 1 6 r 2 0 04 '- NanCy G e n o a r ( UI HC)

1 3 0 5 2 6 0 1 2 5 2 C o l l Dr I C I A 5 2 2 4 6

9 / 1 6 / 2 0 04 T r i s h a Go d a r d S he p h e r d ( UI HC) 2 . 5 0

1 3 0 5 2 6 0 9 30 - 2 3r d Av e A t C C o r a l v i l l e I A 5 2 2 4 1

9 / 1 6 / 2 0 04 L y n d a Gr e e n ( UI HC) 1 0 . 0 0

1 3 0 5 2 6 0 2 0 7 5 Me l r o s e Av e I C I A 5 2 2 4 6

9 / 1 6 / 2 0 04 Me l i s s i a Gr e i n e r ( UI HC) 5 _ 0 0

1 3 0 5 2 6 0 2 6 4 3 6 - 3 05 t h A v e n u e Ke o t a I A 5 2 2 4 8

9 / 1 6 / 2 0 04 Da n Gr i n s t e ad ( UI HC) 7 _ 50

1 3 0 5 2 6 0 1 2 1 8 As h S t I C 1 A 5 2 2 4 0

9 / 1 6 / 2 0 04 Ma r c i a H a h n ( UI HC) 5 . 0 0

1 3 0 5 2 6 0 2 2 8 1 S u g a r Bo t t o m Rd So l o n I A 5 2 3 3 3

9 / 1 6 / 20 0 4 Te r r y Ha mi l t o n ( UI HC) 3 . 0 0

1 3 0 5 2 6 0 7 1 5 N Va n Bu r e n S t I C I A 5 2 2 4 5

9 / 1 6 / 2 0 0 4 L y n n H a n k e ( UI HC) 5 _ 0 0

1 3 0 5 2 6 0 1 0 0 1 Me mo r i a l Dr SE CR I A 5 2 4 0 3

9 / 1 6 / 2 0 04 S ar a h H e l l e ( UI HC) 5 . 0 0

1 3 0 5 2 6 0 1 3 3 0 Upp e r Ol d H 6 Ox f o r d I A 5 2 3 2 2

-71 r u - - 1 V I AL$

X2t

TOTAL( i f l a s t pageof t h i s s c h e du l e )



OCT - 1 9 - 2 0 0 4 0 9 : 1 3

Fo r I n s t r u c t i o n s , Se e Ba c k o f F o r m


( i n c l u d i n g c a n d i d a l 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 St a t eme n t o f O r g a n i z a t i o n )

SE I U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 1 99 PE Fu n d

SCHEDULE

P . 4 6


AMENDI NG FORM

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

STATECANDI DATES NOTE : I F A CONTRI BUTI ON I S R ECE I V ED FROMASTATEPAC ( POL I T I CAL ACT I ON COMMI TTEE ) , L I S T THEPAC I DENT I F I CATI ON

NUMBER ANDTHEPACCHECKNUMBER I N THE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I L ABLE FROMTHE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON: Se ct i o n 58B . 3 2 A( 6 ) , I o wa C o d e , pr 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 ont r i b ut i o ns o r

f o r a n y c omme r c i a l p u r p o s e b y an y p er s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c ommi t t e e s ,

- D i s c l o s u r e l aw r e q u i r e s c a nd i d a t e c ommi 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 an y r e l a t i v e mak i ng a c o n t r i b u t i o n t o t h e

c ommi t t e e . R e l a t i o n s h i p must 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 ns an g ui n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( Se 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 r c o n t r i b u t o r i s t h e same a s c a nd i d a t e , b u t t h e r e i s n o P a g e _ ~ o f

f a m i l i a l r e l a t i o n s h i p , e nt e r " n o t a pp l i c a b l e ' i n t h e r e l a t i o n s h i p c o l umn . ( f o r Sc h e d ul e A)

DATE PAC I D NUMBER NAME AND ADDRESS OFCONTRI BUTOR RELATI ONSHI P AMOUNT I F FOR

RECEI VEDI f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-

( MM/ DD/ Y R) AND PACCHECK ( I f a pp l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 1 6 / 2 0 0 4 S h a r o n N i c k s ( U I H C ) 2 . 0 0

1 3 0 5 2 6 0 2 6 3 9 - 1 4 0 t h S t r e e t NWS w i s h e r I A 5 2 3 3 8

9 / ` 1 6 / 2 0 0 4 ` " M e r o d y H d b e r t - M e l l e c k e r ( U I F i C ) ' 5 , 0 0

1 3 0 52 6 0 3 0 0 Ma i n S t H i l l s I A 5 2 2 3 5


1 3 0 5 2 6 0 2 6 4 7 Ne wp o r t Rd NE I C I A 5 2 2 4 0

9 / 1 6 / 2 0 0 4 Deb R e y n o l d s Hub b a r d ( U I H C ) 3 . 0 0

1 3 0 5 2 6 0 1 4 6 8 V a l l e y Vi e w Dr i v e CV I A 5 2 2 4 1

9 / 1 6 / 2 0 0 4 S h e l l e y J a c o b u s ( UI HC) 1 . 0 0

1 3 0 5 2 6 0 6 5 0 7 Boxwood L n NECR I A 5 2 4 0 2

9 / 1 6 / 2 00 4 J e n n i f e r J u n g e n ( UI HC)5 . 0 0

1 3 0 5 2 6 0 P O Bo x 5 8 8 N o r t h L i b e r t y I A 5 2 3 1 7

9 / 1 6 / 2 0 0 4 No r man K a l v i g ( UI HC) 20 . 0 0

1 3 0 5 2 6 0 1945 P a r k Av e SE CR I A 5 2 4 0 3

9 / 1 6 1 2 0 0 4 V a l e r i e K e f f a l a ( U I H C ) 5 . 0 0

1 3 0 5 2 6 0 1 1 0 9 P r a i r i e DuCh i en Rd I C I A 5 224 5

9 / 1 6 / 2 00 4 Te r e s a A K i n g d o n ( UI HC) 2 _ 5 0

1 3 0 5 2 6 0 2113 N o r c o r Ave A p t 4 CV I A 5 2 2 4 1

9 / 1 6 1 20 04 K a t h e r i n e Kl e l n ow ( UI HC) 5 . 0 0

1 3 0 5 2 6 0 3 3 3 3 Pheasan t Ct NE N o r t h L i b e r t y I A 5 2 3 1 71 At .

$ 5 DOTOTAL ( i f l a s t p a g e o f t h i s s c h e d ul e ) rS



OCT- 19- 2004 09 : 14




COMMI TTEE NAME ( Mus t be s ame a s on St a t ement o f Or g a ni z a t i o n )

SEIU(Servi ce Emp l o y e e s I n t ' l Uni on) Loca l 199 C PE F u n d

SCHEDULE

P . 47

A MONETARY

( Re v . 0 6 1 9 7 ) I RECEI PTS


AMENDI NG FORM

STATE 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 S T THE PAC I DENT I F I CATI ON

NUMBERAND THE PACCHECK NUMBER I N THE DESI GNATED COLUMN, A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68B. 3 2 A( 6 ) , I o wa Cod e , pr 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 me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o r

f o r an y c o mme r c i a l p ur 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 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 n t r i b u t i o n t o t h e

c o mmi t t e e . R e l a t i o n s h i p must 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 F f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e Page 2 o f f o r ms 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 an d i d a t e , b ut t h e r e i s n o P a g e A4 - o f

f a m l 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 ul e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT d I F FOR

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND.

( MM1DDNR) ANDPACCHECK

I( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 1 6 / 2 0 0 4 A r l e n e K l e s n e r ( UI HC) 1 . 0 0

1 3 0 5 2 6 0 1 9 0 1 E a r l Road I C I A 5 2 2 4 6

9 / 1 6 i 2 0 0 4 . . . . , ° AmyK r u s e ( UI HC)

1 3 0 5 2 6 0 2 0 3 F i f t h S t # 1 C o r a l v i l l e I A 5 2 2 4 1

9 / 1 6 / 2 0 0 4 L i n d a K r u t s i n g e r ( UI HC) 1 0 , 0 0

1 3 0 5 2 6 0 2 1 4 7 P l a e n V i e w Dr I C I A 5 2 2 4 6

9 / 1 6 / 2 0 0 4 C y n t h i a L ar e w ( UI HC) 1 _ 0 0

1 3 0 5 2 6 0 P 0 Bo x 4 4 1 Lon e T r e e I A 5 2 7 5 5

9 / 1 6 / 2 0 0 4 P a u l a Lau b e ( UI HC) 7 . 5 0

1 3 0 5 2 6 0 7 1 2 Wal nut S t I C I A 5 2 2 4 0

9 / 1 6 / 2 0 0 4Ra e l e n e L e no c h ( UI HC) 1 . 0 0

1 3 0 5 2 6 0 2 1 3 B r o adway S t WB r a n c h I A 5 2 3 5 8

9 / 1 6 / 2 0 0 4 Lu an n e L i n k ( UI HC) 5 . 0 0

1 3 0 5 2 6 0 2 2 1 5 H i c k o r y C o u r t I C I A 5 2 2 4 0

9 / 1 6 / 2 0 0 4 M i c h a e l L o u c k s ( UI HC) 5 . 0 0

1 3 0 5 2 6 0 1 4 9 5 F a l c o n Av e S w i s h e r I A 5 2 3 3 8

9 / 1 6 / 2 0 0 4 Wi l ma Ma c a l a l a g ( UI HC) 5 . 0 0

1 3 0 5 2 6 0 8 2 8 A u g u s t a C i r c l e N o r t h L i b e r t y I A 5 2 3 1 7

9 / 1 6 / 2 0 0 4 J u n e Ma s b r u c h ( U I H C ) 5 . 0 0

1 3 0 5 2 6 0 2 3 8 7 - 3 4 0 t h S t SW T i f f i n I A 5 2 3 4 05 i t ) L ~ J I ! I I a L




OCT- 19 - 2004 09 : 1 4

Fo r I n s t r u c t i o ns , See Back o f Fo r m

CONTRI BUTI ONS - MONEYTAKEN I N


COMMI TT EE NAME ( Mu s t b e s ame a s o n St a t e me nt o f Or g a n i z a t i o n )

SEI U( Se r v i c e Empl o y ee s I nt ' l Un i on ) L o c a l 1 99 C PE Fund

- UAL

SCHEDULE

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

P . 4 8

QCHECKT HI S BOX I F

AMENDI NG FORM

A MONETARY

( R e v . 0 6 1 9 7 ) RECEI PTS

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D EN T I F I C A T I O N

NUMBER 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 E T HI C S AND CAMPAI GN

DI SCLOSURE BOARD

CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Cod e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me 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 o r

f o r a n y c o mme r c i a l p ur p os 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 mm i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e _

c o mm i t t e e R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma 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 Page o f

f 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 m n , ( f o r S c he d u l e A )

DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT q I F FOR

RECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE ' RECE I VED FUNO-

( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RA I SER

NUMBER I NCOME

9 / 1 6 / 2 0 0 4 An n Ma s o n ( UI HC) 3 . 0 0

1 3 0 5 2 6 0 1 0 3 2 O a k c r e s t S t I C I A 5 2 2 4 6

9 / 1 5 / 2 0 0 4 I t t h McKee v e r ( U I H C ) - - -- 5 . 0 0

1 3 0 5 2 6 0 3 0 2 Wa l n u t S t T i t o n I A 5 2 7 7 2

9 / 1 6 / 2 0 0 4 Ma r y McK i n n e y ( UI HC) 3 . 0 0

1 3 0 5 2 6 0 5 0 6 Wes t S e v e n t h S t T i p t o n I A 5 2 7 7 2

9 1 1 6 / 2 0 0 4 Ma r y J O Meg g e r s ( UI HC) 5 _ 0 0

1 3 0 5 2 6 0 3 3 7 1 O z z i e Dr S o l o n I A 5 2 3 3 3

9 1 1 6 / 2 0 0 4 T e r r i Me n g l e r ( UI HC) 7 . 5 0

1 3 0 5 2 6 0 2 2 1 5 S e c o n d S t SWCR I A 5 2 4 0 4

9 1 1 6 1 2 0 0 4 J e a n M i l l e r ( UI HC) 5 _ 0 0

1 3 0 5 2 6 0 3 7 5 5 C o t t a g e Re s e r v e Rd NE So l o n I A 52333

9 / 1 6 / 2 0 0 4 T a r a M i l l e r ( UI HC) 2 . 5 0

1305260 3 3 3 C a r t e r S t NWCR I A 5 2 4 0 5

9 1 1 6 / 2 0 0 4 R o b e r t M i l n e ( UI HC) 3 . 0 0

1 3 0 5 2 6 0 41 7 C a r t e r S t NWCR I A 5 2 4 0 5

9 / 1 6 / 2 0 0 4 Me l i n d a My e r s ( UI HC) 2 0 . 0 0

1 3 0 5 2 6 0 1 1 1 6 A Av e NWCR I A 5 2 4 0 5

9 / 1 6 / 2 0 0 4 J a n N i e b e s ( UI HC) 5 . 0 0

1 3 0 5 2 6 0 7 2 7 4 - 1 5 t h Av e K e y s t o n e I A 5 2 2 4 9



OCT- 19 - 2004 0 9 - 1 5

F o r I n s t r u c t i o n s , Se e baCK o T t - o r m




SEI U( Se r v i c e Empl oy e es I n t ' l Uni on) Loc al 199 C PE Fund

J t . Nt UULC

A( R e v . 0 6 / 9 7 )

P . 4 9

MONETARY

RECEI PTS


AMENDI NG FORM

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) , L I S T THE PAC I D EN T I F I C A T I O N

NUMBER 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 E T HI C S AND CAMPAI GN

DI SCLOSURE BOARD,



' D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 = _ g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b 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 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 Pag e o f

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 S c he d u l e A )


RECEI VE0 ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK I ( I f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 1 6 / 2 0 0 4 L i n d a P e t e r s e n ( UI HC) 2 . 5 0

1 3 0 5 2 6 0 9 0 7 N G i l b e r t S t I C I A 5 2 2 4 5

= ' 9 1 1 E/ 2 Gt 7 4 ' . . - . - Wmr g a r 6 t Ma r y P i n g ( UI HC) ` ' 3 ' 0 0

1 3 0 5 2 6 0 1 1 0 Sa r e r t D r We s t B r a n c h I A 5 2 3 5 8

9 / 1 6 / 2 0 0 4 Be c k y P o t t o r f f - L e a v e n ( UI HC) 5 . 0 0

1 3 0 5 2 6 0 1 1 4 9 H u n t e r ' s Ru n I C I A 5 2 2 4 6

9 / 1 6 / 2 0 0 4 C a r o l y n P o u l a k o s ( UI HC) 5 _ 0 0

1 3 052 6 0 40 4 S i x t h S t # D6 C o r a l v i l l e I A 5 2 2 4 1

9 1 1 6 / 2 0 0 4 J e f f r e y Rupe ( UI HC)

1 3 0 5 2 6 0 P O Bo x 2 1 8 N o r t h L i b e r t y I A 5 2 3 1 7

9 / 1 6 / 2 0 0 4 Nan c y Sa n ds t r o m ( U I H C ) 7 . 5 0


9 / 1 6 / 2 0 0 4 D o r o t h y S a t a r i a n o ( UI HC) 3 . 0 0

1 3 0 5 2 6 0 3 2 2 2 Sh a s t a C t NE CR 1 A 52402

9 / 1 6 1 2 0 0 4 S t e v e n S c h a e f e r ( UI HC) 2 0 . 0 0

1 3 0 5 2 6 0 3 94 6 Me h a f f e L n NE S o l o n I A 5 2 3 3 3

9 / 1 6 / 2 0 0 4 C h e r y l S c h i l d ( U I H C) 3 . 0 0

1 3 0 5 25 0 9 1 4 - 1 2 t h Av e CV I A 5 2 2 4 1

9 1 1 6 1 2 0 0 4 Ma r y S c h l i c h t e ( UI HC) 1 0 . 0 0

1 3 0 5 2 6 0 449 0 We s t o v e r Rd SE CR I A 5 2 4 0 3

* AAWA - T"~

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



OCT- 19- 2004 09 : 15




COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t eme n t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Emp l oy ee s I n t ' l Un i o n ) Loca l 1 9 9 C PE Fund


c 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 n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma 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

f a m i l i a l r e t a l i o r l s h i p , e n t e r " n o t a p p l i c a b l e " i l l t h e r e l a t i o n s h i p c o l umn .

SCHEDULE

P . 50


AMENDI NG FORM

A MONETARY

( Re v . 0 6 / 9 7 ) I RECEI PTS

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P O L I T I C A L ACTI ON COMMI TTEE) , L I S T TH E PAC I D E N T I F I C A T I O N

NUMBER AND THE PAC CHECK NUMBER I N TH E DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA E T HI C S AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI 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 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 r


Page ~ o f


DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT q I F FOR

RECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 1 6 / 2 0 0 4 J o y c e S c h u l t z ( UI HC) 3 . 0 0

1 3 0 5 2 6 0 3023 R a d c l i f f e A v e n u e I C 1 A 5 2 2 4 5

9 / 1 6 1 2 6 0 4 S h a n n a S e i g e l ( UI HC) 5 _ 0 0

1 3 0 5 2 6 0 2820 U A v e n u e P a r n e l l I A 52325

9 / 1 6 / 2 0 0 4 J e a n n e Sh e e t z ( UI HC) 5 . 0 0

1305260 1 2 0 T a r t a n Dr N o r t h L i b e r t y 1 A 52317

9 / 1 6/ 2 0 04 K a r e n S h i c k e l l ( UI HC) 1 0 _ 0 0

1305250 8 2 7 Dove r S t r e e t I C I A 522 45

9 / 1 6 / 2 0 0 4 An t h o n y Sh r a d e r ( UI HC) 5 . 0 0

1 3 0 5 2 6 0 15 6 0 - 7 t h Av e SE CR 1 A 5 2 4 0 3

9 / 1 6 / 2 0 0 4 V i c k i S i e f e r s ( U I H C ) 3 . 0 0

1305260 1 6 Br o wn Deer K n o l l CV I A 5 2 2 4 1

9 / 1 6 / 2 0 0 4 Pa m Si mon s ( U I H C ) 5 . 0 0

1 3 0 5 2 6 0 1310 F r a n k l i n S t I C I A 5 2 2 4 0

9 / 1 6 / 2 0 0 4 T e r r y Si mon s ( UI HC) 5 . 0 0

1305260 5 1 0 K i m b e r l i t e S t T i f f i n I A 523 40


1305260 2 7 6 0 T u r ~ e Cr e e k L n NE I C I A 522 40

9 / 1 6 / 2 0 0 4 Ma r y St e s s ma n ( UI HC) 1 . 0 0

1305260 3 7 8 8 Su n a u r a D r i v e NE I C I A 522 40

TOTAL ( i f l a s t pag e o f t h i s s c he d ul e )



OCT- 19- 2004 09 : 15




COMMI TTEENAME ( Mus t b e s ame 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 )

SEJ U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n ) Local 199 C PE F u n d

CHECK THI S BOX I F

AMENDI NG FORM

SCHEDULE

P . 51

A MONETARY

( Re v . 0 6 / 9 7 ) RECE I PTS

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A 5TATE PAC ( P OL I T I C AL ACTI ON COMMI T T E E ) , L I S T THE PAC I D E NT I F I C A T I O N

NUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE F ROM THE I OWA E T HI C S AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON : S e c t i o n 688 . 3 2 A( 6 ) , I o wa Cod e, p r o h i b i t s t h e u s e o f i n f o r m a t 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 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 o r


D i s c l o s u r e t a w r e q u i r e s c a n d i d a t e c o mm i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mm i t t e e . R e l a t i o n s h i p m u s t b e s h own t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma 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 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 I ~~ Of

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 Sc h e d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT 4 1 F FOR

RECE I VED ( i f a p p l i c a b l e ) TOCANDI DATE ' RECE I VED FUND-

( MMI DD/ YR) AND PACCHECK

I( i f a p p l i c a b l e ) RA I SER

NUMBER I NCOME

9 / 1 6 / 2 0 0 4 Su e Swe a r i n g e n ( UI HC) 5 . 0 0

13 0 5 2 6 0 42 2 Me l r o s e Ct I C I A 5 2 2 4 6

9 / 1 6 i 2 0 0 4 - Wanda Th a c k e r y ( U I H C ) 1 . 0 0

1 3 0 5 2 6 0 6 0 4 F i r s t Av e S o Mount V emo n I A 5 2 3 1 4

9 1 1 6 / 2 0 0 4 T r i s h a T u r n i s ( UI HC) 5 . 0 0

13 0 5 2 6 0 45 19 Wa l k e r S t NE CR I A 5 2 4 0 2

9 / 1 6 / 2 0 0 4 D i a n e Va n E r s v e l d e ( UI HC) 1 . 0 0

1 3 0 5 2 6 0 3 0 5 1 M e a d o w Rd N 1 = N o r t h L i b e r t y I A 5 2 3 1 7

9 / 1 6 / 2 0 0 4 J o Vo n de r h a a r ( UI HC) 3 . 0 0

1 3 0 5 2 6 0 1 0 2 3 Ma r c S t r e e t I C I A 5 2 2 4 0

9 / 1 6 / 2 0 0 4 An g e l a Wemk e T r e n k a mp ( U I H C ) 1 0 . 0 0

1 3 0 5 2 6 0 3 6 1 Camden Rd I C I A 5 2 2 4 5

9 / 1 6 / 2 0 0 4 P a t s y Wh e e l e r ( U I H C ) 7 . 5 0

1 3 0 5 2 5 0 2 7 6 1 Rh i n e Cr e e k Wa y NW O x f o r d I A 5 2 3 2 2

9 / 1 6 1 2 0 0 4 S h e r r y Wh e t s t o n e ( U I H C ) 5 . 0 0

1 3 0 5 2 6 0 1 1 0 S w i s h e r Vi e w Dr SW S w i s h e r I A 5 2 3 3 8

9 1 1 6 / 2 0 0 4 P a t Wo l f ( UI HC) 1 . 0 0

1 3 0 5 2 6 0 1 4 0 9 We s t e r n C o l l e g e CR I A 5 2 4 0 4

9 1 1 6 1 2 0 0 4 J o a n Comer Wr i g h t ( UI HC) 3 _ 0 0

1 3 0 5 2 6 0 1 6 5 9 P o l k A v e n u e NE S o l o n I A 5 2 3 3 3

TOTAL- ( i f l as t page o f t h i s s c h e du l e )



OCT- 19 - 2004 09 : 1 6 P . 5 2


MONETARYCONTRI 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 a r s o n a l f u n d s )

COMMI TTEE NAME( Mus t be s ame a s o n S t a t e m e n t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I nt ' 1 Un i o n ) L o c a l 19 9 C PE Fu n d

C ] CHECK THI S BOX I F

AMENDI NG FORM

( Re v . 0 6 / 9 7 ) I RECEI PTS

S TATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROM A S T ATE PAC ( P O L I T I C AL ACT I ON COMMI T T E E ) , L I S T THE PAC I D E N T I F I C A T I O N

NUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA E T HI C S AND CAMPA I GN

DI SCLOSURE BOARD .

CAUTI ON : Se c t i o n 8 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 m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r

f o r a n y c omme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l Commi t t e e s _


c 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 own t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d A f f i n i t y ( r e l a t i v e s b y

ma 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 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 Page o fla

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 a r S c he d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT - d I F FOR

RECE I VED ( i f a p p l i c a b l e ) TO CAND I DATE - RECE I VED FUND-

( MM/ DD/ YR) AND PAC CHECK

I I( f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 1 6 / 2 0 0 4 M a r i e t t a Yode r ( UI HC) 7 _ 5 0

1305260 P 0 Bo x 1 3 0 K a l o n a I A 52247

9 / 1 7 1 2 0 0 4 De b B e n f e r ( UI HC) - 3 - 0 0 1

D i r e c t D e p o s i t 1 6 8 3 Hemi n wa La n e I C I A 52240

9 / 1 7 / 2 0 0 4 J u l i e B r y a n t 1 0 . 0 0

D i r e c t D e p o s i t 1 B e l l a V i s t a P l a c e I C I A 52245

9 / 1 7 1 2 0 0 4 B r i a n F l a h e r t y 3 . 0 0

D i r e c t D e p o s i t 1 1 2 2 So Se v e n t h Av e I C I A 52245

9 1 1 7 / 2 0 0 4 A n n e G e n t i l - A r c h e r 5 , 0 0


9 / 1 7 / 2 0 0 4 Ca t h y S i n g e r G l a s s o n1 5 _ 0 0

D i r e c t D e p o s i t 1 9 2 0 - 2 n d Av e SE CR I A 5 2 4 0 3

9 / 1 7 / 2 0 0 4 L i n d a L Hagen 1 0 . 0 0

D i r e c t De o s i t 3 7 5 Mor mon T r e k B l v d # 7 I C I A 52246

9 / 1 7 / 2 0 0 4 D a v i d C Me g g e r s 5 . 0 0

D i r e c t D e p o s i t 3 3 7 1 O z z i e D r i v e NE S o l o n I A 523 3 3

9 / 1 7 / 2 0 0 4 D e v i n P Me ha f f e y 2 . 5 0

D i r e c t D e p o s i t 8 65 Cambu r n C t SE CR I A 52 4 0 3

9 1 1 7 / 2 0 0 4 Ki m R M i l l e r 1 0 . 0 0

D i r e c t D e p o s i t 8 0 5 Sp e n c e r Dr I C I A 52246J Ur S - I =AL $




OCT - 1 9 - 2 0 0 4 0 9 : 1 6 P . 5 3


A MONETARY



COMMI TT EE NAME ( M u s t b e s ame a s o n St a t ement o f Or g a n i z a t i o n)

SEI U( Ser v i c e Empl oy ees I n t ' 1 Un i o n ) Loca l 1 9 9 C PE Fund


AMENDI NG FORM

( Re v . 0 6 1 9 7 ) 1 RECEI PTS

STATECANDI DATES NOTE: I F A CONTR I BUT I ON I S RECEI VED FROMASTATE PAC( P OL I T I CAL ACT I ON COMMI TTEE ) , L I ST THEPACI DENT I F I CAT I ON

NUMBERAND THE PACCHECK NUMBER I N THE DESI GNATED COLUMN. A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS ANOCAMPAI GNDI SCLOSURE BOARD

CAUTI ON : S e c t i o n 6 6 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e use o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me nt s f o r s o l i c i t i n g c ont r i bu t i o ns o r

f o r a n y c o mme r c i a l p u r p o s e by a n 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 mm i t t e e s

' Di s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a ny r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mmi t t e e R e l a t i o n s h i p mus t be s h o wn t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a nd a f f i n i t y ( r e l a t i v e s by

ma r r i a g e) ( Se e P a g e 2 o f f o r ms p a c k e t . ) . I f s u f n a me o f c o n t r i b u t o r i s t h e same a s c an di d a t e , b ut t h e r e i s no P a g e 5 O o f

f a m i l i a l r e l a t i o n s h i p , e nt e r " n ot a pp l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn . ( f o r Sc h e d u l e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE- RECEI VED FUND-

( MM/ 0 0 / YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 1 7 / 2 0 0 4 M i c h e l Mu r p h y ( I C S c h ) 2 . 5 0

D i r e c t D e p o s i t 3 1 5 E l l i s Av e # 1 I o w a C i t y I A 5 2 2 4 6

9 1 1 7 1 2 0 0 4 Do u g l a s L P e t e r s 2 . 5 0

- D i r e c t D e p o s i t 7 0 E C h e s t n u t NL I A 5 2 3 1 7

9 / 1 7 / 2 0 0 4 K i r s t e n A Ru n n i n g 2 . 5 0

D i r e c t D e p o s i t 1 2 1 0 H i t h l a n d Av e I C I A 5 2 2 4 0

9 1 1 7 1 2 0 0 4 S a r a h D S i mp son 1 0 . 0 0

D i r e c t D e p o s i t 3 0 2 5 Hi d d e n Me a d o w Dr R i v e r s i d e I A 5 2 3 2 7

9 / 1 7 / 2 0 0 4 Ga r y D S m i t h 2 . 5 0

D i r e c t D e p o s i t 9 1 7 Bower S t I C l A 5 2 2 4 0

9 / 1 7 / 2 0 0 4 R i t a S t e r l e r 5 . 0 0


9 1 1 7 / 2 0 0 4 Sa r a h C S wi s h e r 4 0 _ 0 0


9 1 1 7 / 2 0 0 4 Tawny L Wi l s o n 7 . 5 0


9 / 3 0 1 2 0 0 4 Do n a l d J B i n e g a r J r ( I C S c h ) 1 . 5 0

2 2 8 6 0 1 P 0 Bo x 3 7 3 N E n g l i s h I A 5 2 3 1 6

9 1 3 0 1 2 0 0 4 K u r t h T Bo y c e ( I C S c h ) 1 . 5 0

2 2 8 6 0 1 4 8 7 6 - 1 2 0 S t NE S o l o n I A 5 2 3 3 3

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



OCT- 19 - 2084 0 9 : 1 7

Fo r I n s t r u c t i on s , Se e Back o f Fo r m



COMMI TTEE NAME ( Mu s t b e same a s on S t a t e me n t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Empl oyees I n t ' l Uni on) Local 1 9 9 C PE Fund

SCHEDULE

P . 5 4

A MONETARY

( Re v _ 0 6 / 9 7 ) RECEI PTS

CHECK T HI S t 3 0X I F

AMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON 1 5 RECEI VED FROMA STATEPAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ON

NUMBER ANDTHEPAC CHECK NUMBER I N THE DESI GNATED COLUMN. A L I ST OF I D NUMBERS I S AVA I LAB LE FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD

CAUTI ON: Se c t i o n 68B . 3 2 A ( 6 ) , I o wa Co de , p r o h i b i t s t h e us e o f i n f o r ma t i on c op i e d f r om r e por 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 on t r i b u t i on s o r

f o r a n y c o mme 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 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 -

" D i s c l o s u r e t a w r e q u i r e s c a n di d at e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 gr e e o f c on s an gu i n i t y ( b l o od r e l a t i v e s ) a n d a f f i n i r y ( r e l a t i v e s b y

ma r r i a g e) ( S e e Page 2 o f f o r ms p a c k e t . ) . I f s ur name 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 di d a t e , b u t t h e r e i s n o

f a m i l i a l r e l a t i o n s h i p , e nt e r n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn .P a g e _ t ~ L _ o f

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

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FOR


( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a bl e ) RAI SER

NUMBER I NCOME

9 / 3 0 / 2 0 0 4 R i c h a r d Hann a n ( I C S c h ) 1 . 5 0

228601 P 0 Bo x 3 2 8 1 I o w a C i t y I A 5 2 2 4 4

9 1 3 0 / 2 U u 4 J o h n Ho a r d ( I C S c h ) 1 . 2 5

228601 Box 46 6 H i l l s I A 5 2 2 3 5

9 / 3 0 / 2 0 0 4 Ron J e n s e n ( I C S c h ) 1 . 0 0

2 2 8 6 0 1 4 2 5 - 3 2 0 t h S t WL i b e r t y I A 5 277 6


228601 2 8 2 1 S R i v e r s i d e Dr I o w a C i t y I A 5 2 2 4 6

9 / 3 0 / 2 0 0 4 J o n L a l l a ( 1 C S c h ) 2 , 5 0

2 2 8 6 0 1 6 0 1 Oa k l a n d Av e I o w a C i t y I A 5 2 2 4 0

9 / 3 0 1 2 0 0 4 B r i a n J Meyer ( I C S c h )1 . 5 0

228601 16 Me t r i c Road I o wa C i t y I A 52240

9 / 3 0 / 2 00 4 Randy Nguye n ( I C S c h ) 1 . 5 0

2 2 8 6 0 1 4 8 Ambe r L a n e I o w a C i t y I A 5 2 2 4 0

9 1 3 0 1 2 0 0 4 Mi c h a e l O' Conno r ( I C S c h ) 1 . 50

2 2 8 6 0 1 2 9 0 El m Ri d e D r i v e No r t h L i b er t y I A 5 2 3 17

9 13 0 / 2 0 0 4 Rodney Pe r d u e ( I C S c h ) 2 , 5 0

2 2 8 6 0 1 6 0 3WP a r i s S t WL i b e r t y I A 52776

9 1 3 0 1 2 0 0 4 WmSa l a s b e r r y ( I C S c h ) 1 _50

2 2 8 6 0 1 1119 P i n e S t I o w a C i t y I A 5 2 2 4 0

TOTAL ( i f l e s t page of t h i s s c h e du l e ) $



OCT - 1 9 - 2 0 0 4 0 9 : 1 7 P . 5 5

Fo r I n s t r u c t i o n s , Se e Ba c k o f F o r m



COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e men t o f Or g a n i z a t i o n)

SEZU( Se r v i c e Emp l o y e es I n t ' l Un i o n ) L o c a l 1 9 9 C PE F u n d

SU[ t - I UI AL


AMENDI NG FORM

SCHEDULE


A MONET ARY( Re v . 0 6 / 9 7 ) RECEI PTS

STATE CANDI DATES NOTE: I F A CONT R I BUT I ON I S RECEI VED F ROMA STATE PAC ( POL I T I C AL AC T I O N COMMI T TEE) , L I S T THE PAC I DENT I F I C AT I O N

NUMBER AND THE PACCHECK NUMBER I N THEDESI GNATED COL UMN, A L I ST OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ET H I C S AND CAMPA I GN

D I SCLOSURE BOARD

CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Co de , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l c i t i n g c o n t r i b u t i o n s o r

f o r a n y c omme r c i a l p u r p o s e b y an 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 o mmi t t e es .

' D i 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 ommi t t e es t o d i 5 r - l o s e t h e 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 k i n g e c o n t r i b u t i o n t o t h e

c 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 eg r e e o f c o n sa n gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e) ( Se e Pa g e 2 o f l o r ms p ac k et . ) . I f 5 u r n a ME o f c o n l i i b u t o r i s t h e s ame a s c a n di d a t e , b u t t h er e i s n o

f a m i l i a l r e l a t i o n s h i p , e nt e r ' n o t a p 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 du l e A)

OAT S PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELA T I ONSHI P AMOUNT q I F F ORRECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECE I VED FUND-( MM1 DDt YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

9 / 3 0 12 0 0 4 Ki mb er l y Sc h l a b ac h ( I C Sch ) 1 - 5 0

2 2 8 6 0 1 5 2 7 2 Oa k c r e s t H i l l Rd Ri v e r s i d e I A 5 2 2 4 6

9 / 3 0 / 2 0 0 4 "* ; Ge r a l d Vo ns t e i n ( I C S c h ) 2 : 8 0

2 2 8 6 0 1 50 4 8 - 2 1 0 t h S t NE So l o n I A 5 2 3 3 3

9 / 3 0 / 2 0 0 4 Da l e We i r ( I C Sch ) 1 . 5 0

2 2 8 6 0 1 2 1 4 5 Pa l me r C i r c l e I o wa C i t y I A 5 2 2 4 0

9 / 3 0 / 2 0 0 4 J e r o me Wi e de me i r ( I C Sch) 1 . 5 0

2 2 8 6 0 1 2 5 0 6 F r i e n d s h i p S t I C 1 A 5 2 2 4 5

9 / 3 0 / 2 0 04 Da r y l L ewi s ( I C Sch) 5 . 0 0

2 2 8 6 0 1 2 1 6 Da r t mo u t h I o wa C i t y I A 5 2 2 4 5

1 0 / 1 / 2 0 04 De b Be n f e r ( UI HC ) 3 . 0 0

D i r e c t De po s i t 1 6 8 3 H emi n wa L a n e I C I A 5 2 2 4 0

1 0 / 1 / 2 0 04 J u l i e B r y a n t 1 0 . 0 0

D i r e c t De po s i t 1 B e l l a V i s t a Pl a ce I C I A 5 2 2 4 5

1 0 1 1 / 2 0 0 4 B r i a n F l a h e r t y 3 . 0 0

D i r e c t De po s i t 1 1 2 2 So Se v en t h Av e I C I A 5 2 2 4 5

1 0 / 1 / 2 0 04 A n n e G e n t i l - A r c h e r 5 . 0 0

D i r e c t De po s i t 1 7 4 4 - 1 1 5 t h S t Wes t L i b e r t y I A 5 2 7 7 6

1 0 / 1 1 2 00 4 Ca t h y Si n g e r Gl a s s o n 1 5, 0 0

D i r e c t De po s i t 1 9 2 0 - 2 n d Av e SE CR I A 5 2 4 0 3



OCT - 1 9 - 2 0 0 4 0 9 : 1 8 P . 5 6S C ; HEUULEr o r 1 n 5 t r u c t i o n s , a e e o a c r . u t r u r r t t



COMMI TT EE NAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g a n i z a t i o n)

SEI U( Se r v i c e Emp l o y e e s I n t ; ' l Un i o n ) L o c a l 1 9 9 C PE F u n d

U - I U I r + t _

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

A MONETARY

( R e v , 0 6 / 9 7 ) RECE I PTS


AMENDI NG FORM

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) , L I S T THE PAC I D EN T I F I C A T I O N

NUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN, A L I S T OF 1 0 NUMBERS I S AVAI LABLE FROM THE I OWA E T HI C S AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON : S e c t i o n 6 6 B . 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 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 r



C 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 how n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma 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 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 Page S3 o f

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 S c h e d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT J I F FOR


( MMI DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

1 0 / 1 / 2 0 0 4 L i n d a L Hag e n 1 0 _ 0 0

D i r e c t D e p o s i t 3 7 5 Mo r mon T r e k B l v d # 7 I C I A 5 2 2 4 6

1 0 1 1 1 2 0 0 4 D a v i d C 5 : U 0 !Megge r s

D i r e c t D e p o s i t 3 3 7 1 O z z i e D r i v e NE S o l o n I A 5 2 3 3 3

1 0 / 1 1 2 0 0 4 D e v i n P Me h a f f e y 2 , 5 0

D i r e c t D e p o s i t 8 6 5 Camb u r n C t SE CR I A 5 2 4 0 3

1 0 / 1 1 2 0 0 4 K i m R M i l l e r 1 0 _ 0 0

D i r e c t D e p o s i t 8 0 5 Spen c e r Dr I C I A 5 2 2 4 6

1 0 / 1 / 2 0 0 4 Mi c h e l Mu r p h y ( I C S c h ) 2 . 5 0

D i r e c t D e p o s i t 3 1 5 E l l i s Av e # 1 I o w a C i t y I A 5 2 2 4 6

1 0 / 1 / 2 0 0 4 Do ug l a s L P e t e r s 2 . 5 0

D i r e c t De o s i t 7 0 E C h e s t n u t NL I A 5 2 3 1 7

1 0 1 1 / 2 0 0 4 K i r s t e n A Ru n n i n g 2 . 5 0

D i r e c t D e p o s i t 1 2 1 0 H i g h l a n d Av e I C I A 5 2 2 4 0

1 0 / 1 1 2 0 0 4 Sa r a h D Si mp s o n 1 0 . 0 0

D i r e c t De o s i t 3 0 2 5 H i d d e n M e a d o w Dr R i v e r s i d e I A 5 2 3 2 7

1 0 / 1 1 2 0 0 4 Ga r y D Smi t h 2 . 5 0


1 0 1 1 1 2 0 0 4 R i t a S t e r l e r 5 . 0 0




OCT- 1 9 - 2 0 0 4 0 9 : 1 8 P . 5 7




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 ni z a t i on )

SEI U( Se r v i c e Emp l oye e s I nt ' 1 Uni on) Loca l 19 9

A MONETARY

( Re v . 0 6 / 9 7 ) RECE I PTS

DCHECK THI S BOX I FAMENDI NG FORM

STATE CAND I DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A4 ACT I ON COMMI TTEE) , L I S 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 E T HI C S AND CAMPAI GNDI SCLOSURE BOARD .

CAUTI ON : S e c t i o n 6 B8 . 3 2 A ( 6 ) , I o wa Co de , 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 nd 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 o r

f o r a n y c o mme 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 ommi t t e e s . "


C o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma 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 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 1514 o f

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 S c h e d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT 4 I F FORRECEI VED ( i f a p p l i c a b l e ) T O CANDI DATE" RECEI VED FUND-( MMl DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

1 0 / 1 1 2 0 0 4 Sa r a h C S wi s h e r 4 0 . 0 0


1 0 1 1 / 2 0 0 4 w T aw n y L ` i l s o n 7 : 5 0


1 0 / 1 3 / 2 0 0 4 R u s s e l l A C l a r k ( CR S c h ) 5 _ 0 0

105572 4 0 4 5 Ch i c k a d e e L n Hi a wa t h a I A 5 2 2 3 3

1 0 1 1 3 / 2 0 0 4 H a r l e s s S Cl emons ( CR S c h ) 1 0 . 0 0

1 0 5 5 7 2 5 0 5 S i x t h S t SE CR I A 5 2 4 0 1

1 0 1 1 3 / 2 0 0 4 Ma r s h a l l R C l emons ( CR S c h ) 5 . 0 0

105572 505 S i x t h S t SE CR I A 5 2 4 0 1

1 0 / 1 3 1 2 0 0 4Wm

A F i a c c o ( CR S c h ) 3 . 0 0

1 0 5 5 7 2 4 1 3 3 - 2 2 n d Av e SWCR I A 5 2 4 0 4

1 0 / 1 3 1 2 0 0 4 J e f f L F o s t e r ( CR S c h ) 5 . 0 0

1 0 5 5 7 2 3 2 0 9 T ama r a Dr SWCR l A 5 2 4 0 4

1 0 / 1 3 / 2 0 0 4 Ke n D G r o u t ( CR S c h ) 2 . 0 0


1 0 / 1 3 / 2 0 0 4 Go r d o n K a l t e n b a c h ( CR S c h ) 6 . 0 0

1 0 5 5 7 2 2 2 7 - 1 1 t h S t NWCR I A 5 2 4 0 5

1 0 / 1 3 / 2 0 0 4 J o y c e E L u c a s ( CR S c h ) 4 . 0 0

1 0 5 5 7 2 1 4 0 1 B Av e V i n t o n I A 5 2 3 4 9! L111I l L : v

L~ r

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



OCT- 1 9 - 2 0 04 0 9 " 1 9 P . 5 8




COMMI TT EE NAME ( M u s t b e s ame a s on St a t e me n t o f O r g a n i z a t i o n )


a U E5 - I UI ^ L -


A MONETARY

( R e v , 0 6 1 9 7 ) RECE I P TS


AMENDI NG FORM

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 ACT I ON COMMI T T E E ) , L I S T THE PAC I D EN T I F I C AT I O N

NUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COL UMN A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD,

CAUTI ON S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Co de , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r


- D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mm i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 d a f f i n i t y ( r e l a t i v e s b y

ma r r i o 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

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

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RE I - AT I ONSHI P AMOUNT 4 I F FOR

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE ' RECEI VED FUND-

( MMl DD1YR) I ANDPACCHECK I ( i f a pp l i c a b l e ) RA I SERNl 1MSER I NCOME

1 0 / 1 3 / 2 0 0 4 Dav e L M a r t ( CR S c h ) 5 . 0 0

1 0 5 5 7 2 9 2 6 - 1 5 t h Av e SWCR I A 5 2 4 0 4

1 D / 1 3 / 0 0 4 - . C h r i s M c L > r e s ( CR S c h ) _ - 5 . 0 0

1 0 5 5 7 2 4 1 1 - 2 7 t h S t NE CR I A 5 2 4 0 2

1 0 / 1 3 / 2 0 0 4 T i m J Ne wc omb ( CR S c h ) 5 . 0 0

1 0 5 5 7 2 7 2 6 E Av e NWCR I A 5 2 4 0 5

1 0 / 1 3 / 2 0 0 4 C h a s A P e r r y ( CR S c h ) 1 0 . 0 0

1 0 5 5 7 2 1 4 7 9 Mi a mi Dr NE CR I A 5 2 4 0 2

1 0 / 1 3 / 2 0 0 4 AL J P o s p i s i l ( CR S c h ) 1 . 0 0


1 0 1 1 3 / 2 0 0 4 T e r r y A S l i c k l y( CR

S c h ) 2 _ 5 0

1 0 5 5 7 2 1 1 2 8 B r o wn Av e NE CR I A 5 2 4 0 2

1 0 / 1 3 / 2 0 0 4 L o i s J B a s s e t t ( CR S c h ) 3 _ 0 0


1 0 / 1 3 / 2 0 0 4 S t e p h a n i e J L e w i s ( CR S c h ) 5 . 0 0

1 0 5 5 7 3 1 6 0 1 - 3 0 t h S t NW# 1 2 CR I A 5 2 4 0 5

1 0 / 1 3 / 2 0 0 4 Ma r s h a An d e r s o n ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 1 9 7 5 So Ri d e Dr C o r a l v i l l e I A 5 2 2 4 1

1 0 1 1 3 / 2 0 0 4 Sa n d r a A n f i n s o n ( UI HC) 2 . 0 0

1 3 2 2 7 8 2 3 0 2 N o r t h F o u r t h S t WB r a n c h I A 5 2 3 5 8



OCT- 19- 2004 09 : 1 9 P . 5 9

F o r I n s t r u c t i o n s , Se e B a c k o f F o r m I SCHEDULE



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 i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 199 C~ PE F u n d

A MONETARY

( R e v . 0 6 1 9 7 ) RECEI PTS

QCHECK THI S BOX I F

AMENDI NG FORM

STATE CAND I DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED F ROM A STATE PAC ( P O L I T I C A L ACTI ON COMMI TTEE) . L I S T THE PAC I D EN T I F I C A T I O N

NUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN A L I S T Of I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o pi e d f r o m r e p o r t s a nd 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 o r

f o r a n y c o mme r c i a l p ur p o s e 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

D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mm i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a l i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mm i t t e e R e l a t i o n s h i p m u s t b e s h o wn t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e P a g e ? o f f o r m s p a c k e t . ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s a r r l e a s c a n d i d a t e . b u t t h e r e i s n o

f a m i l i a 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 )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT 1 I F FOR

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE ' RECEI VED FUND-

( M1wDD1YR) AND PAC CHECK ( i f a p p l i c a b l e ) RA I SER

NUMBER I NCOME

1 0 / 1 3 / 2 0 0 4 Ma t t B a h l ( UI H C ) 5 _ 0 0

13 2 2 7 8 2 2 4 5 H i c k o S t N L i b e r t y I A 5 2 3 5 8

1 0 / 1 3 / 2 0 0 4 M i c h e l l e B a r g r e n ( U I H C ) 5 . 0 0

1 3 2 2 7 8 2 7 0 2 H o d g e S t N o r t h L i b e r t y I A 5 2 3 1 7

1 0 / 1 3 / 2 0 0 4 J a n i c e B a r n e s ( U I H C ) 5 . 0 0

1 3 2 2 7 8 2 1 0 2 1 - 2 0 t h Av e CV 1 A 5 2 2 4 1

1 0 / 1 3 / 2 0 0 4 R a c h a e l Ba r r o w ( UI H C ) 1 0 . 0 0

1 3 2 2 7 8 2 3513 D u n h am Dr SWCR I A 5 2 4 0 4

1 0 / 1 3 / 2 0 0 4 De b B e nn e r - Ha h n ( U I H C ) 5 . 0 0

1 3 2 2 7 8 2 1232 E Co l l e ge S t I C I A 5 2 2 4 5

1 0 / 1 3 / 2 0 0 4 Ma r t h a B r a d b u r y ( UI H C ) 2 _ 0 0

1 3 2 2 7 8 2 1116WI d e Gr e e n Rd I C I A 5 2 2 4 6

1 0 / 1 3 / 2 0 0 4 J a n a B u r k h o l d e r ( U I H C) 1 . 0 0

13 2 2 7 8 2 6 0 4 K i m b e r l f t e S t T i f f i n I A 5 2 3 4 0

1 0 / 1 3 / 2 0 0 4 He i d e B u r s c h ( U I H C ) 5 . 0 0

1 3 2 2 7 8 2 9 7 O b e r l i n I C I A 5 2 2 4 5

1 0 / 1 3 / 2 0 0 4 B a r r y Bu s c h e l mo n ( U I H C ) 5 . 0 0

13 2 2 7 8 2 7 8 0 F a i r v i e w L n N o r t h L i b e r t y I A 5 2 3 1 7

1 0 1 1 3 1 2 0 0 4 An n By me ( U I H C) 5 . 0 0

13 2 2 7 8 2 3 0 2 Oak S t B u f f a l o I A 5 2 7 2 8QUO- v

0

. .

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



OCT- 19 - 2004 09 : 1 9 P . 6 0VI I I I DU 4aUV. I J ~ Vr v emu_ v. . v . . . .





. 7 Vr 1 CV V1 . C

A MONETARY

( R e v , 0 5 / 9 7 ) RECEI PTS

©CHECK THI S BOX I F

AMENDI NG FORM

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) , L I S T THE PAC I D EN T I F I C AT I O NNUMBER AND THE PAC CHECK NUMBER I N THE OESI GNATF0 COLUMN, A L I S T Of I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .


f o r a n y c omme r c i a l pu r p os 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 mm i t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma 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 Su 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 u r E I S n o Page- o f

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



( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

1 0 / 1 3 / 2 0 0 4 M a r j i e C a r u t h ( U I H C) 5 . 0 0

1 3 2 2 7 8 2 8 0 1 A l p i n e D r I C I A 5 2 2 4 5

1 0 1 1 3 1 2 . 0 0 4 . . . F J . e v Cl e a r ma n ( UI H C)t

. ° . 5 _ O O f

1 3 2 2 78 2 1 00 7 E i g h t h S t C o r a l v i l l eI A 5 2 2 4 1

1 0 / 1 3 / 2 0 0 4 L y n e t t e Cooper ( U I HC ) 2 _ 5 0

1 3 2 2 7 8 2 2 4 0 1 H 6 E # 1 2 1 0 I C I A 5 2 2 4 0

1 0 / 1 3 / 2 0 0 4 J u l i e D a v i s ( U I H C) 5 . 0 0

1 3 2 2 7 8 2 3 3 7 No r man dy D r I C I A 5 2 2 4 6

1 0 / 1 3 1 2 0 0 4 C a t h y D o s t a l ( U I HC ) 2 _ 0 0

1 3 2 2 7 8 2 1 9 8 5 S o u t h Ri d e Dr CV I A 5 2 2 4 1

1 0 / 1 3 / 2 0 0 4 A n g e l a Duwa ( U I H C ) 5 _ 0 0

1 3 2 2 7 8 2 2 5 1 9 J Av e Wi l l i a ms b u r I A 5 2 3 6 1

1 0 / 1 3 / 2 0 0 4 C a r o l y n E l l i o t t ( U I HC ) 1 0 , 0 0


1 0 / 1 3 / 2 0 0 4 S h e l l e y Engman ( U I H C ) 5 . 0 0

1 3 2 2 78 2 71 7 R u n d e l l S t I C I A 5 2 2 4 0

1 0 / 1 3 / 2 0 0 4 E l i z a b e t h F i s h e r ( U I H C ) 2 . 5 0

1 3 2 2 7 8 2 1 3 0 7 C a r r o l l S t I C I A 5 2 2 4 0

1 0 / 1 3 / 2 0 0 4 A n i t a F i t e ( U I HC ) 5 . 0 0

1 3 2 2 7 8 2 1 3 3 H i l l s i d e D r E l d r i d e I A 5 2 7 4 8VVV- V n n v


i s - - -



OCT - 1 9 - 2 0 0 4 0 9 : 2 0 P . 6 1


CONTR I BUT I ONS - - MONEY TAKEN I N


COMMI TTEENAME ( Mus t b e s ame a s o n St at ement o f Or g a ni z a t i o n)

SEI U( Se r v i c e Emp l o y e e s I n t ' 1 Un i o n ) L o c a l 1 9 9 C PE Fund

Ju u ' I-. , -

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

C ] CHECK T HI S BOX I F

AMENDI NG FORM

A MONET ARY

( Re v . 0 6 1 9 7 ) RECEI PTS

STATE CANOI DATES NOTE: I F A CONTR I BUT I ON I S RECEI VED FROMA STATE PAC ( P OL I T I C A L AC T I ON COMMI TTEE ) , L I S T THE PAC I DENT I F I C AT I ON

NUMBERAND THE PACCHECKNUMBER I N THE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I $ A VA I L A B L E FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B. 3 2A ( 6 ) , I o wa C o d e , p r oh i b i t s t h e u s e o f i n f o r ma t i o n c o pi e d f r o m r e po 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 nt r i bu t i o ns o r

f o r an y c o mme r c i a l p u r p o s e by a ny 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 .


c o mmi t t e e . R e l a t i o n s h i p must 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 ns a ng ui n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S ee P a g e 2 o f f o r ms p a c k e t . ) . I f su r name o f c o n t r i b u t o r i s t h e s ame a s c a nd i d a t e , b u t t h e r e i s no P a g e o f ~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 , Sc h e d u l e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI OUTOR RELATI ONSHI P AMOUNT J I F FOR


( MM/ DDI YR) ANDPACCHECK ( I f appl i cabl e) RAI SER

NI I MRFR I NCOME

1 0 / 1 3 / 2 0 0 4 K a r l e n e F u l l e r ( UI HC) 3 . 0 0

1 3 2 2 7 8 2 1 6 1 1 - 1 3 t h S t r e e t CV I A 5 2 2 4 1

1 0 i I 3 i l 0 0 4 Ci n d y F u n k ' ( UI HC) 3 . 0 0

1 3 2 2 7 8 2 1 2 3 1 Sandus k Av e I C I A 5 2 2 4 0

1 0 / 1 3 / 2 0 0 4 J o e G a l b r a i t h ( U I H C ) 1 0 _ 0 0

1 3 2 2 7 8 2 3 0 2 1 Raven S t I C I A 5 2 2 4 5

1 0 / 1 3 / 2 0 0 4 Nancy Genoar ( UI HC) 5 , 0 0

1 3 2 2 7 8 2 1 2 5 2 C o l l Dr I C I A 5 2 2 4 6

1 0 / 1 3 / 2 0 0 4 T r i s h a Goda r d Sh e p h e r d ( UI HC) 2 _ 5 0

1 3 2 2 7 8 2 9 3 0 - 2 3 r d Av e A p t C C o r a l v i l l e I A 5 2 2 4 1

1 0 / 1 3 1 2 0 0 4 L y n d a Gr een ( UI HC)1 0 . 0 0

1 3 2 2 7 8 2 2 0 7 5 Me l r o s e Av e I C I A 5 2 2 4 6

1 0 / 1 3 / 2 0 0 4 M e l i s s i a G r e i n e r ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 2 6 4 3 6 - 3 0 5 t h A v e n u e K e o t a I A 5 2 2 4 8

1 0 / 1 3 / 2 0 0 4 Da n G r i n s t e a d ( U I H C ) 7 . 5 0

1 3 2 2 7 8 2 1 2 1 8 As h S t I C I A 5 2 2 4 0

1 0 / 1 3 / 2 0 0 4 Ma r c i a Hahn ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 2 2 8 1 S u g a r B o t t o m Rd S o l o n I A 5 2 3 3 3

1 0 / 1 3 1 2 0 0 4 T e r r y H a m i l t o n ( UI HC) 3 . 0 0

1 3 2 2 7 8 2 7 1 5 N Va n B u r e n S t I C I A 5 2 2 4 5



OCT - 1 9 - 2 00 4 0 9 : 2 0 P . 6 2


CONTR I BUT I ONS - - MONEY TAKEN I N ( Re v

A0 6 1 9 7 ) 1

MONETARY


COMMI TTEENAME ( 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 i z a t i o n )

SEI U( Se r v i c e Empl oyees I n t ' l Un i o n ) L o c a l 1 9 9 C PE Fund


AMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTR I BUT I ON I S RECE I VED FROMA S TATE PAC ( P OL I T I CAL ACT I ON COMMI T TEE ) , L I S T THE PAC I DENT I F I CAT I ON

NUMBER ANDTHEPACCHECK NUMBER I N T H E DES I GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

D I SC LOSURE BOARD.

CAUTI ON: Se c t i o n 688 . 3 2 A( 6 ) , I o wa Code, p r o h i b i t s t h e u s e o f i n f o r ma t i o n c op i e d f r o m r e p or t s and s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o r

f o r any c omme 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 a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c o mmi t t e e . R e l a t i o n s h i p mus t b e s h own t o t h e t h i r d d e g r e e o f c o n sa n gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e P a g e 2 o f f o r ms p a c k e t . ) I f s u r n a me o f c on t r i b u t o r i s t h e s ame a s c a n d i d at e , b ut t h e r e i s n o P a g e o f

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 ot 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 he d u l e A)


RECEI VED ( i f a pp l i c a bl e ) TOCANDI DATE' RECEI VED FUND-

( MM/ D D/ YR)

IANDPACCHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

1 0 / 1 3 / 2 0 0 4 L y n n He n k e ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 1 0 0 1 Me m o r i a l Dr SE CR I A 5 2 4 0 3

t ) / 1 3 7 2 0 0 4 - ' S a r a h r l e l l e ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 1 3 3 0 Up pe r O l d H 5 O x f o r d I A 5 2 3 2 2

1 0 / 1 3 / 2 0 0 4 S h a r o n H i c k s ( UI HC) 2 . 0 0

1 3 2 2 7 8 2 2 6 3 9 - 1 4 0 t h S t r e e t NWS w i s h e r I A 5 2 3 3 8

1 0 / 1 3 / 2 0 0 4 Me l o d y H o b e r t - Me l l e c k e r ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 3 0 0 Ma i n S t H i l l s I A 5 2 2 3 5

1 0 / 1 3 1 2 0 0 4 C l a i r e Ho c k l e y ( UI HC) 7 . 5 0

1 3 2 2 7 8 2 2 6 4 7 Newpor t Rd NE I C I A 5 2 2 4 0

1 0 1 1 3 1 2 0 0 4 De b Re y n o l d s Hu b b a r d ( UI HC)3 . 0 0

1 3 2 2 7 8 2 1 4 6 8 V a l l e y Vi e w D r i v e CV I A 5 2 2 4 1

1 0 / 1 3 / 2 0 0 4 S h e l l e y J a c o b u s ( UI HC) 1 . 0 0

1 3 2 2 7 8 2 6 5 0 7 Boxwood L n NE CR I A 5 2 4 0 2

1 0 / 1 3 1 2 0 0 4 J e n n i f e r J u n g e n ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 P O Box 5 8 8 N o r t h L i b e r t y I A 5 2 3 1 7

1 0 / 1 3 / 2 0 0 4 Nor man K a l v i g ( UI HC) 2 0 . 0 0

1 3 2 2 7 8 2 1 9 4 5 P a r k Av e SE CR I A 5 2 4 0 3

1 0 / 1 3 / 2 0 0 4 V a l e r i e K e f f a l a ( UI HC) 5 _ 0 0

1 3 2 2 7 8 2 1 1 0 9 P r a i r i e DuCh i e n Rd I C I A 5 2 2 4 5- ~ ~t ; a ~ ~ > r r a l

$J ` "

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



OCT - 1 9 - 2 0 0 4 0 9 : 2 1 P . 6 3




COMMI TTEENAME ( Mus t b e s ame a s o n St at ement o f Or g a n i z a t i o n)

SEI U( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 1 9 9C ' T ,

PE Fund


AMENDI NGFORM

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

STATE CANDI DATES NOTE : I F A CONTR I BUT I ON I S RECEI VED FROM A STATE PAC ( POL I T I C AL AC T I ON COMMI TT EE) . L I ST THE PAC I DENT I F I C A TI ON

NUMBER AND THE PACCHECK NUMBER I N THE DES I GNATED COLUMN . A L I S T OF 1 0 NUMBERS I S AVA I L A B L E FROM THE I OWA ETHI CS AND CAMPA I GN

DI SCLOSURE BOARD

CAUTI ON Se 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 ma t i o n c op i e d f r om r e po 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 ont r i bu t i o ns o r

f o r a n y c o mme r c i a l p u r p o s e by a n 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 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 nd i d a t e c o mmi t t e e s t o d i s d os e t h e r e l a t i o n s h i p o f a ny r e l a t i v e maki ng a c o n t r i b u t i o n t o t h e

c o mmi t t e e . R e l a t i o n s h i p mu st b e s h own t o t h e t h i r d d e g r e e o f c o ns a ng ui n i t y ( b l o o d r e l a t i v e $ ) a nd a f f i n i t y ( r e l a t i v e s by

ma r r i a g e ) ( S e e P a g e 2 o f f o r ms p a c k e t . ) I f s umame o f c o n t r i b u t o r i s t h e s ame a s Ca nd i d a t e , b ut t h e r e i s no Page ( o n o f~,

f a m i l i a l r e l a t i o n s h i p , e nt e r " n o t a 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 du l e A)



( MMl OD / YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SER

L I MBER I NCOME

1 0 / 1 3 / 2 0 0 4 T e r e s a A K i n g d o n ( UI HC) 2 . 5 0

1 3 2 2 7 8 2 2 1 1 3 N o r c o r Av e t 4 CV I A 5 2 2 4 1

i 0 1 1 1 4 0 0 4 K a t h e r i n e K l e i n o w ( UI HC) - 1 5 . 0 0

1 3 2 2 7 8 2 1 3 3 3 3 P h e a s a n t C t NE N o r t h L i b e r t y I A 5 2 3 1 7

1 0 1 1 3 / 2 0 0 4 A r l e n e K l e s n e r ( UI HC) 1 . 0 0

1 3 2 2 7 8 2 1 9 0 1 E a r l Road I C 1 A 5 2 2 4 6

1 0 / 1 3 / 2 0 0 4 Amy K r u s e ( U I H C ) 5 . 0 0

1 3 2 2 7 8 2 2 0 3 F i f t h S t # 1 C o r a l v i l l e I A 5 2 2 4 1

1 0 / 1 3 / 2 0 0 4 L i n d a K r u t s i n g e r ( UI HC) 1 0 . 0 0

1 3 2 2 7 8 2 2 1 4 7 P l a e n Vi e w Or I C I A 5 2 2 4 6

1 0 / 1 3 1 2 0 0 4 C y n t h i a L a r e w ( UI HC) 1 . 0 0

1 3 2 2 7 8 2 P 0 Bo x 4 4 1 L one T r e e I A 5 2 7 5 5

1 0 / 1 3 / 2 0 0 4 P a u l a Laube ( UI HC) 7 . 5 0

1 3 2 2 7 8 2 7 1 2 Wa l n u t S t I C I A 5 2 2 4 0

1 0 / 1 3 / 2 0 0 4 Ra e l e n e L en o c h ( UI HC) 1 . 0 0

1 3 2 2 7 8 2 2 1 3 B r o a dwa y S t WB r a n c h I A 5 2 3 5 8

1 0 / 1 3 / 2 0 0 4 Luanne L i n k ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 2 2 1 5 H i c k o C o u r t I C I A 5 2 2 4 0

1 0 / 1 3 1 2 0 0 4 Mi c h a e l L o u c k s ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 1 4 9 5 F a l c o n Av e Swi s h e r I A 5 2 3 3 8

TOTAL ( i f l a s t pa g e o f t h i s s c h ed u l e)

$r



OCT- 19 - 2004 09 : 2 1 P . 6 4

Fo r I n s t r u c t i on s , See Back o f Fo r m I Sf ; HEDULE



COMMI TTEENAME ( Mus t be s ame a s o n S t a t e me n t o f O r g a n i z a t i o n )

SEI U( Se r v i c e Empl oyees I n t ' 1 Un i o n ) L o c a l 1 9 9 C PE Fund

STATE 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 ON

NUMBER ANDTHE PAC CHECK NUMBER I N THE DESI GNATEDCOLUMN . A L I ST OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD.

CAUTI ON : Se c t i on 68B . 3 2 A ( 6 ) , I o wa Cod e , p r o h i b i t s t h e u s e o f i n f o r ma t i on c op i e d f r om 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 on t r i b u t i on s o r

f o r a n y c o mme r c i a l p u r p o s e b y a ny p er 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 .

J


AMENDI NG FORM

A l MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

TOTAL ( i f l a s t page o f t h i s s c h ed u l e ) ID i s c l o s u r e t a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 own t o t h e t h i r d d e g r e e o f c on s an gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( Se e P a g e 2 o f f o r ms p a c k e t . ) . I f sur name o f c o n t r i b u t o r i s t h e s a m e a s c an d i d a t e , b u t t h er e i s n o Pag e o f

f a m i l i a l r e l a t i o n s h i p , e nt e r ' n o t . a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn . ( f o r Sc h e du l e A)


RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE - RECEI VED FUND-

( MMI DDI YR) ANDPAC CHECK ( f a pp l i c a bl e ) RAI SER

NUMBER I NCOME

1 0 / 1 3/ 2 0 0 4 Wi l ma Ma c a l a l a g ( UI HC) 5 . 0 0

1322782 8 2 8 Au u s t a C i r c l e No r t h L i b e r t y I A 5 2 3 1 7

1 0 / 1 3/ 2 0 0 4 J u n e I 0 a s b r u c h ( UI HC) 5 . 0 0

1322782 2387 - 3 4 0 t h S t SW T i f f i n I A 52340

1 0 / 1 3 / 2 0 0 4 An n Mason ( UI HC) 3 , 0 0

1 3 2 2 7 8 2 1 0 3 2 O a k c r e s t S t I C I A 5 2 2 4 6

1 0 / 1 3 / 2 0 0 4 R u t h McK e e v e r ( U I H C ) 5 . 0 0

1322782 302 Wa l n u t S t T i p t o n I A 5 2 7 7 2

1 0 / 1 3 / 2 0 0 4 Mar y Mc K i n n e y ( UI HC)3 . 0 0

1 3 2 2 7 8 2 5 0 6 We s t Se v e n t h S t T i t o n I A 52772

1 0 / 1 3 / 2 0 0 4Mar y J o Megg e r s ( U I H C ) 5 . 0 0

1322782 3 3 7 1 O z z i e Dr S o l o n I A 52333

1 , 0 / 1 3 12 0 0 4 T e r r i Me n g l e r ( UI HC) 7 . 5 0

1322782 2215 Se co nd St SWCR 1 A 524 . 0 4

1 0 / 1 3/ 2 0 0 4 J e a n M i l l e r ( UI HC) 5 . 0 0

1322782 3755 C o t t a g e Re s e r v e Rd NE S o l o n I A 523 3 3

1 0 11 3 / 2 0 0 4 T a r a M i l l e r ( UI HC) 2 _ 5 0

1322782 333 C a r t e r S t NWCR I A 52405

1 0 / 1 31 2 0 0 4 R o b e r t Mi l n e ( U I H C ) 3 . 0 0

1 3 2 2 7 8 2 417 C a r t e r S t NWCR I A 52405



OCT - 1 9 - 2 0 0 4 0 9 : 2 2 P . 6 5


A I MONETARYCONTRI BUTI ONS - - MONEY TAKEN I N


COMMI 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 )

SEI U( Se r v i c e Emp l o y e e s I n t ; ' 1 Un i o n ) L o c a l 1 9 9 COPE F u n d

f o r a n y c omme r c i a l p u r p o s e b y a n y p 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 .



AMENDI NGFORM

( Re v , 0 6 / 9 7 ) 1 RECEI PTS

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROMA STATEPAC ( POL I T I C AL AC T I ON COMMI TTEE) , L I S T THE PAC I DENT I F I C AT I ON

NUMBER ANDTHE PACCHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I L A B LEFROMTHE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Co de , 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 op 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 r

D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h e

c 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 on s an gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e Pag e 2 o f f o r ms p a c k e t . ) , I F Sur name o f c o nt r i b u t o r i s t h e s ame a s c a n di d at e , b u t t h er e i s n o P a g e o f

f a m i l i a l r e l a t i o n s h i p , e nt e r " n a L a pp l i c ab l e " i n t h e r e l a t i o n s h i p c o l u mn . ( f o r S c h e du l e A)

DATE PA C I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT q I F FOR

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE ' - RECEI VED FUND-( MM1 DO1 YR) AND PA C CHECK ( i f a p p l i c a b l e ) RA I SER

NUMBER I NCOME

1 0 / 1 3 / 2 0 0 4 Me l i n da Mye r s ( UI HC ) 2 0 . 0 0

1 3 2 2 7 8 2 1 1 1 6 A Av e NWCR I A 5 2 4 0 5

1 0 1 1 3 / 2 0 0 4 J a n Ni e b e s ( U I H C ) 5 . 0 0

1 3 2 2 7 8 2 7 2 7 4 - 1 5 t h Av e Ke y s t o n e I A 5 2 2 4 9

1 0 / 1 3 1 2 0 0 4 L i n d a P e t e r s e n ( UI HC) 2 . 5 0

1 3 2 2 7 8 2 9 0 7 N G i l b e r t S t I C I A 5 2 2 4 5

1 0 / 1 3 / 2 0 0 4 M a r g a r e t Mar y P i n g ( UI HC) 1 0 0

1 3 2 2 7 8 2 1 1 0 Sa r e r t D r We s t B r a n c h I A 5 2 3 5 8

1 0 / 1 3 / 2 0 0 4 B e c k y P o t t o r f f - l e a v e n ( U I H C ) 5 . 0 0

1 3 2 2 7 8 2 1 1 4 9 H u n t e r ' s Ru n I C I A 5 2 2 4 6

1 0 / 1 3 / 2 0 0 4 C a r o l y n P o u l a k o s ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 4 0 4 S i x t h S t # D6 C o r a l v i l l e I A 5 2 2 4 1

1 0 1 1 3 / 2 0 0 4 J e f f r e y Rupe ( UI HC) 3 . 0 0

1 3 2 2 7 8 2 P 0 Bo x 2 1 8 N o r t h L i b e r t y J A 5 2 3 1 7

1 0 / 1 3 / 2 0 0 4 Na n c y Sa n ds t r o m ( UI HC) 7 . 5 0


1 0 / 1 3 / 2 0 0 4 D o r o t h y S a t a r i a n o ( U I H C ) 3 . 0 0

1 3 2 2 7 8 2 3 2 2 2 Sh a s t a Ct NE CR I A 5 2 4 0 2

1 0 / 1 3 1 2 0 0 4 S t e v e n S c h a e f e r ( U I H C ) 2 0 . 0 0

1 3 2 2 7 8 2 3 9 4 6 Me h a f f e y L n NE S o l o n 1 A 5 2 3 3 3



OCT - 1 9 - 2 00 4 0 9 : 2 2 P . 6 6

F o r I n s t r u c t i o n s , Se e B a c k o f Fo r m ( SCHEDULE



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 i z a t i o n)

SEI U( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 1 9 9 C PE F u n d

Q CHECK T HI S 5 0 X I F

AMENDI NG FORM

MONETARY

( R e v , 0 6 1 9 7 ) RECEI P TS

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I $ RECEI VED FROM A STATE PAC ( P OL I T I C AL ACTI ON COMMI T T E E ) , L I S T THE PAC I D EN T I F I C AT 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 E T HI 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 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 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 n y c omme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c ommi t t e e s .


c o r n m i l t e e R e l a t i o n s h i p m u s t b e s h own t o t h e t h i r d d e g r e e o f c o n s a n g u l n l t y ( b l o o d r e l a t i v e s ) e n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) ( Se e 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 c o n t r i b u t o r i s t h e s e i n 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 a g e o f

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 umn . ( f o r S c he d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT ~ I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE ' RECEI VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

1 0 / 1 3 / 2 0 0 4 C h e r y l S c h i l d ( UI HC) 3 . 0 0

1 3 2 2 7 8 2 9 1 4 - 1 2 t h Av e CV I A 5 2 2 4 1

1 0 / 1 3 / 2 0 0 4 Ma r y S c h l i c h t e ( UI HC) 1 0 . 0 0

1 3 2 2 7 8 2 4 4 9 0 We s t o v e r Rd SE CR I A 5 2 4 0 3

1 0 / 1 3 / 2 0 0 4 J o y c e S c h u l t z ( UI HC) 3 . 0 0

1 3 2 2 7 8 2 3 0 2 3 R a d c l i f f e A v e n u e I C I A 5 2 2 4 5

1 0 / 1 3 / 2 0 0 4 S h a n n a S e i g e l ( UI HC) 5 _ 0 0

1 3 2 2 7 8 2 2 8 2 0 U A v e n u e P a me l l I A 5 2 3 2 5

1 0 / 1 3 / 2 0 0 4 J e a n n e Sh e e t z ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 1 2 0 T a r t a n Dr N o r t h L i b e r t y 1 A 5 2 3 1 7

1 0 / 1 3 / 2 0 0 4 Ka r e n S h i c k e l l ( UI HC) 1 0 . 0 0

1 3 2 2 7 8 2 8 2 7 Dove r S t r e e t I C I A 5 2 2 4 5

1 0 / 1 3 / 2 0 0 4 An t h o n y Sh r a d e r ( UI HC) 5 _ 0 0

1 3 2 2 7 8 2 1 5 6 0 - 7 t h Av e SE CR I A 5 2 4 0 3

1 0 / 1 3 / 2 0 0 4 V i c k i S i e f e r s ( UI HC) 3 . 0 0

1 3 2 2 7 8 2 1 5 Br o wn De e r K n o l l CV I A 5 2 2 4 1

1 0 / 1 3 / 2 0 0 4 Pa m S i mon s ( U I H C ) 5 . 0 0

1 3 2 2 7 8 2 1 3 1 0 F r a n k l i n S t I C I A 5 2 2 4 0

1 0 1 1 3 1 2 0 0 4 T e r r y S i mon s ( UI HC) 5 . 0 0

1 3 2 2 7 8 2 51 0 K i m b e r l i t e S t T i f f i n I A 5 2 3 4 0

J U t 3 - U I n L

TOTAL ( i f f a s t page o f t h i s s c h e du l e )



OCT - 1 9 - 2 0 0 4 0 9 : 2 3 P . 67

Fo r I n s t r u c t i o n s , Se e Back o f Fo r m



COMMI TTEE NAME ( Mus t be s ame as o n St a t emen t o f 0 r g an i z a t i o n )

SEI U( Se r v i c e Emp l o y e e s I n t ' l Un i o n ) L o c a l 199 C PE Fu n d

SCHEDULE

A MONETARY( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NG FORM

STATE CANDI DATES NOTE! I F A CONTRI BUTI ON I S RECEI VED FROMA STATEPAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ON

NUMBERANDTHEPAC CHECK NUMBER I N THE DESI GNATED COLUMN_ A L I ST OF I D 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 6 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 mat 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 me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o r

f o r an y c omme 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 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 .

D i s c l o s u r e l aw r e q u i r e s c an d i d at e Commi t t e e s t o d i s c l o s e t h e r o l a t l o n s h l p o f an y r e l a t i v e ma k i n g a c o n t r i b u t l o n t o t h e

c o mmi l l 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 gr e e o f Co n s a n gu i n i t y ( b l o o d r e l a t i v e $ ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a ge ) ( Se e Page 2 o f f o r ms p a c k e t . ) I F su r name o r c o n t r i b u t o r i s t h e s ame a s c an d i d at e , b u t t h e r e i s n o p a g e - o f

f a m i l i a l r e l a t i o n s h i p , e nt e r " n ot a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn ( f o r Sc h e d u l e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a pp l i c a bl e ) TO CANDI DATE' RECEI VED FUND-

( MM/ DDf Y R) ANDPAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

1 0 / 1 3 / 2 0 0 4 C h r i s S l a t e r ( UI HC) 5 _ 0 0

13 2278 2 2760 T u r k e Cr e e k L n NE I C I A 52240

1 0 / 1 3 / 2 0 0 4 Mar y St e s s ma n ( UI HC) 1 . 0 0

1322782 3 7 8 8 Su n a u r a D r i v e NE I C I A 52240

1 0 / 1 3 / 2 0 0 4 Su e Swe a r i n g e n ( U I H C ) 5 . 0 0

13 2278 2 422 Me l r o s e C t I C I A 52246

1 0 / 1 3 / 2 0 0 4 Wan d a T h a c k e r y ( U I H C ) 1 . 0 0

1322782 6 0 4 F i r s t Av e So Moun t Ve r n o n I A 52314

1 0 / 1 3 / 2 0 0 4 T r i s h a T u r n i s ( UI HC) 5 . 0 0

13 2278 2 45 19 Wa l ke r S t NE CR 1 A 52402

1 0 / 1 3 / 2 0 0 4 Di a n e Van E r s v e l d e ( UI HC) 1 . 0 0

1322782 3 0 5 1 Mea d ow Rd NE N o r t h L i b e r t y I A 5 2 3 1 7

1 0 / 1 3 / 2 0 0 4 J o Vo n d e r h a a r ( U I H C ) 3 . 0 0

13 2278 2 1023 Mar c S t r e e t I C I A 52240

1 0 / 1 3 / 2 0 0 4 An g e l a We r n k e T r e n k amp ( U I H C ) 1 0 . 0 0

1322782 3 6 1 Camden Rd I C I A 52245

1 0 / 1 3 / 2 0 0 4 P a t s y Whe e l e r ( UI HC) 7 _ 5 0

1322782 2 76 1 Rh i n e Cr e e k Way NW O x f o r d I A 52322

1 0 / 1 3 / 2 0 0 4 S h e r r y Wh e t s t o n e ( UI HC) 5 . 0 0

13227 8 2 1 1 0 Swi s h e r Vi e w Dr SW S w i s h e r I A 5 2 3 3 8J v u - V ML

$ + +I v . , .




OCT - 1 9 - 2 0 0 4 0 9 : 2 3F o r I n s t r u c t i o n s , Se e B a c k o f t " o r m



COMMI TT EE NAME ( Mu s t b e s ame a s on S t a t e me n t o f Or g a n i z a t i o n )

SEI U(Ser vi ce Emp l o y e e s I n t ' l Un i o n ) L oc a l 1 9 9 COPE Fu n d

W. 1 - I LUULt

A( Re v ( ) 6 1 9 7 )

P . 68

MONETARY

RECEI PTS


AMENDI NG FORM

STATE CANDI DATES NOTE= I F A CONTRI BUT I ON I S RECEI VED FROMA STATE PAC ( P OL I T I CA L ACT I ON COMMI T TEE) , L I S T THEPAC I DENT I F I C AT I ON

NUMBER ANDTHE PAC CHECK NUMBER I N THE DESI GNATED COLUMN A L I S T OF I D NUMBERS I S A VA I L A B L E FROMTHE I OWA ETHI CS 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 de , p r o h i b i t s t h e us e o f i n f o r ma t i on c o p i e d f r om r e por 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 on t r i bu t i on s o r

f o r a n y c omme 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 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

DATERECEI VED

( MWDDI YR)

PAC I D NUMBER

( i f a pp l i c a b l e )

AND PAC CHECKNUMBER

NAMEANDADDRESS OF CONTRI BUTOR RELATI ONSHI P

TO CANDI DATE`

( i f a pp l i c a b l e )

AMOUNT

RECEI VED

J I F FOR

FUND-

RAI SER

I NCOME

1 0 / 1 3 / 2 0 0 4

1 3 2 2 7 8 2

P a t Wol f ( UI HC)

1 4 0 9 We s t e m C o l l e g e CR I A 5 2 4 0 4

1 . 0 0

1 0 / 1 3 / 2 0 0 4

1 3 2 2 7 8 2

J o a n Comer Wr i g h t ( U I H C )

1 6 5 9 P o l k A v e n u e NE S o l o n I A 5 2 3 3 3

3 . 0 0

1 0 / 1 3 / 2 0 0 4

1 3 2 2 7 8 2

M a r i e t t a Yode r ( UI HC)

P 0 Bo x 1 3 0 Ka l o n a I A 5 2 2 4 7

7 . 5 0

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