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FOR I NSTRUCTI ONS, SEEBACK OF FORM

DI SCLOSURE SUMMARY PAGCOMMI TT EE NAME ( Mu s t b e same a s o n S t a t e me n t o f O r g a r n z a f 0 ' n ,

WTF( ' K F ( 1 R TnWA RPNATRI 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 :

OCHECK I F AMENDMENTTO REPORT DATED

a( 1 ) S t a t e w l d e l L e g l t i v e C a n d i d a t e ( 2 ) S t a t e w i d e PAC ( 3 ) S t a t e P a r t y ( 4 ) C o u n t y / L o c a l C a n d i d a t e( 5 ) C o u n t y P9 , C 6 I l c , f I s s p e l F r a n c p i s e Co~ e 7 / C i t y C e n t r a l C o mm i t t e ee( 1 3 ) S u p p o r t ~ I o f r j i d o sRo u t i n e P e n a l t i e s Du e F o r L a t e F i l e d Re po r t s Range f r o m $ 2 0 t o $ 8 0 0

SEE I NSTRUCTI ONS ON BACK AND COMPL ETE THE FOLL OWI NG SENTENCE :I A MF I L I NGA 0 1 / 0 1 / 0 4 - 1 2 / 3 1 / 0 4

( r e p o r t d a t e )REPORT FORAN/ A ( 1 ) ELECTI ON / ( 2 ) NON- ELECT I ON YEAR.

I n d i c a t e o n e

FORMDR- 2 I DI SCLOSU( R e v . 0 1 / 9 8 ) REPORF o r O f f i c e Us e O n l yComm. #I n d e x e dA u d i t e dC o mp u t e r

17 1 2 / 2 7 6 - 2 0 0 4 0 1/ 1 7 / _ 4 4TELEPHONE DATE SI GNED

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

( Sc h e du l e H a p p l i e s t o C a n d i d a t e s ' Commi t t e e s O n l y )SUB- TOTAL . . . . . . $

SUBTRACT TOTAL MONEY SPENT THI S PERI ODS c h e d u l e B: E x p e n d i t u r e s t o t a l ( A t t a c h Sc h e d u l e B ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n Re p a y me n t s t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2 6 , 4 8 0 . 9 55 , 0 4 0 . 0 0

CANDI DATE COMMI TTEES ONLY:CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) YES _ XX _ NOVALUEOF CAMPAI GN PROPERTY ( F r o m Sc h e d u l e H - A t t a c h S c h e d u l e H ) $ - 0 -

CASH ON HAND a t t h e e n d o f t h i s r e p o r t i n g p e r i o d ( i f f i n a l r e p o r t , b a l a n c e mu s t 2 1 , 4 4 0 . 9 5b e z e r o ) ( A t t a c h DR- 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ,UNPA I D BI L LS ( F r o m S c h e d u l e D - A t t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ - 0 -I N KI ND CONTRI BUTI ONS ( F r o mSc h e d u l e E- At t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ - 0 -OUTSTANDI NG LOANS ( F r o m S c h e d u l e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ - 0 -

E l C h e c k i f t h i s i s f i n a l ( t e r mi n a t i o n ) r e p o r t a n d a t t a c h N o t i c e o f D i s s o l u t i o n F o r m DR- 3 . C o u n t y 8 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( Y o u mu s t c o n t i n u e t o f i l e r e p o r t s u n t i l a N o t i c e o f D i s s o l u t i o n i s f i l e d . ) w h i c h E l e c t i o n i s h e l d

STATEMENT OF CASH ON HANDCASH ON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d . ( T h i s i s t h e t o t a lo f a l l mo n i e s h e l d b y t h e c o mmi t t e e . T h i s amoun t MUST b e t h esame a s t h e c a s h o n h a n d a t t h e e n d o f t h e l a s t r e p o r t i n g p e r i o d ,o r mu s t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1 2 , 2 3 0 . 9 5

ADD TOTAL MONEYTAKEN I N THI S PERI OD 1 4 , 2 5 0 . 0 0S c h e d u l e A : Cash C o n t r i b u t i o n s t o t a l ( A t t a c h S c h e d u l e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n s Re c e i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - 0 -S c h e d u l e H : T o t a l Sa l e s o f Campa i g n P r o p e r t y ( A t t a c h S c h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - n -

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

( 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 ( Mo 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 )

WI ECK FOR I OWA SENATESTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMASTATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THEPAC I DENTI F I CATI ONNUMBERANDTHEPAC CHECKNUMBER I N THEDESI GNATED COLUMN. A L I S T OF I D NUMBERS I S AVAI LABLEFROMTHE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD.CAUTI ON Se ct i o n 68B. 3 2 A ( 6 ) , I o wa Co d e , p r o h i b i t s t h e use 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 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 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 .

SUB- TOTAL

TOTAL ( i f l a s t p ag 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 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 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 ) ( Se 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 same a s c a n d i d a t e , b ut t h e r e i s n o Page 2 o f 4f 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)

SCHEDULEA MONETARY

( Re v . 0 6 1 9 7 ) RECEI PTSX / CHECK T HI S BOX I F

AMENDI NG FORM

DATE PAC I D NUMBER NAMEAND ADDRESSOF CONTRI BUTOR RELATI ONSHI P AMOUNT d I F FORRECEI VED ( d a p p l i c a b l e ) TOCANDI DATE' RECEI VED FUND-( M11 NDDf YR) ANDPACCHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOMEI D # 6 4 8 6 I OWA TELECOM PAC0 8 / 3 1 / 0 4 1 1 5 S 2 ND AV W $ 2 5 0CK# 1 4 3 2 NEWTON I A 5 0 2 0 8I D# 8 1 4 0 PF I Z ER - STATE }0 9 / 0 1 / 0 4 2 35 E 42ND ST 2 5 0CK# 1 4 9 7 NEW YORK NY 1 0 0 1 7I D # 6 0 5 6 BANKERS UNI TE I N LEGI SLATI VE0 9 / 0 3 / 0 4 CK# DECI SI ONS 8 8 0 0 NW 6 2ND A 30 03 2 7 9 J OHNSTON I A 5 0 1 3 1 - 6 2 0 0I D # 6 0 5 6 BANKERS UNI TE I N LEGI SLATI VE9 / 1 0 / 0 4 CK # 8 8 0 0 NW 62ND AV 2 0 03 2 9 3 J OHNSTON I A 5012106200I D# 6 4 1 1 MCI I OWA PAC9 / 1 0 / 0 4 7 0 7 1 7 T H ST SUI TE 3 6 0 0 5 0 0CK# 1 3 4 4 DENVER CO 8 0 2 0 2 - 3 43 6I D # WAYNE R WOOLRI DGE9 / 0 5 / 0 4 4 1 0 SAC 5 0CK# 2 0 2 7 CHEROKEE I A 5 1 0 1 9I D # 6 0 6 7 I OWA HEALTH PAC9 / 0 5 / 0 4 CK# 6 7 5 0 WESTOWN PARKWAY # 1 0 k 1 5 03 1 6 1 WEST DES MOI NES I A 5 0 2 6 6I D # 8 2 5 1 PRI NPAC9 / 1 3 / 0 4 CK # 7 1 1 HI GH ST 2 5 01 3 3 1 DES MOI NES I A 5 0 3 9 2I D # 6 1 0 7 QWEST I PAC9 / 1 7 / 0 4 CK# 9 2 5 HI GH ST 5 0 03 4 1 8 DES MOI NES I A 5 0 3 0 9I D # DI CK PRUEHS0 9 / 1 7 / 0 4 CK# 5 5 1 7 STONE AV 5 0 05 7 3 8 SI OUX CI TY I A 5 1 1 0 6

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

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( A l i u s t b e same as o n S t a t e me n t o f Or g a ni z a t i o n)

WI ECK FOR I OWA SENATESTATECANDI DATES NOTE- I F ACONTRI BUTI ON I S RECEI VED FROMASTATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THEPAC I DENT I F I CATI ONNUMBER AND THEPACCHECKNUMBER I N THEDESI GNATED COLUMN. A L I S T OF I D NUMBERS I S AVAI LABLEFROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSUREBOARD .CAUTI ON : Se ct i o n 68B. 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 nf o r ma t i o n c o pi e d f r o m r e p o r t s and 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 u t i o ns o rf o r an y c omme r c i a l p u r p o se 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 .

SUB- TOTALTOTAL ( i f l a s t page o f t h i s s c h e du l e )

' D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c 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 a n 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 ec ommi 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 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 ) and a f f i n i t y ( r e l a t i v e s b ym a r r i a g e ) ( Se e Page 2 o f f o r ms p ac k et ) . 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 as c a n d i d a t e , b u t t h e r e i s no Page 3 - o f 4f 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 du l e A)

SCHEDULEA MONETARY

( Re v . 0 6 1 9 7 ) RECEI PTS/ Q CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT I F Fa tRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE' RECEI VED FUND-( MhMDD I YR) AND PAC CHECK ( i f ) RAI SERNUMBER I NCOMEI D # 6 4 7 8 I ANA - PAC $0 9 ' / 1 8 / 0 4 CK# 1 1 1 8 URBANDALEOR I A A5 0 3 2 2 1 0 0

I D# CRAI G H NEI LSEN 10 9 / 20 / 04 CK # 8 6 2 0 T I T LEI ST CR 2 5 09 4 3 6 L AS VEGAS NEVADA 8 9 1 1 7

I D# 6 2 9 1 I HA PAC0 9 / 2 6 / 0 4 CK# 1 0 0 E GRAND SUI TE 1 0 0 2 5 02 3 9 2 DES MOI NES I A 5 0 3 0 9I D# 6 0 8 7 I OWA TELECOMMUNI CATI ONS I N1 0 / 0 3 / 0 4 CK # 2 9 8 7 1 0 0 T H ST 5 0 01 3 6 3 URBANDALE I A 5 0 3 22 - 5 50 1I D# 6 1 5 9 AMERUS GROUP PAC1 0 / 0 5 / 0 4 CK # 6 1 1 5TH AV 5 0 01 0 9 8 DES MOI NES I A 5 0 3 0 9I D# LES DOUMA1 0 / 0 8 / 0 4 CK# 3 0 4 MARTI N DR NE 505 7 6 7 ORANGE CI TY I A 5 1 0 4 1I D# 6 0 5 2 I NDEPENDENT I NS . AGENTS OF I A1 0 / 1 2 / 0 4 C K # 4 0 0 0 WESTOWN PK Y STE 2 0 0 4 0 02 8 2 2 WEST DES MOI NES I A 5 0 2 6 5I D# BARBARA ULBRI CH1 0 / 1 2 / 0 4 CK# 29 CANDKE RI DGE RD 2 5 02 3 9 9 TOWANDA I L 6 1 77 6 - 7 5 1 3I D# 6 0 8 2 MI DAMERI CAN ENERGY CO EF F .1 0 / 1 0 / 0 4 CK # DES MOI NES I A 6 5 0 3 0 3- 0 6 57 2501 0 6 4I D# 6 0 5 8 I OWA CH I ROPRACT I C SOCI ETY1 0 / 1 6 / 0 4 1 6 0 5 N ANKENY BLVD SUI TE 0 0 3 0 0CK # 2 5 3 5 ANKENY I A 5 0 021 - 415 9

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

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

WI ECK FOR I OWA SENATE

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

STATE CAND I DATES NOTE: I F A C O N T R I B U T I O N I S R E C E I V E D FROM A S T A T E PAC ( P O L I T I C A L A C T I O N C OM MI T T E E ) , L I S T T H E P AC I D E NT I F I C AT I O NNUMBER ANDT HE PAC CHECK NUMBER I N T HE D E S I G N A T E D COLUMN . A UST OF I D NUMBERS I S A V A I L A B L E FROMTHE I O WA E T H I C S AND C A MP A I G ND I S C L O S U RE 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 p i e d f r o m r e p o r t s a n d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c o m me 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 .

$ 3 , 2 50$ 14 , 2 50

D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p 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 ym a r r i a g e ) ( S e e P a g e 2 o f f a r m s p a c k e t . ) . I f s umeme 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 4 o f 4f 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 eA )

SCHEDULEA MONETARY( Re v . 06M7) RECEI PTSF o l CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( M MN D D I Y R ) AND PAC CHECK ( i a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# 842 9 P CI P AC1 0/ 1 4/ 0 4 2 6 0 0 SOUTH RI VER RD $ 15 0CK # 2 5 3 7 DES P LA I NES I L 6 0 0 18 - 3 28 6I D# 6 1 2 5 I OWA REALTORS PAC j1 0 / 2 4 / 0 1 3 7 0 NW 114TH ST SUI TE 10 0 1 , 0 00CK # 2444 CL I VE I A 5 0 3 2 5I D# 9 6 8 7 GRI NNELL MUTUAL REI NSURANCE PAC1 0 / 2 3 / 0 CK # 4215 HI GHWAY 146 2 5 01036 GRI NNELL I A 5 0 1 1 2I D # 6 0 5 6 BANKERS UNI TE I N LEGI SLATI VE1 0 / 2 7 / 0 CK # 3 3 9 0 J J OHNSTONS I A 80 5 0 1 31 - 6 2 00 AV 1 , 0 00I D# 6 16 0 I OWA I NDEPENDENT BANKERS1 0 / 2 7 / 0 1 6 0 3 22ND ST SUI TE 20 2 5 0 0C E C # 2114 WEST DES MOI NES I A 5 0 2 6 6I D # 9 6 7 5 OAAI PAC10 / 2 8 / 0 CK # 3101 SW 61ST ST 1001039 DES MOI NES I A 5 0 3 2 1I D# 9 7 0 1 I OWA MORTGAGE ASSOCI ATI ON10 / 3 1 / 0 CK # 2014 6I AND 5 0 13 1 - 6 2 0 0 2 5 0J OHNSTONCK#I D#CK #I D #CK #

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T HI S BOX APPL I ES TO CANDI DATES' COMMI TTEES ONLY :P u r c h a s e s o f c e r t a i n c a mp a i g n p mp e r t y c o s t i n g 5 5 0 0 o r mo r e , r u s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H . ( R e f e r t c ) Sc h e d u l e H i n s t r u c t i o n s . )

i t u r i m 1 0 PGr W1Wf t AbM PMdRh9 9 . n g . f i n d - r a i s i n g . f 0 1 1 1 1 1 1 h 9 . ma n a g i n g . a g o n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e mi z e d o nS c h e d u l e G b y t h e a mo u nt , P u r p o s e . a n d d a t a o f e a c h t y p e o f e > t l x e made b y t h e p e r s mV e r i b l y o n b e h a l f o f t h e c a n d i d e t e ' s c o mmi t t e e . ( R e f e r t oS c h e d u l e Gk a u c t i o n s a n d l o x " Co d e 5 6 . 6 ( 3 ) ( 1 ) . )Pa g e 1 o f

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

FOR I NSTRUCTI ONS SEEBACKOF FORM SCHEDULEEXPENDI TURES B- MONEY SPENT FROMCOMMI TTEE ACCOUNT MONETARY( Re v . 0 9 / 9 7 ) EXPENDI TURES

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI DATES . L I S T T HE CANDI DATE I D EN TI F I C AT I ON NUMBER I N THE DES I GNATEDCOLUMN AND THE F o l CHECK T HI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE. A USTOF I D NUMBERS I S AVAI LABLE FROMTHE I OWA AMENDI NGFORMETHI CS & CAMPAI GN DI SCLOSURE BOARD.COU1QTTEE NAME ( l l o f r s t be s ame a s o n St a t e me n t o f O r g e n m a Gi o r r )

WI ECK FOR I OWA SENATECANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D b b u r s e r n e n f ) WAS MADE( MI NDDI YR) ANDPACCHECKNUMBERI D # LEGI SLAT I VE MAJ ORI TY1 0 / 0 8 / 0 CK# 1 0 3 4 FUND DONATI ON $ 5 , 0 0 0 . 0 0DES MOI NES I AI D # DOMAI N REGI STRY OF1 0 / 0 8 / 0 CK# AMERI CA RENEW OF DOMAI N NAME1 0 3 6 ON T HE WEB 4 0 . 0 0I D #CK#I D #CK#I D #CK#I D #CK#I D #CK#I D #CK#

SUB- TOTAL $ 5 , 0 4 0 . 0TOTAL ( i f l a s t page o f I l h i s s c h e du l e ) $ 5 0 4 0 . 0 0