OCT-22-2004 15 :23 INVESTAMERICA 13193639683 P .

03

FOR INSTRUCTIONS, SEE BACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
COMMITTEE NAME (Must be same as on Statement of Organlaarlon) (Rev. 07/2004) REPORT

For Office Use Only

Committee To Elect Don Palmer Comm . #
IMPORTANT : Indicate by # type or committee you are reporting for : logged In
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate (2 )State PAC ( 3 )State Party Scanned
( 4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or Other
Political Subdivision Candidate (8 )County PAC (B )City PAC (10 )School Board or Other Political Computer
Subdivision PAC ( 11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES, ONLY:
Candidate Name ! . Political Party (If applicable)
Late reports are subject to
Donald D . Palmer- _ RCT 2 2 20 14 ublican
possible civil and criminal
rlct (If Senate or House) penalties .
House District 38

tC -t+t8 -2C=Cr+
SIGNATURAOF PEfSON FILING REPORT TELEPHONE DATE SIGNED

10-19-2004
I AM FILING A REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .
(report dale) Indicate by #0

Local Committees, enter Data of Election

(]CHECK IF AMENDMENT TO REPORT DATED

County & Local Committees, enter County in

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

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (Total of all funds hold by the
committee . This amount MUST be the same as the cash on hand at the end 9 .13
of the last reporting period or must be zero if this is first report filed .) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADD TOTAL MONEY TAKEN IN THIS PERIOD

Schedule A : Cash Contributions total (Attach Schedule A) ("also see in-kind below) . . . . . .. . . . 0
Schedule F : Loans Received total (Attach Schedule F) . . . . . . . . . . . .. . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1193 .90

Schedule H : Total Sales of Campaign Property (Attach Schedule H) . . . . . .. . . . .. . . . . . . . . . . . . . . . . . . . . . .

-Schedule H applies to Candidates' Committees Only)

SUB-TOTAL . . .. . $
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B : Expenditures total (Attach Schedule B) ("also see debts and loans below) .. . . 1193 .90

Schedule F: Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . 9 .13

CASH ON HAND at the end of this reporting period (if final report balance must 0
be zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . ._ . . . . . . . . .. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . $

"UNPAID BILLS (From Schedule D - Attach Schedule D) . . . . . . . . .. . . . .. . . . . . . . . . . . . . . . . . . . . . ._ . . . . . . . . . . . . . . . . . . . . ._ . . . . .$ N/A

*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ N/A
-OUTSTANDING LOANS (From Schedule F -Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7293 .90

CANDIDATE COMMITTEES ONLY:

CONSULTANT BREAKDOWN (Schedule G Attached?)

VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
El. YES a NO
OCT-22-2004 15 :24 INVESTANERICA 13193639683 P . 04

FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev. 07/03) EXPENDITURES
STATE PAC COMMITTEES, NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN ANDTHE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF 10 NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.

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

Committee To Elect Don Palmer

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (If applicable) (Disbursement) WAS MADE
(MMIDD/YR) AND PAC
CHECK
NUMBER
I[)#
Communications Engineering Co . Web Site Hosting - Design -
10-12-2004 Artwork & Campaign Signs $ 1193 .90
CK#

ID#

CK#

DO

CK#

I D#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

1D#

CK#

SUB-TOTAL $ 1193 .90

TOTAL (if last page of this schedule) $ 1193 .90

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

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

Expenditures to persons/entitles providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee. (Refer to
Schedule G Instructions and Iowa Code 69A.402(3)(i),)

(for Schedule B)
 15 " 24 INVESTAMERICR 13193639683 P .05
OCT-22-2004

J
FOR INSTRUCTIONS, SEE SACK OF FORM SCMEOULE
F
COMMITTEE NAME(Musf be same as on Statement 0fOf08Mtegon) (Rev . 07103) I
I LOANS
RECEIVED
A REPAID
Commitrce To Elect Don Palmer
CHECK THIS BOX IF
NOTE: Thle schedule reports money loaned to the Committee which Is deposited In the commll(ee OCCOUML AMENDING FORM
66100,00 __-- -___---
TOTAL UNPAID LOANS FROM LSU REPORTING PERIOD S , -----------

PARTI- MONETARY LOANS RECEIVED =REPORTING PERIOD PART 11- MONETARY LOAN REPAYMENT$ MADE THIS REPORTING PERIOD
(Orfgknar sauna 00061), such as a bank, must De ?hewn It a third perfy is (Loans forgiven must be reported on Schedule E -- In-kind Conidbullons .)
Involved, InclVda lama item candidate's personal lands.)
AMOUNT NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT
DATE NAME ANDADDRESS OF LENDER RELATIONSHIP DATE PAID
(Include Endorser's Name, If Applicable) TO CANDIDATE OF LOAN (MMIDDfYR) (Include Endorser's Name, If APWIcaLI9) TO CANDIDATE' REPAID
RECEIVED
If If licable
MMIDDIYR Ildebls"

Don Palmer Don Palmer

1436 25th Sveet SE 1436 2$Th Street. SC
10 "12-2004 7-27-2004 Self 9.13
Cedar Rapids, IA 52403 Self 1193 .90 Cedar Rapids, IA 52403

TOTAI. (PART 1) 1 1193 .90 TOTAL CASH REPAYMENTS (PART rf) s 9.13
0
From Schedule E--TOTAL LOANS FORGIVEN $
7294 .77
TOTAL OUTSTANDING LOANS END OF REPORT PERIOD s

'Disclosure lawrequires candidate committees to dleclose the role onahlp of any reladva
making a contribution to she oommI1tee . Relabonship must be shown to me third degree or
consangulnlty (blood relatives) end amnlly (relatives by manlsge), if surname or contributor 19
the same am candidate, but here 19 no familial relationship enter 'not applicable' In the Page 1 0l
relationship column when It apprise . (for Schedule F)

TOTAL P .05