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41 ., C'- 0F / 5 e474f-"i1~ S Comm . #
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IMPORTANT : Indicate type of committee you are reporting for:
Scanned
( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate
( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee Computer _ __ _
Audite
CANDIDATE COMMITTEES ONLY :
Candidate Name Political Party
rJQ :d ~. 6a i) c/&, A
Office Sought District (if Senate or House)
Late filed reports are subject to possible civil and criminal penalties.
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :
I AM FILING A 7r /S-~ - f0 -/ -D :y REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate one
..7
Cand~ 0
4,- 4t-5, 40 4204: r$
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .
I D#
$ 106 .00
$-3-.0 CK# 1,1Wl%n Actu~eaS
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CK# 97 36 c'a-b/e
ID# C'ct~-c i y.ll Knoll
g-3-,oy CK# jai , .~ ocus/- SY SO~od
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ID#
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S-3-off cK# 5o3P ..Uer+h lam 51- loo .c')d El
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ID# lte ,Br e-orG
~' -3 -4V CK# /yo5 5. l yti'~f "SO . o p
v~fo0 3
SUB-TOTAL
the
' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to
by
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives
Page ------- of
marriage) . If surname of contributor is the same as candidate, but there is no
(for Schedule A)
familial relationship, enter "not applicable" in the relationship column .
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 07/03) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
ban dG .
t-Ir ocLSG nil" 5 g-nAf l1 eS
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . ALIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees.
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
.
60~ /W4Z ,, h
S_3_av CK#
Ad ., , .Z',fL -15~v40 3
ID#
A" drecznaa" i 5~ r
rs
8-3°~51 CK# az57 _ s~Wj .S)'o- 5o .od
5'0t-6-3
ID#
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ID#
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CK# 13 q:~ NW %b .2-vQl' Lawe, SD . vd
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1,514 Orchard So . od
Ad-- 4 ,TA- 300
ID# Je IPIP ~Ue ..tom'! cLr) - L ee
` Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) . If surname of contributor is the same as candidate, but there is no Page !_ of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
Fot Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 07/03) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
STATE CANDIDATES NOTE: IF ACONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . ALIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
RECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
8-lfO~ CK# 16 .4
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J~O El
ID# MawK L f".94 IL
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ID#
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8 - ll- n CK# 1/127 .v . 11Yj, PL /oo , od
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ID#
4u'tA J`*Qije~~ -7o .4 r 3
* Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) . If surname of contributor is the same as candidate, but there is no Page 0- _ of
(for Schedule A)
familial relationship, enter "not applicable" in the relationship column .
For Instructions, See Back of Form Reset Form
SCHEDULE
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
J
ID# S2cg 4f l, *4e3 CG/eM&h
J
J-//D4
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$ r 0 00 i/
CK# drrec+~a. St.
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ID# ~-c CP 4 Myer 6
.30#f9 o0'4zoly''h sfrle~ 50 °~
CK#
I P4 1 Or /", ao 6 3
SUB-TOTAL
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) . If surname of contributor is the same as candidate, but there is no Page - . of
familial relationship, enter "not applicable" in the relationship column . (fof Schedule A)
For Instructions, See Back of Form f SCHEDULE
Reset Form
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
0 CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD .
CAUTION : Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
:
.5a
12 .Z68W s f fv.% io6 P,q-G 7
CK#
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ID# papas Pa!/a5 Co s
coaan+y Aemocrat S
/4de4 . Z~_A to-Moc,fIds+ 900
7 r-254-0 / CK# Zo3r
' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) . If surname of contributor is the same as candidate, but there is no Page of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
Reset Form
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
0 CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
or
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions
for any commercial purpose by any person other than statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
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CK# .
C~5 h -~rro r» ~u r9 I-a i 5 t: Y
ID#
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CK# 5R & 'do 43fh s
AdeC. . Z7oul .a ~ fic9d 3
ID# ~~
l_rY ,t3~~ .~d J a $ is Q
ft) CK#
de< . 7tf+ X000 3
ID#
Alary,BttS°fAD
CK# ~la 5 . /,a n a 5'.od
i 0 00 C1 We . ' 50 7
CK#
ID#
CK#
SUB-TOTAL
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) . If surname of contributor is the same as candidate, but there is no Page __~__ of _~_-
(for Schedule A)
familial relationship, enter "not applicable" in the relationship column .
FOR INSTRUCTIONS, SEE BACK OF FORM Reset.,Form, SCHEDULE
B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev. 07/03) EXPENDITURES
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to persons/entities 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 68A.402(3)(i) .) -
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form SCHEDULE
B I MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev. 07103) EXPENDITURES
I D#
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)
Expenditures to personsientities 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 68A.402(3)(i) .)
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form SCHEDULE
B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 07103) EXPENDITURES
STATE PAC COMMITTEES: NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.
ID# N-etch
Pa ma ~~ . ,qc,r
CK# 7, 4.` n l 3 b " :5c7
, P,
rive- 0 .0 hi p
CK#
ID#
CK#
1D#
CK#
1D#
CK#
ID#
CK#
SUB-TOTAL $
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
D INCURRED
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev. 08/98) INDEBTEDNESS
Oarfe r- Pr r'n7F01
Ir
po~_,A Lpards
l0 -1-09 $
1-73q FasA- d /4v-e- for to, a2oo
SUB-TOTAL $ ~`
*If actual figure is unknown, show "estimated" beside the figure. Page / Of____Z
(for Schedule D)
5 ~a in ~'
S 4 Al a.. p4 d
Ru ,ilk at,
c1#t,`5-taa5 .n .
f~drau n na mos ., r- 4)vedaMrd
"2d'e~ ~ l~nlJgS Cen~sr
Naac,'' Sn.,dp _ _
bc+of-h 5
SUB-TOTAL