FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form FORM

DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE

(Rev . 12/2005) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization
For Office Use Only
Comm . #
IMPORTANT : Indicate by # type of committee you are reporting for : I I Logged,6 11 12
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party
( 4 )County Central Committee ( 5 )County Candidate ( 6 )Cit idate ( 7 )School Board or Other Scanned
Political Subdivision Candidate ( 8 )County PAC 1 )School Board or Other Political Computer
vr, " --
Subdivision PAC 11 Local Ballot Is
Audited
CANDIDATE COMMITTEES ON %
DISC~Oca
Cand+Ce Name Political Party (if applicable) File with :
k, Varl
r1a ~ r GCtn ~e- Iowa Ethics and Campaign
Disclosure Board
istrict (if Senate or House) 510 E . 12", Ste . 1A
31 Des Moines, Iowa 50319
Fax : 515-281-3701
Late reports are subject to possible civil and criminal penalties . Pursuant to Iowa Code section 68B .32A(7)
the candidate, for a candidate's committee, and the chairperson, for any other type of committee, is the
indivi ual responsible fo filing timely and accurate reports .
~t1 S ~31 IO(,
(515~~85 -6901
SIGNATURE (ktERSON FILING REPORT TELEPHONE DATE SIGNED

I AM FILING A 5 ) 15 1 p t,-5~31IDb REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .

(report date) Indicate by # ID

M CHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election

Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County & Local Committees, enter County in
(You must continue to file reports until a DR-3 is filed .) which Election is held

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (Total of all funds held by the
committee . This amount MUST be the same as the cash on hand at the end
of the last reporting period or must be zero if this is first report filed .) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ I,~, 3L+ I . i3

blao4 , m
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) (*also see in-kind below). . . . . . . . . . . . . . . . . . . . . . . . . AlL

Schedule F: Loans Received total (Attach Schedule F) . . . Q . .I(~W . . .[P~~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Schedule H : Total Sales of Campaign Property (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL . . . . . . . . . . . . . . . . . . . . . . . $ 1$, 5"F-'s' , i3
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B : Expenditures total (Attach Schedule B) (**also see debts and loans below) . . . . . . . . . . . . . . . . . . 3,A -13, 55
Schedule F : Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

**UNPAID BILLS (From Schedule D - Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
() U
**OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ I

CONSULTANT BREAKDOWN (Schedule G Attached?) LC YES - NO

CANDIDATE COMMITTEES ONLY:

VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)

STATE COMMITTEES : Submit a reconciled campaign account bank statement in January of each year .
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

N i C k va n PCJt'en 4;r- :12) Wa S-ta-te Senal2

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 otherthan statutory political committees .

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT V IF FOR
RECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
'
&reo -e-Frail er`
ID#
I i5l~~ CK# A -7b3 j-74WFleurl~"Ve 4f310
--CA 5a3--A 1
ID#
Se~rr DVG~rl2
61151 Ob CK# dera JDr 0D
I ~Fb I WeSf 50A 6b
ID#
(~, t 5heere
5115 1 bb CK# a5g3 q1~ ~I , 50 0
.", r Sol i
Crd)ivf~rd '4U bbel 13r-
.~~
ID#

15 # D6 CK# 15 b~f I H ~ err V i eve/ Dr j 00

.7A 5031d
r'le
ID# RICK VernbYl
15 ~ C6 CK# y%5 3rerlfwood C-4 rc1e
3Sb8
a.u. N,ee ~"A 5a~ b~
ID#
Nanc~i I rrne ida.
5 l5 la goI eK Lct.r~e 50
J()5b Dame o n M
CK#
x9081
Robert .Saf-) bbr
ID#

l5 ae cr,#
-~ 4 1 One z6M PIaz6(
CI-, I ca 100
a .M. L 61 I
ID#
Suzanoe Fisher'
IS, bb CK# s ab bt51' a5 0
'b3 0
ID#
Steve Flood
5 ~ i5~bb CK# 3a G-~-reenvVvod L7r_
5x-6:3 50
M61 1A 503 a,
ID# CAJ~l Jeer) Fr^ee5en

co 8AL4 1--,00 C 1 11-Vil-ter-

,-
- 1 . ~a -7 )1
SUB-TOTAL

TOTAL (if last page of this schedule)

* 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 sumame 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

CONTRIBUTIONS -- MONEY TAKEN IN

A MONETARY
(Rev . 07/03) RECEIPTS
(Including candidate's personal funds)

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

Q AMENDING
CHECK THIS BOX IF
FORM
-5--n-+e
-
N (--k UUnPa ~n -For1~vva
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 IF FOR
RECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-
(MM/DDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID# i1__,:
.
r)~
5 i S ~ab a65y- 156
l 50 5
CK#

ID#
Evereff~, her.
5 15 Ob CK# 18g~5 8g~75 N , . ib1K Li+y Dr pd
Sob-,A3
lD#
Choi . D hq ahar
511-6106 346 -7 ~ ~5
as
CK#
rW n
ID#
fu role charcH-
5 CK# 1665 1 -7 -7t-., NW 130-+h 5f 56
C e 5o a5
1D#
136tr bo rCt t_.-i r~~
.~ I I~Ibb cK#
L%3 45 Rirrnh=~ e, ,0 . x73 Cousin a, 56
hG le o 3
ID#

5 1B~ob cK# SRba ~35Nre'y~i~Po x 4a ,-, ov 0

rr1hamVi 11e -:CA 50533
Chr15-I-i ne Ml i I er
5' -~ bb CK#
IN 8~ ' 705 . . Ir r )00
lD#
s u r,es T~ Soal~S
rn I-f15 ox
.~ blob CK# 3b~ 809 )14th ~4 0
e oi ne5 ~ ScL,~ b5
ID#
Chns viernbn
18lob cK# a5 I I crab 8wd 00 0
j
i, 5031a
IIV
A116-hoe-1 entwrlni
©b cK# 811 OLA rr a KS ID r o
3
We J De-6M o ne --171 Gc b
SUB-TOTAL

TOTAL (if last page of this schedule)

* 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
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
Q CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Senate
h! ( C . K Van P&+en -(~ r Iowa 5 -e

STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM

:1 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-
(MMIDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
Newt an
ID#
'5 iDince5, r- 503
Wj I jGt m, ~ VV n
C~-x5t_
i8 bb cK# 43oa a _ ~"o0 0
nes TA .5~31a - 1
D
ID#
('(rICA Wood
411 b S I5- 1- r'tre ' a, n~
1x,015
let SA 5o.3~a a
~1 ~Ob CK#
cin - Cv~t 5I r) 1
ID#
0- . /37jsil a-hD o
o It,cc -F ~phn ml -r- e~
~o~ Ob '~01 L-
CK# O p e--,
ry
rr1-,W~a SU,i d0
UD
.T:.

5 ~~b
K# 1633 M11 I 0
5D
SA 503 I
ID#
4n n u-i re.
5 ~~bb CK# Itp39 red
1143 ~'Q
D r 5 66aa
ID#
rn i (:e 13al c . i -f-art
)aa~bb CK# g593 Ion 100
5x311
ID# BnirloAra Rsher
5 ~aa bb CK# 6334 161 to 84A 7 {Ve,
rinne 11, SUlla, 1
ID#
Jon GTj 1 herbr).,
rcle
S ~Ob cK# S~I9A i $ds NW !x,151- L:-i 706
CI) ve ~rA 503x5
ID#
John .rrlsc_
51a ~ co 1331 6~ ~K an Rd, r~D 0
. -1 z -o3a a
SUB-TOTAL

TOTAL (if fast page of this schedule)

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 sumame of contributor is the same as candidate, but there is no Page of
familial relationship, enter "not applicable" in the relationship column. (for ScheduleA)
For Instructions, See Back of Form SCHEDULE

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

(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
_ fie
~l I,-?< Van ~r'J'oWa SWe
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE 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 V IF FOR
RECEIVED (if applicable) TO CANDIDATE` RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID# h ire er'
~- Ob CK# y- 5 6A -T be~- I
es`f- ~ " rnof fle ~f1 5a~b5
ne-Or $ ) oD
Charles Lozler
ID#
5j~`t~Ob cK# -7C)Aa, 330 -J-~)nawandcC Dr-
asA1oirne5 5o3ta
35
I D# hn BrasWe
51,3L+JOb CK# ~a19 4DO0
~e5 DI r~ "
s.W, 19A "
~! 50315
o0
°yaa
ID#

lad lob CK# Y -t-~'

e't ~s u~ ~ 565
nn J.r,
0
ID#
1/Vebs-l-er L-e--hm
5 `F'bb co 440 1 lnles~awn V% S 1Cl ~o0
e5f in2 wom
ID#
Doro+ . 1 hI 1 I i 5
Ob C. ~'S6R q h bV five- ~
C ;ar1~5 CI T.E a'~
ID#
Ronald jan c~~
- ~bL~~ W, -58~ S=1-.
5 y Job CK# 538,1 50o
LIC5/ " In nes SEA 503 I
ID# WiIIIAM -ii nyJr:
~~a'- .}1(,~o
co 3417 39 I-+9th 56
', ~ 503
ID# ~rfon 'c)G~ 1
~30~Db cK# 517 36dd W Q. e(vVc~rKS ~
K
500
iD e
. 6 Mct ne-5 ~a31
ID# 5
~b Ma )1~t
~eslVl o~ 503 t 1
SUB-TOTAL
TOTAL fiflastpage ofthis schedule)
' 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 ofconsanguinity (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

CONTRIBUTIONS -- MONEY TAKEN IN

A MONETARY
(Rev . 07/03) RECEIPTS

a
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
N icK fan Patfet') -fOf' Tan/ct 6+o-+e
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER ANDTHE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS ANDCAMPAIGN
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/DDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
Julie, Evarl5 $ `D
5131( Ob CK# Ida 3 aoo Purls /Ajenue
10.7-MAN, 16e5
ID# --~-
n
v
Ma
5 ~3((Y, St"
CK#a463
17e6 IVlofeie5
s ~~` ~' sew
~A 503,41
ID#
Mcmeleoe fort-e5~'
CK# `1 ~J1 b03 b - rerrace Dr.
hn5fvn 50131 - 155P
ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL

TOTAL (iflast page of this schedule)

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) . U surname of contributor is the same as candidate, but there is no Page 5 of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
 FOR INSTRUCTIONS, SEE BACK OF FORM

I
SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY

(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 AND THE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
THCS & CAMPAIGN DISCLOSURE BOARD .

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

Nl icK van Pa-I-16n -FDr_-rD via -5*fe Serate

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if annlicable) (Disbursement) WAS MADE
(MM/DD/YR) Af :D PAC
CHECK
N1 ',9BER

( n''amen (3 is hop CDI'ISi.t ~ l t~')JC.' Jelrvt~CeS

Skid 106 35~0 ,~5,w i AfA Place $ 6Lf 5. 00
CK# jbd8 D:-,5M1>oe,5 ) TA 5o315
amen i3ishoo~ Co~'~5c~ I fi n3c Se-,w' Ce5
350 S,W, )A+h plac 5q6 , vv
5 1301 At, CK# ipaq Get, Mof ne5, S/f 50315

S 131 Ia> CK# 1036

/I~clcd oro ld Le-He' Seme p)ro, hure.
0hro
V
M, 09
De.5mo ino, 5034
No-fion-wide 6Idr5: rhc . U h (i ties ~'
5131lob
CK# 103 I '70b E, r)rid t ~n1(a-iron 0-~ b 0. 5r3
Des Mo in e 5, J31i 50309
I D# Naha-w4 e BId6T~e, Rent ~br c=spa-iqn
~3 00, 00
10e I_ a st.
CK#1o3a 0-~ -3,.-rne
DesMolnes, Tf3 50309
ID# J'lrlezzCJ Fur--~JrG,i5e( -~)o ar14
513)1 61, CK# 1033 4519 Flour Dri ve beverQqe,5 1-549, R5
DeSM 0i I-Ies,1A 5 I
I D#

CK#

ID#

CK#

SUB-TOTAL

TOTAL (if last page of this schedule) F3573155

I 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/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
SCHEDULE

I COMMITTEE NAME(Must be same as on Statement of Organization) F LOANS

(Rev. 07/03) RECEIVED
& REPAID
1A)C1
NOTE : This schedule reports money loaned to the committee which is deposited in the committee account . CHECK THIS BOX IF
AMENDING FORM
TOTAL UNPAID LOANS FROM LAST REPORTING PERIOD $ O C )o
1- MONETARY LOANS RECEIVED THIS REPORTING PERIOD PART 11- MONETARY LOAN REPAYMENTS MADE THIS REPORTING PERIOD
(Original source of loan, such as a bank, must be shown if a third party is (Loans forgiven must be reported on Schedule E - In-kind Contributions .)
involved. Include loans from candidate's personal funds.)
DATE NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT DATE PAID NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT
RECEIVED (Include Endorser's Name, If Applicable) TO CANDIDATE OF LOAN (MM/DD/YR) (Include Endorser's Name, If Applicable) TO CANDIDATE* REPAID
MM/DDNR If Applicable*) If Applicable)

TOTAL (PART/) TOTAL CASH REPAYMENTS (PART 11)

From Schedule E - TOTAL LOANS FORGIVEN $

TOTAL OUTSTANDING LOANS END OF REPORT PERIOD

*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 familial relationship, enter "not applicable" in the
relationship column when it applies. Page
(for Schedule F)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
G BREAKDOWN
OF MONETARY
(Rev . 02/96) EXPENDITURES
BY CONSULTANT
COMMITTEE NAME(Must be same as on Statement of Ofganization)
91 CHECK THIS BOX IF
AMENDING FORM
~c . . an &L-Ee r
PART il- ITEMIZED BREAKDOWN OF UNREIMBURSED EXPENSES PAID BY CONSULTANT
TO OTHERS IN PERFORMING SERVICES OF CONTRACT (These expenses should NOT be
PART 1- NAME AND ADDRESS OF CONSULTANT reported on Schedule B, as they are direct payment from the consultant.)

Name of Consultant DATE

amen ash EXPENDED

MM/DD/YR
NAME AND ADDRESS TO WHOM EXPENDITURE
Disbursement WAS MADE PURPOSE
AMOUNT
EXPENDED
Mailing-Address

TOTAL ANTICIPATED
COMPENSATION FOR
CONTRACT PERIOD (MM/DD/YR) PERFORMANCE

To 5J-3! D $ 118.5'"
I 1

ESTIMATES OF PERFORMANCE

(!amp&qjln A/k~-Oa~ SUB-TOTAL

TOTAL (If last page of this schedule)

Page
(for Schedule G)
FOR INSTRUCTIONS, SEE BACK OF FORM
SCHEDULE

THIS FORM IS USED BY CANDIDATES' COMMITTEES ONLY H

(Rev . 07/03) I CAMPAIGN
PROPERTY

COMMITTEE NAME ust be same as on Statement of Organization) Reset Form ATTACH SCHEDULE H TO

N iL I0M S`fete Se
EACH REPORT, MAKING
vxn ~-- - =e CHANGES AS REQUIRED.

0 CHECK THIS BOX IF

PART I - ONGOING INVENTORY OF CAMPAIGN PROPERTY AMENDING FORM
PART II - SALES OR TRANSFERS OF CAMPAIGN PROPERTY **
Date Purchased
(Schedule B) Purchase Current
or Date Received Description of Property Price or Est . Value at Fair Date Name and Address of Purchaser/Donee Description of Property Sold? Sale Value of
(Schedule E) Value When Market This (MMIDD/YR) YIN Price Donation
(MWDD/YR) Acquired* Report

Pe(sorla-(
q l~ I0fo COMP iRf&r~- 4 h4lll IS W~1
1

I~l on i +V

TOTAL VALUE CAMPAIGN PROPERTY THIS POR ** PROPERTY SALES & TRANSFERS TOTAL TOTALS $ $
(TRANSFER TO SUMMARY PAGE) $ I l'-f L+ (TRANSFER TO SUMMARY PAGE) $

* If estimated, show est beside figure . (Attach Additional Schedules if Needed) Page ~- Of Pages
(For Schedule H)