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Sent by : IOWA MED SOCIETY 515 223 0590 ; 10/18/06 5 :26PM ;JetfX #742 ;Page 2

FOR INSTRUCTIONS, SEE BACK OF FORM


DISCLOSURE SUMMARY PAGE
COMMITTEE NAME (Must be same as on Statament of Organization)
OCT 1 ' ZOOS

Citizens to Floct Whitver


IMPORTANT : Indicate by Ir type of committee you are roportintl for: i
( 1 IStatewidatLeplslative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party
( 4 )County Central Committee ( 5 )County Candidate ( 6 )City C'rndldaw (7 )School Board or Other
Political Subdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 10 )School Board or Other Political
Subdivi!ilpn PAC (11 )hoc®I Ballot 10657!
AN DA COMMITTEES L
Candidate Name Political Party (Itapplicable) File with:
Jack A  Whitvar Republican Iowa Ethics and Campaign
Disclosure Board
Office Sought District (if Senate or House) 510 E. 12`°, Ste. 1A
Iowa House of Reprusc:ntdtiv" 66 Des Moines, Iowa 50319
Fax: $15-281-3701
Late reports are subject to possible civil and criminal penalties, Pursuant to Iowa Code section 68B,32A(/)
the candidate, for a candidate's committee, and the chairperson, for any other type of committee . Is the
individual r#porjgble for filing timely and accurate reports .
S7S=g6a_ .331Y
TELEPHONE DATE SIGNED

closure REPORT FOR (1) ELECTION I(2)NOWELECTION YEAR.


I AM FILING A ___Dis
(report date) Indicate by #
[]CHECK IF AMENDMEIYr'tO REPORT DATED - Local Committees, enter Date of Election

© Check rt 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 0.00
ofthe last reporting period or must be zero if this is first report filed,) .,. . . .... ... . .... . .. . ... . . . .. . .. .. .... .. . . ..$
ADD TOTAL MONEY TAKEN IN THIS PERIOD
6,285,00
Schedule A: Cash Contributions total (Attach Schedule A) ("also see in-kind below). . . . .. .. .
Schedule F. Loans Received total (Attach Schedule F). .. . . . . . . . . . . .... .. . ......... .. .... . .... .. . .. - ._.-..,...---.".
Schedule H: Total Sales of Campaign Property (Attach Schedule H) . . . . . . . .. .. ...... ...... .. ..... . . ... .. . . ....
(Schedule H ttgghes toCandlggteg' CoMMIttees Onlvl
SUS-TOTAL ......... ..............$ 6,285.00
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
55 35 .64
Schedule t3: Expenditures total (Attach Schedule b) ("also see debts and loans below). . .. ... .. .. .. .
Schedule F: Loan Repayments total (Attach Schedule F) ~ . .,.. .. , .. .... . .. ...... . . .. . ... . ........ . . . ... . . ... . ... . .........
CASH ON HAND at the end of this reporting period (if final report balance must 749 .36
be zero) (Attach OR-3) .. . ......... .. ... . . .. . ... . .. .. ..... . . ..... . .. . .. . . .. . ... .. . . ...... . . ....... . ..... . . ........ .. .. . .. . ........ . .. ...... . .$

"UNPAID BILLS (From Schedule D - Attach Schedule D) . .. ..... . . . ... . . . . ..... . ... . .. . . ....... . ...... . .. .... ... ........ . ....... .
'IN KIND CONTRIBUTIONS (from Schedule E - Attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . .$
"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . ., . .
Attached?) YES NO
CONSULTANT BREAKDOWN (Schedule G
CANDIDATE CQMM1TTLK9 ONLY: 0.00
VALUE OF CAMPAIGN PROPERTY (From Schedule hl - Attach Schedule H)
STATE COMMITTEES : Submit a reconciled campaign account bank statement In January of each year.
Serft by : IOWA MED SOCIETY 515 223 0590 ; 10/18/06 5 :27PM ;JetraX #742 ;Page 3/11

For Instructions, See Back of Form SCHEDULE

CONTRIBUTIONS -- MONEY TAKEN IN


A
(Rev. 07/03)
I MONETARY
RECEIPTS
(InGudirg candidate's personal fund%)
CHECK THIS 130K IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
Citizens to Elect WhitveI'

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 10 NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.

NOTE : ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD,

CAUTION; Section 6BB.32A(6), 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 i~e~6Rl41mBGn Z0 "0 e " e e - i. e5-


-W- e-F RELATIONSHIP - -AMOllfNT J IF FOR -
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
10#
R. Edward Whil:ver $250,00
8/IS/06 Father
CK# 1816 Stoecker Street
Grinnell, 1:A 5(1112
ID#
Rachel Lea 50 .00
8/15/06 CK# 4425 Mills Civic Parkway Unit 1602
Ups
ID#
Niehollas Lea. 20 .00
9/15/06 CK# 231 Adams Street, Apt. 17
Lincoln, NE 68521
ID#
Charles F_ Davis III 100.00
8/15/06 CK# 320 E. 21 st Street Uncle
Madrid TA- 50156
ID#
Wes Finch 75 .(10
8/15/06 C K# 917 16th Avenue:
Cirittnell lA 50112
ID#
Colin Tague 50 .110
8/15/06 CK# 7028 W. 50th Street
Sioux Fails, I A 57106
ID#
Robert Kaloupek 15,0()
8/ 15/06 CK# 730 Pint: Vallay Drive
Grinnell TA 50112
ID#
Arnold Adelberg 25,00
8/15/06 CK# 1930 Matter Drive;
Grinnell, TA 501 .12
ID#
.Brian Brown, D.C . 50 .011
9/18/06 CK# 222 420th Avenue
Grinnell, IA 50112
ID#
Richard Weigel 50 .00
8/19/06 CK# 1.820 Stoecker Street
Grinnell, )A 50112
S B-TOTAL $ 685 .00

TOTAL (if last page of this schedule)

Diwloeum law requires candidate committees to dixelosee tha ralationehip of any relative making a contribution to the
committee. Relationship must be shown to 11to third degree of consanguinity (blood relatives) and affinity (relatives by 1
marriage) . If surname of eentributor is the same as candidate, but there is no Page of _~
tsmltl relationship, enter "not applirablo" in the relvtiont~hlp column . (for Schedule A)
Serit by : 'IOWA MED SOCIETY 515 223 0590 ; 10/18/06 5 :28PM ;JetffiX #742 ;Page 4/11

I
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 (Mustbe same as an Statement of Organization) AMENDING FORM

Citizens to Elect Whitvor

&TATE 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 AVAILACILE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.

NOTE : ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD.

CAUTION: Section 68B,32A(6), 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

A !L1!U'4L~" ~~I~J~L[~Z~I!7 :1~-3".1~!7i+ril~l=a . ~ M r NT J IF FOR


RECF-IVED (if applicable) TO CANDIDATE' RECEIVED FUND.
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME

Kathryn Slinkey $200 .00


8/18/06 CK# 5703 Coach IightCourt
West Des Moines, I.A 50266-2837
I D#
Miles Luchtenburg 200.00
8/ 19/06 CK# 562 Riesling Point
3
ID#
Brian Huincman 100,00
W16/06 CKd 1905 Stoecker Street
Grinnell. 1A 50112
ID#
Michael Cavanagh 25_00
8/16/06 CK# 917 9th Avenue
ir'yrinnpl) )A 50111
ID#
Donald Christonyen 35 .00
8/20/Oft CK# 305 Crystal Court
Sergeant Bluff, 1A 51()54
ID#
Driunne Goeminger 25 .(10
8/16/06 CK# 2203 F. 140th Stroot N.
Grinncll, IA 50112
ID#
David Smith 250.0(1
8/20/06 CK# 1 822 StoeckeT Street
Grinnell IA 0 112
ID#
Anthony Lea 500.00
8/22/06 CK# 2279 CoLutty Road W42
Decorah,IA 521.01-7512
ID#
Charles f . Davis 500.00
8125/06 CK# 205 E_ Vest, P.O . Box 244 Crandlauher
_ Jefferson I A 501 12
10#
Michael Johnson 25 .()0
9/28/06 CK# 1610 Spencer Struct
(rrinnell, IA 50112
SUB-TOTAL

TOTAL (if last page of this schedule)

DIsclasure law requires candidate committees to disclose the rolationtihip of any rolafve making a contrlbuton to the
committee, Relationship must be shown to the third degree of ovnsanguinity (blood relatives) and affinity (relatives by
marriaae) . If surname of contributor is the same as candidate, but there is no Page of
tamilial relationship, enter "not .Ippllceblr" in t11a rdliltlonahlp column . (for Sc cdulo A)'~
Serit by : IOWA MED SOCIETY 515 223 0590 ; 10/18/06 5 :28PM ;JetFaX #742 ;Page 5/11

For Instructions, See Back of Form SCHEDULE

CONTRIBUTIONS -- MONEY TAKEN IN


A
(Rev . 07/03)
I MONETARY
RECEIPTS

a
(Including candidate's pomnal funds)
CHECK THIS BOX IF
COMMITTEE NAME(Must be same as on Statement of Organization) AMENDING FORM

Citizens to Elect Whitver

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM AASTATE PAC (POLITICAL ACTION COMMITTEE), LI6'r THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . LIST OF ID NUMBERS IS AVAILA13LE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.

NOTE: ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $760 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD .

CAUTION : Section 68B,32A(6), prohlblts the use of information copied from reports and etatembnts for soliciting contributions or for any
commercial purpose by any person other than statutory political committees-

--DATE--- me IL.lrXlr~r ,tH aa.'J: -t~1~ 1,LL LI"7~~Z"I~YII U l"7 R GV\I IVIVSHIr' AMOUNT V IF FOR
RECEIVED (rf applicable) TO CANDIDATE' RECEIVED FIJND-
(MM/DD1YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME

Bill D . Weelu $10 .00


8/27/06 P . O . Box 568
CK#
Grinnell, LA 50112
ID#
'Todd Miller 30 .00
9/27/06 CK# 305 Baker Street
Mt. Plcasant~ 52 (4 1,
ID#
Brad Archer 25 .00
8/27/06 CK# 2695 NW 161 Street
Clive, 1A 50325
ID#
Kennoh /,ally 125 .00
8/27/06 CK# Uncle
P.O . Box 161

ID#
D . Michael Anderson 250,00
9/08/06 CK# 3774 20th Street
Grinnell 1A 50 .1 .12

Robert Mahaffuy 100 .00


9/09/06 2_2() E
., 22nd Street
CK#
Des Mouies, ]A 50317-3108

lames Buker 50,00


9/09/06 35303 Cabernet Circle
CK#
Waukee 1A 50263-7047
I D#
Michael Baker 25,00
9-12-06 CK# 1836 Summer Street
Grinnell, IA 50 112
ID#
Michael Allen 25,00
9-12-06 CK# 542 462nd Avenue
Grinnell IA $ 0112
ID# -
William Smith 100 .00
9-i2-Ob CK# 111716th .Avenuc
Grinnell, IA 50112
SUB-TOTAL I $ 740 .00
TOTAL (if last page of this schedule)

" Disclosure law requires candidate committees to disclose tha relationship of any relative making a contribution to the
committee . Relutionship meet be shown DD tho third degree of consanguinity (blood relatives) and afflnlty (relatives by 3
marriage) . If surname of contributor Is the same as candidate, but there is no page '.,_._,. __ of -
farrliliel rblatlortrohip, anter'not applicable' in the relationship Column . (for Sehodulo A)
Sent by : 'IOWA MED SOCIETY 515 223 0590 ; 10/18/06 5 :29PM ;,Jetrax #742 ;Page 6/11

For Instructions, See Back of Form SCHEDULE


A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 07103) RECEIPTS
(Including candidate's personal funds)

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


0 CHECK THIS BOX IF
AMENDING FORM
Citizens to Elect Whitver

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECkIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND TFIF PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LI81 OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD .

NOTE : ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD .

CAUTION : Section 6BB .32A(a), prohibits the use of information copied from reports and Statements for soliciting contributions or for any
commercial purposo by any person other than statutory political committees .

A I N D ADDRES F N I E IONSHIP AMOII'NT - q IF FOR


RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
AND PAC CHECK (if applicable) RAISER
(MM/DDIYR)
NUMBER INCOME
ID# - .
E4 . .I rbens $100 .00
CK# S$2 Westown Parkway
/1vVV 1I~rV I IVi11VrV 7 i11 ~V~.vv
ID#
Kit Curry 40 .00
9/13/06 CK# 228 52nd Street, Apt, 51
_ _ Wps -r Des v
ID#
William Atnund.son SO_00
9/15/06 CK# 131 S, 20th Street
I,a Crosso W1 54601

a
__
Ip#i
Anthony Davis Cousin 50 .00
9/20/06 CK# 1310 Cooledge Drive
An= TA 500 1 11
ID
Marianne Kramer 100.00
9/21106 CK# 313 5th Street
West Des Moines IA 50265
ID#
Brian Poindexter 100.00
9/21/06 CO 314 N. 16th Street
Inditlnola ., IA 50125
ID#
Mark Kcairnes 100.00
9122106 CK# 809 56th Streel
West Des Moines lA 50260
ID
Craig .l ohmon 100.00
9/22/06 CK# 822 Burr Oaks Drive
West Des Moines, IA 50266
lD#
Dale Hurniston 100.00
9/23/06 CK# 528 Champagne Road
Waukee .1A 50263

Man ford Than 100 .00


9/23/06 CK# 415 5th Street
West Des Moines, IA 50265
- O

TOTAL (iflast page of this schedule)

" Disclo.ure law requires candidate committees to disclose the rclationslilp or any relative making e contribution to the
committee . Relationship muel be shown 1o the thud degree of consanguinity (blood relatives) and affinity (relatives by 4
marriage) . If surname of conldbulor is the same as candidate, but there is no Page of 7
(for Schedule A)
familial relationship, enter 'not applicable" in the relationship column .
Sent by :'IOWA MED SOCIETY 515 223 0590 ; 10/16/06 5 :29PM ;,fetrax #742 ;Page 7/11

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
Citizens To Acct Whitver

STATE CANDIDATES NOTE : IF A GONfRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTF-F) . 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.

NOTE : ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY !-LAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD .

CAUTION : Section 68B .32A(6), prohiNts 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 PA I ! R NAME , RKATIONSHIP AMOUNT -4 IF"


RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DDNR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
James Camplu:y $100 .00
9/23/06 CK# 1444 NW 124th Court
Des Moines, IA 50325
ID#
1-101 li iggs 100 .00
9/23/06 CK# 2024 NW 92nd Cowl
('. e IA 50325
ID#
Leon Shcaror 100 .00
9/25/06 CK# 421 Silverado Trail
Waukee, IA 50263
ID#
Larry Dybvarl 100 .00
9/25/06 CK# 3109 Jordan Grove

ID#
Laurence Anderson 100 .00
9/25/06 CK# 1656 Burr Oaks Drive
West Des Moines . IA 50266
ID#
Dean Neese 100 .00
9125/06 CK# 4933 W . Park Drive
West Des Moines JA 50266
ID#
Cindy Sullivan 50 .00
9/20/06 CK# 2440 Windovcr
Anken lA 50021
I D#
Jeffrey Harsh 30 .00
9/21/06 CK# 1612 Aspen Drive
Adel, 1 A 50003-1970
ID#
Michael Grossmtn 40 .00
9/25106 CK# I I l l 66th Street
Windsor Hei hts IA S0311
IDA
Jonathan Narcisse 100 .00
9/26/06 CK# 1083 27th Street
Des Moines, IA 50311
S Ut3-TOTAL

TOTAL (If last page of this schedule)

Piaclosure law requires candidatecommittees to dlscloae the relationship of uny ralatlve making a ccnirlbution to the
commmee . Relationship must be shown to the two asgren ur cunsangulniry (bloou relatives) and amnlry (reiatrvns by 5
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)
Sent by : IOWA MED SOCIETY 515 223 0590 ; 10/18/06 5 :30PM ;JgtF
aX #742 ;Page 8/11

For Instructions, See Back of Form SCHEDULE

CONTRIBUTIONS -- MONEY TAKEN IN


A MONETARY
(Rev 07103) RECEIPTS
(Including candidate's personal funds)
[] CHI=CK THIS BOX IF
COMMITTEE NAME(Must be same as on Statement of Organization) AMENDING FORM
Citizens to Elect Whilver

STATE CANDIDATES NOTE : Ir 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 NUMDER8 IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD .

NOTE : ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD .

CAUTION : Section 68B,32A(6), prohibits the use of information copied from report5 and statements for sollalling contributions or for any
commercial purpose by any person other than statutory political committees .

DATE PAC IV P~1rt - . 1C t'~1<-3T1LTT!LTr~ ~~ `_ ~- f_"1!tl!1:


rT ~)t~~!, #NSNiP AMOUNT V IF FOR
RECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-
(MMIDDNR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID# _
Geot3 Jensen $100 .00
9/26/06 2412 33rd Street
CK#
Des Moines, IA $0310
I D#
,lack Whitver 500 .00
9/28/06 CK# 300 Walnut Street, Box 44.
oi es A 50309
I D#
Kachcl Lea 260,00
9/28/06 CK# 4425 Mills Civio Parkway, Unit 1602
West Des Moines, 1A 50265
I D#
Tim Cinder 20 .00
9128/06 CK# 2168 Poplar Avenue NE,
SniaaIA 32111
I D#
Kenactli Noyce 100 .00
9/21106 CK# 1680 Cedarwood Circle
Cl ive CA 50325
IDt
Jack Arendt 100 .00
9/28/06 CK# Box 30
Brooklyn, IA 52211
I D#
Cindy Sullivan 50 .00
1 U/13/O6 CK# 2440 Windovcr
Anken IA 50021
ID#
Burt Sewel1 100 .00
10113/06 CK# 2941 NW 75th Place
Anken , 1A 50021
ID#
Due Amundson 10 .00
10/U7/U6 CK# 1413 S. Clinton
Sioux Ci TA 51106
1D#
Paul Miller 50 .00
10/09/06 CK# 2(14 tiloomftcld Avenue
Defnar, IA 52037
-TL) AL

TOTAL (if last page of this schedule)

Disclosure law requiros oandtdate commitlnets to disclose the ralatlonshlp of any relative making a contribution to the
committee. Relationship must be shown to the lhlrd degree of consangulnlty (blood rekatlves) and affinity (relatives Dy 6 7
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 Schedules A)
Sent by :'IOWA MED SOCIETY 515 223 0590 ; 10/18/06 5 :30PM ;,JetFax #742 ;Page 9/11

For Instructions, Seta Rack of Form SCHEDULE

CONTRIBUTIONS -- MONEY TAKEN IN


A MONETARY
(Rev. 07t03) RECEIPTS
(Including candidate's personal funds)

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


IQ CHECK THIS BOX IF
AMENDING FORM
Citizens to Elect Whitver

STATE CANDIDATES NOTE= IF A CONTRI13UTION IS RECEIVED FROM A STATE PAC (POLII'ICAL 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.

NOTE: ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILING
RESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD,

CAUTION : Section 68B,32A(6), 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 .
. ,r
DATE PAC ID NUM BER i EU4W . RELATIONSHIP - - _ A:~daL.  v IF FOR
RECEIVED (ifapplicable) TO CANDIDATE' RECEIVED FUND-
(MM/DDNR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
Worthin Grattan $50 .00
1 0/06/06 546 320th Avetiua
CK#
Grinnell, 1A 5011 .2
ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

I D#

CK#
ID#

CK#

C K#

ID#

CK#

ID#

C K#

TOTAL (if last page of this schedule)

" Disclosure law requires candidato commlneas to disclos0 the relationship of any rulatlve making a contribution to the
committee . Relauonlinlp must be shown to the third dneree or consanvlnity (flood rniativea) and atrnlty (relatives ay
marriage) . If surname of contributor is the same as candidate, but there is no Page 7 of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
Sent by : IOWA IVIED SOCIETY 515 223 0590 ; 10/18/06 5 :31PM ;jetfa
- X #742 ;Page 10/11

FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B07/03)


(Rev .
MONETARY
EXPENDITURES

STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE


CHECK THIS BOX IF
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.

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


Citizens to Elect Whitver
CANDIDATE NAM F AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MMIDDIYR) AND PAC
CHECK
NUMBER
ID# Supply of checks
Wells F .trgo
08/29/06 CK# 8301 Douglas Avenue $ 50 .86
Urbandale, IA 50322

ID# Run radio ads


KJMC Minority Communications
9/08/06 1169 25th Street 1,050.00
CK# Des Moines, IA 50311

ID# Wells Fargo Hank service charges


9/15/06 CK# 8301 Doughty Avenue 2.12
Urbandale, TA 50322

ID# Printing of yard signs and purchase


Carter Printing
9/25/06 1739 E. Grand Avenue metal. stands 1,192 .50
CK#
Dcy Moines, fA 50316
ID# Wells Fargo Bank service charges (net of interest
9/29/06 8301 Douglas Avenue camod of $0 .08) 2.92
CK# Urbandalc, IA 50322

ID# Advertising insert in newspaper


The New Iowa Bystander
9/29/06 1922 Ingersoll Avenue 975.00
CK# Des Moines, fA 50309
ID# Jonathan Narcisse Media Services Print campaign flyers
9/29/06 CK# 813 25th Street 1,674.82
Des Moines, IA 50312

ID# KJMC Minority Communications Run radio ads


10/06/06 CK# 1169 25th Street 530.00
Des Moines, IA 50311
SUB-TOTAL $ 5,478 .22
TOTAI- (if last page of this schedule) $

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 personslentitles providing consulting, adverilslng, 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 personlentity on behalf of the candidate's committee. (Refer to
Schedule G Instructions and Iowa Code 58A .402(3)(i))

(for Schedule B)
Sent by : IOWA MED SOCIETY 515 223 0590 ; 10/18/06 5 :31PM ;Jeffix #742 ;Page 11/11

FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDUI-E

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY


(Rev, Oi/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
ETHICS & CAMPAIGN DISCLOSURE BOARD.

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


Citizens to Elect Whitver
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disburaement) WAS MADE
(MM/DDIYR) AND PAC
CHECK
NUMBER
ID#
KJMC Minority Communications Production of radio ads
10/09/06 1162 25th Strcct 50 .00
CK#
Des Moines, IA 50311

ID#
Wells Fargo Bank service chnrgcs
10/16/06 CK# 8301 Douglas Avenue 7 .42
Urbtindfle, IA 50322

1D#

C KO

ID#

C K#

ID#

C K#

IDf#

C K#

ID#

CK#

ID#

CK#

SUB-TOO. $ 57 .42
TOTAL (If last page of this schedule) $ 5,535,64

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :


Purchases of certain campaign property costing $500 or more mural also tm inventoried on Swedule H, (Rotor 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 personientity on behalf of the candidate's committee . (Refer to
Schedule G Instructions and Iowa Code 6BA,402(3)(1) .)
Page

(for Schedule B)

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