FOR INSTRUCTIONS, SEE BACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 I DISCLOSURE

7~E': NAME
COMMITTF (Must be ame as on Statement of rganr anon) (Rev . 0712003) REPORT

a
For Office Use Only

(
IMPORTANT: Indicate type of committee you are reporting for. Comm . #
Logged fn
1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate
Scanned
( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee
(8)Support Slate of Candidates Computer
CANDIDATE COMMITTEES O
~i ~.'s Audited
Candidate Name ~f !;'~.M14
;- UP

Office Sought O .6 7004

OF TREASURER (or person filing this report) DATE SIGNED

Late filed reports are subject to possible civil and criminal penalties.
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :
t AM FILING A iC f--4'6'V'- /,V, 2-06 ,9, REPORT FOR ANIA (1) ELECTION l(2)NON-ELECTION YEAR .
(report date) Indicate one

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

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

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (This is the total of all monies 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.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADD TOTAL MONEY TAKEN IN THIS PERIOD

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 applies to Candidates' Committees Only)

SUB-TOTAL . . .. . . $
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
5.0
Schedule B : Expenditures total (Attach Schedule B) ('"also see debts and loans below) . . .
Schedule F : Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3
5-75. 9
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) . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

*"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

CANDIDATE COMMITTEES ONLY :

CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
For instrucdom, Ses Basic of Fo m SCHEDULE
A MONETARY
CONTRIBUTIONS- MONEY TAKh,N IN (ROV .OW) RECEIPTS
(Irfniirlg csnddate's peso" Amds)
_ _ © CHECK THIS BOX IF
COMMITTEE NAVE (Must be same as on Statevnenf of Otganizedon)- AMENDING FORM

8TA'M CANWOiATEB NOTE IF A CONTRlBUT10N IS RECENED FROM A STATE PAC (POLMCAL ACTION COVWTfEE)6 LIST THE PAC 1OENTtFICATION
NUMBER AND THE PAC CHECK NUMBER 1N THE VPSIWTED COUJUN . A LIST OF tD NUMBERS IS AVA"BLE FROM THE IOWA ETHICS AND CAMPAIGN
DSCWSURE BOARD. ,

CAUTION: Section 6t38.32A(S). lows Code, pnoMbrta the use of information copied front reports and statement for satiating contributions or
for " oxmnerdsl pups by any ( other than staEutwy pohdcW comnWAm.
_
DATE
PAC
113 R NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT -4 IF FOR
RECEIVED (if apps) TO CANDIDATE' RECEIVW FiS(O-
IMIrAIDOYR) AND PAC CHECK lif appliaible) RAISER
NUMBER INCOME

CK#

(DO

CIC
`~
ID#

CK#

. IDx

CK#

ID*
.
CK#

(t3#

CK#

ID*

CK#

ID#

' CIIs

ID#
CK#
[DO
CK#

SUB-TOTAL

.
S. ~ S_ av

TOTAL (If lam paje of this ~ 5 ", v

S17-
DNClosrss law requires amddsate coaenatsee to dsdose the reiaflahip . of RM rates MAft a von trburban to the
colmlitom . Rdadonsh p:must be sho rn tQ the third dapm of cmaagWr* (WW mtalwes) and aBU* (re1slMas bar
manfmpe) (Sea Page Z of iomns pedaet~ If surname of contbttor is the sane as coKlIdMs; but thm is no Pqp l of
(for Sd;dtrte A)
 FOR 1NSTRUC770NS, SEE BACK OF FORM SCHEDULE
MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B
(Rev. QW97) EXPENDITURES
STATE PAC COMMITTEES : NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, USTTHE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE 0 CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID-NUMBERS IS AVAILABLE FROM THEIOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.

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

A(-
r,L.~ Aej, C ,,~ Zest .,,) (~ -, /;,',C"
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (DlaburssMOM) WAS MADE
(MMAXYYR) AND PAC
CHECK
NUMBER
ID#
be -s P4 a)19J P10 ' $o)/
CK# /0,0
S~3ib'-O~pl
ID# ~

Y4
yJ
CK# 1~i'd
Y111- 1 ~r~~C~s Q~ C".CP~'arAy'70w

ID# /
.7Sa 0
.~ safe so
CK#Id// pf033 ,~,'vq-as
s />zc,.u~s :~A Sc'3 . " l ll~~ pu~N~ T..4 sc~.zS
ID#
CK#

CK#

ID#
CK#
ID#
CK#

lD#
CK#
- -
SUB-TOTAL $
TOTAL (if last page of this seftaduie) 7 s~>
1$ y
THIS BOX APPLIES TO CANDIDATES' GOMMrrMES ONLY:
Purchases of certain campaign property costing $500 or moro must also be inventoried on Schhedule H, (Refer to Sdheduie H instructions.)
Expenditures to personslenMes providing consuiting, advertising, fund-raising, polling, managing. organizing services must ado bedetall hemmed on
Schedule G by the amount,purpose, and date of each type ofexpenditure made by the pemon/entity on behalf ofthe candidate's committee. (Refer do
Sdmdule G instrudfons and Iowa Code 56.8(3)(1).)
Page