FFOf1 : DI lCDona l d. PHONE HO . : 515 270 2796 OCT .

15 2004 08 :15AI1 P1

FOR INSTRUCTIONS, SEE BACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE

COMMITTEE NAME (Must be same as on Statement of Organizarlon) (Rev. 01/2003) REPORT

For Woe U
Comm . ft
IMPORTANT: Indicate type of committee you are reporting for :
Index
( )StatewloelLeglstative Candidate (2 ounty/Local Candidate
Audited -
(5 )Cbunty PAC (B )Ballot Issue/F il Committee
(8 )Support Slate of Candidates computer _

SIGNATURE OF TREASURER (or perxon filing this report) TELEPHONE DATE SIGNED

Late filed reports are subject to possible civil and criminal penalties .
SEE IN$TRVCTION§ ON RACK ANp COMPLETE THE FOLLOWING SENTENCE :
I AM FILING A .7- ay
Vs-, N - T ht-" C) (J v Oy REPORT FOR AN/A 1 ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate one

HECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Electon

Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County& Local Committees, enter County in
which Election i5 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 hell
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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
f$ghortullp_H_anpll"J4 Candldbtett-Committee Only)
SUB-TOTAL ... . . $
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B : 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
be zero) (Attach DR-3) . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . $ r~r" mar~rn enr

- 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ SOO

0
_---
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?) LDYES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $ --------
r"um IIVJ I NUUIIVIYJ, JCC L7.~tl-1~ (oY r- vKNI
SCHEDULE
LOANS
COMMITTEE NAw1E(Must be same as on SlaterneM of Organization)
(Rev . OQJ%) RECEIVED
& REPAID

0 CHECK THIS BOX IF

C', ), C4 h j ~ 0 )Z. C~
NOTE: This schedule reports money [oared to the committee which is deposited in the committee accour'
AMENDING FORM!
TOTAL UNPAID LOANS FROM LAST REPORTING PERIOD $ 5 tz~ 0 ` 0 v

PART I - MONETARY LOANS RECEIVED THIS REPORTING PERIOD PART II - MONETARY LOAN REPAYMENT S MADE TLS REPORTING PERIOD
(Odgvml source of loan, such as a bank, must be shorn if a third party is (Loans forgiven must be reported on Schedule E - In-kind GordfiMions.)
invofvad, Include loans from candidateF personal funds .)
DATE NAME AND ADDRESS OF LENDER DATE PAID NAMEAND ADDRESS OF LENDER RELATIONSHIP AMOUNT
RELATIONSHIP AMOUNT
RECEIVED (Include Erdorsens Name, If Applicable) (Include ErdorserF Name, I(Applicable) TO CANDIDATE' REPAID
TO CANDIDATE OF LOAN (hl%VDDIYR)
MWODfYR) If icable') If A !fcabte

TOTAL (PART I) 5 TOTAL CASH REPAYMENTS (PART 11) $

From Schedule E -- TOTAL LOANS FORGIVEN $

TOTAL OUTSTANDING LOANS END OF REPORT PERIOD 5

'Disclosure la<v requires candidate oommitlees to disclose the ielatiansh p of any relative
making a corinbrllion to [he committee . Relationship must be shown to the third degree of
consariguiniiy (blood relatives) and affinity (relatives by marriage) (SQe Page 2 of forms
packet) If surname of contribar7or is the same as candidate, br.t there is no familial
relationship, enter ,bot applicable-7n the relationship column when it applies, Page
(far Schedule t=)