DR-2 (Rev. 07/2003) DISCLOSURE SUMMARY PAGE DISCLOSURE REPORT L (1 tatewiderLagiaiatve Candicato'{ 2 )Statauldo PAC (3 State Party (4 )CountyLocal Canccate {5 )Gauny PAC (6 )oalotlasuelranchise Commitee (7 )CountyCty Central Commitee 8 )Sugpor Site of Cancistos IMPORTANT: Indicate type of commitise you are reporting for [Candidate Name fe ny) Poltical Party : District (f Senate or House) a if 102 SE7n7e 763 _f) 4 fe TELEPHONE DATE SIGNED Late filed reports are subject to possible civil and criminal penalties. ey ‘SEE JUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE: 2 tameunc aL 4 REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR. (repor date) Indicate ono COCHECK IF AMENDMENT TO REPORT DATED Tae Coronet Data of Eason Check i this i inal (termination) report and atach Notice of Dissolution Form DR-2, | Counhy& Local Gammitees, ater County n (You must continue fo fle reports unt a Notice of Dissolution i fled) wich Election iol ‘STATEMENT OF CASH ON HAND CASH ON HAND at the beginning of the reporting petiod. (This isthe total ofall 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 fled.) .. 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 (Aitach Schedule F), ‘Schedule H: Total Sales of Campaign Property (Attach Schedule H). ‘Schedule H applies to Candidates’ Committees Only) ak suBTOTALs — 5 272 SUBTRACT TOTAL MONEY SPENT THIS PERIOD o oo ‘Schedule 8: Expenditures total (Attach Schedule B) ("also see debts and loans below)... 2a Schedule F: Loan Repayments total (Atach Schedule F) CASH ON HAND at he end of this reporting period (if final repor, balance must a ‘be zero) (Attach DR-3) . $ 50/0 “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 ONL) CONSULTANT BREAKDOWN (Schedule G attached?) Yes No VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) sFor Instructions, See Back of Form SCHEDULE Reset A MONETARY CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 0700) | "RECEIPTS (indding canada persona! funds) CO check THis 80x IF [AMENDING FORM STATE CANDIDATES NOTE: if A CONTRIBUTION 18 RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), IST THE PAC IDENTIEICATION SUUBEN AND Toe Pac ENE HUMBER W'THE DESIGNATED COLUMN, RUT OF 1D NUMBERS Is AVALABLE FROM THE IOWA ETHICS AND CAMPAIGN 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 688.3246), prohibits the use of information copied from reports and statements for soliciting contibutions oF for any ommereial purpose by any person othor than statutory politcal commitees. DAE, PACT NOMEER ANE AND ADDRESS OF CONTRIGUTOR FETATONSHP] AMOUNT RECEIVED (Gf applicabie) TocanowaTe: | RECEIVED | “FUND. (wwooryR) | AND PAC CHECK (@ eppicable) RAISER NUMBER INCOME ee ys wdle wr lh {da ceuagrou DC, 2 3000 | loo CY SAL + FOX M WAL Ot ll #/o |" waca, |B S333? <0 PF €070 | Tarja LA wir | daee | BBS Bn EEA oan ae | lo 7 ck# TOF KH oF cKe oF wit oF cKet DF cit TOF cKet SUBTOTAL TOTAL (if last page of this schedule) + Disclosure law requires candidate commons ta dio he relatonship of ny relaive making» conbuton ta the ‘commalee. Relationship meat be showa ote tid degree of careanguiny (elood rlaves) an aay (lates by ‘marrage _ If surrame of conttbutor isthe same 2s candidate, bul heres no rage__f ot _f familia eiaionship, enter “not applicable” n te celaionship cokumn. Wor Schedule AYFOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE B MONETARY EXPENDITURES ~ MONEY SPENT FROM COMMITTEE ACCOUNT (pavers | oem ‘STATE PAG COMMITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE (CANDIDATES, LIST THE CANOVDATE IDENTIFICATION RUMBER IN THE DESIGNATED COLUMN AND THE D0 creck ths 80x PAG CHECK NUMBER FOR EACH EXPENDITURE. AIST OF 1D NUMBERS Is AVALABLE FROM NS TOA ‘AMENDING FORM ETHICS & CAMPAIGN DISCLOSURE BOARD. [COMMITTEE NAME (Mus! bo same as on Slalement of Organization) "CANDIDATE: ‘ow AMOUNT IDNUMBER EXPENDED appticabe) AND PAC ‘CHECK NUMBER CombiBeuTi00) ICO A Meee AU Bo a eHSO & peut AZ RAO HSO Cee TOTAL (if last page of this schedule) [> 2pS [THiS BOX APPLIES TO CANDIDATES’ COMMITTEES ONLY: Purchases of certain campaign property costing $600 ormore mus also be inverted on Schedule H. (Refer to Schade H irsructons) Expendtres 1 personslenies proving consulting, advertising, fund-raising, poling, managing, orgoizing services mus also be deta temized on pute, and date ofeach {ype of expenditure made bythe parsorvenity on bea ofthe canddne's soma, cto ions Case 4 045) poet a 1 (for Schedule 8)