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DATE SIG D
G .<: 2 J'l y
I AM FILING A REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .
Indicate by # ~l
El 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
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 V IF FOR
RECEIVED (if applicable) TO CANDIDATE` RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
~o "1ci"(io~,s --For ~uSh ~JI~S
l CK#
fitnlfe~%Ze~
ID# Ids
/2 ~Ow~ iou ,f ~Ut' ~uS~
f/a~ CK# l~4 0o is
fitN I fP-i Zed
- ~a
ID#
S/2 Y10 if CK#
ID# S~a/Jrrd
~PNVr- e 00
-7/1 /0 2003' s, jvo,~xan
CK#
Sioux C:! /A S- 1lolP
ID# er®p
/`/) `t CK# 2132 l4U-,ti (tyS+
L w-TOra~ 1A 5/6,30
ID#
'~~Kd-~- ;GkS '~or CfhcSL Plans
/I~o~ CK# ~ .1s-
9 0
ID#
CK#
SUB-TOTAL
$712- .DL/
ID# ~p
"~lereso_ HQw.w~o .~f
Rr~l bu~se zv
w~2L/0~(
CK#2J447 Izzt w, L t -4 k l' ', 2~
07 CC 5w ~ i f'J
Sioux C? >4
1D#
lQIvercod e.
4 3 6a Dr; Q%~~e ~Pe 5C~ 40
CK#~lffg j2,o/
6/09
Cjr~, 1A
SUB-TOTAL $
sO i
TOTAL (if last page of this schedule) $ '
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) .) ,
Page 1 of 2
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Fwi?t.'
SCHEDULE
B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 07/03) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
L
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 .
CK#
ID#
CK#
ID#
CK#
ID#
CK#
1D#
CK#
ID#
CK#
SUB-TOTAL $~ p
TOTAL (if last page of this schedule) $ 0, -~~
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) .)
Page of
_
L
(for Schedule B)