FOR INSTRUCTIONS, SEE BACK OF FORM FORM

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DISCLOSURE SUMMARY PAGE DR-2 I DISCLOSURE
(Rev . 07/2004) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization)
For Office Use Only
Waukee Citizens for Excellence in Education Comm . #
IMPORTANT: Indicate by # type of committee you are reporting for I I I I Logged In
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State'P0y-, Scanned
( 4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or bther
Political Subdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 10 )School Board or Other Political Computer
Subdivision PAC ( 11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES ONLY :
Candidate Name Political Party (if applicable)
Late reports are subject to
possible civil and criminal
District (if Senate or House) penalties.

r14 - j3 ,Je /9 10 _((_0`l

SI F ERSON FILING REPORT TELEPHONE DATE SIGNED
t~r~/

Final Report
I AM FILING A REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate by # 2-

Local Committees, enter Date of Election

EICHECK IF AMENDMENT TO REPORT DATED

County & Local Committees, enter County in

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

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
237 .25
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) . . . . . . . . . . 0.00
Schedule F : Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00

Schedule H : Total Sales of Campaign Property (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 .00

(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL . . .. . $ 237 .25
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B : Expenditures total (Attach Schedule B) (**also see debts and loans below) . . . . 237 .25

Schedule F : Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00

CASH ON HAND at the end of this reporting period (if final report balance must
000
be zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ -

**UNPAID BILLS (From Schedule D-Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 0 .00

*IN KIND CONTRIBUTIONS (From Schedule E -Attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ 0 .00

**OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 00-00

CANDIDATE COMMITTEES ONLY :

CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H -Attach Schedule H) $
 FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form
SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B

(Rev . 07/03)
MONETARY
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.

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

Waukee Citizens for Excellence in Education

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DDNR) AND PAC
CHECK
NUMBER
ID# Wells Fargo Bank, N.A . Bank Fees

01-04 666 WalnutStreet

3.18
CK# Des Moines, IA 50309 $

ID# Wells Fargo Bank, N.A . Bank Fees

02-04 66 Walnut Street 3.18

CK# es Moines, IA 50309

ID# Wells Fargo Bank, N.A . Bank Fees

03-04 66 Walnut Street

3.18
CK# es Moines, IA 50309

ID# Wells Fargo Bank, N.A . Bank Fees

04-04 66 Walnut Street 3.18
CK# Des Moines, IA 50309

ID# Wells Fargo Bank, N.A . Bank Fees

05-04 666 Walnut Street

CK# 3 .18
Des Moines, IA 50309

ID# Wells Fargo Bank, N.A . Bank Fees

06-04 66 Walnut Street
3.18
CK# Des Moines, IA 50309

ID# Wells Fargo Bank, N.A . Bank Fees

07-04 666 Walnut Street

CK# IA 50309 3 .18
Des Moines,

ID# Wells Fargo Bank, N.A . Bank Fees

08-04 66 Walnut Street 3.18
CK# Des Moines, IA 50309

SUB-TOTAL $ 25 .44
TOTAL (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 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) .)

I
Page -__ ----- of -2-_____

(for Schedule B)
 FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form '
SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B

(Rev . 07/03)
MONETARY
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 .

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

Waukee Citizens for Excellence in Education

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
ID# Wells Fargo Bank, N .A . Bank Fees
09-04 666 Walnut Street 3 .18
CK# Des Moines, IA 50309 $

ID# aukee Community School Distribution of final funds to a

oundation non-profit organization within the
10-07/04 208,63
CK# 60 SE University school district
v-1- r A cn1c1
ID#

CK#

ID#

CK#

1D#

CK#

1D#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL $ 211 .81

TOTAL (if last page of this schedule) $ 237,25

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 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) .)
2 2
Page --------- of ----------

(for Schedule B)