FOR INSTRUCTIONS, SEE BACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE

(Rev . 07/2004) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization)
For Office use Only ,
Sh' ends ?;- eeda~ Comm . #
IMPORTANT: Indicate by # type of committee you are reporting for : Logged In
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party Scanned ,c4yv
( 4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or Other Political
Subdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 10 )School Board or Other Political Subdivision PAC Computer
11 ) Local Ballot Issue Audited ,~a4 Y`
CANDIDATE COMMITTEES ONLY :
Candi to Name Political Party (if applicable)

Office So ght District (if Senate or House)

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Late reports are subject to possible civil and criminal penalties .

SIGNATURE OF PE SON ILING REPORT TELEPHONE

3\g3~~ o53`l \\-3-o S-
DATE SIGNED

1 AM FILING A -
1~2m D 3 1
24905- REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate by # 7

Local committees, enter Date of Election

-'CHECK IF AMENDMENT TO REPORT DATED
veen6e"^ 8 12-00S -
County & Local Committees, enter County in
LJ 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 .)
I_"i 7t7

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
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
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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

*"UNPAID BILLS (From Schedule D - Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ~Sf.

2 ., b~
*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ i30,93~
**OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
CANDIDATE COMMITTEES ONLY :
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
STATE COMMITTEES : Submit a reconciled campaign account bank statement in January of each year.
 For Instructions, See Back of Form SCHEDULE

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

(Rev . 07103) RECEIPTS
(Including candidate's personal funds)

CHECK THIS BOX IF

COMMITTEE NAME (Must be same as on Statement of Orgartzation) AMENDING FORM
Shields For Cedar Rapids

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 J IF FOR
RECEIVED (if applicable) TO CANDIDATE` RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER

w
NUMBER INCOME

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ID#
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CK#
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ID#
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ID# `-~ -P C Son
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CK#
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CK#
0
SUB-TOTAL

TOTAL (iflast page of this schedule)

* Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) . If surname of contributor is the same as candidate, but there is no Page of
familial relationship, enter "not applicable" in the relationship column .
(for Schedule A)

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