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For Office Use O I
--fo_ r S f~c iee,o . 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
( 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
CANDIDATE COMMITTEES ONLY:
File with :
Candid ate Name Political Party (if applicable) Iowa Ethics and Campaign
r~ r 12,,,6 b I ;e k.L Disclosure Board
510 E. 12"', Ste. 1A
Office Sought District (if Senate or House) Des Moines, Iowa 50319
Fax: 515-281-3701
Late reports are subject to possible civil and criminal penalties. Pursuant to Iowa Code section 68B .32A(7)
the candidate, for a candidate's committee, and the chairperson, for any other type of committee, is the
individual responsible for filing timely and accurate reports .
**UNPAID BILLS (From Schedule D - Attach Schedule D) .. .. .. .. . ..... ... ..... ... .. . .. ... .. ....... ... .. ..... .. ... .. .. . . .. .. ..... ..$
*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .. ... .. ... .. ... .. ..... ..... .. ... .. ... .. .. ... . . ... ..... .:$ -7 Z 3
**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
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN
(Rev . 07/03) I RECEIPTS
(Including candidate's personal funds)
© CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
'To c` S -Gjt V~ C A
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 .
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 68B .32A(6), 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 IF FOR
RECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
b
C K# Leo .-,
ID#
G CK# toZ
G
AAi
Z 1 $7S Pla~y`6 /. o o0
.4 of
ID#
,~~;c Ly~~
7/Z ylolo 19 Srdhv;t,. 0r . ~o6o, c/j/
CK#
292 V OSCeol4 ,4 of I
I D# C~ej . 3-1- e,-jC 4d
CK# //7 /Yls,.AIL 5TF
3811 .d 5"0 1 -2 30
I D#
p~I~ICG CK# 2ao S . kvss~,~{ 5 ~.
17y2 D c / .4 oi 2S=
ID# t
I Cr/dp l Y3& rr
~G
/~ CK# WC7 3/o -,1% 4Jc, a
to ;Z "Je", Ti9 Z6 y 2 5- -°-"
AJ
So
I D#
Z/dt!S ~ 44-1,
090
CK# y30 S . T°~y lL _o o
t 2 y~- c75ceola. -ZW
Z s ._-
5-0-1- 1 3
ID# 5+r-f- Jea~ cr%.., js
/lZ/OG l6Gf A/... 15-L J' R~-
CK#
fr$y3
GSccola TW Sc-,t13 /oo
ID# iQdP A t 4iA c Miller
CK# 2071 I Gb+n Iq .-c
oSCa ls. -rAl 0ZI So
iD#
* 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 ScheduleA)
For Instructions, See Back of Form SCHEDULE
Reset Form
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 07/03) RECEIPTS
(Including candidate's personal funds)
© CHECK THIS BOX IF
COMMITTEE NAME (Mustbe same as on Statement of Organization) AMENDING FORM
CAUTION: Section 68B.32A(6), 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 DRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (ifapplicable) TO CANDIDATE* RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (ifapplicable) RAISER
NUMBER INCOME
ID# Cn....~ ~ed~St~c... Cenf~l CeAr ;-~te
uk;.e
PO fwX ZG 3
':ri44 300 0-4
9/1`)~(X, CK#
I12S Cr. 6 "" 50901
fill
CK# rovoJar~~1
719S" lo"
cr" so80
I D#
~Uw;n
CK# 17?L1 050,94 54
.
79 y0 Sozl3 Z S'
D ce It,
ID# AAA a- ge .ti
/16/oG 1 ya cJ
cK#
o5ce.l~. 0213
ID#
V/IRIOco SLt,ile Atn4oa
cK# 329 Of ._ ~0/,Lc. e .d1
ySSS' Osteol*- Svzf3 r
I°
/ ID#
X91 ; Ph:ll, S Z~ : f,-y
CK# 1203 tjssf Ad.: r
`131 C« -ho~f .#4 So v
ID#
Sirf w
P ~~id l,3c r h7ar~,
014106 cK# A0 6ox 57C7
Ll SC 2.
ID# Jo4~ .~ (04 4 ; C 3irdk,s
cK#
Hell C96C r 5-C Z 13
ID#
~~ftlab Ja^, e +
CK# 2/r -7 110+`r t
2 SS* C . es'Ifo j ~` /ov s-*-
tW 50fsvl
ID#
51 e) t + /nic1a lie ~orla~+
°8~is1 o G
CK# )7 78 9 301,.6 Z
J _~ 5- 3 v
~~ J ; .-, olti 0 5-v )z 5'
SUB-TOTAL
$ 6/5
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, butthere is no Page Z of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
Reset Form
CONTRIBUTIONS -- MONEY TAKEN IN A I MONETARY
(Rev. 07/03) RECEIPTS
(Including candidate's personal funds)
60 CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
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.
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 68B.32A(6), 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 .
P060x ao~
2126
oseeQlr. Ts9 Scp 7 13 " /vo °=
ID#
or/ 211vG IDe'~' e> 4-74
44- LQAG)0hrSfAe usrv~:~ ~av
CK# 7S J̀ilet.e s~sl /4, . ~d
/S.SV Elk4o1, z t z I 5d r Zv `~
01 I /DG CK#Mo,a>/
oct)er Ve c-. ,E' l I Z s-
ot/ ID#
Jtac k f
1lvG Gta rfri 4. I~Y1srLforn
cK# 27&1 010 C,,,, 5,-v
X28/ ~tJe~.~ - 1 7
ID# *
f21 /p G J04^ Mc~r/l rJw !a-ol~~
. ~7 S'SFer h /e w
Jn 21 )I
ID# ,.
' 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 sumame of contributor is the same as candidate, butthere is no Page of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form Reset Form
SCHEDULE
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev.07/03) RECEIPTS
(Including candidate's personal funds)
~L CHECK THIS BOX IF
COMMITTEE NAME (Mustbe same as on Statement of Organization) AMENDING FORM
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.
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 68B.32A(6), 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 .
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) . ofIf surname of contributor is the same as candidate, butthere is no Page Ll
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
Reset Form
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN
(Rev. 07/03) RECEIPTS
(Including candidate's personal funds)
® CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
Uar ~ -F,, r 54a,+v-
aZ
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.
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 68B.32A(6), 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 .
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) . ofIf sumame of contributor is the same as candidate, but there is no Page .5-
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
Read Form
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
® CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
Rr S+-Je- [~e d
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 .
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 68B .32A(6), 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 .
q~G
CK# Cl y oD f o 150 c i I eo
f"V rrq%
~`IIpl /V L
ID# s4n,a a. Sara ~
CK# ~t: Sev4.~. I~r . s'O 00
2712 ,E k+or.
ID#
LCw rti Jones
~lt~c ~c .1.
09406106 3Z11 UJeoc) bru.(~ L -n,
CK#
S hy K)e-,, ,t,4 S-o z i o / oo °~
ID# ~.
~~onray ikq,c~~e)
osJdy/d~
CK# r OS .t- I6r .
i3ec.or OF 1570f
ID#
0i /1,Z) p6 wX;a vt t:e&,Oj /It aSSer cI le
CK# hler~'e 4 . ,~ 0d
)sl X113n0+f-
_e s ,.A,
/ ID#
two ~a~y + .S A
CK# 230 1304 '' A~c
9,s7v e- , -rd 51 ~ -7 1 tim-
ID#
~I /~zhG
;,
W ,/ f f'49a~e~t / c~S~e )
CK#~~ ZZ9 w' L~1Ca~n sf,
Gli.r, C/o Z S °~
/IZ/oh
CK# ( ltsrl& lr-/ 1rZ ''
39 7 C79ceo &_ lvv
.~C*4 Sot I
SUB-TOTAL $
I6,7(-/
TOTAL (if last 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 sumame 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)
For Instructions, See Back of Form SCHEDULE
Reset Form
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev .07/03) I RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
I66i -X411 41r S 4J-c-
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.
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 68B.32A(6), 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 NAM AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (ifapplicable) RAISER
NUMBER INCOME
ID# E~"7s~f a. (~ ;n 4b;a 6eSS C-141'
CK# 2~ Jo n y'YU .. n *J $ C0
34 of 7192) Sv-
I D# $ q d Z,
f7(A w ke t Ip/~J C
0//7/0G CK# PO 7 Z $' o0
Iz s-3 0~ - ~ Z*4 Sv c 2 S~
05/17/0(-
ID#
/4,44 . r .Ir w~ ~T'c rc~ n
CK# - 10s IF 501A
345-5 Get-no-j" 14 O/ y0
ID#
Janti G
C9 /7O/aG
C S,n
~Qtrr'S
CK# 7 ~I tC. Z Z-14
SO X519 / S00
ID# +No- sk.-~~ f
,3e," ~I
0s/0G cK#
2 7 44e^ ae.l( 5 f
~061g
0 s« 0 ( o,. 14 5-0 Z
ID#
41-i1-if4t1G - FV e)).'.~7 3, iei)t;I
0/7 5-10&
CK# loo) 5v .n A#,A A-e. . 14 1171. IH
c a0 n 57-0 r
ro
09/VIOG ID#
ai G PO e~e-e 5
cK# )I& toe )a ed
~~96 d 5C . cola. 5-0Z) 3 15--v
/0G, ID#
6/1A .~- Lt
17, 1 S'- 1 30 +" 5 trV
CK#
2z~3 C~rs~~, SP4 60
-
2,0`'
CK# 4~ ) ~ [05 SV,,e*- G~ r-Jc,
SS ea.
_ )~ i ct ? 0 I
1010(o ID# Gtsy C,-«
101 cc,4,t
CK# 5Z) l G- rib k e. AuA-WC ..y SL:b .
6e5 ,, `-l ee A 0 37, 0
SUB-TOTAL r ~~ ~
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the $j
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 7 of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
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 .
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 68B.32A(6), 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 I NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
RECEIVED (ifapplicable) TO CANDIDATE' RECEIVED FUND-
(MMIDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
/ ID# 7,"t=77 e7 797773
ID#
CK# ac7
G7ol c~oo~ oC7 z -l ~CX~
ID#
CK#
ID#
CK#
CK#
I D#
CK#
I D#
CK#
ID#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL
\kw - mQ1'I'
/ ID# e n vzloph5
2I lib CK# 1564 N. Jefferscs, S+. 'l~ iddiE. wXes
$ L47-o6
I4Gcnoja ., Ifl 5z'12-5
ID#
~SC~eIcL PCst S'tamps
71211o6 CK# 0scIIJa 1w S"vZ 13 / /7, ©a
ID#
So iu4' ov,5 Lt;L0r C - Sri 7}u -1 Lc_
CK# PO Btu 3 N
7 /21 /b6
10t)cJefi-4y3 Or. O6Cecja, 1A tf-
ID# $oj,~-Fiov,S! 3cr Color C1_~p/FS
pt) Box 364
11 CK# ~~Ys Pr . 6SCecIQ, IA B(a& P1,Aitr
s '43
ID# Wa [ - SIR rfi {~i dd5 ~I jxFS r4'a/
jobs 73Sf W,nd56r
CK# C5
Des Mo;nrs, IA
ID# ^
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)
Expenditures to personstentities 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 -
3
'
Schedule B)
(for
FOR INSTRUCTIONS, SEE BACK OF FORM Reset
Foral SCHEDULE
- "o7 S TG3&--
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# Ca5f ~'5 ~~ene~Q-f s-~~~.
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to persons/entifes 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 ti8A.402(3)(i) .)
Page -2--of- -3
--
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form SCHEDULE
I D#
CK#
1D#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL $ ~7
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)
Expenditures to personstentities 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).)
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN-KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev . 06/97A CONTRIBUTIONS
fo/- SAI~_ La .
(p CHECK THIS BOX IF
AMENDING FORM
Reset Form
0JI.13lo(o (C ?
0 .,s b);Z&-, /any
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'tee
9 +4
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f row 41
1'~a : ~
gr~r
l~ss~ i, SOUK F
30 oG C,1t G~,t ~t~ Os~a~ S 7 S 93
es o "..a ,4 S0 3 c' 5
13 /a(, Qea,,~h f~ 1°w~y c f To".x. lri~ ec} ,h4: 1
so o 1Ar0d y~ . .,
Re,O41,1a^ PaJy s-f .LO".,q r 094. 1
01Vots AoSFayc. 4 ~~. ~s
East -5 .4L, ^ lS E::]
A9 :r ~03o r ;n~'w
Jea"O-kCa~ 0-P To--_ tfl,~ec'f"
09 1,106 r.7 t last s 1416 ~' ' '~ y 95! y z
,p4 s0 cl
t~ ~ ~ ~ rl0v~j~e l G~ /ACtl 7y D ~- Vi rcc~ ~4. l
C-ti, ~.t F, n
z t ~- ~ EJ
'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page of Z
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule E)
by marriage) . (See Page 2 of forms packet.) If sumame of contributor is the same as candidate, but there is no
familial relationship, enter "not applicable" in the relationship column .
-FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E I IN-KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev. 06/97) CONTRIBUTIONS
u/ L,/-
To r cJ 7 -tL ed,
® CHECK THIS BOX IF
AMENDING FORM
Reset Form
1-9Ak
Ldp ol.-
93 Ac
.Z"W S-o, 2 S.-
{mr /'1te.) FW]
0'%J& rvyrress S:c)a drA
F-1
F-1
`Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page Z of _Z-
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule E)
by marriage) . (See Page 2 of forms packet .) If surname of contributor is the same as candidate, but there is no
familial relationship, enter "not applicable" in the relationship column.