10/18/2004 19 :57 7122626674 EMAGINE PAGE 01

FOR INSTRUCTIONS, SEE BACK OF FORM FORM

DISCLOSURE SUMM~bIIRY PAGE DR-2 DISCLOSURE
COMMITTEE NAME (Must be same as on State ~Pnt of Organization) (Rev . 0712004) REPORT

For Office Use ONy ~~

Iowa Family PAC Comm . #
IMPORTANT: Indicate by # type of committee you arpl *orting for: Logged In ~.
(1 )Statewide/LegislativelJudge Standing for RetentidnlGandldate (2 )State PAC (3 )State Party Scanned
(4 )County Central Committee ( 5 )County Candidate, I(~6 )City Candidate (7 )School Board or Other
Political Subdlvlslon Candidate (8 )County PAC (9) , hy PAC (10 )School Board or Other Political Computer
Subdivision PAC ( 11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES ONLY: E'c 9':.+i?'.

Candidate Name Politic Party (if applicable)

Late reports are subject to
fi
J~ possible civil and criminal
Office Sought District Senate or House) penalties.
K
7 2~ ?.~2^ bb7y _ / D l~ 2ta~
SIGNATURE O RSON FILING REPORT TELEPHONE DATE SIGNED

10119/2004

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

I
OCHECK IF AMENDMENT TO REPORT DATA Local Committees . enter bate of Election

I
Check if this is final (termination) report and aQ itch Notice of Dissolution Form DR-3. County & Lacel Committees, enter County in
(You must continue to file reports until which Election is held
)R-3 is filed .)

II :
I ..
STI . TEMENT OF CASH ON HAND
CASH ON HAND at the beginning of the reportin Fperiod . (Total of all funds held by the
committee . This amount MUST be the .~ me as the cash on hand at the end
0
of the last reporting period or must be zo'm if this is first report filed .) . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . $
ADD TOTAL MONEY TAKEN IN THIS I +ERIOD
Schedule A , Cash Contributions total (~1t(ach Schedule A) (`also see in-kind below) . . . . . . . . . . 21,325 .00
Schedule F: Loans Received total (Attach, Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule H : Total Sales of Campaign I-? party (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Schedule H applies to CandS ~~tes' Committees Only)

SUB-TOTAL . . . .. $ 21,325 .00

SUBTRACT TOTAL MONEY SPENT TA, IS PERIOD
Schedule B : Expenditures total (Attach dchedule B) (also see debts and loans below) . . . . 5,000 .00
~ i.
Schedule F ; Loan Repayments total (Aft4ach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

CASH ON HAND at the end of this reporting periplrt) (if final report balance must
16,325 .00
be zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

"UNPAID BILLS (From Schedule D-Attach Sc~,4,dule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  ,_,___ ._  ____,____,_  ,$

`IN KIND CONTRIBUTIONS (From Schedule E Iulttach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
-OUTSTANDING LOANS (From Schedule F-H'tthch Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
CANDIDATE COMMITTEES ONLY:
CONSULTANT BREAKDOWN (Schedule G Att~ hed9) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schgclule H -Attach Schedule H) $
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For Instruction$, See Back of Form SCHEDULE

A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev, 07/03) RECEIPTS
(Including candidate's personal funds)
0 CHECK THIS SOX IF
COMMITTEE NAME (Must be same as on State AMENDING FORM

_n r.fIL~
f_ P14c- 1
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS IVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUM5FK IN THE DESIG ED COLUMN, A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.

CAUTION . Section 68B.32A(6), Iowa Code, prohloi the use of information copied from reports and statements for soliciting contributions or
for any commercial purpose by any person other th

DATE PAC ID NUMBER NA AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR

RECEIVED (f applicable) ' TO CANDIDATE' RECEIVED FUND-
(MMIDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID# Mr . & Eugene Ver Steeg
10/12J2004 1819250 Street $1,000 .00
CK# 15240 Inwood, . 51240
ID# Mx . & Charles Hurley
454 Ty , r. 200 .00
10/12/2004 CK#
10327 Pleasant I I LA 50327
ID# Citrus VI Holland
10/1212004 CK# 1409 161 } Street 10,000 .00
11247 Rock Vall, y, IA 51247
ID# David an ~Arlone VanNingcn
10/12/2004 1802 9th 1. 25 .00
CK# 7421
Roclc Va ,y, IA 51247

Mr. & ~I Mike Wells

366 16t~rt t S£ 10,000.00
10/12/2004 CK# 13015
LeMars,~ A. 51031
ID# Mr. & M << . Melviin Smith
10/12/2004 CK# 61205
4405 Pat~~~ am,a Dr .
Panora, i~ 50216 -
100,00
ILI
ID#
I
CK#
I .
ID# a

CK#

ID#

CK#
I
ID#

G K#

SUB-TOTAL

TOTAL (iflast page of this schedule)

' Disclosure law requires candidate committees tD dlscloel el he relationehip of any relative making a contribution to the
committee . Relationship must be shown to the third deg+ of consanguinity (blood relatives) and affinity (relatives by 1 1
. If aumame of cohtflbutor Is the same as
marriages) didate, but there is no Page ___ of -_
familial relatlonshlp, enter 'trot applicable" In the falatl? hip column . (for Schedule A)

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10/18/2004 19 :57 7122626674 EMAGINE PAGE 03
. IIa

FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

B MONETARY
EXPENDITURES -- MONEY SPE FROM COMMITTEE ACCOUNT (Rev, 07/03) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTI NS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION ~~. MBER IN THE DESIGNATED COLUMN AND THE D CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LI ''OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD . I

COMMITTEE NAME (Must be same as on Statrii ant of Organization)

CANDIDATE NAME AND DRESS TO WHOM PURPOSE AMOUNT

DATE ID NUMBER EX , NDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (pisburs ant) WAS MADE
(MM/DDNR) AND PAC
CHECK
NUMBER
ID# Judicial Accour bility Group PAC Postcards, Yard signs, & Postage
10/14/2004 Box 826 $ 5,000.00
CK# 101 Sergeant Bluff, 51054
, i
ID#
.J
CK#

I D# a
I
CK# '

ID#

CK#

ID*

CK# ,

ID* j

CK# ! I

1D# ! .

CK#

ID#
I
CK#
i
SUB-TOTAL $ 5,000_00
TOTAL (if last page of MIs schedule) $ 5,000,00

i
THIS BOX APPLIES TO CANDIDATES' COMMIT` ES ONLY :

Purchases of certain campaign property costing $500 {more must also be inventoried on Schedule H . (Refer to Schedule H Instructions.)
,
Expenditures to persons/entitles providing consulting, i , ertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each a 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

(for Schedule B)