Download as pdf or txt
Download as pdf or txt
You are on page 1of 13

FOR INSTRUCTIONS, SEE BACK OF FORM FORM

DR-2 I DISCLOSURE
DISCLOSURE SUMMARY PAGE (Rev . 11/97) REPORT

For Office Un Only

rT ,
COLR4 ,T,E
..~E NAME (M e same as o tatement of Organization) Comm. # W
lr.P/I P.lSO N ~u r ~,OJG Index
Audited
IMPORTANT : Indicate type of committee you are reporting for: Computer
( 1 )Statewide/Legislative Candidat ewide PAC ( 3 )State Party ( 4 )County/Local Candidate
( 5 )County PAC (q )Ballot Issu ;ommittee ( 7 )County/City Central Committee
( 8 )Sypp:~t Slate Cao id)*

Z- 773 - ) V
SIGNAT RE "ITTWSUNER-fsfperson filing this report) TELEPHONE -

Penalties Due For Late Filed Reports Range from $10 to $400

SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWIASENENCE:


I AM FILING A ftw . REPORT FOR A~A (1) ELECTION /(2)NON-ELECTION YEAR.
n
(report date) Indicate one

[]CHECK IF AMENDMENT TO REPORT DATED ,' `4 \1 Local Committees, enter Date of Election

0 Check if this is final (termination) report and attach Notice County & Local Committees, enter County
which Election is held
(You must continue to file reports until a Notice

STATEMENT OF CASH ON HAND


CASH ON HAND at the beginning of the reporting period. (This is the total
of all monies 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 N this is first report filed.) ............................................................................$
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) ...... ............................... ............
Schedule F: Loans Received total (Attach Schedule F) .. ........................ ..................... ....... .
Schedule H: Total Sales of Campaign Property (Attach Schedule H) ..................................
(Schedule H avalies to Candidate' Committees Only)
SUB-TOTAL.....S
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ............ .................. ............. ............... .
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) . ....... ....... .. ....... ......... ............................ ........................... ..................$, U 91 & t

UNPAID BILLS (From Schedule D - Attach Schedule D) ............ .. ................. ....... .... ................. ....... .$
IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .. . ........ .. .. .... ....... ........... ....... .... .$
OUTSTANDING LOANS (From Schedule F - Attach Schedule F) ........ .. .. ....... ........... .. ..... .. .. ......... ...$
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
SCHEDULE

CONTRIBUTIONS - MONEY TAKEN IN A MONETARY


(Rev .07/03) I RECEIPTS
(Including candidate's personal funds)

O CHECK THIS BOX IF


CO ITTEE NAME (Mu be same as Statement of Organization) AMENDING FORM

STATE CANDIDATES NOTE: IF ACONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IDENTIFICATION
DISCLOSURE BOARD. IOWA ETHICS AND CAMPAIGN

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 d IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER _ - INCOME
ID#
t'valn,C, ~ rdr~,
$
lq/o~ CK# ~~
$
a 45t
I sA
ID#
o P-1 14
01 9 10 CK# 434q S . Q0VI-5+
0
ID#
L, :)ov WvUi6WLS

ID#

CK# SU

ID#

r
I 1
~~31 cK# %i 3t5 l S 1~ O
ID# A11 4 Y u.e,
/(~oN CK#
ID# d'w

)t s' -
CK# r3~~ 3S- 'r

lD#

cK# a
ID#
(ol K~ ~~~ ~- l,s-bovCwuuc~1 ,, c
CK# oig S,
ef
*a ~ I QA~L 04 1eq

el
CK# NW .
~~ N4u¢s 4))
SUB-TOTAL

TOTAL ffflast 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 P ~
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
ForInstructions, See Back of Form SCHEDULE

CONTRIBUTIONS - MONEY TAKEN IN A MONETARY


(Rev. 07/03) RECEIPTS
(including candidate's personal funds)
O CHECK THIS BOX IF
CO ~//5 (Must saGt
e as P Organization) AMENDING FORM

t7~ 4V Y o

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 d IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MWDD/YR) AND PAC CHECK (d applicable) RAISER

'T
NUMBER INCOME

c/6 L, j
$
w
D# 10~qw I il P (,-

yea
lD#

/Sr CK#

ID#

cK# 0

Ira
CK# ..
G~- ~J4
ID#
Y
i AL GA Y

cK# ~~~~
Y,
~ NINe I
0,5

Lq CK#

ID#
3 .
S&4*-W%1
yhl l"rvA,.
Zs 0
WA~ ID# cK# o S3
~ IV CU
~
Dv'N-e ',
Wdvnr5 tjJ~'"
CK# V~ LUY11~n .'wlb `S
ffm t Gc 4
1D# K)
OW -7 4&
CK# 3; S Ct r,Ka 'e
I ~ v CG,

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
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 07/03) RECEIPTS
(Including candidate's personal funds)

COMY(fTEE NAME (Mustbe same as on Stat9fi-*nt of Organization)


0 CHECK THIS BOX IF
AMENDING FORM

U,v
01Q
X/1 U50N -
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 d IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-

0
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#

CK# s $1Cn~
u
ID#

CK#
Z4*e-

CK# goo 51V1jQL, 4%K-


wto- -94 0
iD#
8
cK# U 0~
WWA 1, Wo
"5
l0#

cK#

3
ID#

CK# im",,
v ~'~''"'
~ , _ _

w
ID#
f'v"Wdc uvd bow-
CK# l Z'3 ~-&tks lw

O
1414 ~L
lD#
CT ~v

v
CK# l ?? 1 -f
1w-
ID# avr. "
(,'t IN

CK# 1S 4--U
lit

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)
For Instructions, See Back of Form SCHEDULE
Reset Feztn 1
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(including candidate's personal funds)
CHECK THIS BOX IF
CO ITTEE NAME (M same as on tement of Organization) AMENDING FORM

k~ 12
-'
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 d IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID# 1 )~ I WtQS~
WI

v,,Ot Z4
-
ID#

CK#

LE CK#

ID#
"I
luMoities
ba,3, ~iK
-
e
0

CK# ~
~S~w nnli~ie (c1

M
CK#
warAzt Z-5 Lj
y0~
ID # W
~=f-'j
, bw-r s 0

VI
CK# Moatc 10 e~u tSl
CPI

1D#

CK#
vaf~-j
-t"44~Z
CIO
k 11

a 0
tv G, 0
CK# Azrwl
tL IA' r4 5- -j

' Disclosure lawrequires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to thethird 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)
For Instructions, See Back of Form SCHEDULE

CONTRIBUTIONS - MONEY TAKEN IN A MONETARY


(Rev. 07/03) RECEIPTS
(Including candidate's personal funds)
O CHECK THIS BOX IF
CO ITTEE NAME (Mus sa s on State ~~
t of Organization) AMENDING FORM

~t

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 infomtation 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 d IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME

F/I ID#
h

MCK#
- ice bahK~L _
Q, ^ V4 0

d;
E]
aM,a
CK# 'N c%k
WAX

CK# -7 E:1
WA
N i W~
1o# t Ov QhAl
CK# 3u 3W S L,~ ".
.,

FA~ CK# ~ ~~T J~ u1+ts'ti

lod~ f

F
I rv rt--1#W. X4711= Sux .C -

CK# K1
`n
I D# vw

ID#
CK# Vi s a P,

' 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)
For Instructions, See Back of Form SCHEDULE
Rust Form 1
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (ust be same al~on Statement of Organization) AMENDING FORM

l~, N

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 d IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME

q13 710 K# ~~ 094 9. ;


q 1 ?~
'D#
~! cal,
CK# 158 0
" l
ID# M~~ti ~. /Aavr~
CK# 30 l~~ r Q-̀v h

W
CK# ~~ S*p~'~N
I D#

CK# / 0
40 w ~L aG

nu

Ito CK#

1i

CK#
-_ . .

Z
ID# _
~f,t
p~ .
CK# Z107 A44W Q

CK# -Z5 0i,


__4J a-d- 04; iP~®

Disclosure law requires candidate committees to disclose the relationship of arty relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) . ff 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
Reseform
SCHEDULE

CONTRIBUTIONS - MONEY TAKEN IN


A MONETARY
(Rev. 07/03) RECEIPTS
(Including candidate's personal funds)
Q CHECK THIS BOX IF
COM TTEE NAME Mus sa son
, State~yt 0f o
7anization AMENDING FORM

STATE CANDIDATES NOTE: IF ACONTRIBUTION 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
NUMBER INCOME
'ID#

CK# ? 7 3 r"~
ID#
33017 "40111C'611C-- V/ (o
CK# atiac V V

LIN , E:1
ID#

CK#
~~~ vas !z3

y hw7~
Cos
x El
ID#
4e,
CK#

~
WA L
ID#

rmiI
CK# 3 G~ev 'U

ID#
~ r l ~ ~. ..
CK#

WA;
i~
0
ID#

CK#

c
a
ID#

E-01
~~yN
ICK# ~w

CK# 1101 611


O

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)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
Q CHECK THIS BOX IF
CO IltE NAME Must bye sa on State7t of O nization1 AMENDING FORM

P~ QNSa v
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
NUMBER INCOME
ID#
OV
I U~ U CK#
w

lU 1~ ~ ~ q~o73 ~ i Ilu~

`ta *4 . 0
ID#
0U Get
cK#
T Z~1a~ ~~-
ID#
~6 OA_ d, ICU
CK# I~5
y

" P~
CK# ~O z5
i
ID#
U h. ec f l~Z
CK#

iD#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

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 . jr Schedule A)
FOR INSTRUCTIONS, SEE BACK OF FORM Rest F SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY

D
(Rev . 07103) 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 .

CO tTTEE NAME (Must me on State t of ~anization)

CANDIDATE NAMEAND ADDRESS TO WHOM PURPOSE AMOUNT


DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (N applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK

_7/
NUMBER
~T(
o $

~ f I( I
~ d

io# 8
6
r
~ i r ~ ° >ti.1
CK#

I°#

CK#

- ~ o
/ CK#
1Jos
"
1 3Z
CK#

of
cv O~ Z',9- e
~
d-tr

CK# ~-

1/6 ~ll 1°~j~


j d1 X~ U
CK# r'11
4-1
~., chi 1~ racer-~c. Yt~ 1/'l~ IJ -~ h ~Ll ltutu' P.'.
AA
W/ CK# 5b)

SUB-TOTAL $ 1,
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. (Re(er 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

(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM 1 -Reset Form SCHEDULE

EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY


(Rev. 07103) EXPENDITURES
STATE PAC COMMITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE D 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.

CO ITTEE NAME (Mus be same as on nt of Organization)

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT


DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MMIDD/YR) AND PAC
CHECK
NUMBER
ID*

~l3"1 CK# $ AS

y
CK#

1D#

CK#

ID#
f v, ,,,~ 11~.~Ila les t C a~ lh, ~v n
CK#

jori ~~ y3
CK# Z
- c~ . Cv` ~-t Z9- Cc~o~

CK#
IVA
U, Jo VAM
I
ID#
vy~i W~v I d. C'A 4K- v
CK#

1
~ ~ v NpC . C1,
ID#
WYa A-,4, t, YiY~r1t
Gt'+ CK# 1

SUB-TOTAL $ ~~ 7J

TOTAL (iflast 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 personsientities 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 68AA02(3)(i) .)

Page
4

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

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B


(Rev . OT/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 D 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.

CO E NAME (Must same as on '"77jment of Organization)

~la CGr )e
CANDIDATE NAME AND AI3DRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (If applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK

C4& j>
NUMBER

o G3h12 4~_e.,
~

l IJ~
CK#
V4
~ys )C
CK#

D# .11
9
0Z 40,
Or0~dl Ccr.~' d VJ
CK# D*,
ID#
~21~0~/C~ ry+~~ B y Z7
~~lro CK#

CK# v

ID#
SAk r 10Z
l~ n

CK#
Z2 *7

lD I~ CK#
llU~
- _
SUB-TOTAL $ 9 llt~

TOTAL (N 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 behad of the candidate's committee . (Refer to
Schedule G instructions and lows Code 68A.402(3)(i) .)

Page Of

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

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B I MONETARY


(Rev. 07t03) EXPENDITURES
STATE PAC COMMITTEES : NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE D 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.

C ITTEE NAME (Must same as on nt of Organization)

~J-wWN je~ Qc~~~,ok~


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#
1 UuradN ~Av e
0/14/04 CK#
~t 6 Ki)L

iv~
ID#
P0L46 rd PY'1' 4 P" jv~*rj 'Ct0wtjwyjV
CK#
Alyw
ID#
eOVA 6J , Pri - Cd Nti~d4/'
CK# All Pr 1
r,\,
yw
ID#
C~a wL ~~ u ~~lr~~~
CK# y

ID#
r C4In"Iatlw -111JAwisi
CK#
%dam .O~q 9-
ID#
~e t~ .S- pa-,~' .
CK# 37 ~'
ID#

CK#

ID#

CK#

SUB-TOTAL 1 $
1z53V
TOTAL (if last page of this schedule)
F~

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY:

Purchasesof certain campaign property oostirg $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 persoNentity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 68A.402(3)(i) .) _

(for Schedule B)

You might also like