712 325 6141 P .

02i06
PEOPLES NATL BANK 333BDb.IY
SEP-18- 2003 05 : 19

FOR INSTRUCTIONS, SEE BACK OF FORM

I
FORM
DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
COM TTEE NAME (Must be same as on Statem t of Orga~nation) (Rev. 07/2003) REPORT
- tinm , -r& !:- - eD tl4nfl
For Office Use One!`
44~_ ,
IMPORTANT: Indicate type of committee you are reporting for: Comm . # _
13
Logged In
( 1 )Statewide/Legielative Candidate ( 2 )Statewide PAC ( 3 )State Party (4 )CountyLocal Candidate
( 5 )County PAC ( 5 )Ballot Issue/Franchise Committee ( 7 )CountyiClty Central Committee Scanned I , __L_~_ 3
( 8 )Support Slate of Candidates Computer
CANDIDATE COMMITTEES ONLY : Audited _
Cand to Nam~'' Political Party

Office Sought District (if Senate or House)

SC Fke,_ / .:.

TREASURER (or person riling this report) TELEPHONE DATE SIGNED

Late filed reports are subject to possible civil and criminal penalties.
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE:
I AM FILING A , 9 -19 - J 3 REPORT FOR ANIA (1) ELECTION /(2)NON-ELECTION YEAR .
(report date)
Indicate one
Local Committees, enter Date of Election
QCHECK IF AMENDMENT TO REPORT DATED .03
9-9
County & Local Committees, enter County in
Check if this is final (termination) report and attach Notice of Dissolution Form DR-3. which Elpptlon is held
(You must continue to file reports until a Notice of Dissolution is filed.) TAW- ~E

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 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) .. . . ... . . . .. ..... ... . .. ..... . . ... .. ..... .. ... .. . . ... .. ... . .. .. ... . .. . ... .. .. . ..... ... .. ... ..... ... . ..... . S

"UNPAID BILLS (From Schedule D - Attach Schedule D) .. . .. .. . .. .. ... . .. . . . ... . . .. . ...... ... ... .. .... .. ... . $ _.-.
'IN KIND CONTRIBUTIONS (From Schedule E -Attach Schedule E) . ... . . . .. . ..... . .... . ... .. ... .. ... ..... . .. ..... $ -_,-_ i~a,aq~
-OUTSTANDING LOANS (From Schedule F - Attach Schedule F) ...... .. ... ... ..... . ... ..... ...... .. ... . . $
CANDIDATE COMMITTEES ONLY:
CONSULTANT BREAKDOWN (Schedule G Attached?)
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
 712 325 5141 P-1213/015
05 :10 PEOPLES NATL BANK 333BDLJY
SEP-18 - 2003

For Instructions, See Back of Form SCHEDULE

CONTRIBUTIONS -- MONEY TAKEN IN A MONETARY

(Rev. 07/03) RECEIPTS
(Including cendldale's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

06W1 f) r rr-6 -1; )P

/)W) e p" INS

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 10 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#

q .3.o3 CK# tanj fT~Wvzj57)> Ct~raul3~c~7~1.5 N~' gS°4

ID#

s 0
4-t1-o3 CK# uN ITze-mlzsz)
C - ~s
s Is~ a~
ID#

-ti-o3 cK# uN'"l2.4-,

I D#

_8 03 CK#

ID#

CK#

1D#

CK#

ID#

CK#

ID*

Co

ID#

CK#

CK#

SUB-TOTAL

TOTAL (if last page of this schedule)

° Disclosure law requires candidate committees to dlaclose 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 (hero is no Page - -I- Of __L_
familial relationship, enter - not applicable" in the relationship column . for Schedule A)
 712 325 5141 P- 0 4/05
PEOPLES NATL BPNK 333BDIA)Y
SEP-18 - 2003 05 :13

FOR INSTRUCTIONS, SEE BACK OF FORM

i~ SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY

(Rev. 07/03) EXPENDITURES
STATE PAC COMMITTEES : NOTE , FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA
D CHECK THIS BOX IF
AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .

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

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DDfYR) AND PAC
CHECK
NUMBER

4-9
.o3 ~sr
CK#
l~ " +ynR~><~wr - u s . PaY lls,~-x~ . ~ Sag $ 6S.a5
ID#

q_Q-P3 CK#
S As: O'tC -%

a-3 CK#
(U PA,Nr7i16
3"13 .ld 1
ID#
( C.aL~-+niS

I D# ~'
~,rn IGC .n~S /
y .> ,SIBS
bY. 18
CK# g f
vIC;m Srd z~ .C :~ "n
ID#
~c4:tIJ~
~ItcYrnc  JG' ~~sA~
Q -`}a3
'~
CK# - r
~NJ,-IN

CK#

CK#

SUB-TOTAL
at 130
TOTAL (if last page of this schedule) S
a-I 30 '

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 person slentltles 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/enthy on behalf of the candidate's committee. (Refer to
Schedule G Instructions and Iowa Code 68A .6(3)(i) )

Page _I _ of

(for Schedule 8)
 712 325 5141 P . 05i05
SEP-18-2003 05 : 19 PEOPLES NATL BANK, 333BDIWY

FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

E IN KIND
COMMITTEE NAME (Must bs same as on Statement of Organization) (Rev. 06/97) CONTRIBUTIONS

P/)M CaCLJ,8
O CHECK THIS BOX IF
AMENDING FORM
ZINI

DATE RELATIONSHIP DESCRIPTION ESTIMATED -V IF FOR

RECEIVED NAME AND ADDRESS TO CANDIDATE OF IN KIND FAIR MARKET FUND-RAISER

F7
(MMIDDIYR) OF CONTRIBUTOR ' (If a pricable) CONTRIBUTION VALUE CONTRIBUTION

PAM t.,Ou tr1 S

F-1 I
1,9 . .)3 -noc rjLV2j-0
sti "'O3

F7
F7
a
0
F7
0
TOTAL (if last
page of this
schedule)

'Disclosure law requires candidates to disclose the relationship of any relative making an In kind contribution to the Page I of
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 to the same as candidate, but there is no
famlllal relationship, enter 'not applicable' in the relationship column .