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No t i c eo f Di s s o l u t i o n

Ma i l t o:I ECDB5 1 0 E a s t1 2h, S u i t el ADe s Mo i n e s ,I o wa 5 0 3 1 9 I

COMMI TTEE NAME

WHEN TO F I L E:

Th e No t i c eo f D i s s o l u t i o nmu s t b e f i l e dw i t h i nt h i r t y( 3 0 )d a y s o f c o mp l e t i o no f a l lt h ef o l l o w i n g:

1 . A l ld e b t s ,l o an sa n d o b l i g a t i o n sh a v e b e e n p a i do r t r a n s f e r r e d;2 . A l lc a mp a i g n f u n ds ha v e b ee n s p e n t ;3 . A l lc a mp a i g np r o pe r t y s o l do r t r a n s f e r r e d( c a n d i d a t e so n l y ); a n d4 . A f i n a lr e p o r td i s c l o s i n ga l lt r a n s a c t i o n sc l o s i n gt h e c o mmi t t e e.

FORM ( R e v. 0 7 / 0 3 )

Fo r O f f i c eUs e On l y

DR- 3NOTI CEOF

DI SSOLUT I ON

Comm . #I n d e x e dAu d i t e d "Compu t e rC e r t i f i e dD a t eo fD i s s o l u t i o n

Fo r s t a t ec a nd i d at e sa n d s t a t ePACs , a f i n a lb a n k s t a t e me n tmu s t b e f i l e dw i t ht h e No t i c eo f D i s s o l u t i o no r a s s o o n a sp o s s i b l ei ft h e b an k s t a t e me n ti s n o t a v a i l a b l ea t t h e t i met he No t i c eo f D i s s o l u t i o ni s f i l e d.

' r eo f Ca n d i d a t eo r Tr e a s u r e r ( i fc a n d i d a t e ' sc o mmi t t e e ) / Si g na t u r eo f Ch a i r o r Tr e a s u r e r ( i fPAC)

Wo oDa t e Si g ne d

FOR I NSTRUCTI ONS, SEE BACK OF FORMTh i s f o r m i s n o t a p p l i c a b l et o s t a t u t o r yp o l i t i c a lc o mmi t t e e s.

H aw k e y eS t a t ePAC

O f f i c i a lName o f Co mmi t t e e

P . O. Bo x 3 0 2 1

S t r e e t

Si o u xC i t y ,I A 5 11 0 2

C i t y ,S t a t e ,Z i pCode

7 1 2 8 9 8 - 2 5 0 5

Ar e a Te l e p h o n eCod e

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FOR I NSTRUCTI ONS,SEE BACK OF FORM

DI SCLOSURE SUMMARY PAGE

COMMI TTEE NAME ( Mu s t b esame a s o n St a t e men t o fOr g a n i z a t i o n )

Hawkey eS t a t ePAC

I MPORTANT: I n d i c a t eb y #t y p eo fc o mmi t t e ey ou a r er e p o r t i n gf o r:(

1 2 11 ) S t a t e w i d e / L e g i s l a t i v e / J u d g eS t a n d i n gf o rR e t e n t i o nCa n d i d a t e( 2 ) S t a t ePAC ( 3 ) S t a t eP a r t y

( 4 ) C o u n t yC e n t r a lCommi t t e e( 5 ) C o u n t yCa n d i d a t e( 6 ) Ci t yCa n d i d a t e( 7 ) S c h o o lB o a r do rO t h e rP o l i t i c a lS u b d i v i s i o nCa n d i d a t e( 8 ) C o u n t yPAC ( 9 .~ C i t yPAC (_ 1 0 ) S c h o o lB o a r do rO t h e rP o l i t i c a l

S u b d i v i s i o nPAC ( 1 1 ) L o c a lB a l l o tI s s u e; ~ " , ' ..CANDI DATECOMMI TT EESONLY :

C a n d i d a t eName

, - iO f f i c eSo u g h t * r i c t( i fSe n a t eo rHouse )

P o l i t i c a lP a r t y( i fa p p l i c a b l e )

L a t er e p o r t sa r e s ub j e c tt o p o s s i b l ec i v i la n dc r i mi n a l p e n al t i e s. P u r s u a n tt o I o w aCod e s e c t i o n6 8 B. 3 2 A ( 7 )t h ec a n d i d a t e ,f o r ac a n d i d a t e ' sc o mmi t t e e ,a n d t h ec h a i r p e r s o n ,f o ra n yo t h e rt y p eo f c o mmi t t e e ,i s t h ei n d i v i d u a lr ul e f o rf i l i n g I d I m e ly a n d ac c u r a t er e p o r t s.

I AM F I L I N GA Ma y 1 9 ,2 0 0 6

( r e p o r td a t e ) I n d i c a t eb y #

CHECKI FAMENDMENT TO REPORTDATED

Che c k i ft h i si sf i n a l( t e r mi n a t i o n ) r e p o r ta n d a t t a c hN o t i c eo fD i s s o l u t i o nF or mDR- 3.( Yo umust c o n t i n u et o f i l er e p o r t su n t i la DR- 3 i sf i l e d. )

TELEPHONE DATES I NED

REPORT FOR( 1 )ELECTI ON/ ( 2 ) NON- ELECTI ONYEAR.

FORM

DR- 2 I DI SCLOSURE( R e v. 1 2 / 2 0 0 5 ) REPORT

F o rO f f i c eUs e On l yComm . #

Log g e d I n

S c a n n e d

Compu t e r

A u d i t e d

F i l ew i t h:I o waE t h i c sa n dCampa i gnD i s c l o s u r eB o ar d5 1 0E . 1 2 " ' ,S t e. 1 ADes Mo i n e s ,I o wa5 0 3 1 9Fa x: 5 1 5 - 2 8 1 - 3 7 0 1

L o c a lCo mmi t t e e s ,e n t e rD a t eo f E l e c t i o n

Co un t y &L o c a lCo mmi t t e e s ,e n t e rCo u n t yi nw h i c hE l e c t i o ni s h e l d

" * UNPAI DB I L L S( F r o mS c h e d u l eD - A t t a c hSc h e d u l eD) . . ... . . . . ... . . . .. .. . . .. .. . . . ... . . . ... . . . .. .. ,. .. ,. . . ... . . . . . .. . . , . $

I N KI NDCONTRI BUTI ONS( F r o m Sc h ed u l eE - A t t a c hS c h e d u l eE ) . ... . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . .. . . . . . . . . . . . . . . . . . . .. _ ,. .. ,. $

" * OUTSTANDI NGLOANS( F r o mS c h e d u l eF - A t t a c hSc h e d ul eF ) . . . ... . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . .. . . . . . . . . . . . . ... . . .. $

CONSULTANTBREAKDOWN ( Sc h ed u l eG A t t a c h e d ? ) YES NO

CANDI DATECOMMI TTEESONLY :

VALUE OF CAMPAI GNPROPERTY( F r omS c h e d u l eH - A t t a c hS c he d u l eH)

STATE COMMI TT EES: Su bmi t ar e c o n c i l e dc amp a i g n a c c o u n tb a n k s t a t e m e n ti nJ a n u a r yo fe a c h y e a r.

STATEMENT OF CASH ON HANDCASH ON HAND a t t h eb e g i n n i n go f t h er e p o r t i n gp e r i o d. ( T o t a lo fa l lf u n d sh e l db y t h e

c o mmi t t e e. T h i samou n t MUST b e t h esame a s t h ec a s h o n h a n d a t t h ee n do f t h el a s tr e po r t i n g p e r i o d o rmust b e z e r oi ft h i si s f i r s tr e p o r tf i l e d. ) . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ 0 . 0 0

ADD TOTALMONEY TAKENI NTHI SPERI OD

S c he d u l eA : Cash C o n t r i b u t i o n st o t a l( A t t a c hSc h e d ul eA) ( ' a l s os e e i n - k i n db e l o w). ... . . ... . . .. .. . . . . . . . . . . 1 00 . 0 0

Sc he du l e F: Lo a n s Re c e i v e dt o t a l( A t t a c hSc h e d u l e F ). . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . ... . .. ,. . . . . .

S c he d u l eH: T o t a lS a l e so f Camp a i g n P r o p e r t y( A t t a c hSc h ed u l e H). . . . . . . . . ... . . . .. .. . . .. .. . . ... . . . . . . . . . . . . . . . . . . . . .

( Sc h ed u l eH a pp l i e st o Ca n di d a t e s ' Commi t t e e sOn l y )

SUB- TOTAL.. . . . . .. . . . . .. . . . .. . . . .$ 1 0 0. 0 0SUBTRACT TOTALMONEY SPENTTHI SPERI OD

Sc h e d u l e B: E x p e n d i t u r e st o t a l( A t t a c hSc h e d u l e B) ( " a l s os e e d e b t sa n d l o a n s b e l o w). . . . . . . . ... . . .. .. . 1 0 0. 0 0

Sc he du l e F: Lo a n Rep a y men t st o t a l( A t t a c hSc h e d ul eF ). . . . . .. . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . .. ,. . ... . . . ... . . . . . . .

CASH ON HAND a t t h ee n d o f t h i sr e p o r t i n gp e r i o d( i ff i n a lr e p o r tb a l a n c emust 0 . 0 0b e z e r o ) ( A t t a c hDR- 3 ). . . . . ... . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . .... . . .. . . . . . . . . . . . . . . . . . ... . . .. .. . . ... . . . . . . . . . . . . . . . ... $

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Fo r I n s t r u c t i on s , Se e B a c k of Fo r m

CONTRI BUTI ONS - - MONEY TAKEN I N( I n c l u d i n gc a n d i d a t e ' s p e r s o n a l f u n d s )

COMMI TTEE NAME ( Mu s t b es ame a s on St a t e me n to f Or g a n i z a t i o n )

Hawkeye S t a t ePAC

SCHEDULE

A MONETARY( Re v. 0 7 / 1 0 3 )I RECEI PTS

CHECK THI SBOX I FAMENDI NGFORM

STATE CANDI DATES NOTE : I FA CONTRI BUTI ONI SRECEI VEDFROM A STATE PAC ( POL I T I CALACTI ONCOMMI TTEE) ,L I S TTHE PAC I DENTI F I CATI ONNUMBER AND THE PAC CHECK NUMBER I NTHE DESI GNATEDCOLUMN . A L I STOF I DNUMBERS I SAVAI LABLEFROM THE I OWAETHI CSAND CAMPAI GNDI SCLOSUREBOARD .

NOTE: ANY PERSON, OTHER THAN ANI N DI V I D UA L ,THATCONTRI BUTESMORE THAN $ 7 5 0TO YOUR CAMPAI GNMAY HAVE F I L I N GRESPONSI BI L I T I ESAND SHOULD I MMEDI ATELYCONTACT THE BOARD .

CAUTI ON: S e c t i o n6 8 B. 3 2 A ( 6 ) ,p r o h i b i t st h eu s e o f i n f o r ma t i o nc o pi e df r o mr e p o r t sa n d s t a t e me n t sf o r s o l i c i t i n gc o n t r i b u t i o n so r f o ra n yc omme r c i a lp u r p o s e b y a n y p e r s o n o t h e rt h a ns t a t u t o r yp o l i t i c a lc ommi t t e e s.

SUB- TOTAL

TOTAL ( i fl a s tp a g e o f t h i ss c h ed u l e )

*D i s c l o s u r el a wr e q u i r e sc a n d i d a t ec o mmi t t e e st o d i s c l o s et h er e l a t i o n s h i p o fa n yr e l a t i v ema k i n ga c o n t r i b u t i o nt ot h ec o m m i t t e e. R e l a t i o n s h i pm u s tb e s h ownt o t h et h i r dd e g r e eo f c o n s a n g u i n i t y( b l o o dr e l a t i v e s )a n da f f i n i t y( r e l a t i v e sb yma r r i a g e ). I fs u r n ameo f c o n t r i b u t o ri s t h es ame a s c a n d i d a t e ,b u tt h e r ei sn o Page 1 of _ 1f a mi l i a l r e l a t i o n s h i p ,e n t e r" n o ta p p l i c a b l e "i n t h er e l a t i o n s h i pc o l umn. ( f o rSc h e d ul e)

DATE PAC I DNUMBER NAME ANDADDRESS OF CONTRI BUTOR REL ATI ONSHI P AMOUNT I FFORRECEI VED ( i fa p p l i c a b l e ) TOCANDI DATE* RECEI VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i fa p p l i c a b l e ) RAI SE

NUMBERI NCOM

I D#

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THI S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY :

P ur c h a s e s o f c e r t a i nc a mp a i g np r o p e r t yc o s t i n g$ 5 0 0 o r mo r e mus t a l s ob e i n v e n t o r i e do n Sc h e d u l e H . ( R e f e rt o Sc h e d u l e H i n s t r u c t i o n s. )

E x pe nd i t u r e st o p e r s o n s / e n t i t i e sp r o v i d i n gc on s ul t i n g , a d v e r t i s i n g ,f u n d - r a i s i n g ,p o l l i n g ,ma n a g i n g , o r g a ni z i n g s e r v i c e smus t a l s o b ed e t a i li t e mi z e do nSc h e d u l eG b y t h e amo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x pe nd i t u r emad e b y t h e p e r s o n / e n t i t yo n b e h a l fo f t h e c an di d at e ' sc o mmi t t e e. ( Re f e rt oSc h e d u l eG i n s t r uc t i o n sa n d I owa Code 6 8A . 4 0 2 ( 3 ) ( i ). )

( f o rSc h e d u l e B)

FOR I NSTRUCTI ONS, SEE BACK OF FORM Res et F o r m SCHEDULE

EXPENDI TURES - - MONEY SPENT FROM COMMI TTEE ACCOUNT B MONETARY( Re v. 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLATI VECANDI DATES,LI STTHE CANDI DATE I DENT I F I CATI ONNUMBER I NTHE DESI GNATED COLUMN AND THE CHECK THI SBOX I FPACCHECK NUMBER FOR EACH EXPENDI TURE . A LI ST OF I DNUMBERS I SAVAI LABLEFROM THE I OWA AMENDI NGFORMETHI CS& CAMPAI GN DI SCLOSURE BOARD .

COMMI TTE ENAME ( Mus t b e s a me a s o n St a t eme n t o f Or g a n i z a t i o n )Hawkeye St a t e PAC

CANDI DATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNTDATE I DNUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED

EXPENDED ( i fa p p l i c a b l e ) ( Di s b u r s e me n t )WAS MADE( MM/ DD/ YR) AND PAC

CHECKNUMBER

I D#Ha r l a nd Chec k s Chec k s

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0 5/ 0 5/ 0 6 CK# 15012 4 1 7 S Sa i n t Au b i n St . $ 0 . 4 0 p e r mi l e = $ 7 9 . 2 0 7 9 . 2 0Si o u xC i t y ,I A 5 1 1 0 6

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