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FOR i , NSTRUCT I ONS, SEE BACKOFF ' M

DI SCLOSURE SUMMARY PAGECOMMI TTEE NAME ( Mu s t b e s ame a s o n St a t eme n t o f O r g a n i z a t i ,' C i C 3 S z 0 Fo g S E t - J A t CI MPORTANT : I n d i c a t e t y p e o f c o mmi t t e e y ou a r e r e por t i n g f o r : a( 1 ) S t a t e w i d e / L e g i s l a t i v e Ca n d i d a t e ( 2 ) S t a t e wi d e PAC ( 3 ) S t a t e P a r t y ( 4 ) Co un t y / L oc a l Ca n d i d a t e( 5 ) Cou n t y PAC ( 6 ) B a l l o t I s s u e / Fr a n c hi s e Commi t t e e ( 7 ) C o u n t y / C i t y Ce n t r a l Commi t t e e( ) k ' j S Z V p o r t Sa t e o f Ca n d i d a t e s

l ( 7 1 2 - )ATUREOF TREASURER ( o r p e r s o n f i l i n g t h i s r e p o r t ) TELEPHONEP e n a l t i e s Du e Fo r L a t e F i l e d Re p or t s Ra n ge f r o m $ 1 0 t o $ 4 0 0

SEE I NSTRUCTI ONS ON BACK AND COMPLETE THE FOL LOWI NGSENTENCE :I AMF I L I NGA J i 4 # J I Ur 4 Ry ZZ I Zc~o Z. _

( r e p o r t d a t e )

MCHECK I F AMENDMENT TOREPORT DATED

pC h e c k i f t h i s i s f i n a l ( t e r m i n a t i o n ) r e p o r t a n d a t t a c h N o t i c e o f D i s s o l u t i o n Fo r m DR- 3 .( Y o u mus t c o n t i n u e t o f i l e r e p o r t s u n t i l a N o t i c e o f D i s s o l u t i o n i s f i l e d . )

REPORT FORAN/ A ( 1 ) ELECT I ON / ( 2 ) NON- EL ECT I ON YEAR.

STATEMENT OF CASH ON HAND

I n d i c a t e on e

CASH ON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d . ( T h i s i s t h e t o t a lo f a l l mo n i e s h e l d b y t h e c ommi t t e e . T h i s amoun t MUST b e t h es ame a s t h e c a s h on h an d a t t h e e n d o f t h e l a s t r e p o r t i n g p e r i o d , 4 0o r mus t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ bADD TOTAL MONEY TAKEN I N THI S PERI ODSc h e du l e A: Cas h C o n t r i b u t i o n s t o t a l ( A t t a c h Sc h e du l e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e du l e C: F u n d - r a i s i n g Ev e n t s t o t a l ( A t t a c h Sc h e du l e C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e du l e F : L o a n s Re c e i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e du l e H : T o t a l Sa l e s o f Campa i gn P r o p e r t y ( A t t a c h Sc h e du l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h ed u l e H a pp l i e s t o Ca n di d at e s ' Commi t t e e s On l y )SUB- TOTAL . . . . . $

SUBTRACT TOTAL MONEYSPENT T HI S PERI ODSc h e du l e B : E x p e n d i t u r e s t o t a l ( A t t a c h Sc h e du l e B ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e du l e F : Loa n Re p a yme n t s t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON HAND a t t h e e n d o f t h i s r e p o r t i n g p e r i o d ( i f f i n a l r e p o r t , b a l a n c e mus tb e z e r o ) ( A t t a c h DR- 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

UNPAI D BI L L S ( Fr om Sc h e du l e D - A t t a c h Sc h e du l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $I N KI NDCONTRI BUTI ONS ( Fr om Sc h e d u l e E - A t t a c h Sc h e du l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $OUTSTANDI NG LOANS ( Fr om Sc h e du l e F - A t t a c h Sc h e du l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI TTEES ONLY :CONSUL TANT BREAKDOWN ( S c h e d u l e GA t t a c h e d ? )VALUEOF CAMPAI GN PROPERTY ( Fr om Sc h e du l e H - A t t a c h Sc h e du l e H )

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L o c a l Commi t t e e s , e n t e r Da t e o f E l e c t i o n

Co u n t y & L o c a l Commi t t e e s , e n t e r Co u n t y i nwh i c h E l e c t i o n i s h e l d

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Fo r I n s t r u c t i o ns , Se e Ba c k o f FoCONTRI BUTI ONS - MONEYTAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEENAME ( Mu s t b e s ame as o n St a t e men t o f Or g an i z at i o n )

KL~. r 3 SZ c r FORL S ~ - _w. o _ cSTATECANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROMASTATE PAC( P OL I T I CA L ACT I ON COMMI TTEE) , L I STTHEPACI DEN71F I CAT I ONNUMBERANDTHEPACCHECKNUMBER I N THEDESI GNATED COLUMN. AUSTOF I D NUMBERS I S AVA I L A BL E FROMTHEI OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68 B . 3 2 A ( 6 ) , I o wa Co d e, p r o h i b i t s t h e u s e o f i n f o r mat i o n c o p i ed f r o m r e p o r t s an d s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o nf o r a n y c o mme r c i a l p u r p o s e b y an y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e es .

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' D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f an y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p mus t be s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) ( S ee Page 2 o f f o r ms p a c k e t . ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s ame as c a n d i d a t e , b u t t h e r e i s n of 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 t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn .

SUB- TOTAL

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F o r I n s t r u c t i o n s , Se e Back o f F oCONTRI BUTI ONS - MONEY TAKEN I N

( I n c l u d i n g c 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 e s ame a s o n S t a t e me nt o f Or g an i z at i on )K. L3SzL r - 0 , 2 s t =A1 . o - c

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I C A L ACTI ON COMMI T T E E ) , UST THE PAC I DENTI F I CATI ONNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE F ROM T HE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON : Se c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Cod e , p r o h i b i t s t h e u s e o f i n f o r mat i on c op i e d f r o m r e p o r t s and s t a t e m e n t s f o r s o l i c i t i n g c o n t r i b u t i o n sf o r a n y c omme r c i a l p u r p o s e b y any p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c ommi t t e e s .

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4/15

F o r I n s t r u c t i o n s , S e e B a c k o f F cCONTRI BUT I ONS - MONEY TAKEN I N( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TT EE NAME ( M u s t b e s a m e a s o n S t a t e m e n t o f O r g a n i z a t i o n )

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Fo r I n s t r u c t i o n s , Se e Ba c k o f FcCONTRI BUTI ONS - MONEYTAKEN I N

( I n c l u d i n g c 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 e s ame as o n St a t emen t o f Or g an i z a t i o n )K. . i l 3 S= C. Fa i 2 SA1 . 4 i ' & - - -

l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f an y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h emi t t e e . R e l a t i o n s h i p mu s t be s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) an d a f f i n i t y ( r e l a t i v e s b ya r r i a g e ) ( S ee Page 2 o f f o r ms p a c k e t . ) . I f s u mame o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n oi l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u mn .

SCHEDULEA MONETAR

( Re v . 0 2 1 9 6 ) RECEI PT1 7 CHECK T HI S BOXAMENDI NG FORM

STATE CANDI DATES NOTE: I F A CONTRI BUT I ON I S RECEI VED FROMA STATEc c PAC ( P OL I T I CA L ACT I ON COMMI TTEE) , L I ST THEPAC I DENT I F I CA TI ONNUMBER AND THE PAC CHECK NUMBER I N THEDESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I L AB LE FROMTHE I OWA = i HI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON : Sec t i o n 68B . 3 2 A ( 6 ) , I o wa Co d e, p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o p i ed f r o m r e p o r t s an d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n sf o r a n y c o mme r c i a l p u r p o s e by an y p er s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e es .

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( I n c l u d i n g c an d i d at e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t b e s ame as o n St a t e me n t o f Or g an i z a t i o n )XT70 0 1 : 0 F 0 i 2 s E. v . o - F c

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a r r i a ge ) ( Se e Pag e 2 o f f o r ms p a c k e t . ) . I f sur name o f c on t r i b u t o r i s t h e s ame as c a nd i d at e , b u t t h e r e i s n or e l a t i o ns h i p , e n t e r ' n ot ap pl i c ab l e ' i n t h e r e l a t i o n s h i p c o l u mn .P a g e ' 5- o f

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F o r I n s t r u c t i o n s , S e e B a c k o f F cCONTRI BUTI ONS - MONEYTAKEN I N

( I n c l u d i n g c 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 e s ame a s o n S t a t e me n t o f Or g ani z a t i on)

1~c~ 1 ~Et ~ _i ~ } S130I D " 0 y ~ vc K# 2 . ~ 3 8 - Z.~. / s r ST/ D3 0 - D/ / y l z ~ r - o r 2 D ~ ' ~l 3 S /I D# / f f , , Q . , , Q / ~ I 4 SS , y l L SSL 3 ~c K#I D#

/ CK# r ? o , f 3o x S' / l ~ l ~ ~D- 3D- OJ v . v s Sdsi l


8/15

For I n s t r u c t i o n s , Se e B a c k o f F L . .CONTRI BUTI ONS - MONEY TAKEN I N

( I n c l u d i n g c 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 e s ame a s o n S t a t e me n t o f Or g an i z a t i o n)

1


9/15

FOR I NSTRUCTI ONS, SEEBACK OFFORMEXPENDI TURES - - MONEY SPENT FROMCOMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE: FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L EGI SLATI V ECANDI DATES, L I ST THE CANDI DATE I DENTI FI CATI ON NUMBER I N THE DESI GNATEDCOLUMN AND THEPAC CHECK NUMBERFOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S A VA I L A BL E FROMTHE I OWAETHI CS & CAMPAI GN DI SCL OSURE BOARD .COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t eme n t o f Or g an i z a t i o n )

DATEEXPENDED( MM/ DD/ YR)

/ - mo oa ~

CANDI DATE .I D NUMBER( i f a p p l i c a b l e ) ,AND PACCHECK NUMBER

CK#ST4/ 0 G. 1 9 " $ s~A i j e

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1 ~ 1 2 - Ga /I D#CK#I D*c K#

NAME AND ADDRESS TOWHOMEXPENDI TURE PURPOSE AMOUNT( Di s b u r s e me nt ) WASMADE ( CANDI DATES SEE EXPENDED

BELOW&ENTER1 , 2 . 3 )

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I S BOX A PP L I E S TO CANDI DATES' COMMI TTEE S ONLY :a mp a i g n f u n d s may b e u s e d o n l y f o r1 ) c a mp a i g n p u r p o s e s ,2 ) c o ns t i t u en c y ex pen s es , a n d3 ) e d u c a t i o n a l a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .l e as e i n s e r t t h e a p p l i c a b l e n umbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x pe n d i t u r e .u r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $5 0 0 o r mo r e mu s t a l s o be i n v e n t o r i e d o n Sc h e d u l e H . ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )x p en d i t u r e s t o p er s o n s e n t i t i e s p r o v i d i n g c o n s u l 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 n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l i t e m i z e d o nc h e d u l e G by 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 p e n d i t u r e made by t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( Re f e r t oc h e d u l e G i n s t r u c t i o n s a n d I o wa Code 5 6 . 6 ( 3 ) 0 . )

Page / -o f~_, - _ ( f o r Sc h e d u l e B)

SCHEDULEB MONETARY( R e v . 0 2 / 9 6 ) EXPENDI TUR

7 E CHECK THI S BOX I FAMENDI NGFORM


10/15


11/15

FORI NSTRUCTI ONS, SEEBACK OF FORMEXPENDI TURES - MONEY SPENT FROM COMMI TT EE ACCOUNT

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L EGI S L AT I V ECANDI DATES, L I ST THE CANDI DATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVA I L A B L E FROM THE I OWAETHI CS & CAMPAI GN DI SCLOSURE BOARD.COMMI TTEE NAME( Mu s t b e s ame a s o n S t a t eme n t o f Or g an i z a t i o n )

CANDI DATEDATE I D NUMBEREXPENDED ( i f a p p l i c a b l e ) .( MM/ DD / YR) AND PACCHECK NUMBERZ - d o ' d ' > ! I D#

CK#f [ ) *C K#

I D#c K#1 0 #C K#

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hh ; d6 AP e , ; Z~4 So S' ' 8 k 31 D#CK# f ? l > , / 3 o X / S~" G o G, , . ~

NAME ANDADDRESS TOWHOMEXPENDI TURE PURPOSE AMOUNT( Di s b ur s eme n t ) WASMADE ( CANDI DATES SEE EXPENDEDBELOWi ENTER

1 2 , 3 )

.D~ t J - Zoao C* A4p,1Hr c - q6EF- D . a y , 1 Ql n l z , o i o \ 1 0s * - f s * ~ e~s j 3 u . e 6 ~ s ~4 6 _05 ~ '3G 3~ I ) S 9 7 o 2 3p?O. wo k / Z6r s o o w , 7l ? D. ~o . YX~ , ~ u . G ' . c 3 ) ~ o33

0 6- 1 1 A l C_ ; qH~~GI l l

, 4 4 h 6.41STd ? ~ s n l o : . . e s , ~A So39~.

t f f - -A ) . t VC v A ) A-- ( 3 ) 3s

SU6- TOTAL [ $393yS(eTOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) 1 $

I S BOX APPLI ES TO CANDI DATES ' COMMI TTEES ONLY:p a i g n f u n ds may b e u s ed o n l y f o r .c a mp a i g n p u r p o s e s ,c o n s d h : e r c y ex pen s es , an de d uc at i o n al an d o t h er e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .s e i n s e t , t h e a p p l i c a b l e numbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x p e n di t u r e _

c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e must a l s o be i n v e nt o r i e d o n Sc hed ul e H _ ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )n d i t u r e s t o p er s o n s e n t i t i e s p r o v i d i n g c o n s u l 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 , mana g i n g , o r g a n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l i t e m i z e d o n

l e G by ' 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 p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mm i t t e e . ( R e f e r t od u l e G i n s ' - u d i c ns an d I o wa Code 5 6 . 6 ( 3 ) ( 1 ) . )

. - v l f a r Sc h e d u l e Bl

SCHEDULEB MONETARY

( R e v . 0 2 / 9 6 ) EXPENDI TURE

L CHECK T HI S BOX I FAMENDI NGFORM


12/15

FORI NSTRUCTI ONS, SEE BACK OF FORMEXPENDI TURES - - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E GI S L AT I V ECANDI DATES . L I ST THE C A NDI DA T E I DE NT I F I C AT I ON NUMBER I N T HE DESI GNATED COLUMN AND T HEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF I D NUMBERS I S A VA I L A B L E FROMTHE I OWAET HI CS & CAMPAI GN DI SCLOSURE BOARD .COMMI TT EE NAME ( Mu s t b e s a me a s o n St a t e me n t o f Or g a n i z a d o n )

/ f / , : t rCANDI DATEDATE I D NUMBEREXPENDED ( i f a p p l i c ab l e ) ,

( MM/ DD/ YR) AND PACCHECK NUMBER

Oo7a2 Ol

1 D*CK#1 D#CK#I D#CK#

I D#CK#1 D#CK#

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NAME AND ADDRESS TOWHOMEXPENDI TURE PURPOSE( Di s b u r s e me n t ) WASMADE ( CANDI DA TE S SE EBELOW& E NTE R

1 , 2 , 3 )

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Cs ~ - r . - ~ e o~~L r v t ~ . ~ Sl > 3 ' 3 r ! o( ~ / Y I I ~ Y l ~7~; L " r / T~ L I i l. 1 9 0 .

t > . . ~O X 73C~s . - r t ~ s ~ u ~ ' . SOS3 t oN, c j . ~W- r e i 2 ~F7 9 t J e - sPo . , ~ ' o x c ) 6 4 .H i 4 - d e i - o c / c , Z ^ r 4 SS4 tk ~ Z WI n - 0 Sq ( ; , L - OCL e S 7 -f o e s f ~1p ; . W e - C - - 2 r --A so309

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AMOUNTEXPENDED

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393

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TOTAL ( i f l a s t page o f t h i s s c h e du l e ) 1 $

I S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY :p a i g n f u n d s may b e u s e d o n l y f o r .c a mp a i g n p u r p o s e s ,c o ns t i t u en c y e x p e n s e s , a n d

e d uc a t i o n al a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .i n s e r t t h e a p p l i c a b l e n u m b e r i n t h e p u r p o s e c o l u mn f o r e a c h e xp en d i t u r e .

SCHEDULEB MONETARY

( R e v . 0 2 / 9 6 ) I EXPENDI TURF 1 CHECK T HI S BOX I F

AMENDI NGFORM

c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mu s t a l s o b e i n v e nt o r i e d o n Sc h ed u l e H . ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l 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 n i z i n g s e r v i c e s mu s t a l s o b e d e t a i l i t e m i z e d o ne G b y t h e a mo 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 p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o m m i t t e e . ( Re f e r t oe Gi n s t r u c t i o n s a n d I o wa C o d e 5 6 . 6 ( 3 ) 0 . )

P a ge o f_ ( f o r Sc h e d u l e B)


13/15

FOR I NSTRUCTI ONS, SEE BACK OFFORMEXPENDI TURES - - MONEY SPENT FROMCOMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO ST ATEMDE OR LEGI S L AT I VECANDI DATES . L I ST THE CANDI DATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWAETHI CS & CAMPAI GN DI SCLOSURE BOARD .rCOMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e men t o f Of g a n i z a So n )

. z ao / I D#CK#

9~ - , o f9 - 2 7 - 0 1

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2 Z - / - 0 - / D ST.A" e - 7 4~i 01 4 o A, 4 4 9 , 5' 3 d o~ ' - Pr e= ~~ o j q ; & e Sk pp l 59i 8 , 8. -4 o. F~ r u m y

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AMOUNTEXPENDED

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I S BOX APPLI ES TOCANDI DATES' COMMI TTE) = S ONLY :p a i g n f u nd s may be u s e d o n l y f o r .c amp a i g n p u r p o s e s ,c o ns t i t uen c y e x p e n s e s , an de d uc a t i o n al an d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .s e i n s e r t t h e a p p l i c a b l e number i n t h e p u r p o s e c o l umn f o r e a c h e x p e n d i t u r e _

SCHEDULEB MONETARY

( R e v . 0 2 / 9 6 ) I EXPENDI TURE

QCHECK THI S BOX I FAMENDI NGFORM

s es o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mu s t a l s o be i n v en t o r i ed o n Sc h e d ul e H . ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l 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 f n g , manag i n g , o r g a n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l i t e m i z e d o nl e G b y t h e amo u n t , p u r p o s e , an d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mm i t t e e . ( Re f e r t od u l e G i n s t r u c t i o n s a n d I o wa Co de 5 6 . 6 ( 3 ) 0 . )

P a g e S_ o f- r f f o r Sc h e d ul e 1 3 1

CANDI DATE . NAME AND ADDRESS TOWHOMEXPENDI TURE PURPOSEDATE I D NUMBER ( D i s b u r s e m e n t ) WASMADE ( CANDI DATES SEEEXPENDED ( i f a p p l i c a b l e ) , BELOW& ENTER( MMI DD/ YR) AND PAC 1 , 2 , 3 )CHECK NUMBER


14/15


15/15

FORhVSTRUCTI ONS, SEE BACK OF FORM

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO S T A T EiWOEOR LEGI S L AT I VECANDI CAES, L I ST THE CANDI DATE I D ENT I F I CA T I O N NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S A VA I L A BL E FROM THE I OWAETHI CS 3 CAMPAI GN DI SCLOSURE BOARD .COMM1 1i EE NAME ( Mu s t b e same a s o n S t a t e me n t o f Or g an i z a t i o n )

zoo tZ~o- o!

EXPENDI TURES - - MONEY SPENT FROM COMMI TTEE ACCOUNT

I C

1 0 1 1 "CKI D#

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S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY:p a i g n f u n ds may b e u s e d o n l y f o r .p a i g n , ; ; u . , , c s e s ,: e r . c r e x p e n s e s , a n du c at i o n al a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .

G! , S ~~: S i P v r 4 S-1 7 9 ' 2 - 6 e .Z2i o-~a3 s ~~ J SoS36 L ~ t ~ . )EDc0Fr - . = e . . ~ suAPG sPAP( ~ )Az a

POSTA c o oK~ ~. f ~ OST" y L I ~ S y G/ z - -ZZ~ D- l O ~ . STWELLS FA26o 8 A- A) k -1 1 0 1 BI ' O4DW. 4 L JEN~l M~TS t 3 u 2 ~ , ~ A - - SD~~ 3 6

i n s e r t : : : e a pp f i c ab l e numbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x pe nd i t u r e -

SUE- TOTAL

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c f .: e ^ . a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mu s t a l s o b e i r r v emo r i e d o n Sc h e d ul e H . ( R e f e r t o S c ~ : e d u l e H i n s t r u c t i o n s . )

AMOUNTEXPENDED

i o n ' - /

47

s Z~; S

; c ; : e r s c n s / e n t i t i e s p r o v i d i n g c o n s u l 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 n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l i t e m i z e d o nG b y : . ` e a mo 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 p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( Re f e r t o

SCHEDULEB MONETARY

( R e v . 0 2 / 9 6 ) EXPENDI TURF E CHECK THI S BOX I F

AMENDI NGFORM

CANDI DATE . NAME AND ADDRESS TOWHOMEXPENDI TURE PURPOSEDA-1 = I D NUMBER ( Di s b ur s e me n t ) WASMADE ( CANDI DATES SEEEXPENCED ( i f a p p l i c a b l e ) . BELOW& ENTER( MMI DC/ YR) AND PAC 1 , 2 , 3 )CHECK NUMBER

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