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FOR I NSTRUCTI ONS, SEE BACK OF FORM

DI SCLOSURE SUMMARY PAGEJ AN 1 4 2 0 0 2COMMI TTEE NAM Mus t b e s ame a s o n S t a t e me n t o f O r g a n i z a t i o n )

CUS ' QI MPORTANT : I n d i c at e t y p e o f c o mmi t t e e y ou ar e r e por t i n g f o r . 0 1( 1 ) S t a t e w i d e / L e g i s l a t i v e C a n d i d a t e ( 2 ) S t a t e w i d e PAC ( 3 ) S t a t e P a r t y ( 4 ) C o u n t y / L o c a l C a n d i d a t e( 5 ) C o u n t y PAC ( 8 ) B a l l o t I s s u e / F r a n c h i s e C o mm i t t e e ( 7 ) C o u n t y / C i t y C e n t r a l C o mmi t t e e( 8 ) S up p or t S l a t e o f C a n d i d a t e sSI GNATURE OF T

FORMDR- 2( R e v . 0 1 / 9 8 ) DI SCLOSUREREPORTFo r O f f i c e Us * On l yComm . S .I n d e x e d4 u d i t e dC o mp u t e r

DATE I GNEDSURER ( o r p e r s o n f i l i n g t h i s r e p o r t )

SEE I NSTRUCTI ONS ON BACKAND COMPLETE THE FOLL OWI NG SENTENCE :- 1 9 - 0 L - . _I AMF I L I NG A REPORT FORAN/ A ( 1 ) ELECT I ON / ( 2 ) NON- EL ECT I ON YEAR.

^ '( r e p o r t d a t e ) I n d i c a t e o n eOCHECK I F AMENDMENT TO REPORT DATED

TEL EPHONE

Rou t i n e Pe n a l t i e s Du e F o r L a t e F i l e d Rep or t s R a n g e f r o m $ 2 0 t o $ 8 0 0

0Che 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 an 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 F or m DR- 3 .( Y o u mu s 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 . )

STATEMENT OF CASH ON HANDCASH 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 mon i e s h e l d b y t h e c o mmi t t e e. T h i s amou n t MUST b e t h es ame a s t h e l as h o n h a n d a t t h e en 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 , ~o 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADD TOTAL MONEY TAKEN I N T HI S PER I OD /Sc h ed u l e A: Cash C o n t r i b u t i o n s t o t a l A t t a c h S c h e d u l e ASc h ed u 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 S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h ed u l e H : T o t a l S al e s o f Campa i g n P r o p e r t y ( A t t a c h Sc h ed u l e H ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . O

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

SUBTRACT TOTAL MONEY SPENT T HI S PER I ODSc h ed u 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 d u l e B ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h ed u l e F : Loan Repa y men t s t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON HAND a t t h e en 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 m u s tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

L o c a l C o mmi t t e e s , e n t e r D a t e o f E l e c t i o nC o u n t y & L o c a l C o mm i t t e e s , e n t e r C o u n t yw h i c h E l e c t i o n i s h e l l

, 5 ' 4 0 . 3 05 0 , O4: 2

0 1 1 0 0

UNPA I D BI L L S ( F r o m Sc h ed u l e D - A t t a c h Sc h e d u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ O~ DUI N K I ND CONTRI BUTI ONS ( F r o m S c he du l e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . $ ' aOOUTSTANDI NG LOANS ( F r om S c hed u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0100CANDI DATE COMMI TTEES ONLY :CONSUL TANT BREAKDOWN ( S c h ed u l e G A t t a c h e d ? ) YES NOVALUE OF CAMPAI GN PROPERTY ( F r o m Sc h e d u l e H - A t t a c h S c he du l e H ) $ Om O d

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F o r I n s t r u c t i o n s , Se e B a c k o f F o r t hC ON T RI B UT I ONS - MON EY T ) , : N I N

( I n c l u d i n g c a n d i d a t e ' s p w e o n e l I t , r r d h )COMMI TTEE NA ME ( M u s t b e same a s o n Sf &n a Wo f O r p s n i z e d c n )

STATE CAND I DATES NOTE : I F A C ON T RI B UT I O N I S R E CE I V E D FROMA S T A T E PA C ( P O L I T I C A L A C T I O N C OMMI T T E E ) , L I S T THEPAC I D E NT I F I C A T I ONNUMBER AND THE PAC CHECK NUMBER I N THE D E S I G NA T E D COL UMN . A UST OF I D NUMBERS I S A V A I L A B L E FROM T HE I O WA E T H I C S AND CAMPAI GNDI SCL OSURE BOARD

CAUT I ON : S e c t i o n 6 8 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 m a t i o n c o p i e d f r o m r e p o r t s a n 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 n sf o r a n y c o m m e r c i a l p u r p o s e b y a n 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 mm i t t e e s .

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 mm i 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 a n y r e l a t i v e m a k i n g a c o n t r i b u t i o n t o t h ec o m m i t t e e . R e l a t i o n s h i p m u s t b e 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 r q 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 ym a r r i a g e ) ( S e e P a g e 2 o f f o r m s p a c k e t . ) . I f s u r n a me o f o o n b t b u t o r i s t h e same a $ c a n d i d a t e , b u t t h e r e i s n of a m i 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 m n .

SCHEDUL EMONETARY( R e v . 0W97 ) RECEI PTS0 CHECK T HI S BOXAMENDI NG FORM

P a g e -o f /( f o r S c h e d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSH I P AMOUNT qRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RNUMBER I

v s / a i 4e o g zCK#I D s r

0 CK#J

/ l a m.i Z/3I - ) o l d

CK X

I D#CK X

I D#CK #

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SUB- TOTAL 3TOTAL ( I f l a s t p a g e o f t h i ss c h e d u l e ) $

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T HI S BOX APPL I ES TOCANDI DATES' COMMI TTEES ONLY :Pu 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 SS0 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H . ( R e f e r t o Sc h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s t 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 mus t a l s o b e d e t a i l i t e m i z e d o nSc h e d u l e G b y t h e a m o 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 ma d e b y t h e p e r s o n l 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 . ( R e f e r tSc 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 Co d e 5 6 . 6 ( 3 ) ( 1 ) . )

Pa g e 0 / / ' 4 _ o f eUt _

( f o r Sc h e d u l e B )

FORWSTRUCTI ONS, SEE BACKO ) RM SCHEDULEEXPENDI TURES B MONETARY- MONEY SPENT FROM COMMI TTEE ACCOUNT ( Re v . 0 9 / 9 7 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONSMADE TO STATEWI DE OR LEGI SLATI VECANDI DATES, L I S T THE CANDI DATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THE O CHECK T HI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NG FORMETHI CS 3 CAMPAI GN DI SCLOSURE BOARD .COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g a n i z a t i o n )

, e v 6 / r ~ 5 _l r Fa l z l ' OW4 , y aVS5_CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNT

DATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( MMI DDI YR) AND PACCHECKNUMBER

I D#a ZZ CK# $ 4 6 1 0I D#CK#I NCK#I D#CK#I NCK#I D#CK#I NCK#I NCK#

SUB- TOTAL $ vC 1TOTAL ( H l a s t page o f t h i s s c h e d u l e ) $ so / t ie