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FOR I NSTRUCT I ONS, SEE BACK OF FORM

DI SCLOSURE SUMMARY PAGECOMMI TTEE NAME ( Mu s t b e same 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 )Wi n n e b a g o Re pu b l i c a n Wo me nI MPORTANT : I n d i c a t e t y p e o f c o mmi t t e e y o u a r e r e p o r t i n g f o r :( 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 mmi 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 u p p o r t S l a t e o f C a n d i d a t e s~ r 6 4 1 5 8 5 5 2 6 0SI GN&URE OF 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 ) TELEPHONE

R o u t i n e P e n a l t i e s Du e F o r L a t e F i l e d R e p o r t s Range f r o m $ 2 0 t o $ 8 0 0SEE I NSTRUCTI ONS ON BACK AND COMPLETE THF FOL L OWI NG SENTENCE :

I AM F I L I NGA REPORT FOR AN/ A ( 1 ) E LECT I ON / ( 2 ) NON- E L ECT I ON YEAR .( r e p o r t d a t e )

pCHECK I F AMENDMENT TOREPORT DATED, f i r , I - . I n d i c a t e o n ei

pCh 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 F o r m D R- 3 .( Y o u must 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 mo n i e s h e l d b y t h e c ommi t t e e . T h i s amount MUST b e t h esame a s t h e c a s h o n h a nd 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 ,o r must 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 4 3 5 . 8 1

ADD TOTAL MONEY TAKEN I N T HI S PERI ODSc h e d ul 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 Sc h e d u l e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d ul 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 d ul e H : T o t a l Sa l e s o f Campa i g n P r o p e r t y ( A t t a c h Sc h e d ul e H ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

SUBTRACT TOTAL MONEY SPENT T HI S PERI ODSc h e d 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 e d u l e F : L o a 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 mustb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

UNPAI D BI L L S ( F r o m Sc h e d u l e D - A t t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $I N K I ND CONTRI BUTI ONS ( F r o m Sc h e d u l e E- At t a ch Sc h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $OUTSTANDI NG LOANS ( F r o m Sc h e d ul e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI TTEES ONLY:CONSULTANT BREAKDOWN ( Sc h ed ul e G A t t a c h e d ? )VALUE OF CAMPAI GN PROPERTY ( F r o m Sc h e d u l e H - A t t a c h Sc h e d u l e H ) $

FORMDR- 2 DI SCLOSURE( R e v . 0 1 / 9 8 ) REPORT

F o r O f f i c e Us e O n l yCo mm. # , , q Wi l DI n d e x e dA u d i t e dCo mp u t e r

0

/ e - / 5 - 0 YDATE S I GNED

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 n

C o u n t y & L o c a l C o mmi t t e e s , e n t e r C o u n t y i nw h i c h E l e c t i o n i s h e l d

4 4 2, 0 0

877_R l3 10 . 0 0

5 6 7 . 8 1

YES NO

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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 mCONTRI 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 St a t e me n t o f O r g a n i z a t i o n )

Wi n n e b a g o Re pu b l i c a n Wo ma nSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED F ROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D E NT I F I C AT I O NNUMBER AND THE PACCHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE F ROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARDCAUTI ON : S e 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 m a t i o n c op i e d f r o m r e p o r t s a n 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 b y a n y pe 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 e s .

SUB- TOTAL

TOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) $ 4 4 2 .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 a n 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 mu 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 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 ym a r r i a g e ) ( S e e Pa ge 2 o f f o r m s 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 a s c a n d i d a t e , b u t t h e r e i s n o P a g e I _o f _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 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 . ( f o r Sc h e d u l e A )

SCHEDULEA MONETARY( R e v . 0 2 / 9 6 ) RECEI PT

F / CHECK THI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSH I P AMOUNRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE" RECEI V( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e )NUMBERI D# 2 0 0 4 d u e " $ 5 1 . 0 09 / 2 4 J 0 4 l u n c h e o n 9 2 . 0 0 $ 1 4 3CK#D# 2 0 0 4 d u e s $ 1 5 . 0 0 2 88 ,9 / 2 8/ 0 4 CK# 2 0 0 4 d u e s 1 9 8 . 0 0l u n c h e o n . 0 0D#1 0 / 1 3 / 0 4

" 2 0 0 4 d u e t ; 1 1 . 0 0 1 1 ,CK#1 b #CK#I D # 'CK# ,I D #CK#D#CK#I D #CK#D# -CK#I D#CK#

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I S BOX APPL I ES TO CANDI DATES' COMMI TTEES ONLY :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 n t o r i e d o n Sc h e du 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 . )d i t u r e s t o p e r s o n s l e n t i f 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 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 m a d e 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 . ( R e f e r t od u l e G i n s t r u c t i o n s a nd I o wa Co d e 5 6 . 6 ( 3 ) ( 1 ) . )

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

FOR I NSTRUCTI ONS, SEE BACKOF FORM SCHEDULEB MONETARY} EXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT ( Re v 0 9 1 9 7 ) EXPENDI TURESPAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DEOR LEGI SLAT I VE O CHECK T HI S BOX I FI DATES, L I S T THE CANDI DATE I DENT I F I CAT I ON NUMBER I N THE DESI GNATED COLUMN AND THEC CHECK NUMBER FOR EACHEXPENDI TURE. A UST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NG FORMI CS & CAMPAI GN DI SCLOSURE BOARD .

MMI 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 )%i n n e b a g o Re c u b l i c a n Wo me n

CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADEMMI DDI YR) AND PACCHECKNUMBER

I D # J e r r y Twe e t e n2 0 5 8 7 Hwy 9 , Ea s t De l e g a t e t o t h e7 / 2 1 / 0 4 CK# 1 0 3 6 Fo r e s t Ci t y , I A 5 0 4 3 6 n a t i o n a l c o n v e n t i o n $ , 5 0 . 0 0I N Kr i p Co l b y4 4 6 3 2 1 9 0 t h Av e n u e8 / 3 / 0 4 CK# 1 0 3 7 L a k e Mi l l s , I A 5 0 4 5 0 Do n a t i o n 5 0 - 0 0I N Se n a t o r C h u c k Gr a a o l e yP . 0 . Bo x 1 0 0 0 Do n a t i o n 5 0 - 0 08 / 2 4 / 0 4 CK# 1 0 3 8 D e l i Mo i n e s , I A5 0 3 0 4- 9 9 71I D# Se n a t o r E Th u r ma n G a s k i 1

8 / 2 4 / 0 4 1 0 3 9 3 2 0 Bi r c h Av e n u e Do n a t i o n 5 0 - 0 0CK# Co r wi t h , I A 5 0 4 3 0I D # La t : r a m f o r Co n g r e s s1 7 8 1 8 0 t h St r e e t Do n a t i o n

8 / 2 1 / 0 4 CK# 1 0 4 0 I ' l e xa nd e r , I A5 0 4 2 0 5 0 - 0 0I NCK# 1 0 4 1 VOI DI NCK# 1 0 4 2 VOI DI N I o wa Fe d e r a t i o n o f Two d el eg at e- t o t h eRe p u b l i c a n Wo ma n s t a t e c o n v e n t i o n 6 0 . 0 09 / 7 / 0 4 CK#

SUB- TOTAL $TOTAL ( I f l a s t p a g e o f t h i s s c h e du l e ) 1 $ 3 10 - 0 0