. INSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE DR-2 … · ForInstructions,SeeBackofForm...

. INSTRUCTIONS, SEE BACK OF FORM

DISCLOSURE SUMMARY PAGECOMMITTEE NAME (Must be same as on Statement of Organization)

FJC- Ns LC Y -~oir c~ , Y co L./ Y1 c~ ~.IMPORTANT: Indicate by # type ofcommittee you are reporting for:( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party( 4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or OtherPolitical Subdivision Candidate (8 )County PAC (9 )City PAC (10 )School Board or Other PoliticalSubdivision PAC (11) Local Ballot Issue_

_ .CANDIDATE COMMITTEES ONL s .Candidate Name

w

'

Political Party (if applicable)

Dis#4ct (if Senate or House)

51,5-- 2-55-LJ -7TELEPHONESIGNATU#kE OF PERS N FILING REP

I AM FILING A

S 1OA`f5

Pn OR t0 C~~N,ca: G- REPORT FOR(1) ELECTION 1(2)NON-ELECTION YEAR(report date)

[]CHECK IF AMENDMENTTO REPORT DATED

El Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 .(You must continue to file reports until a DR-3 is filed.)

Indicate by #

STATEMENT OF CASH ON HAND

0

CASH ON HAND at the beginning ofthe reporting period . (Total of all funds held by thecommittee. This amount MUST be the same as the cash on hand at the endof the last reporting period or must be zero if this is first report filed.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ADDTOTALMONEY TAKEN IN THIS PERIODSchedule 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ISchedule Haautles to Candidates' Committees Only)

SUB-TOTAL ... . .$SUBTRACT TOTAL MONEYSPENT THIS PERIODSchedule 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

'UNPAID BILLS (From Schedule D-Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .� . . . . . . . . . ._ ., . .$*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $'OUTSTANDING LOANS (From Schedule F -Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDIDATE COMMITTEES ONLY:CONSULTANT BREAKDOWN (ScheduleGAttached?)VALUEOF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)

FORM

DR-2

I DISCLOSURE(Rev. 07/2004)

REPORT

For Office Use OnlyComm. #Logged InScannedComputerAudited

Late reports are subject topossible civil and criminalpenalties.

/o-Zy-DATE SIGNED

Local Committees, enter Date of Election

//-8 - OrCounty & Local Committees, enter County inwhich Election held

.~ `76, /6

Ago22.&a

~

9t3. 8Y

I A10 o 't 9

26

/7, 9/q.5S8

AYES F-~_NO$ -~~d o3

For Instructions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN IN(Including candidate's personal funds)

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

f'1 t_= dvl 5 L` `i 4jr C; TY Cwkic L-

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER ANDTHE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICSAND CAMPAIGNDISCLOSURE BOARD .

CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If sumame ofcontributor is the same as candidate, but there is nofamilial relationship, enter "not applicable" in the relationship column.

SUB-TOTAL$

1'

r! 2.5TOTAL (if lastpage ofthis schedule)

'

Page

/of / I /(for Schedule A)

SCHEDULEA MONETARY

(Rev. 07/03) RECEIPTS

CHECK THIS BOX IFAMENDING FORM

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# C Ea ~-~' C oo pc=

0 C3 .3

--

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CONTRIBUTIONS -- MONEY TAKEN IN(Including candidate's personal funds)

COMM

E NAME (Must be sa r3 as on Statement ofOrganization)

STATE CANDIDATES NOTE : IF ACONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person otherthan statutory political committees.

' Disclosure law requires candidate committees to disclose the relationship of any relative making a oontribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by

1-7marriage) . If surname of contributor is the same as candidate, but there is no

page

~offamilial relationship, enter"not applicable" in the relationship column .

(for Schedule A)

SCHEDULEA MONETARY


0 CHECK THIS BOX IFAMENDING FORM

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-(MMlDDNR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# C-asvHij:~7 J=~~LNCrI

8\jxa o~,IC5 I~n.-QZ. (0 ~

ID# )q L,FI 1\i E; U'+LP+ Ih Jl) +' V ~7

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CONTRIBUTIONS -- MONEY TAKEN IN(including candidate's personal funds)

CO

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

STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROMA STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBER ANDTHE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LISTOF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD .

CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees .

' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) .

If surname of contributor is the same as candidate, but there is no

Page

-offamilial relationship, enter "not applicable" in the relationship column .

(for Schedule A)

SCHEDULE

A MONETARY(Rev. 07/03) RECEIPTS


DATE PAC ID NUMBER NAME ANDADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEIN CAL=K,p l--i .) tll

r .5l3~-v5~ CK#

-.5 ~17 ,`

.~ CK# (0 0 ',3- Gf3 A IV IO CA K-S EjIDs

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STATECANDIDATES NOTE: IFACONTRIBUTION IS RECEIVED FROM ASTATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBERANDTHEPACCHECKNUMBER IN THEDESIGNATED COLUMN. A LIST OF ID NUMBERS ISAVAILABLE FROM THE IOWA ETHICS ANDCAMPAIGNDISCLOSURE BOARD.

CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees .

SUB-TOTAL

TOTAL (iflast page of this schedule)

" Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) .

If sumame of contributor is the same as candidate, but there is nofamilial relationship, enter "not applicable" in the relationship column .

Page of / 7chedule A)

SCHEDULE

A MONETARY(Rev . 07/03) RECEIPTS

a CHECKTHIS BOX IFAMENDING FORM

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MWDD/YR) AND PACCHECK (if applicable) RAISER

NUMBER INCOME

ID# "-JA ry\1?S C /V

CK# °t-' C1te r I = I=~ r\I 67cc Q C)c=5 rV'14, H ~03.

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STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER ANDTHE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS ISAVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD .


SUB-TOTAL

TOTAL (iifast page ofthis schedule)

Disclosure law requires candidatecommittees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must beshown tothe third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) .

Ifsurname ofcontributor is the same as candidate, but there is no

Page

offamilial relationship, enter "not applicable" in the relationship column .

(for Schedule A)

SCHEDULE

A MONETARY(Rev . 07/03) RECEIPTS


DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOME

ID# C14 n-$t L /'1/cL 6"oAlCK# o't S3 S O isYL C/1 d7.- /LTYZ -o " t-

l0 DOJ c;S m4"W3 Ti6 9 i3ID# ~Jro~ .~~J Croi~LS <~ dlCK# ~ .~ sI~5-. r3q~. ,~ o v

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CK# ~y~l nlv.t Isa^'b s"r-- la s( .Je Z -037,6

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CONTRIBUTIONS -- MONEY TAKEN IN(including candidate's personal funds)

COMMITTEE NAME (Must

same as on Statement of Organization)

1'

e `C

C~~

J YI rr ~Z..

STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROMA STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD .


* Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee . Relationship must be shown to the third degree of consanguinity (bl)od relatives) and affinity (relatives bymarriage) . If surname of contributor is the same as candidate, but there is no

Page

,- offamilial relationship, enter "not applicable* in the relationship column .

(for Schedule A)

SCHEDULEA MONETARY



DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# OAJ ~ .6kI6 rLCK# I0 14 m~~clC A'Ve

$uDZ' S0 3i aID# r ft . ue YoIL Call

~_$.o CK# y z"C:, IQ, C1 y.A si b E:1a rnar

ID# ~Lltc:oJo 5U~v:~ Wt? :CIdT0 CK# I~tt 6°1~~

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ID# »~,tihfaeLrVf~; rn whPLLfJiy0 `i 19NL7ti:GW-5 r- ,,r-r

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CONTRIBUTIONS -- MONEYTAKEN IN(Including candidate's personal funds)

COMM

ENAME (Must be sa

ason Statement of 0(yanization)rE

(w,0111

STATECANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM ASTATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBER ANDTHEPACCHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS ANDCAMPAIGNDISCLOSURE BOARD.

CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees .

TOTAL (iffast page of this schedule)

Disclosure law requires candidatecommittees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to thethird degree ofconsanguinity (blood relatives) and affinity (relatives bymarriage) . If surname ofcontributor is the same as candidate, but there is nofamilial relationship, enter"not applicable" in the relationship column .

SUB-TOTAL

SCHEDULE

A MONETARY(Rev . 07103) RECEIPTS

0 CHECKTHIS BOXIFAMENDING FORM

_DAT PACID NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR

RECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-(MM/DD/YR) AND PACCHECK (if applicable) RAISER

NUMBER INCOME

. -s -~

~ee

CA~~ 14 Vim, . $

l- -J~ 1`11 <-S ~~ .~ 5X32

'' CK# v~ w vd L n pJn 1 Ve

ID#i~Pfv L 0c_I1

CK# j G IM In- V - ---

CK#._r ElC; «. - Z_ 4, ,~~ _ :331

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CK# 31 `I Pro i o rh ; rY ~G V4 _

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CONTRIBUTIONS -- MONEY TAKEN INpnciuding candidate's personal funds)


~ea)S~e~ ~- o- C ;iy

( flalY)C' :I--

STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD .


SUB-TOTAL

TOTAL (If lastpage ofthis schedule)

Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee . Relationship must be shown to the third degree of consanguinity (bk)od relatives) and affinity (relatives bymarriage) .


Page

8

offamilial relationship, enter "not applicable" in the relationship column.

(for Schedule A)

SCHEDULEA MONETARY

(Rev . 07103) RECEIPTS

Q CHECK THIS BOX IFAMENDING FORM

DATE PAC ID NUMBER NAMEAND ADDRESSOFCONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-(MMlDD1YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# T~ m ~Y rvM.;rL-CK# a 31 Q12~ :Q 1d

1 ps M9, -I ,So315ID# Cfa r-4,91 rn 0A C AN

^l~_°~~- CK# 100 C rZA ev 3 NQ- '7 . c '

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CONTRIBUTIONS - MONEYTAKEN IN(Including candidate's personal funds)

COM ITTEE NAME (Must be same as on Statement of Organization)

1 ~V15)e' . 4 C1-

ar(',' 7 Y

o jvr

STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM ASTATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER ANDTHE PACCHECKNUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS ANDCAMPAIGNDISCLOSURE BOARD.

CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements forsoliciting contributions orfor any commercial purpose by any person other than statutory political committees.

SUB-TOTAL

TOTAL (iffast page of this schedule)

* Disclosure lawrequires candidatecommittees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must beshown to the third degree ofconsanguinity (blood relatives) and affinity (relatives bymarriage) .

Ifsumame of contributor is the same as candidate, but there is no

Page

of

/r7familial relationship, enter"not applicable" in the relationship column .

(for Schedule A)

SCHEDULEQ MONETARY


Q CHECKTHIS BOX IFAMENDING FORM

DATE PACID NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-(MMIDDIYR) ANDPACCHECK (ifapplicable) RAISER

NUMBER INCOME

ID# ad6G/V7 L . MA00'DK 1 1 (cK# 86 Z3 MC` (013 v h A -le, $

.2r~~ ,

05

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CONTRIBUTIONS -- MONEYTAKEN IN(including candidate's personal funds)


I-~e)As~~.

C~\jYtc ,-L

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER ANDTHE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.


Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If sumame of contributor is the same as candidate, but there is nofamilial relationship, enter "not applicable" in the relationship column .

(for Schedule A)Page of

i' 7

SCHEDULE



DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MMIDDIYR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOME7.C .

IYl1~ ~,r 771A 0,0 Z x-

__ CK# 9 3S - SQ~ rya ; sw~z C 4 d

ID# PA v L =-, rn~ :wav,' s I 1 Ele rY14,n ,_~ 5 't

iD#-~K

-`n';c

t'CYtv1N :h wJhAr5 o~ we11~e/L

~ ~CK#

~5 yjcb, ~#~ s o 31ZID# Lea WQ V1e Y1 cQ ` Y~ Jo K f,~l0{'l~9 ~ YYlpS

w

0 6ID# ~r . rmAr2C C .'7- ww Yz.17

CK#~

O t-( WoZ19 Cblj /3IV,/2

°~ 5~ 0a-l8-o~ P5 l'Yl9 ;rf~, Z'~9 ,~~o3~Z

ID#t3

,. c 5. ~Q ~ =~2l

CK# o Zmom

: n L-ni e.5 M 03~~

ID# I(.-j A i2. A IJ 1 ~0 t0 7~1 ~~ OG~P rt 15 0 C

$O C-1AAN0 a so0

.5 -aS ~AS rn'0 ;~~5 J,~

~,

s30

ID#Cl c~~e c t--) 1 Nph1c

C~[3r3

CK# 33 01 !06 "'40~ n

-/S v nb o~r>7 tC Z 5 ~3 zZID# v.i~N~ K E tY1c~7,J~r~l i3 0l3

Lico 3~`h s iCK#t?-5 m {ilr.-I~° 5 Z so 3 i

ID#~ro vL 1~ .130 ~N~

Nfo

!2-00 r1 ~bn wo op ~0iI .

t-,5 Y1~ 4.' PS- 0 Ji Z



COMMITTEE NAME (Must be same as on S tement of Organization)

, ey5)i

o / ' CI7 Co\ln6r'L

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.


SUB-TOTAL


' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) .


Page

offamilial relationship, enter "not applicable" in the relationship column .

(for Schedule A)

SCHEDULEA MONETARY

(Rev . 07/03) RECEIPTS


DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MMIDD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# 5t t ~t vL % t)AwA1 (1~o~3L~rs

-- CK# wAtNV-T -' a a~ao7 e3 rY10 : ~9 _ 10 3 0 / O

ID# ~;- G)G f g o x : D ta~re ;CK# 13 'o n1 2 0 ` J . E:1-) ~On L~ ~ oo ticID# 10o "rv ygL1) . C-NKECK# 2 Z~o C-7nrQdvV_

) doc7ID# 0o-:Y-4 e 5:~ .9,dv5uA~CK# (,p (4 5ov4ht=,0/t)c 102. . CoOw~v LC,ID# ~h"rclL-:7 Y ,OpCK# ! 0 L .`~ crj aV ~y8 -

-~, eJID#

YJ m A . VA" 017s9

CK# ~I 3 5 - W .P wvId"

ID# ~o ham_ Rv1aoJ II I

~e~ ~~o a.Z,Ip_d~ IYIQ,' k7 eo b pa --) I - --

ID# 0e .Raf5L--11 < 5eArv Sh~ 2~5

CK# b I I P~ol k 13 Lvl~ .

ID#L ,,Z C~ o o d w j-Iv

CK# -3 3 o C n 14 A/ Z o (~ -.

r 1 y .-_A) 16 S~3 1 ?ID# IZa a t,J O mIq rLY (VL-'t_ s oN

CK# K I C' T~ m L=nvvtt0 a/2 .

. ~J5m 5



COMM TTEE NAME (Must be same as on Statement of Organization)

I1`-r1S)ei

~,%/'

C' -1 -C~Qj mc, , L-

STATE CANDIDATES NOTE: IFA CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD .


SUB-TOTAL

TOTAL (if lastpage of this schedule)

' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) .

If sumame of contributor is the same as candidate, but there is no

Page

i s--of

/ r7familial relationship, enter "not applicable" in the relationship column .

(for Schedule A)

SCHEDULEA MONETARY

(Rev . 07/03) RECEIPTS


DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# Dk'3r3~~ e,rn " )1e tz-eLL

Z 2Z .,°~CK# -7 '7 / '7 C :N C o / n/ /VL - .

S W ,04103 '. 0312- I! C Q)

ID# ICcN -T 11'1 W v wtCK# 3 $ ZZ G n c L-: Al w'b '4 b . EjZ 2 ~ =S ~5 .~' so31LID# J l f F L A n5 QQCK# 1 ,09 4 3 z''z-s"N 0rZ

O;,3 rot ; P 5 S '~3 zZID# n o fj q' A A CL C? i2 \/ )3 ~V

..) - yID# L-Awerence ~ MAW .'L'AN 57"A~)e5

-- CK# 3So ~ CQvL,19 12. We-- --

ID# G v 51AV t` ch pn ~ 0-4~_ AA-:-L 5 0 &ICK# I t 1-1 I C v wIm ~'I7 5 C-,'le -

(=S moo : h~5 J~3I )ID#

rt WA~n6Vw YCK# a Is a ,ZZ?_ 3 r~=s mo : 17&S Q s' 3'3/ z

ID# _0 to rnr 5 r1 jA #j L:- W : N tr

CK# Ay 5 S 4 *, IJt�_S yY)<) p5 Z, 14 5 03ID# 114 Ar t CJote44 F, leQoj

CK# c, o _ S-( -41.

.2 ,?l ~~ c=5 ~'YI 4 on 1.,~1 ,5 03ID# moo r6)L t L i3 74Zrd )<-CK# 5 I l 1 eAJA w ? 5



COM ITTEE NAME (Must

same as on Statement ofOrganization)

STATE CANDIDATES NOTE: IFA CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBERAND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS ISAVAILABLE FROM THE IOWA ETHICSAND CAMPAIGNDISCLOSURE BOARD .


SUB-TOTAL$~68s

TOTAL (iflastpage of this schedule)

* Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to thecommittee. Relationship must be stwwn to the third degree of consanguinity (blood relatives) and affinity (relatives by

`f ~marriage) . Ifsumame of contributor is the same as candidate, but there is no

Page

--%f-L-familial relationship, enter "not applicable" in the relationship column .

(for Schedule A)

SCHEDULE



DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# ~-)a YL T7 1d 70k77 YCK# 0 ,.,A Co C Vsr 51 . AL `7 g~ $

0,?-a3-oj43-O'- ue, , 1-3 ,i 5 ,0 3 ,) lID# Kahn Y. Ntaut A)

CK# t3oo ~0CJ5T" Lje2-23-~j .-6 '0 : p3 ScanID# C q j h~ g c/fKA (vrnc mV Lcca1CK# 4 I I J-A A)A wANViQ )O~19 .

-~ S,~ -23-oa C- s mo ; -C--

C" Ll(a Tit n.AACC nD.35-1 -~i ~~ tvlo ; 05 . ~ S°3

ID# Z' o e If /4at2 pig oc.r13~-

'9 Z3. 0S-CK# l o~ Sm >~; 5 e5

:1~j Sa311.

~-'

ID# ~, C lc ry1 11 ~~wZ)l~S

CK# o A/ I L4- o nY~Oi ~J

ID# 14 Wtol W - p nn(= TT

CK# P .,o . d ox 17-74

ID# C oLAC i O__

CK# y (-Y a Glrn

~t2-t6-o~ w . ,~5rv1 o~ 6ID# rn-Ch)QL-"L W , 5,r~vNso .~l

__

CK# 3 00 L:LW1 Wo 0oZ S C~2 -L8 I7) c-zs )'y) p . r"S . -- -~3> Z

ID# C o NN iL (~/ ; /.yIL

l"o~ CK#

[&,5 Moj, 4.-j,-T7)4- 3b3 ~So



CO

ITTEE NAME (Must be same as on Statement of Organization),7

~_ I~

STATECANDIDATES NOTE: IFACONTRIBUTION IS RECEIVED FROMASTATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER ANDTHE PACCHECKNUMBER IN THE DESIGNATED COLUMN. A LISTOF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS ANDCAMPAIGNDISCLOSURE 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.

SUB-TOTAL

TOTAL(iflastpage ofthis schedule)

' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by

t..(marriage) . If surname of contributor is the same as candidate, but there is no

Page~- offamilial relationship, enter "not applicable" in the relationship column .

(for Schedule A)

SCHEDULE


CHECKTHIS BOX IFAMENDING FORM

DATE PAC ID NUMBER NAME ANDADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MWDD/YR) ANDPAC CHECK (ifapplicable) RAISER

NUMBER INCOME

ID# J~r)= N~n/T~t2CO I oo vlgLIvv7 s~ . 5 o2 z(-~ (;F-.S Mo,ri~ps -, _~30_ . ID#

0iov :0 ( Uenn*t.'/l Iy'Y1~'4~l

CK# ~ 35

~3tro;

ID#

CK# 2%11 0tZv ; l~ r1,Ct_ 0/Z-C)i9c--s

ID# L~ I~ 5 "M (~S o~J

cK#-s mo"0ps,

ID# C-Y,a. f ( .' L NLv m/qN'

CK# 3 so ~~~ C~~4= rz0 .S `73 s Mo ~6 s-o 3 Z

lD# W:)),'A m t 1"otant 5Cher(la-cK# 4 8 J 1') W nVV 0 o t~~2

ID# ybz lp h i L va nOn! C ,-11x5 -rT ,'5 . L/;~ NVW ~

ID# Su5tall NOLQW21Lr°sl. ~~CJc rr6) 8 29 -i h

CK#_

ID# h'1 t;--L CO (;:~it J I0, mc`xAly7zCK# 1 vz~S(~, LA)4e v,- eA-i YJ& -

S5- -V> GC .v~ _ 5".b 32J-

ID# ~L,-Gkl L

_

VCj~ ANLi7VZ--

CK# P . 9 9

lY~0b



COM

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

STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM ASTATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LISTOF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

SUB-TOTAL

TOTAL (Iflast page of this schedule)

Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shownto the third degree of consanguinity (blood relatives) and affinity (relatives by

Sofmarriage) .


Pagefamilial relationship, enter "not applicable" in the relationship column .

(for Schedule A)

SCHEDULEA MONETARY

(Rev . 07103) RECEIPTS


DATE PAC ID NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MMIDDIYR) ANDPACCHECK (ffapplicable) RAISER

NUMBER INCOME-

ID#~ n0 L:oU ~ WA k7 AA 1:~r,30lLC~t:

cK#-oy ~_ ~n L=s -r a/L .

l7

CK# 3 ` C7 nwnfD # '7'0 16 l E]3 - -o\ ~s Mo ; c-5 :1 3 i Z.

ID#5h%LDWet2o5e(:K7 /2m0 :tiow :r7-

ofCK# 1 ~W 51 s?

~.s ma : -~~, Z a5 aP~ -ID#

CK# Yors wdo(7Crno~~ ~°~e _3~- of 1'YI~:nPS -o aI O

ID# 001331.P.+-~Je- 131t*-W1 oa

Z-aS-oSCK# -:5 ° I R Metct;01%-ZS Lj

ID# W.. CK#

yes 5 . so-+

ID# 7,g 5 t sAM0AA w:rv05oR--y o ~l c ~-

ID# j'LaarwOiaLL L- tnIALTL-'2-Sp.o . /fox ~IOgH

3-IO o CIC# G L ; J , sr'r4- 03 z~ 5 0

ID# C~.Qeil e.._

3S_as' CK# C4'5-931

-T-A- 5 a -L- 6~/r 0 0=

-

o~

ID#

CK#

CA THSo .~ :LLs

C od(~,MU/L- .

A0~1

s--=G~5 M4AP5,TA-- j


CONTRIBUJJONS -- MONEY TAKEN INnafuding candidate's personal funds)

COMM

EE NAME (Mu t be same as on Statement of Organization)

-7~sL~

4a~ C:rti

C,~ Vv) c,

STATE CANDIDATES NOTE : IFA CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD .


SUB-TOTAL

TOTAL (iflast page ofthis schedule)

Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) . If surname of contributor is the same as candidate, but there is no

Page

of7familial relationship, enter "not applicable" in the relationship column .

(for Schedule A)

SCHEDULE

A MONETARY(Rev. 07103) RECEIPTS


DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MMIDD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# r-~ 12 f. a~ m L5 - 3phh fd . 5rn .` 114

ID# 'Jlti~ce- Gt Ktr LLl.CK# c, I o.t v.'dW n-. -

rn0 ;,/jj Q5 , oslio# LoAN4 K.q-rr4 LaeN _jc#AItoV13j-:rtGI

cK#tit '~ t:AauL

C.~ rr nn', 1! C1 --"x7rlG 50 10 0 C~

ID#Vy) ."

r. 0oLA i,J

3..~a--or C"# (ZoYs Lno: n~ ~ ' 03i -Z.-

00ID# ~Q).r :~-eiti. A - coo,perZ

yo ~ W ~e .. Co~~T' i93-.1.3~0~

ID # w . Aft r15e -f' 1.AAS z~ jID# >Zov3~rtT m .'LLsml 09 aq ~- s7-- _

3-z8~~~ CK# UIti6PN_ ~gLOZ-Tt9- So3ztID# fn)9T ~ (1ebecc, Aa6of

(,~7-7 -j-QL.- Titre CN

3-3Q) -r4 ~- CK#

W . QSn-.Tx1 - Sozt~ID# J1,-ch,e rv ;-c,a40L svru CA1.5

cK# 3ooB :70RPAw qRv:6- 0

W oZ 6. ~SyYJ -~~' S ~ID#

t3~h

s~ Lc~v Y

/.?S 0

ID# Coo3Y74y~ 0 tN,g (rA

A0 CK#

Yarn "l~3 hs~ v~7 tS 0~ P5 1~ S 03, o



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

f2

C; r~ Cov Nc . , L

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.


SUB-TOTAL


Disclosure law requires candidatecommittees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage) .

Ifsumame ofcontributor is the same as candidate, but there is no

Page

of

1 17familial relationship, enter "not applicable" in the relationship column .

(for Schedule A)

SCHEDULE



DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID#6 C) MPk*V:r,,q c k-v/,Zp ~c

i -if(o LoCJS`f' ST . $ a~/.zo-os

CK#=S mv,

3 -0 S CK# 390't -S r'oNts do t)01C- cr-C . /00 Ej/O rh~'S T ~o '010ID# ~GKaj ; L. . Loz~e2cK# 3511 s T .7,~ h n S 14D.

0 \0 E:1J--Sri -o~ 0 p.s m 0 ;ae3 1A 5~3) ZID# C A 12lZ,'C ?-.1 pt_L

CK# 2a2.3 00,9/& Ave- ./ ~1O7~Z6

~o~e m o" nP l p 3 z~`t F

ID# G4 ty em,-,1 ac, "70L 1`Ly0 tJAIV~,,n,. s m o~ rr z -r-r4 y3n m

CIC#11 n+e0PsZ =Pan 00 .

ID# LZ 1D N i4 ~4 452 1 C-1 t4 -+h S -~ r_Q e t.

!o _trl-~~CK#

~ eS Md%YIeS~ -Llq S-,33 ~ t 5 CC

ID# C7AK,~ t C`JNhf Ar: 2

CK# Ja ~`'~oico-r~`A?~Zd O

~

ID#

CK#

ID#

CK#

ID#

CK#r r r r r ~,

THIS BOXAPPLIES 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 personstentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule Gby the amount, purpose, and date of each type of expenditure made by the personfentity on behalf of the candidate's committee . (Refer toSchedule Ginstructions and Iowa Code 88A.402(3)(i) .)

Page I of

(for Schedule B)

FOR INSTRUCTIONS, SEEBACK OF FORM SCHEDULE

B MONETARYEXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 07/03) EXPENDITURES

STATE PAC COMMITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE D CHECK THIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD .

COM NAME (Must same as on Statement of Organization)7E

N s L~~' C, - Cv LJ V? c, . LCANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDEDEXPENDED (if applicable) (Disbursement) WAS MADE(MM/DDIYR) AND PAC

CHECKNUMBER

-.ID# C14r,

.5 J .gin) PIZ .v1e 5 .` nv,'7 7 ; Im 5 ;

Icyll 1 s-r 5T . q'erIvJ

ID# Ic-L FT- JF5 rV10 :yes 1'- uNn 2A . %5 i2_y(oom AOWT,6L

cK# / LG6ID# ot=r ; cc rvlAx arc. n -~I e rG ~~!<

~I ~Atz.Trt "'bC~ k=5_

.oCK#

-,5 rn,p, Ylr,~~l j s. Y6ID# veo00(l9ALC F)q LL FoSr Vq L ~AYZA OC 1`e

CK# CA nnq re C PigaAOe.> 54.0 0

ID# 3r4 M ,$ C L v~3 CA/Vo y 1' ~--

W:rv9S0tNpShi3 13eaVQnOnZt;-

~-~Z "oaCK#

e- .s /Y10;ms _1:A AA ve, S. 3

ID#C h,q 5fnt 1,&h51e.`f IZ-P "

et^;en^hJY7~PhMh '~i't'

-fH PA P"m5', s pteo%WVASCK#

WNC" tie 1%04i5 4^- 5'x .1 SYY)4 "11~ .~. "^0 /

ID# .V Qw\V1 Cz_ S CA rop .ylJ AWgg dfSWoY~IC'e~`+~

CK# n/4Wibnrj_1A_bCL°t~-Z~G~-

e .$, T-Sh:rtrS

FYI~sheL_ S NP'oQ twe.) .

sZ5-05 6 33.0 0

ID# CD~Q ,,ll. ~L~o~Kc'es F-4 av19 fiAj'S:rvj 1=ee-

CK#"rl o~ C-~)ernSt T S~UY~C I\j A e

5r~bTo 0e-,~

~t-9 52--WI p,n,r~ "ny m:J aryl C3 e e s~N

SUB-TOTAL $ SO'~-9 $

TOTAL (If lastpage ofthis schedule) $

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 persons/entifes providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date ofeach type ofexpenditure made by the person/entity on behalf of the candidate's committee . (Refer toSchedu le G instructions and Iowa Code 68A.402(3)(1).)

Page ~_7 of 2--

(for Schedule B)

FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

EXPENDITURES B MONETARY- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev. 07/03) EXPENDITURES

STATE PAC COMMITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE D CHECK THIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD .

COMMITTEE NAME (Must be same as on Statement of Organization) LC,'CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDEDEXPENDED (if applicable) (Disbursement) WAS MADE(MM/DD/YR) AND PAC

CHECKNUMBER

ID# 10 I` aJ 1) r i c T U% C o r-f 7 d14 V 0,V

CK# $z ~ b o0

ID# CLt=1%IR- CI'4ANIG t-~' I ( f3o Al2 aS3 f 4 ( Sw ~ ( 5

io-CK#

yes mo: nps, 1. 5p3i1 a r) o 1QID# 0 iz t= ; Ce Y%l jqx -

h lc cl4l'LTrt, p c~.'t ~o~ ~ryer~ s a I l

h-13 - i() 5 m, --# 503 i 2-- 20,13ID# -J 1Z V - \,/~ Vn~9- T" , e 5

j0-J~-oq CK# sr~1 ~ 'y~-- ~ , 8 GID# MA :(, SE.R.J .NCe°_5 t;,C " rAA .C :N ~ o~

y,(,00 121 s-6 . 6nochJAe -to!0-3( .0~

CK#h srVl y0-323 wrnD 3 vofen-S

~ 030 .ID# C h ~(L -S 7:ju hi VA "» ~ S r r "~-~ ~ vr ~ D 'F

_

11-1-0 S s m, .~x~ 5o3i1 m ,a , I e ~z / S~~J . 2yID#

CK#

ID#

CK#

SUB-TOTAL

TOTAL (Iflast page of this schedule)I

$ 6 s~ t "Z8

$j

~~ q , Z

FOR INSTRUCTIONS, SEEBACK OF FORM

I THIS FORMIS USED BYCANDIDATES'COMMITTEES ONLY

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

0 eKSW~

C,T~ CoJvlc .'l

PART 11- ITEMIZED BREAKDOWN OF UNREIMBURSED EXPENSES PAID BY CONSULTANTTO OTHERS IN PERFORMING SERVICES OF CONTRACT (These expenses should NOT be

PART I - NAME AND ADDRESS OF CONSULTANT

reported on Schedule B, as they are direct paymentfrom the consultant.)

TOTAL ANTICIPATEDCOMPENSATION FOR

CONTRACT PERIOD (MMIDDIYR)

PERFORMANCE

From

To

ESTIMATES OF PERFORMANCE

Page of(for Schedule G)

SCHEDULE

G BREAKDOWNOF MONETARY

(Rev . 02/96) EXPENDITURESBY CONSULTANT

FM CHECK THIS BOX IF

AMENDING FORM

DATEEXPENDEDMMIDDIYR

NAME AND ADDRESS TO WHOM EXPENDITURE(Disbursement) WAS MADE PURPOSE

AMOUNTEXPENDED

2~-,3 c, v s ost OFP,'CC-'-

Lt gA3° ~Q~

)t *, ee-tn~

11A.

rt :n~:~tR

FQ~~

; o

SUB-TOTAL

TOTAL (If last page of this schedule)$

FORINSTRUCTIONS, SEEBACK OF FORM

THIS FORMIS USED BYCANDIDATES' COMMITTEES ONLY

CO

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

ycPART I - ONGOING INVENTORY OF CAMPAIGN PROPERTY

PART 11- SALES OR TRANSFERS OF CAMPAIGN PROPERTY **

SCHEDULE

H CAMPAIGN(Rev. 07/03)1

PROPERTY

ATTACH SCHEDULE H TOEACH REPORT, MAKINGCHANGES AS REQUIRED .

®CHECK THIS BOX IFAMENDING FORM

TOTAL VALUE CAMPAIGN PROPERTY THIS REPORT

.4

** PROPERTY SALES & TRANSFERS TOTAL

TOTALS

$

$(TRANSFER TO SUMMARY PAGE) $

~O

(TRANSFER TO SUMMARY PAGE) $

* If estimated, show est. beside figure .

(Attach Additional Schedules if Needed)

Page

of

Pages(For Schedule H)

Date(MM/DD/YR)

Name and Address of Purchaser/Donee Description of Property Sold?YIN

SalePrice

Value ofDonation

Date Purchased(Schedule B)

or Date Received(Schedule E)MMIDD/YR

Description of PropertyPurchase

Price or Est.Value WhenAcquired*

CurrentValue at FairMarket This

Report

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e 5 ~! L

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