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DI SCLOSURE SUr ' + I A R Y PAGECOMMI TTEE NAME ( M u s t b e same 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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h e c k i f t h i s i s f i n a l ( t e r mi 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 e d l o n F o n n 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 . )

STATEMENT OF CASH ONHANDCASH 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 o mmi t t e e . T h i s amoun t MUST b e t h esame 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 ,o r mus t b e z e r o d t h i s i s f i r s t r e p o r t f l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADD TOTAL MONEY TAKEN I N THI S PER I ODSc h e du l e A: C a s 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 ed u l e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - - 0_ _Sc h ed u l e F : L oa ns Re ce i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - - n -Sc h ed u l e H : T o t a l Sa l e s o f Camp a i g n P r o p e r t y ( A t t a c h Sc h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - - 0 - -

( Sc h ed u l e H a p o l i e s t o Ca n d i d a t e s ' Commi t t e e s On l v t

SUBTRACT TOTAL MONEY SPENT THI S PER I 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 R e p a y me 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 mu s tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ - - 0_ _

UNP A 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . $I N K I ND CONTR I BUTI ONS ( F r o m Sc h ed u l e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $OUTSTANDI NG LOANS ( F r o m Sc h e du l e .; : - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SCANDI DATE COMMI TTEES ONLY :CONSUL TANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) YES __Z_ NOVALUE 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 ) S

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T HI S BOX APPL I ES TO CANDI DATES ' COMMI TTEES ONLY :P 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 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 S c 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 i 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 nS c 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 mad 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 mm i t t e e . ( R e f e r t oS c h e d u l e G i n s t r u c t i o n s a n d I o w a Code 5 6 . 6 ( 3 ) ( 1 ) . )

( f o r S c h e d u l e B )

FOR I NSTRUCT I ONS, SEE BACK OF FORM SCHEDULEEXPENDI TURES B MONETARY- MONEY SPENT FROM COMMI TTEE ACCOUNT ( Re v . 0 9 / 9 7 ) EXPENDI TURES

S T AT E PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE ORLEGI SLAT I VECANDI DATES, L I S T THE CANDI DATE I D EN TI F I CA T I ON NUMBER I N THE DESI GNATED COLUMN AND THE El CHECK T HI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NG FORMETHI CS & 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 O r g a n i z a t i o n )NI CHOLS FOR SENATE

CANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNTDATE 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 m e n t ) WAS MADE( MM/ DDI YR) ANDPACCHECKNUMBER

0 7 - 3 1- 0 2 I D # HI GHLAND B . NI CHOLS PARTI AL LOAN REPAYMENT1 9 5 4 GLENDALE RDCK# 1 0 3 0 CLI NTON I A 5 2 7 3 2 $ 5 2 . 8 9I D #CK#D#CK#D#CK#I D #CK#I D #CK#I D #CK#D#CK#

SUBTOTAL $TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) $ 5 2 . 8 9

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1 1O 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 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 n i n k i n d c o n t r i b u t i o n t o t h e P a g e o fc o r n n i t t a e . R e l a t i o n s h i p mus t b e s h ow 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 ( f o r Sc h e d u l e E )o y ma r r i a g e ). ( S e e P a g e 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 a m e a s 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 mn .

DATERECENED( MMI DD/ YR)- NAME AND ADDRESSOF CONTR I BUTOR

RELATI ONSHI PTO CANDI DATE' ( E a D p ~ c a b l e )DESCRI PTI ONOF I N K I NDCONTRI BUTI ON EST I MATEDF AI R MARKETVALUE

J I F FORFUND- RAI SERCONTR I BUT I ON07- 31- 02 HIGHLAND B . NICHOLS

1954 GLENDALE RDCLI NTON I A 52732

CANDIDATE LOAN FORGIVEN $2, 947 . 11

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FOR I NSTRUCTI ONS, SEE BACK OF FORMT h i s f or:*t i t a p p l c a b l e t o s t a t t A a - o l l d c a l c o mmi t t e e s .N o t i c e o f D i s s o l u t i o n

E v e r y N o t i c e o f D i s s o l u t i o n s h a l l b e a c c o mp a n i e d b y ac o mp l e t e d D i s c l o s u r e R e p o r t F o r t h c u r r e n t t o t h e d a t e o fd i s s o l u t i o n .

COMMI TTEE NAVE

NI CHOLS FOR SENATEO f f i c i a l Name o f Co mmi t t e e

S t r e e t1 9 5 4 GLENDALE RD . , PO BOX 1 3 0 2CLI NTON I A 52732

C i t y , S t a t e , Z i p Co d e

Ar e a T e l e p h o neCOd e 5 6 3/ 2 4 4- 0 5 68

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FORM

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I n d e x e dAt d i l s d o - ~Co mp u t e rC e r d l i s d Do e o f D i s s o k t t i o n 4 - 4

I S Bo x APPLI ES TO CANDI DATES' COMMI TT EES ONL Y :t h e c a nd i d a t e . ceNy t h a t my c a nd i d a t e c o nv n i t l e e ' s c a s h b e l a n c e i s z e r o , s o d e bt s , o b l i g a t i o n s an d ba ns h a v e b e e n p a i d o r s a t i s f i e d i n a c c o r d a n c eM l awa s sh own o n my c o r r r n i t t e e ' s f i n a l r e p o r t and a l c a mp a i g n p r o p e r t y and l e f t o v e r f u n d s h a v e b e e n d i s t r i b u t e d i n a c c o r d a n c e wi t h mymi t t e e ' s l a s t Al e d St a t e me n t o f Or g wf t e t i o n .

HEN TO F I L E :Th e N o t i c e o f D i s s o l u t i o n mu s t b e f i l e d w i t h i n t h i r t y ( 3 0 ) d a y s o f t h e c o mmi t t e e ' s d i s s o l u t i o n , w i t h a c o p y o f t h ef i n a l b a n k s t a t e me n t a t t a c h e d .