(Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE...

14
FOR INSTRUCTIONS, SEE BACK OF FORM DISCLOSURE SUMMARY PAGE COMMITTEE NAME (Must be same as on Statement of Organization) 6cr kt/ --fo_ r S f~c iee,o . IMPORTANT : Indicate by # type of committee 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 Other Political Subdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 10 )School Board or Other Political Subdivision PAC ( 11 ) Local Ballot Issue CANDIDATE COMMITTEES ONLY: Candid ate Name r~ r Office Sought Late reports are subject to possible civil and criminal penalties . Pursuant to Iowa Code section 68B .32A(7) the candidate, for a candidate's committee, and the chairperson, for any other type of committee, is the individual responsible for filing timely and accurate reports . I AM FILING A Political Party (if applicable) 12,,,6 b I; e k.L District (if Senate or House) IA ETH,,,- ;S it r~ ~~ r~ D IO U 09IK i#f )~UL (report date) Q T 005 []CHECK IF AMENDMENT TO REPORT DATED FILED 6y/ .1-)9 TELEPHONE 1-1 (Schedule H applies to Candidates' Committees Only) SUB-TOTAL . . . . . . . . . . . ..$ SUBTRACT TOTAL MONEY SPENT THIS PERIOD Schedule 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) .... . ............................. . .... . . . . . ....... . ....... . .... . ....... . ...... . ...... . .. . . . ................. . . . . .$ FORM DR-2 DISCLOSURE (Rev. 12/2005) ~ REPORT For Office Use O I Comm . # Logged In Scanned Computer Audited File with : Iowa Ethics and Campaign Disclosure Board 510 E. 12"', Ste . 1A Des Moines, Iowa 50319 Fax : 515-281-3701 ECTION /(2)NON-ELECTION YEAR . /o - 7 tr- 0 DATE SIGNED InIcate by # Focal Committees . enter Date of Election **OUTSTANDING LOANS (From Schedule F - Attach Schedule F) ..................... . ................ . ...... . ... . ........ .,$ CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO CANDIDATE COMMITTEES ONLY : VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $ STATE COMMITTEES : Submit a reconciled campaign account bank statement in January of each year . 3SIz . GS - " 5 7 **UNPAID BILLS (From Schedule D - Attach Schedule D) ........ . .. . ....... . ....... . ......... . . . ......... . ........... . ....... . ... .$ *IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) ................... . .... . .................... . . . ... . ... :$ -7 Z 3 El Check if this is final (termination) report and attach Notice o Is (You must continue to file reports until a DR-3 is filed .) County & Local Committees, enter County in which Election is held STATEMENT OF CASH ON HAND CASH ON HAND at the beginning of the reporting period . (Total of all funds held by the committee. This amount MUST be the same as the cash on hand at the end L1 7 .6 of the last reporting period or must be zero if this is first report filed .) ......... . .... . ........... . .............. .$ ADD TOTAL MONEY TAKEN IN THIS PERIOD Schedule A : Cash Contributions total (Attach Schedule A) (*also see in-kind below) ...... . . . .......... 6- 1 -7 3 a Schedule F: Loans Received total (Attach Schedule F) . ............... . ......... . .... . ................ . ... . .. ., ., .... Schedule H : Total Sales of Campaign Property (Attach Schedule H) .. . ............. . ......... . . . ....... . ......

Transcript of (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE...

Page 1: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

FOR INSTRUCTIONS, SEE BACK OF FORM

DISCLOSURE SUMMARY PAGE

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

6crkt/ --fo_ r S f~c

iee,o .IMPORTANT : Indicate by # type of committee 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 Other PoliticalSubdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 10 )School Board or Other Political Subdivision PAC( 11 ) Local Ballot Issue

CANDIDATE COMMITTEES ONLY:

Candidate Namer~ r

Office Sought

Late reports are subject to possible civil and criminal penalties. Pursuant to Iowa Code section 68B .32A(7)the candidate, for a candidate's committee, and the chairperson, for any other type of committee, is theindividual responsible for filing timely and accurate reports .

I AM FILING A

Political Party (if applicable)12,,,6�b I ;e k.L

District (if Senate or House)

IA ETH,,,-;S itr~

~~ r~DIOU

09IKi#f )~UL(report date)

Q

T

005[]CHECK IF AMENDMENTTO REPORT DATED

FILED

6y/ .1-)9TELEPHONE

1-1

(Schedule H applies to Candidates' Committees Only)

SUB-TOTAL . . . . . . . . . . . ..$SUBTRACT TOTAL MONEY SPENTTHIS 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 mustbe zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

FORMDR-2 DISCLOSURE

(Rev. 12/2005) ~

REPORT

For Office Use O IComm . #Logged InScannedComputerAudited

File with :Iowa Ethics and CampaignDisclosure Board510 E. 12"', Ste. 1ADes Moines, Iowa 50319Fax: 515-281-3701

ECTION /(2)NON-ELECTION YEAR .

/o - 7 tr-0DATE SIGNED

InIcate by #

Focal Committees . enter Date of Election

**OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,$

CONSULTANT BREAKDOWN (Schedule G Attached?)

YES

NOCANDIDATE COMMITTEES ONLY:

VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)

$

STATE COMMITTEES : Submit a reconciled campaign account bank statement in January of each year .

3SIz . GS-"

5 7

**UNPAID BILLS (From Schedule D- Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :$

-7 Z

3

El Check if this is final (termination) report and attach Notice o Is(You must continue to file reports until a DR-3 is filed .) County & Local Committees, enter County in

which Election is held

STATEMENT OF CASH ON HANDCASH ON HAND at the beginning of the reporting period . (Total of all funds held by the

committee. This amount MUST be the same as the cash on hand at the endL1 7.6of the last reporting period or must be zero if this is first report filed.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

ADD TOTAL MONEY TAKEN IN THIS PERIODSchedule A: Cash Contributions total (Attach Schedule A) (*also see in-kind below) . . . . . . . . . . . . . . . . . . . 6- 1 -7 3 a

Schedule F: Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., ., . . . .Schedule H : Total Sales of Campaign Property (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Page 2: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

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)

'To c`

S-Gjt

V~CA

SCHEDULE

A MONETARY(Rev . 07/03) I

RECEIPTS

© CHECK THIS BOX IFAMENDING FORM

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 .

NOTE: ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILINGRESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD.

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

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

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

(for ScheduleA)

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

NUMBER INCOME

b

CK# Leo .-,ID#

AAiG CK# toZ G Z 1 $7S Pla~y`6/. o o0

.4 ofID# ,~~;c Ly~~

7/Z ylolo CK# 19 Srdhv;t,. 0r . ~o6o, c/j/292 V OSCeol4 ,4 of I

I D# C~ej . 3-1- e,-jC 4dCK# //7 /Yls,.AIL 5TF

3811 .d 5"0 1 -2 30I D#

p~I~ICG CK# 2ao S. kvss~,~{ 5 ~.17y2 D c / .4 oi 2S=

I/~

~GID# Cr/ tdp l Y3& rr

CK#to;Z

WC7 3/o -,1% 4Jc,"Je", Ti9 So Z6 y 2 5-

a-°-"

090Z/dt!S

ID# AJ ~ 44-1,CK# t 2y~- y30 S. T°~ylL

c75ceola. -ZW 5-0-1- 1 3Z os_o._-

/lZ/OGID# 5+r-f- Jea~ cr%.., js

CK# fr$y3l6Gf A/... 15-L J' R~-

GSccola TW Sc-,t13 /ooID# iQdP A t 4iA c MillerCK# 2071 I Gb+n Iq .-c

oSCa ls. -rAl 0 Z I SoiD#

CK# 134:3 o4k wood Sf . tooI - I Of-e ra ~$~O

Page 3: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

For Instructions, See Back of Form

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

COMMITTEE NAME (Mustbe same as on Statement of Organization)

21 &,1--

7P-1 r

Stc`+e--

AID yd -

Reset Form SCHEDULE

A

I MONETARY(Rev. 07/03)

RECEIPTS

© CHECK THIS BOX IFAMENDING FORM

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM ASTATE 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.

NOTE: ANYPERSON, OTHERTHAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAYHAVE FILINGRESPONSIBILITIES ANDSHOULD IMMEDIATELY CONTACTTHE BOARD.

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

SUB-TOTAL$ 6/5

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 surname of contributor is the same as candidate, butthere is no

Page

Z

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

(for Schedule A)

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

NUMBER INCOMEID#

uk ;.e Cn....~ ~ed~St~c... Cenf~l CeAr;-~te

9/1`)~(X, CK# PO fwX ZG 3 0-4I12S Cr. 6 "" ':ri44 50901 300

fillCK#

719S" lo"rovoJar~~1

cr" so80I D#

~Uw;nCK#

79 y017?L1 54D

050,94ce It, Sozl3 ZS'

.

/16/oGID# AAA a- ge .ticK# 1 ya cJ

o5ce.l~. 0213

V/IRIOcoID# SLt,ile Atn4oacK# 329 Of._ ~0/,Lc.e .d1

ySSS' Osteol*- Svzf3 I° r/ ID# X91 ; Ph:ll,S Z~ : f,-y

CK# 1203 tjssf Ad.: r`131 C« -ho~f .#4 So v

014106ID#

P ~~id l,3c r h7ar~,A0 ircK#

Ll6ox S

SC 2. 57C7f w

ID# Jo4~ .~ (04 4; 3irdk,sCcK#

Hell rC96C 5-C Z 13

~~ftlabID#

Ja^, e +CK# 2SS*

2/r-7 110+`r tC ..es'Ifo j tW 50fsvl ~` /ov s-*-

°8~is1o GID#

51e) t + /nic1a lie ~orla~+

CK#J_~ 5- 3

) 7 7 8 9 301,.6~~ J ;.-, olti 0 5-v )z 5'

Zv

Page 4: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

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)

Reset Form SCHEDULEA MONETARY

(Rev. 07/03)I

RECEIPTS

60 CHECK THIS BOX IFAMENDING FORM

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.

NOTE : ANY PERSON, OTHERTHAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAYHAVE FILINGRESPONSIBILITIES ANDSHOULD IMMEDIATELY CONTACTTHEBOARD.

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

TOTAL (Iflast page ofthis schedule)

SUB-TOTAL: $yyo

' 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, butthere is no

Page

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

(for Schedule A)

DATERECEIVED

PAC ID NUMBER(ifapplicable)

EANDADDRESS OF CONTRIBUTOR RELATIONSHIPTO CANDIDATE'

AMOUNTRECEIVED

IF FORFUND-

(MMIDD/YR) ANDPACCHECK (if applicable) RAISERNUMBER INCOME

4//elloc CK# I ZAPn s, re :~~ I?~.2777 DSc'. la 1~4 Svzr3 Sv ~-

~~l9~oGCK#

31 69soq #w/ a9osc e0/4 TW v2 f 3 3S

a& I a~ lr0 ~r .~. L, �J0. ~~, f Trrk e4

CK#2126

P060x ao~"oseeQlr. Ts9 Scp 7 13 /vo °=

or/211vGID# 44-IDe'~'e> 4-74 LQAG)0hrSfAe usrv~:~ ~avCK# 7S J̀ilet.es~sl /4, . ~d

/S.SV Elk4o1, z t z I 5d r Zv `~

01 I /DG CK#Mo,a>/oct)er Ve c-. ,E' l I Z s-

ot/1lvG

ID# Jtack f Gta rfri4. I~Y1srLforncK# X28/

27&1 010C,,,,~tJe~.~ - 1 7

5,-v

f21 /p G ID# J04^*

Mc~r/l rJw !a-ol~~

. ~7 Jn 21 )IS'SFer h/ew

ID# ,.

CK# 13a Z3631 S2'~' ~f.

1*/--210co ID#A-,.44

cK# 820 OSce,I~. 1'-

o z. 13 loo°°--/al6e ID# a~~ A)e le

1 ty OSceo~CK#3 735" BSce.lL ~~ S'o z r 3 J~d

Page 5: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

For Instructions, See Back of Form

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

COMMITTEE NAME (Mustbe same as on Statement of Organization)

Reset Form SCHEDULE

A

I MONETARY(Rev.07/03) RECEIPTS

~L CHECK THIS BOX IFAMENDING FORM

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.

NOTE: ANYPERSON, OTHERTHAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAYHAVE FILINGRESPONSIBILITIES ANDSHOULD IMMEDIATELY CONTACTTHE BOARD.

CAUTION: Section 68B.32A(6), prohibits the use of information copied from reports and statements for soliciting contributions or for anycommercial 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 surname of contributor is the same as candidate, butthere is no

Page

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

(for Schedule A)

DATE PAC ID NUMBER EAND DRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 1 IF FORRECEIVED (ifapplicable) TO CANDIDATE` RECEIVED FUND(MM/DD/YR) ANDPAC CHECK (ifapplicable) RAISER

NUMBER INCOME

o lzGjoGID# x/'+ 54'r,011

273oY1 .13 $

CK# o`k.~onJ3100 03 C ev :T74 S-0-Z

ID# AL... + kc)s04/u /oc CK# ZSy

lose cQ.l~ .4..~ .p57o on~'C1 411� P4 S0 0f

_/2~joGI D# A-/ /IJef)-e/CK#

C45ll N E. G.,fr.WGeol.,- Q4 5-c,-?-13 20

ID# 6; 6yx_jZGjot; CK PJtoya,tto, 12J

~' Zo °°'

dtj4/0GID# l~~r." He c K~+a n

CK# C4$h ©939 wLeco~ ~ o,S~ t 3

/Z /`~G

ID# 5T-.C414- ~o.Ak~5CK# ce34 1Sog ~wl" G If 57C700-95CC,04 S0 Z, 3

o~~a6jo~ID# w,,A YCK#C6

5h 31 S2 G sf 5f

wnoJ .7~ SoZ s- io.�n

o~jaGjG

ID# ., ~qrr/o(f6WQ�y 0.3411

~' XCK#S3S's~7 3!0 -4-1-

Uc I J .9 SvzG Zoo0

$ 2G~ID# ~~ 4 .Suc lVcr~tSsCK#

3~y2~r 14OSCe.k

1-161.4 S-L-PZ I3 2S

ID# //7 CK#Ofl7

y~o w. rr t~Ofl

Page 6: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

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)

Uar~ -F,, r 54a,+v- aZ

Reset Form SCHEDULEA

I MONETARY(Rev. 07/03)

RECEIPTS

® CHECK THIS BOX IFAMENDING FORM

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.

NOTE: ANYPERSON, OTHERTHAN AN INDIVIDUAL, THAT CONTRIBUTESMORE THAN $750 TO YOUR CAMPAIGN MAYHAVE FILINGRESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACTTHE BOARD.

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

5TOTAL (if last page ofthis schedule)

SUB-roTAL78

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

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

(for Schedule A)

DATE PAC ID NUMBER NAM DADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FORRECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-(MMW/YR) ANDPACCHECK (ifapplicable) RAISER

NUMBER INCOMEID#

Q"ol+ + Ce l~a ~l~~tlv/o G 1014 S .

d) 001ID# Mer i1 Jn'4ef

~Jtt;/v` CK# 61423°H Osc Arf Svzl3 boa°

`

oft/Zc%~ID#

Yt,o.11 "1e- ., FmA Jr, k,,,(c&d,.l3~'3 )w 4 '% 1~"

.~ stID# 14 ,,'J tCK#

ZSSS-GIG!

ose,,lwSoa4J;cw /4r.

x,.4 3--oz 13

901zclG

ID# /1tor .h .5k',1 A a.-27CK#ce 2 ke,o)a l~ 34sc~o 1... ,L~.4 S'v2) Yv

'/ ID#271't:

cK#Cag4, 3f9z Govsf- sfwoor)5v,--, T`9 570 Z S

o~~aG~xID# Cry J

I l 13.,r'

CK#ca5

11 67

rP4 s~Z~HM/2

G/oGID#

/br;d,~c+- 14yi-~, e I J

cK#ce

rosy tree" s PL 1 ye5-o i '7

ID# ,

$~GlO .. CK#Ca54

I to e

03cevll< Z-.*4 Sv Lf 3 / ---

S~t G/06

ID#Sir : r G ,-,'C I2

2'~LIx

D CK# ct tr0S c eoh .Ti9 c z t l5 --S-

Page 7: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

For Instructions, See Back of Form

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

COMMITTEE NAME (Must be same as on StatementofOrganization)

Rr

S+-Je-

[~e d

Read Form SCHEDULE

A MONETARY(Rev . 07/03)

I

RECEIPTS

® CHECK THIS BOX IFAMENDING FORM

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 .

NOTE: ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILINGRESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACT THE BOARD .

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

SUB-TOTAL $I6,7(-/

TOTAL (iflast page ofthis schedule)

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

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

(for Schedule A)

DATE PAC I NUMBER E AND ADDRESS O CONTRIBUTOR RELATIONSHIP AMOUNT IF FORRECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-(MM/DD/YR) AND PAC CHECK (if applicable) RAISER

NUMBER INCOMEID# G .~C)a- Ca~,(er d'oie-

72Gl0G CK# C45~lS2 oA Z So'fh Arc0Scevtti. J_A4 510"1 -3

01/29/06ID# 41an 4 /Ua-c,/ &4 eS

2 015- CCK# S-~ oGv,.

C $ ¢-~ r ,4 kv ~)1 e so CA

q~G CK# C ol y D

f o 150c i If"V

eorrq%

~`IIpl /VLID# s4n,a a. Sara ~CK#

2712~t: Sev4.~. I~r . s'O 00,E k+or.

09406106ID# ~lt~c ~c .1. LCw rti JonesCK# 3Z11 UJeoc) bru.(~ L -n,S hy K)e-,, ,t,4 S-ozi o /oo°~

ID# ~~onray~.

ikq,c~~e)osJdy/d~ CK#

i3ec.orr OS .t- I6r .OF 1570f

0i /1 ,Z) p6ID# wX;a vt t:e&,Oj /It aSSer cI leCK#

)sl X113n0+f-hler~'e 4 . ,~ 0d

_e s ,.A,/two

ID#~a~y + .S A

CK#9,s7v

230 1304 '' A~c-rd tim-e-, 51 ~ -7 1

~I/~zhGID#

;,W,/ f f'49a~e~t / c~S~e )CK#~~ ZZ9 w' L~1Ca~n sf,

°~Gli.r, C/o Z S

/IZ/oh''CK# ( 39 7

ltsrl& 1rZC79ceo&_

lr-/.~C*4 Sot I lvv

Page 8: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

For Instructions, See Back of Form

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

COMMITTEE NAME(Must be same as on Statement ofOrganization)

I66i -X411 41r S4J-c-

Reset Form SCHEDULE

A

I MONETARY(Rev .07/03) I RECEIPTS

CHECK THIS BOX IFAMENDING FORM

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.

NOTE: ANYPERSON, OTHERTHAN AN INDIVIDUAL, THAT CONTRIBUTESMORE THAN $750 TO YOUR CAMPAIGN MAYHAVE FILINGRESPONSIBILITIES AND SHOULD IMMEDIATELY CONTACTTHE BOARD.

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

$j

TOTAL(iflastpage of this schedule)

SUB-TOTAL r ~~ ~

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 (blood relatives) and affinity (relatives bymarriage) .

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

Page

7

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

(for Schedule A)

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

NUMBER INCOMEID# E~"7s~f a. (~ ;n4b;a 6eSS C-141'

CK#34of

2~ Jo n y'YU .. n *J7192)

$Sv-

C0

0//7/0G

ID# $qd Z, f7(A w k e t Ip/~JCPOCK#

Iz s-3 7Z $'0~ -� ~ Z*4 Sv c 2 S~o0

05/17/0(-ID# /4,44 . r .Ir w~ ~T'c rc~n

10sCK#345-5- IF 501AGet-no-j" 14 O/ y0

C9 /7O/aGID#

JantiG ~Qtrr'S

CK# 7 ~I CtC.S,n ZZ-14

SO X519 / S00

0s/0GID# ,3e,"~I +No- sk.-~~ f

27 44e^ae.l( 5 fcK#~061g

0s« 0 (o,. 14 5-0Z

0/75-10&ID# 41-i1-if4t1G - FV e)).'.~7 3, iei)t;ICK# loo) 5v .nA#,A A-e. . 14 1171. IH

c a0n 57-0 rro

09/VIOGID#

ai G POe~e-e 5cK#

~~96)I& toe )a edd5C . cola. 5-0Z) 3 15--v

/0G, ID#6/1A .~- Lt

CK#2z~3

17, 1 S'- 1 30 +" 5C~rs~~, SP4 60

trV

CK# 4~ )S~ [05 SV,,e*- G~ r-Jc, 2,0`'-

S ea. )~ i ct ? 0 I

1011010(o ID#

CK#cc,4,t

_Gtsy C,-«

l G- k AuA-WC ..y5Z) r SL:b .6e5

ib e.,, `-l ee A 037,0

Page 9: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

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)

Reset Form SCHEDULEA

I MONETARY(Rev. 07/03)

RECEIPTS

Wj CHECK THIS BOX IFAMENDING FORM

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

NOTE : ANY PERSON, OTHER THAN AN INDIVIDUAL, THAT CONTRIBUTES MORE THAN $750 TO YOUR CAMPAIGN MAY HAVE FILINGRESPONSIBILITIES ANDSHOULD IMMEDIATELY CONTACTTHEBOARD.

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

SUB-TOTAL

$ 5")73"TOTAL (if lastpage of this schedule)

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 (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)

DATE PAC I NUMBER NAME ANDADDRESSOF CONTRIBUTOR RELATIONSHIP AMOUNT IF FORRECEIVED (ifapplicable) TO CANDIDATE' RECEIVED FUND-(MMIDD/YR) AND PACCHECK (if applicable) RAISER

NUMBER INCOME/ ID# 7,"t=77 e7 797773

ID#

CK#G7ol c~oo~ oC7z-l ~CX~ac7

ID#

CK#

ID#

CK#

CK#

I D#

CK#

I D#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

Page 10: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

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 personstentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf ofthe candidate's committee . (Refer toSchedule G instructions and Iowa Code 68A.402(3)(i).)

Page -__-_ of

'3-

(forSchedule B)

FORINSTRUCTIONS, SEEBACK OF FORM Resd Form SCHEDULEEXPENDITURES B MONETARY-- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 07103) EXPENDITURES

STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE ~- 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)

/A, ~_~ _(~; , S4J--e_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

/2I lib

ID# \kw - mQ1'I'Jefferscs, S+.

e n vzloph5'l~ wXesCK# 1564 N. iddiE. $ L47-o6

I4Gcnoja., Ifl 5z'12-5ID# ~SC~eIcL PCst S'tamps

71211o6 CK# 0scIIJa 1w S"vZ 13 / /7, ©a

ID# Soiu4'ov,5 Lt;L0r C - Sri 7}u -1 Lc_7 /21 /b6 CK# PO Btu 3

10t)cJefi-4y3N Or . O6Cecja, 1A tf-

ID# $oj,~-Fiov,S! 3cr Color C1_~p/FS11 CK#

pt) BoxBox 364364Pr . 6SCecIQ, IA B(a& P1,Aitr~~Ys

s '43ID# Wa [ - SIRrfi

~IjxFS r4'a/CK# jobs 73Sf W,nd56r

{~ idd5C5

Des Mo;nrs, IAID# ^

f Io CK# d, .CaeJt 1`f' (/ 170 {~ '+~0~ f(JOs'uJ{_ ~1 P ~~!%~ctrs 4p. ex)~ ~ t~ ,Mur ca Aav 4C

ID# ~xcni2 c e- S+avwps

CK# d5Le0Ir~- T /4 5nz l3 -::3 q bv

ID# wa,1 - AAav+

IF/I8~e6 CK# l3DO dl Jef'e-5p ,, ft . ThQ,K q0t, ca-r6(5 3s~ iSlhd l'a .z?Cla_ 5z 13S, IA E'n Ve l a s

SUB-TOTAL $ S7R.0TOTAL (iflast page ofthis schedule) $

1 __j

Page 11: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

THIS BOXAPPLIESTO CANDIDATES'COMMITTEES ONLY :

Purchases ofcertain 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 Gby the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee. (Refer toSchedule Ginstructions and Iowa Code ti8A.402(3)(i) .)

Page -2--of- -3--

(for Schedule B)

FOR INSTRUCTIONS, SEEBACK OF FORM ResetForal SCHEDULE

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

STATE PACCOMMITTEES : NOTE : FORCONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN ANDTHE CHECKTHIS BOX IFPACCHECK NUMBER FOREACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THEIOWA AMENDING FORMETHICS &CAMPAIGN DISCLOSURE BOARD.

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

- "o7 STG3&--CANDIDATE NAME ANDADDRESS TO WHOM PURPOSE AMOUNT

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

CHECKNUMBER

ID# Ca5f ~'5 ~~ene~Q-f s-~~~.

~-ys of Z(-C- CO- $ q3 laDSLr?~lk.. ~A 52<i~ 3 J -k

ID# t! ~Se~S 6tn S4- t. nS -t 1 v, , ),,_ 'fe,

CK# IIq 0, 0EVC,3L, . '1- c)oo~ LCnvc~+:~nr~U . DD

C) (e0Imo- V0w_ +c cJ SI D# C re,,cw've Lec~ fnG , PGLlh1 CCc rd S

q1 -l Dt, CK# 1 bbl 6f~iCr (-cir~ ~Cl - 600 .0 0

13f WeSi` Des ~ U;IflPID#

Or,.eatua 'Te,d,; 09 Pr ;~S /-I59 /5106 CK# Pp box 33cg- D-3

dma.il~_

,tJL G~/o3-~3~ID#

~BC- 5~ h Si2 o CK# .s.. ; s - Mob. ~ l~l ( . 366~t 7, SZ~

ID# "4dyer-~-i5~-r~ Ad in tiLe9 Ih b~ CK# 111

~a/37H

os&eola, /.4

9/i CK# ~J S -'r- 7Vp . bU

ID#Ciat-kQ Ccvlr,-) PLLblI's1~~~>- I~ ~n Ix=pei

CK# (15 F wetski-hn,

/UD

SUB-TOTAL $ 2 - ZH zg

TOTAL (iflast page of this schedule) $

Page 12: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

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 personstentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized onSchedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf ofthe candidate's committee . (Refer toSchedule G instructions and Iowa Code 68A.402(3)(i).)

Page __3 _-_ of __ -~?

(for Schedule B)

FOR INSTRUCTIONS, SEEBACK OF FORM Reset Form SCHEDULE

EXPENDITURES B MONETARY-- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev. 07/03) EXPENDITURESSTATE PAC COMMITTEES: NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVECANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IFPAC CHECK NUMBER FOR EACH EXPENDITURE . A LISTOF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORMETHICS & CAMPAIGN DISCLOSURE BOARD .

COMMITTEE NAME (Must be same as on Statement ofOrganization)

t3c r_ 5at qtr .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# CreS-fare f khl"ski,Ct. . 'n~'d /11 ~'1f'. PGC .l-.~.i°~,,,

5-D3 w/ . /~dQ~s Sfi . 1

I/c~, CK# $ '7~3/. oresin Ip 5-be"',

ID# - )-Qrnon~ -i-CniC-~E. ~~ 1'n thr oL pPr-q~al lo~ CK# ilb N- Llri den l o ,~- . &C;

LCt.n,C~1 . A 3a I qcID# LeaYl JUL-~i-KCLI d rr\ +ke CcPe,-

~~af CK# IIO A)- Main -73Lee

I D#

CK#

I D#

CK#

1D#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL $ ~7

TOTAL (iflast page ofthis schedule) $ 3S12 G s'

Page 13: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

FOR INSTRUCTIONS, SEE BACK OF FORM

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

fo/- SAI~_ La .

Reset Form

SCHEDULEE IN-KIND

(Rev . 06/97A CONTRIBUTIONS

(p CHECK THIS BOX IFAMENDING FORM

'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the

Page

of

Zcommittee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives

(for Schedule E)by marriage) .

(See Page 2 of forms packet.) If sumame of contributor is the same as candidate, but there is nofamilial relationship, enter "not applicable" in the relationship column .

DATE RELATIONSHIP DESCRIPTION ESTIMATED 4 IF FORRECEIVED NAME AND ADDRESS TO CANDIDATE OF IN KIND FAIR MARKET FUND-RAISER(MM/DDIYR) OF CONTRIBUTOR ' (if applicable) CONTRIBUTION VALUE CONTRIBUTION

of/x/cG re?) Ea,f 9 {i S ~o°~ 7 v dos FDes-4fotnrs .174 S'0301

~sf1v~~~ca.n I06+y C rc,4 c

-L09o ~Aw EJ

`s ^,;i e ~9 570309

0JI.13lo(o0.,s� b);Z&-, /any o f row 41 gr~r F(C ? I EAS+ 9 +4

'tee .1I~ SD o 1'~a : ~ l~ss~ i, SOUK

30 oG C,1t G~,t ~t~ Os~a~ S7S 93es o "..a ,4 S0 3 c' 5/a(, Qea,,~hf~ 1°w~y cf To ".x. lri~ ec} ,h4: 113

so o 1Ar0d y~ . .,

01Vots Re,O41,1a^ PaJy s-f .LO".,q r 094. 1AoSFayc. 4 E::]East -5 .4 L, ^ lS~~. ~s

A9 :r ~03o r ;n~'wJea"O-kCa~ 0-P To--_ tfl,~ec'f"

09 1,106 r.7 t last s 14 1 6 ~' ' '~ y 95! yz,p4 s0 cl

t~ ~ ~ ~ rl0v~j~e l G~ /ACtl 7y D ~- Vircc~ ~4. lz t ~- ~C-ti, ~.t F, n EJ

Page 14: (Rev. 12/2005) ~ REPORT 6crkt/ r Sf~c€¦ · FORINSTRUCTIONS, SEEBACKOFFORM DISCLOSURESUMMARYPAGE COMMITTEENAME(Mustbesameas onStatementofOrganization) 6crkt/--fo_ r Sf~c iee,o.

-FOR INSTRUCTIONS, SEE BACK OF FORMCOMMITTEE NAME (Must be same as on Statement ofOrganization)

u/ L,/-Tor

cJ 7-tL

ed ,

Reset Form

SCHEDULEE IN-KIND

(Rev. 06/97)ICONTRIBUTIONS

® CHECK THIS BOX IFAMENDING FORM

`Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the

Page

Z

of

_Z-committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives

(for Schedule E)by marriage) .

(See Page 2 of forms packet .) If surname of contributor is the same as candidate, but there is nofamilial relationship, enter "not applicable" in the relationship column.

DATERECEIVED NAME AND ADDRESS

RELATIONSHIPTO CANDIDATE

DESCRIPTIONOF IN KIND

ESTIMATEDFAIR MARKET

4 IF FORFUND-RAISER

(MM/DD/YR) OF CONTRIBUTOR ' (if applicable) CONTRIBUTION VALUE CONTRIBUTION

1-9Ak 93 Ac{mr /'1te.) FW]Ldp� ol.- .Z"W S-o, 2 S.-

080 ~oG0'%J& rvyrress

l S.2 o 2$'o sti -, eS:c)a drArD~er It,fafc '~ -~s FIX

eeo lti i9 So t 1 3 ~..Kq t.'1~.

O~lG/aGAo. /Suo~e ",tiasen S,J~ c~;s~+ FYNe%3V ~ia~ss4 'fir .K04,(

SoZly

8l2%` /-twoj~y S,a~ x,54 ooOSCan r., S"o2t3 ~o~ ~+ee./

Wri 5/0 A/c, 4 " 6c, 4Z,r rA -7Osceola . Z7r9 Svt t 3

~-- FTIg/ZG~G 187q

Aie,r X

eS«o~E,11c,^

.9 0 2 I'S~ rolls `)v=

~Z/~l4wvJ f- IJe~4,'e_ .5i:, ell.,-,23117 Is7ple M.'lly Rd

&bre, 6,4 .t.a~.1t14Y.

St~'fsefs' 3Voivv0n~~5 C:~. 5'onG 5' e

-16016/0r. 8/O N ;~Sf' f(77 °iOscwk =,4 ,Sw z i 3

F-1

F-1