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Batch processed using the IECDB Web Reporting System on Schedule A Contributions 04/26/2005 04:44:52 Committee Name Grinnell Mutual Reinsurance Company PAC Audited Committee Type Iowa PAC Committee ID 9687 Statutory Due Date Adjusted Due Date Filed Date Amended Date Received Date 1/19/2003 1/21/2003 12/31/2002 9/2/2003 Status Contribution Date Contribution Committee ID Name and Address of Contributor Relationship To Candidate Contribution Amount Fund- Raiser 10/2/2002 Heinen, Stacy None $250.00 1872 510th Avenue 1 Montezuma, IA 50171 10/2/2002 Kelling, Carla None $260.00 1827 Spencer Street 2 Grinnell, IA 50112 12/27/2002 Agnew, Dan None $90.00 1935 Reed Street 4 Grinnell, IA 50112 12/27/2002 Amsbaugh, Tammie None $30.00 7308 SW 17th 15 Des Moines, IA 50315 12/27/2002 Bachmann, Tom None $60.00 14834 Hwy 6 11 Grinnell, IA 50112 12/27/2002 Chittick, Dana None $30.00 402 West Street 20 Victor, IA 52347 Schedule A: Contributions -- Money Taken In Sch-A IOWA ETHICS AND CAMPAIGN DISCLOSURE BOAR D | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 Batch processed using the IECDB Web Reporting System on Page 1 of 5 04/26/2005 04:44:52

Grinnell Mutual Reinsurance Company PAC_9687_A_Contributions

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Batch processed using the IECDB Web Reporting System on Schedule AContributions

04/26/2005 04:44:52

Committee Name

Grinnell Mutual Reinsurance Company PAC

Audited Committee Type Iowa PAC

Committee ID 9687 Statutory Due Date

Adjusted Due Date

Filed Date

Amended Date

Received Date

1/19/2003

1/21/2003

12/31/2002

9/2/2003Status

ContributionDate

ContributionCommittee ID

Name and Address of ContributorRelationship ToCandidate

ContributionAmount

Fund-Raiser

10/2/2002 Heinen, Stacy None $250.00

1872 510th Avenue

1 Montezuma, IA 50171

10/2/2002 Kelling, Carla None $260.00

1827 Spencer Street

2 Grinnell, IA 50112

12/27/2002 Agnew, Dan None $90.00

1935 Reed Street

4 Grinnell, IA 50112

12/27/2002 Amsbaugh, Tammie None $30.00

7308 SW 17th

15 Des Moines, IA 50315

12/27/2002 Bachmann, Tom None $60.00

14834 Hwy 6

11 Grinnell, IA 50112

12/27/2002 Chittick, Dana None $30.00

402 West Street

20 Victor, IA 52347

Schedule A: Contributions -- Money Taken In Sch-A

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028

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Page 2: Grinnell Mutual Reinsurance Company PAC_9687_A_Contributions

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Batch processed using the IECDB Web Reporting System on Schedule AContributions

04/26/2005 04:44:52

Committee Name

Grinnell Mutual Reinsurance Company PAC

Audited Committee Type Iowa PAC

Committee ID 9687 Statutory Due Date

Adjusted Due Date

Filed Date

Amended Date

Received Date

1/19/2003

1/21/2003

12/31/2002

9/2/2003Status

ContributionDate

ContributionCommittee ID

Name and Address of ContributorRelationship ToCandidate

ContributionAmount

Fund-Raiser

12/27/2002 Connelly, Gary None $30.00

604 VanHorne Circle

10 Grinnell, IA 50112

12/27/2002 Day, Dennis None $90.00

507 N. 16th Street

22 Marshalltown, IA 50158

12/27/2002 Henderkott, Janice None $60.00

1403 West Street

21 Grinnell, IA 50112

12/27/2002 Larsen, Brent None $30.00

479 390th Street

7 Grinnell, IA 50112

12/27/2002 McDonald, Mac None $50.00

115 Crabtree Road

19 Montezuma, IA 50171

12/27/2002 McDonald, Teri None $48.00

115 Crabtree Road

8 Montezuma, IA 50171

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028

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Batch processed using the IECDB Web Reporting System on Schedule AContributions

04/26/2005 04:44:52

Committee Name

Grinnell Mutual Reinsurance Company PAC

Audited Committee Type Iowa PAC

Committee ID 9687 Statutory Due Date

Adjusted Due Date

Filed Date

Amended Date

Received Date

1/19/2003

1/21/2003

12/31/2002

9/2/2003Status

ContributionDate

ContributionCommittee ID

Name and Address of ContributorRelationship ToCandidate

ContributionAmount

Fund-Raiser

12/27/2002 McKay, Shawn None $60.00

1413 Ann Street

25 Grinnell, IA 50112

12/27/2002 Menary, Jeff None $50.00

701 East Dallas Street

17 Montezuma, IA 50171

12/27/2002 Mugge, Mark None $60.00

1102 W 16th Street S

16 Newton, IA 50208

12/27/2002 Schultz, Diane None $60.00

329 Main Street

5 Grinnell, IA 50112

12/27/2002 Shell, Rich None $30.00

2120 Country Club Drive

6 Grinnell, IA 50112

12/27/2002 Sheridan, Hugh None $50.00

307 East Street

24 Grinnell, IA 50112

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028

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Batch processed using the IECDB Web Reporting System on Schedule AContributions

04/26/2005 04:44:52

Committee Name

Grinnell Mutual Reinsurance Company PAC

Audited Committee Type Iowa PAC

Committee ID 9687 Statutory Due Date

Adjusted Due Date

Filed Date

Amended Date

Received Date

1/19/2003

1/21/2003

12/31/2002

9/2/2003Status

ContributionDate

ContributionCommittee ID

Name and Address of ContributorRelationship ToCandidate

ContributionAmount

Fund-Raiser

12/27/2002 Smith, Denise None $60.00

301 1st Avenue

14 Laurel, IA 50141

12/27/2002 Smith, Todd None $60.00

1527 Reed Street

12 Grinnell, IA 50112

12/27/2002 Steffen, Phyllis None $60.00

4020 100th Street

3 Malcom, IA 50157

12/27/2002 Tjarks, Rick None $60.00

109 E. High Street

13 New Sharon, IA 50207

12/27/2002 Unitemized N/A $12.00

N/A

Check # N/A23 N/A N/A, N/A N/A

12/27/2002 Unitemized N/A $15.00

N/A

Check # N/A

18 N/A N/A, N/A N/A

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028

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Batch processed using the IECDB Web Reporting System on Schedule AContributions

04/26/2005 04:44:52

Committee Name

Grinnell Mutual Reinsurance Company PAC

Audited Committee Type Iowa PAC

Committee ID 9687 Statutory Due Date

Adjusted Due Date

Filed Date

Amended Date

Received Date

1/19/2003

1/21/2003

12/31/2002

9/2/2003Status

ContributionDate

ContributionCommittee ID

Name and Address of ContributorRelationship ToCandidate

ContributionAmount

Fund-Raiser

12/27/2002 Ward, Mike None $60.00

301 N Main

9 Gilman, IA 50106

Total Regular Contributions $1,665.00

Total Fundraiser Contributions

Grand Total All Contributions $1,665.00

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028

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