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FOR I NSTRUCTI ONS, SEE BACK Of - I R M

DI SCLOSURE SUMMARY PAGE

SI GNATURE 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 DATE SI GNEDR 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 Ra ng e f r o m $ 2 0 t o $ 8 0 0

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( ] Ch 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 DR- 3 .( Y o u m u s 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 . )

REPORT FORANNA ( 1 ) ELECTI ON / ( 2 ) NON- ELECT I ON YEAR .

STATEMENT OF CASH ON HAND

I n d i c a t e o n e

ADD TOTAL MONEYTAKEN I N THI S PERI ODS c h e d u l 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 S c h e d u l e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n s R e c e i v e d t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e H : T o t a l S a l e s o f Camp a i g n P r o p e r t y ( A t t a c h S c h e d u l e H ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

! Sc h e du l e H a p p l i e s t o C a n d i d a t e s ' Co mmi t t e e s On l y )SUB- TOTAL . . . . . . $

SUBTRACT TOTAL MONEYSPENT THI S PERI ODS c 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 S c h e d u l e B ) . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n Re p a y me n t s t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

FORMDR- 2 DI SCL OSURE( R e v . 0 1 1 9 8 ) REPORTF o r O f f i c e Us e On l y 4 3Comm . # . 1

L o c a l C o mm i t t e e s , e n t e r D a t e o f E l e c t i o nC o u n t y 8 L o c a l C o mm i 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

CASH 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 m m i t t e e . T h i s amo u n t MUST b e t h es am e a s t h e c a s h o n h a n 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 mu s t 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

33 . ( D t -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 m u s tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 7 . 5 9UNPAI D BI L L S ( F r o m S c h e d u l e D - A t t a c h S c h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $I N KI ND CONTRI BUTI ONS ( F r o m S c h e d u l e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $OUTSTANDI NGLOANS ( F r o m S c h e d u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMM7TEES ONL Y :CONSULT ANT BREAKDOWN ( S c h e d u l eGA t t a c h e d ? ) YES NOVALUEOF CAMPAI GN PROPERTY ( F r o m S c h e d u l e H - A t t a c h S c h e d u l e H) $

COMMI TTEE NAME ( M u s t b e s am e 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 ) f I - I < I n d e x e d ,A u d i t e d I 1 . W . t i >I MPORTANT : I n d i c a t e t y p e o f c o m m i t t e e y o u a r e r e p o r t i n g f o r : 0 C o mp u t e r C ~ - - - 4 -( 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 ( 6 ) B a l l o t I s s u e / F r a n c h i s e C o mm i t t e e ( 7 ) C o u n t y / C i t y C e n t r a l C o m m i 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

, 2 v t c~ L o a - 7 _ ' Z - S 3 %- l - P 1 Z - -

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( 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 TT EE 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 )

Re , & , 1 ; v ne - r Tvr Sf a~- ~ . pef r ' 1 7 S e , njA" ~/ v e -STATE CANDI DATES NOTE: I F A C ON T R I B U T I O N I S R E CE I V E D FROMA S T A T E P A C ( P O L I T I C A L A CT I O N C O MMI T T E E ) , L I S T T H E P A C I D EN T I F I C A T I O NNUMBER A ND T H E P AC CHECK NUMBER I N T HE D E S I G N AT E D COL UMN . A L I S T OF I D NUMBERS I S A VA I L A B L E FROM T H E I OWA E T H I C S AND C A MP A I G ND I S C L O SU R E BOARDCAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o 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 o p i e d f r o m r e p o r t s a n d s t a t e m e 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 s o rf 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 p e 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- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e )

* 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 m u 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 P a g e 2 o f f o r ms p a c k e t . ) . I f s u r n a m e 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 o P a g e~_o ff 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 . ( f o r S c h e d u l e A )

SCH EDU L EA MONETARY

( R ev . 0 6 / 9 7 ) RECEI PTSCHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-( MMI DDNR) ANDPAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

I D# p h i l k e ZT, Ty / ~ rl 9_ l S_O, CK# #Pl SKmmi f e ~ } ve , HU~ , ACO, DDGr y f o n , =1~raL , ms s /

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0 CK# f 3 - ~ ; o 1 ) 5 a f 'e . S ' ~ -r e e f ~ c p . 00Cr e S n ~$d 1I D # 1 34 . 3 f e t r o j v u r t I t i k r k e t e ; , s d: rW4 f AG i # b 3 s l~ ~ CK# 1 0 , 0 3 5 ' p p ~ f V A F- 5 Pl on e5 ~~ ~0 I , + . ' a

I D# S n c qy r ~ t s sL - r e s t o n , ~' ow~ z 3 ~ 8 ~ ' l Col o0I D # 3 ~ k y t ~ F~ g e i 5 r1 ' ' ~ % t t G ! ~ ~ ' _ l n-

CK # / 7 - 7 I / r ' e n f k J . v ~ P DY l y e v v/ ~ Dk n ' ~ a1 n O r i t ~ Y ~ 4 x 5 a j ~. Z b s ;I D # l g ~V i n C>Gk1Vr , a1 1 - 2 3- 0 CK# 1 : L P + F Nvr 44 1 3 i r e - ~ 2 _ 4 7 , OC>I D #CK # / 6 9 ? T - . ~ wa N i S k we y 2 S J00, v l rG: ^ e 5 f ~ r t . WK 5P&1I D # U1 . 3 h u r o

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CONTRIBUTIONS - - MONEYTAKENI 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 same as o n S t a t e me n t o f O r g a n i z a t i o n )"oner er 50~~, Per t e5e~f abve

STATE CAND I DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P O L I T I C A L ACTI ON C OMMI T T E E ) , L I S T T HE P AC I D EN T I F I C A T I ONNUMBER AND THE PAC CHECK NUMBER I N T HE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD.CAU T I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Co de , 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 o p i e d f r o m r e p o r t s an d s t a t e m e 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 s o rf 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 p e 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- TOTALTOTAL ( i f l a s t page o f t h i s s c h e du l e )

* 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 mm i 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 m m i t t e e . R e l a t i o n s h i p m u 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 P a g e 2 o f f o r m s p a c k e t . ) . I f s u r n ame o f c o n t r i b u t o r i s t h e same a s c a n d i d a t e , b u t t h e r e i s n o Page ~' o ff 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 ( f o r S c h e d u l e A)

SCHEDULEA MONETARY( Re v . 0 6 / 9 7 ) RECEI PTSQCHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI B U TOR RELA T I ONSHI P AMOUNT I I F F ORRECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI V ED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI S ERNUMBER I NCOMEI D# John f Xc ) ~CK# l 1 1 l ~ - # J/ A S t r e e t / g v " a U~5J ?~( p i n es w. L Sg3J1I D# ~l H i ' f r ~ ' l H . ~ r ~ t t ~ + t Gr a n . ~

/ a 2 - 1 7 _q CK# Of 5 n- 4 L 5 - u n n e * - f~Ao f 1 71 DCA - 1 t 1 t . i . i J . 3 G1 > , 005wg 0 (I D# 9 1 e 4 / 1 ' P L ~, ~Y " y k t n

o , CK# 1 9 3 ; > - > K I K ~- C~ , t Y 1 P* 4 f ov , v pCr r t l n . , WA- - - F V5*I D# r n i i l j i e qAr ' d a I _ 1 ~ f&c o 1 LS i uCK# q ' ~ l. o ~ 4 k "6- ( e t - '25r ODI D# 1 . ~ > 1 d~ ~Yf i s ~u kCK# J o 5 " ~ o u ~ k p o n d 1 V o , ODI D#

l OL l r Ur ,~5~r t i ~wa- . ~ ~ ' a WI D# ~~a . s f r c f g Sa v i ` j ~ GH"JA. ~

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T HI S BOX A PP L I E S 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 m o r e m u 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 l 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 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 nS c h e d u l e Gb 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 made b y t h e p e r s o n l 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 oS c h e d u l e Gi n s t r u c t i o n s a n d I o w a C o d e 5 6 . 6 ( 3 x i ) . ) -

( 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 FROMCOMMI TTEE ACCOUNT ( R e v . 0 9 / 9 7 ) EXPENDI TURES

STATE PAC COMMI TTEE S : NOTE : FOR CON T RI B UT I ON S MADE TO STATEWI DE OR L E G I S L A T I V EC A ND I D A T E S , L I S T THE CANDI DATE I D E N T I F I C A T I O N NUMBER I N THE DESI GNATED COL UMN AND THE 0CHECK THI S BOX I FPA C CHECK NUMBER FOR EACHEXPENDI TURE . A L I S T OF I D NUMBERS I S A V A I L A B L E FROMTHE I OWA AMEND I NG FORME T H I C S & CAMPAI GN D I SCLOSURE BOARD .COMMI TTE E NAME ( M u s t b e s ame 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 )R e a S v A e Y - P C ; - _ 5 f A f e I e r r e 5 e i r f A T j w vCANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( D ES CR I B E 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/ D D/ Y R ) AND PACCHECKNUMBER

I D# S - '1 n g e a ' n v r ^ r e s 'G G t Y ~ i i d K ' r ~' ~ ~d f o y y a ~ hi ~ ~ F w ~ r + ~ , made S~~tCK# $ 6 0I D#CK#1 D#CK#I D#CK#I D#CK#I D#CK#I D#CK#I D#CK#

SUB- TOTAL $ 3 3 9TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) $ 33, 6o ]