I Dem. Governors Assn . Fax :'202-7725602 Feb 2 2005 16 :38 P .

02

FOR INSTPUCT10NS, SEE BACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
(Rev. 07/2004) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization)
Democratic Governors'Association-Iowa For Office Use Only
Comm . #
IMPORTANT: Indicate by # type of committee you are reporting for ~ I Logged In
(1 )Statewide/Legislative/Judge Standing for Retention Candidate (2 )State PAC (3 )State party Scanned
(4 )County Central Committee ( 5 )County, Candidate (6 )City Candidate (7 )School Board or Other
Political Subdivision Candidate ( 3 )CountyPAC ( 9 )City PAC .t 10 ;)Sgtool Board or Other Political Computer
Subdivision PAC ( 11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES ONLY :
Candidate Name r Ek, 2 2005 optical Party (if applicable)
Late reports are subject to
possible civil and criminal
Office Sou g ht :.; ~r District (if Senate or House) penalties.

202-772-5611 February 1, 2005

I r-
SIGNAT14RI 4F PERSOWF'1'LING REPORT TELEPHONE DATE SIGNED

January 19, 2005 REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .

I AM FILING A
(report dale) Indicate bylt

Local Committees, enter Date of Election

7CHECK IF AMENDMENT TO REPORT DATED

Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County & Local Committees, enter County in
which Election is held
(You must continue to file reports until a DR-3 is filed .)

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 1 .00
of the last reporting period or must be zero if this is first report fled .) .  .. .. ... .. . . . . .. .. . . . .. . . . .. .. . $
ADD TOTAL MONEY TAKEN IN THIS PERIOD
100,000 .00
Schedule A: Cash Contributions total (Attach Schedule A) ('also see in-kind below) .. . . . . .
Schedule F : Loans Received total Attach Schedule F 0
Schedule H, Total Sales of Campaign Property (Attach Schedule H) . . .. .. .. . . . .. .. .. . . .. .. . . . .. . . .. , 0
(Schedule H applies to Candidates' Committees Onl l
SUB-TOTAL ..... $ 100 . 0 01 . 0 0
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
100,000 .00
Schedule Bi Expenditures total (Attach Schedule B) ( - also see debts and loans below) . .. .
Schedule F: Loan Repayments total (Attach Schedule F) . ., .. . .. .. .. . . . . . . ... .. .. .. .. .. . . . ... . .. . .. . 0
CASH ON HAND at the end of this reporting period (if final report balance must
1 .00
be zero) (Attach OR-3) ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . $

- `UNPAID BILLS (From Schedule D- Attach Schedule D) . .. .. . . .. , .. . . ... . . .. . . . . .. .. .. ., .. .. .  .$ _0

"IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . .. .. . . . . . .. . . . . . .. . . . .. . . . .. . . .. . $ _0
"OUTSTANDING LOANS (From Schedule F-Attach Schedule F) .  .. .  .. .5 0
CANDIDATE COMMITTF Q ONI_Y-
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
 Dem . ho%,7ernors Assn . Fax :202-7725602 Feb 2 2005 16 :34 P .03

For Instructions, See Back of Form SCHEDULE

A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev, 07103) RECEIPTS
(Including candidate's personal funds)
~] CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Democratic Governors'Association-lowa

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

CAUTION: Section 68B 37A(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

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT v IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MI`111DDiYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID# Sheet Metal Workers Intl Assoc
10/20/04 CK# 1750 New York Ave, NW N/A 5 25,000
Washington,DC 20006
ID#
Communication Workers of America
;25,000
0/20/04 CK# 501 3rd Street, NW N/A
ID#
Communication Workers of America
0/20/04 CK# 501 3rd Street ; NW N/A $25,000
Washin ton D 20001
ID# Laborer's Political League
0/20/04 N/A $25,000
CK# 905 16th Street, NW
Wash' n DC 2
ID#
CK#
ID*
CK#

ID#
CK#

ID#

CK#

D#

CK#

ID#

CK#

SUB-TOTAL
$100,000
TOTAL (if last page of this schedule)

° Disdosum law requires candidate committees to disclose the relationsnlp of any relative making a contribution to the
cemM75too. Rolat :onGhlp must no >.hown ho tha third d07mo of cD-gncuir, ;ty (blooA eol.q4i,NR) and Affinity (rolatlv¢s by
marriage) If surname of contributor is the same as candidate, but there is no page . 1 of _1
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
 Dem . Governors Assn . Fax : 202-77 ,25602 Feb 2 2005 16 :34 P.04

FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev. 07103) EXPENDITURES

STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE

L
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF
PAC CHECK. NUMBER FOR EACH EXPENDITURE, A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ET'4ICS & CAMPAIGN DISCLOSURE BOARD .

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

Democratic Governors'Association-Iowa
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MMIDDIYR) AND PAC
CHECK
NUMBER
ID ; 9098 Iowa Democratic Party
0/20/04' 1408 Locust Avenue Contribution
CK# Wire Des MOines,IA 50309 $ 100,000
Transfer
ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

C:K#

I D#

CK#

ID#

CK#

SUB-TOTAL ~ 1 OO, OOO

TOTAL (if last page of this schedule) $

j
THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Purchases of certain campaign property costing 5500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)

Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the personlentity on behalf of the candidste's committee . (Refer to
Schedule G Instructicns ar,d lows Code 6aA .4o2(3)ti) .)

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