FOR INSTRUCTIONS .

SEE BACK OF FORM

DISCLOSURE SUMMARY PAGE

COMMIX'TNAME (A61-e sarr~e .a~ qn S~\m

Senf ol~Or nizlon)J
S

IMPORTANT: Indicate type of committee you are reporting for:

( I )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party (4 )County/Local Candidate
( 5 )Co my PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee
( 6 )port at Af Candid21es,)

/
r 15'0<
HER br person filing this reportTELEPHONE DATE SIGNED

Routine Penalties Due For Late Filed Reports Range from $20 to $800

SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :

I AM FILING A &CZbK-Q'a %!V i 0;4004 ~ REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate one

OCHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election

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

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (This is the total
of all monies held by the committee. This amount MUST be the

790-47-
same as the cash on hand at the end of the last reporting period,
or must be zero i( this is first report filed.) ............... .......................................... .. .. .. .......... ...$
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) .................... .. .. .. .... .. .. .. ........ .. ... ,5-5-0.00
Schedule F: Loans Received total (Attach Schedule F) ...... ...... ..... .. .... ............. .. .. .......... .. .. . O

Schedule H: Total Sales of Campaign Property (Attach Schedule H) .. .. ........... .. .. ....... .. ... .. .
(Schedule Happlies to Candidates' Committees OnW
SUB-TOTAL......$ 9, 330. t2
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ...... ........ .. .. .. .. ....... .. .. .. .. .. .. .. .... .. ..........
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) . .. . .. ... .. . . . .. . . . .. .. .... .. .. ......... . ..... .. ... .. . . . ... .. .. .. ........... .. .. .. .. .. .. ........ .. ....... .$

UNPAID BILLS (From Schedule D - Attach Schedule D) ....... .. ..... .. ...... .. .. .. .. ........... .. .. .. .. .. .... .. .. ...... ..$ d
IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .... .. .. .. .. .. .. . . .. . .. .. .. .. .. .. .. .. .. ..........$ 0
OUTSTANDING LOANS (From Schedule F - Attach Schedule F) .. .. .. .. .. .. .. .. ... .. .. .. ........ . . .... .. .. .. .. .. ....$

-Z
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 06197) I RECEIPTS
(Including candidate's personal funds)
O CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Fo eJ?- Gx_, gens X887- _

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.32A(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 J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
~na.Qa( C/ac,ccss~n
X0 .22o~ ~3s klorwrh ~e- $ zSab
CK#
ZSb3 /4A..f`-t Or) 4 SZ-302-
ID#
0 33 FQ-J,e W
Zl~ LID !
K5 t Aa . -PAS.
~S''~' ~'f' .
I 0 . 22 .0 ` CK#
~lD(o 6oone %JA .5:-003&
ID# b~ ¢ld4i SU'rn
// . /0 .0~ CK#
`tl N . 3t 3 i .V: WeT-f
3Z-124',i-
l23f'p Mo vP~-no-h CJA
Ro nau S. If~ ~r
1/, It? . o t~ 301(o 6UkA'dd- Dw . N E
CK#
9 73 ~stier ~ ~~S lSAo6
ID# A
TWO- `PAS
~1/~d A00 3 92w
A-Pe~S".k 207-
CK#
Za'14 Wits* S Mol'rls ilA 50 1 b,z
ID#
Z 1-l IleG- ,5tc . /ogee's PAG
S& We_S-kwn &P k-A
l0 U~ CK#
Od/~q0 OZ&-7ZZ
l
WISf ~t s mol us -
ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL

TOTAL (if last page of this

schedule)
' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page - / of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
 FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B

(Rev . 09/97)
MONETARY
EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE 0 CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .

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

007
Y r hS -
'/CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
ID#
L(S' . f'bS~`rKQs'tY.l~'
16* 1 4o cK#
t5_73 /W. V an, 64 52314 . s $
ID# J;~u md r/t~~&~Ad
1aw/a JJC.r~'tOGYq~ G
1b , 24`l CK# 515' 6-&4,1 Fleu-v 've_ J
°'~' 5,106, Ob
oiK1S ~b32l
ID# 2 /p~ "" ~ .
"h,oolG .~-ive. ALhuI'I iSi~ W- :54-4&-S
11 ~-9o~ CK# , 710 M4 UP SZ30Z
.*]", 7s: ~b
ID# 7h c
l13 Second. Ave, Al
12~Z3'o~ CK#
Mf VU-nwn 44 5231
ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL $

TOTAL (if last page of this schedule) $

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 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 person/entity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(1) .)

(for Schedule B)