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JeN-21-2003 08:38 FROM PSH UMOLESALE 10 FOR INSTRUCTIONS, SEE BACK OF FORM Re ance [Fora DR2 DISCLOSURE DISCLOSURE SUMMARY PAGE (Rov. 01788) REPORT [COMMITTEE YARRE (lust bo game as on Statement of Organization) fev As ve Coy PORTANT: Inca toe of coment you scerparing toc: [7] 1 tlnttzane Ceca (2 ovania PAC (2 em ery (4 eyo Conte {2 awed Bears Sots (7 Yeomeyty Core a U2 )eapport Siete of Carcheten ‘SGNATORE GF TREASURER (or parson fing the report) TELEPHONE DATE ORES Routine Penatties Due For Late Filed Reports Range from $20 to $800 TAM FHI A LL atlas T=PORTFOR A 9) RLATTON EE RARECTON EA (report dato) Indicate coe TJCHECK IF AMENOMENT TO REPORT DATED cet Comrie Bet of Eaton crete tal Qomiouten pert gd atach Notce of Diecilon For DR, | CARRE Ua Sins. er Sayin {rou mat contr tp Nc f Dowco ee.) repent | STATEMENT OF CASH ON HAND (CABH ON HAND at the beginning of the reporting period. (This i thé total {CASH ON HAND a heer of ie reporting ptd Of al report, balance mut ‘vo zero) (Aacn OR) vonnnnnnennts 4 GES {UNPAID BILLS (From Schedule D Attach Schedule D) nn |W KIND CONTRIBUTIONS (From Schedule E- Attach Schedule E) ‘OUTETANDING LOANS (From Schadwe F - Atloch Schodta F) ‘SANDIDATE. GOMMITIEES ONLY: CONSULTANT BREAKDOWN (Schecuto G Atached7) VALUE OF CAMPAION PROPERTY (From SchexiuleH-Axtach Schedule) s OM PAH WHOLESALE: 70. CONTRIBUTIONS -- MONEY TAKEN IN (Inchesing candidate's persons! funds) [COMMITTEE NAME (Must be same as on Statement of Organization) P.23 (Rev 0296) | RECEIPTS OO CHECK THIS 80x iF ‘AMENDING FORM STATE CANDIDATES NOTE: IF COWTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEC)_LIST THE PAC 1DENTIFICATION NUMBER AND THE PAC CHECK MAMRER IN THE DESIGNATED GOL Usb A UST OF 19 MUMBERS ig AVALABLE FROM THE [OWA ETHICS AND CAMPAICH CAUTION: Section 688.224(6), lowa Code, prohiie the use of information copied from reports and staternenta for soliciting contibutions or for any commercial purpowe by any person cover inan statsioy poical commitines. Ameria STIle Bre k 1% S2owe Mae AVE e

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