Generated On: 10/18/2010 5:15:05 PM

Schedule E: In Kind Contributions Sch-E

Common Sense Status: Filed
Committee Type: Iowa PAC Statutory Due Date 10/19/2010

County: Hancock Adjusted Due Date

District: 0 Filed Date 10/18/2010 5:05:36 PM

Committee Code: 9798 Postmark Date

Political Party: Not Available Amendment Date

Date Name & Address of Relationship to Description of in Estimated Fair "X" for
Contributor Candidate *(if Kind Market Value Fund-
applicable) Contribution Raiser
9/1/2010 Bast, Greg None Campaign Signs $300.00
1770 Xenia Ave
Goldfield, IA 50542
9/1/2010 Bremer, Leonard None Campaign Signs $100.00
308 8th St S
Dakota City, IA 50529
9/1/2010 Gronbach, Jim None Campaign Signs $200.00
1005 11th Ave N
Humboldt, IA 50548
9/1/2010 Kohlhaas, Joan None Campaign Signs $100.00
1704 Texas Ave
Hardy, IA 50545
9/1/2010 Tammen, Don None Campaign Signs $200.00
102 North Highway 17
Renwick, IA 50577
10/2/2010 Burleson, Dale None Mileage $159.00
1125 N. 5th Street
Clear Lake, IA 50428 Travel to deliver
signs to cities on
a route to Sioux
City, IA from Clear
Lake.
10/2/2010 Wacker, John None Mileage $681.00
1950 Hwy 69
Garner, IA 50438 Delivering signs,
driving truck and
trailer, Garner, IA
to Keokuk, IA and
towns along the
route. Rate -
$1.00/ mile.
10/9/2010 Wacker, John None Mileage $559.00
1950 Hwy 69
Garner, IA 50438 Delivering signs,
using truck and
trailer, from
Garner, IA to
Dubuque, IA and
towns along the
route. Rate $1.00/
mile.

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 1 of 2
 Generated On: 10/18/2010 5:15:05 PM

Schedule E: In Kind Contributions Sch-E

Common Sense Status: Filed
Committee Type: Iowa PAC Statutory Due Date 10/19/2010

County: Hancock Adjusted Due Date

District: 0 Filed Date 10/18/2010 5:05:36 PM

Committee Code: 9798 Postmark Date

Political Party: Not Available Amendment Date

Date Name & Address of Relationship to Description of in Estimated Fair "X" for
Contributor Candidate *(if Kind Market Value Fund-
applicable) Contribution Raiser
10/12/2010 Burleson, Dale None Mileage $108.00
1125 N. 5th Street
Clear Lake, IA 50428 Delivering signs
from Clear Lake,
IA to Decorah and
towns along the
route.
10/13/2010 Miller, Mike None Campaign Signs $390.00
309 Washington St
Floyd, IA 50435

Total Estimated Fair

$2,797.00
Market Value

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 2 of 2