FAX NO . Oct .

17 2004 08 :38AM P1
ROM

FOR INSTRUCTIONS, SEE BACK OF

FORM
DISCLOSURE SUMMARY PAGE M

COMMITTEE NAME (Musts be same as on Statement of

~pr~a tAhlpn
Orgenizstlon)
.4J
60
W -2
~17/2004)
For Office U1!* 4rrfv
DISCLOSURE
REPORT

Comm, S
IMPORTANT. Indleete by .0 type or comnlraee you arrtie repongor
(1 )Statewide/Legislative/Judge Standing for Retention Candid tof : Logged In i~
(4 )County Cenval Committee (5 )CountyCandidate ( ( 2 )State PAC ( 3 )State party
ndldate (7 )School Board or Other Scanned
Political 6ubdNis(on Candidate (8 )County PAC 10 )School Board or Other Poltical
SubdlvllonP`~ (11 ) Local 3N109 Issue Computer
-
Audited

Late reports are subject to

possible civil and criminal
penalties.

. cell, asS - ;>3 F,5;-

TELEPHONE
_/ !0-
DATE SIGNED

I AM FILING A REPORT FOR (1) ELECTION /"ON-ELECTION YEAR .

(report date) Indicate by If

Local Committees, enter Date of Election

(]CHECK IF AMENDMENT TO REPORT DATED

County & Local Committees, enterCounty In

[] Check if this Is final (termination) report and attach Notice of Dissolution Form DR-3 . which Election Is held
(You must continue to file reports until a DR-3 is filed.)

1111101111111111111

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
of the last reporting period or must be zero if this is first report filed.) .. ... ...... . ... ... ... ......... .. $
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash ContAbutlons total (Attach Schedule A) ("also see in-kind below) . .. ... ... .
Schedule F: Loans Received total (Attach Schedule F) .. . .. ......... ..... ... ... ...... ...... ..... . ........ .. . .
Schedule H: Total Sales of Campaign Property (Attach Schedule H) . ........ ... ... . .... . ... ... .. ... . .
IS ahltdule H aRnlies at7dldetea' Committees On1Y1
SUBTOTAL .... .5 Sg 0S,~F
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ("also see debts and loans below) ....
Schedule F: Loan Repayments total (Attach Schedule F) ., .. ... . . . .. . . .. ... . . ......... ......... ... ... .......
must
CASH ON HAND at the end of this reporting period (if final report balance
zero) (Attach DR-3) ... ... ... .. .. . ...... .......... . ... ... ... ................... .. .. .. ... .... .... . ..... . . .. .. . . .... . . .. .. ... . .. $
be

"UNPAID BILLS (From Schedule D -Attach Schedule D) ...... ... ........ .... .. . ...... ... .. .... ....., .. . .... .., .. ......$
"IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) ..... .... . ... ... ... ... . ........... ... ... ..... . . $
"*OUTSTANDING LOANS (From Schedule F -Attach Schedule F) .. ... ... .. . .. .... .. . ..... .. . ...... ... .... .. ... .... .$
COMMITTEES ONLY:
C-a NO
CANrfj0ATP

YES
CONSULTANT BREAKDOWN (Schedule G Attached?)
VALUE OF CAMPAIGN PROPERTY (From Schedule H -Attach Schedule H)
COMMITTEE NAME: IOWA STAFF UNION-NATIONAL STAFF ORGANIZATION PAC #6177

DATE NAME AND ADDRESS AMOUNT

RECEIVED OF CONTRIBUTOR RECEIVED

STEVE ADAMS
8/6/04 1 HILLCREST HEIGHTS $20 .00
9/9/04 MOUNT VERNON, IA 52314 $20 .00
10/4/04 $20.00

WAYNE BAUMAN
8/6/04 4122 LEYDEN AVE $5.00
9/9/04 DES MOINES, IA 50317 $5.00
10/4/04 $5.00

BOB BROWN
8/6/04 603 S. BIRCH RIDGE $6.00
9/9/04 PEOSTA, IA 52068 $6.00
10/4/04 $6.00

KIRK BAUMANN
2401 SENECA WAY
SIOUX CITY, IA 51104

STAN BURKE
717 36TH STREET
WEST DES MOINES, IA 50265

TONYA CARUTH
8/6/04 900 SHAWVER DRIVE $5 .00
GRIMES, IA 5011

LYNETTE CLAEYS
8/6/04 933 W 16TH ST $20 .00
9/9/04 DAVENPORT, IA 52804 $20 .00
10/4/04 $20 .00

JIM CROTTY
8/6/04 7525 CODY DRIVE $15.00
9/9/04 WEST DES MOINES, IA 50266 $15 .00
1014/04 $15.00

BEV CRUMB-GESME
8/6/04 700 LINDEN $10 .00
9/9/04 DECORAH, IA 52101 $10 .00
10/4/04 $10 .00

SUB TOTAL $233.00

PAGE 1 OF 4 SCHEDULE A
 FAX NO. Oct . 17 2004 08 :39AM P2

COMMITTEE NAME : IOWA STAFF UNION-NATIONAL STAFF ORGANIZATION PAC #6177

BETTY FULLER
8/6/04 4400 ASHWORTH ROAD $10 .00
9/9/04 WEST DES MOINES, IA 5026,9 $10,00
10/4/04 $10 .00

MYRON HALVERSON
8/6/04 21937 114TH LANE $12 .00
9/9/04 BLOOMFIELD, IA 52537 $12,00
10/4/04 $12 .00

JAY HAMMOND
8/6/04 5405 CENTER STREET $5.00
9/9/04 WEST DES MOINES, IA 50266 $5.00
10/4/04 $5.00

CAROL HAUPERT
8/6/04 812 E WOODLAND $10 .00
9/9/04 OTTUMWA, IA 52501 $10 .00
10/4/04 $10 .00

BRAD HUDSON
8/6/04 4301 38TH STREET $10 .00
9/9/04 DES MOINES, IA 50310 $10.00
10/4/04 $10 .00

ANGIE KING
8/6/04 1361 72ND STREET $7.00
9/9/04 DES MOINES, IA 50311 $7.00
10/4/04 $7,00

STEVE KING
8/6/04 113 W KENNEDY $10 .00
9/9/04 ALGONA, IA 50511 $10 .00
10/4/04 $10 .00

KATHY KREHBIEL
8/6/04 3145 HICKORY DR $15.00
9/9/04 SOLON, IA 52333 $15.00
10/4/04 $15 .00

JEREMY,KUNZ
10/4/04 911 MAPLEWOOD DRIVE #2 $20.00
CEDAR FALLS, IA 50513

BRUCE LEAR
8/6/04 3531 IDLEWOOD STREET $10 .00
9/9/04 SIOUX CITY, IA 51104 $10 .00
10/4/04 $10 .00

SUB TOTAL $287 .00

 FAX NO. : Oct . 17 2004 08 :39AM P3

COMMITTEE NAME: IOWA STAFF UNION-NATIONAL STAFF

ORGANIZATION PAC #6177
PAGE 2 OF 4 SCHEDULE A
JOANN MACKIN
8/6/04 15 7TH ST SE $10 .00
9/9/04 HAMPTON, IA 50441 $10,00
10/4/04 $10 .00

GARY MEYER
8/6/04 6516 ROSELAND DR $5 .00
9/9/04 DES MOINES, IA 50322 $5 .00
10/4/04 $5.00

RANDALL PADDOCK
8/6/04 1502 29TH STREET $5 .00
9/9/04 SIOUX CITY, IA 51104 $5.00
10/4/04 $5.00

JOHN PHILLIPS
8/6/04 1601 TORMEY $10.00
9/9/04 RED OAK, IA 51566 $10 .00
10/4/04 $10.00

SUE QUAIL
6301 CROW VALLEY DR
BETTENDORF, IA 52722

RANDY RICHARDSON
10/4/04 3016 FOX HOLLOW CIRCLE $10 .00
DES MOINES, IA 50321

DOREEN RICK
8/6/04 1025 WEST STATE $20 .00
9/9/04 MASON CITY, IA 50401 $20 .00
10/4/04 $20 .00

LANA SCHLAPKOHL
8/6/04 13908 BUENA VISTA DR $10 .00
9/9/04 DES MOINES, IA 50323 $10 .00
10/4/04 $10 .00

LINDA SCHNEIDER
8/6/04 15 SCHWARTZ DRIVE $10 .00
9/9/04 OTTUMWA, IA 52501 $10 .00
10/4/04 $10 .00

PAT SHIPLEY
8/6/04 BOX 32 $35 .00
9/9/04 NODAWAY, IA 50857 $35 .00
10/4/04 $.35 .00 .

SUB TOTAL $325 .00

PAGE 3 OF 4 SCHEDULE A
 FAX NO . Oct . 17 2004 09 :40AM P4

COMMITTEE NAME: IOWA STAFF UNION-NATIONAL STAFF ORGANIZATION

PAC #6177

JON STUDER
8/6/04 1501 NE TRILEIN DRIVE $5.00
9/9/04 ANKENY, IA 50021 $5.00
10/4/04 $5.00

ELWOOD THOMPSON
8/6/04 730 WEST AIRLINE HWY $5.00
9/9/04 WATERLOO, IA 50703 $5 .00
10/4/04 $5 .00

DAVE ULRICK
8/6/04 514 TERRACE ROAD $10 .00
9/9/04 IOWA CITY, IA 52245 $10 .00
10/4/04 $10 .00

BILL UNGER
8/6/04 4214 87TH STREET $5 .00
9/9/04 URBANDALE, IA 50322 $5.00

DAVE WILKINSON
8/6/04 2504 GUTHRIE AVE $'10 .00
9/9/04 DES MOINES, IA 50317 $10.00
10/4/04 $10.00

MORA ZINN
8/6/04 1509 17TH ST BOX 162 $10 .00
9/9/04 MILFORD, IA 51351 $10 .00
10/4/04 $10 .00

SUB TOTAL $130.00

PAGE 4 OF 4 SCHEDULE A

TOTAL ALL PAGES $975.00

 FAX NO . Oct. 17 2004 08 :40AM - P5
FROM

EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT

SCHEDULE B MONETARY EXPENSES

COMMITTEE NAME ; IOWA STAFF UNION-NATIONAL STAFF ON PAC #8177

DATE CANDIDATE ID
EXPENDED NUMBER & PAC NAME AND ADDRESS TO WHOM
(MM/DD/YR) CHECK NUMBER EXPENDITURE WAS MADE PURPOSE AMOUNT
Jeff Danielson
9/24/04 CHK# 1001 Danielson for Senate CAMPAIGN $500 .00
ID #1338 3906 Monterey Drive CONTRIBUTION
Waterloo, Iowa 50701-3527
Tom Fiegan
9/24/04 CHK# 1002 Friends and Neighbors of Tom Fiegen CAMPAIGN $500.00
ID #1285 93 f,ombard Street CONTRIBUTION
Clarence, Iowa 52216
David Fry
9/24/04 CHK# 1003 David Fry Election Campaign Commit CAMPAIGN $500.00
ID #1591 503 N. Fremont CONTRIBUTION
Stuart, Iowa 50250
Tom Hancock
9/24/04 CHK# 1004 Hancock for Senate CAMPAIGN $500.00
1D #1502 310 E. Main Street CONTRIBUTION
worth, Iowa 52045
Judith Peterson
9/24/04 CHK# 1005 Peterson for Our People CAMPAIGN $500.00
ID #1538 2612 S . Lyon Street CONTRIBUTION
Sioux City, Iowa 51106
Wayne Sawtelle
9/24/04 CHK# 1006 Sawtelle for Senate CAMPAIGN $500.00

ID #1523 308 South 6`h Street CONTRIBUTION

Marshalltown, Iowa 50158-2658
Brian Shoenjahn
9/24/04 CHK# 1007 Citizens for Schoenjahn CAMPAIGN $500.00
ID #1534 221 Park Avenue CONTRIBUTION
Arlington, Iowa 50606-0132
- - Steve Waterman
9/24/04 CHK# 1008 Waterman for State Senate CAMPAIGN $500.00
ID #1508 214 E. Cass CONTRIBUTION
Osceola, Iowa 50213
SUB-TOTAL $4,000 .00
(If last page of this schedule) TOTAL

Page 1 of 2
for Schedule B
 FAX NO . Oct . 17 2004 08 :40AM P6
FROM

EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT

SCHEDULE B MONETARY EXPENSES

COMMITTEE NAME : IOWA STAFF UNION-NATIONAL STAFF ORGANIZATION PAC #6177

DATE CANDIDATE ID
EXPENDED NUMBER & PAC NAME AND ADDRESS TO WHOM
(MM/DD/YR CHECK NUMBER EXPENDITURE WAS MADE_ PURPOSE AMOUNT
John Whitaker
9/24/04 CHK# 1009 Committee to Elect John Whitaker CAMPAIGN $500.00
ID #1434 32500 145' Street CONTRIBUTION
Hillsboro, Iowa 52630
Russell Wiesley
9/24/04 CHK# 1010 Friends for Russ Wiesley CAMPAIGN $500.00
ID #1584 805 Walnut Ridge Drive CONTRIBUTION
Waukee, Iowa 50263
Frank Wood
9/24/04 CHK# 1011 Frank Wood for Senate CAMPAIGN $500.00
ID #1563 P. O . Box 402 CONTRIBUTION
Eldrid e, Iowa 52748
Ray Zirkelbach CAMPAIGN $500 .00
9/24/04 CHK# 1012 Citizens for Zirkelbach CONTRIBUTION
ID #1535 637 West First Street
Monticello, Iowa 52310

Senate Truman Fund

9/24/04 CHK# 1013 Iowa Democratic Party CONTRIBUTION $1,250 .00
1408 Locust
Des Moines, Iowa 50309

House Truman Fund

Iowa Democratic Party CONTRIBUTION $1,250.00
9/24/04 CHK# 1014
1408 Locust
Des Moines, Iowa 50309

South Ottumwa Savings Bank Deposit Slips $11 .49

9/21/04
P.O. Box 516
Ottumwa, IA, 52501

SUB-TOTAL $4,511 .49

(If last page of this schedule) TOTAL $8,511 .49

Page 2 of 2
for Schedule B