FOR INSTRUCTIONS, SEE BACK OF FORM

DISCLOSURE SUMMARY PAGE S Reset Form y~

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

4Aessej-A~ e)eSK 4e It I

a
(
IMPORTANT : Indicate type of committee you are reporting for :
1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate
( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee

CANDIDATE COMMITTEES ONLY :

Candidate Name Political Party F SOAM
D180 LI'~,I.RE
-
SSeDe-sGkP II ',Veb,vUfe
Office Sought District (if Senate or House) NOV 4 Z004

"Ie171101 5 e ~Ifue- ..~~ . ~~u5 Pi o;r I'd JR

ao
SI ATUREIV TREASURER (or person filing this report) TELEPHONE DATE SIGNED

Late filed reports are subject to possible civil and criminal penalties .
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :
I AM FILING A - ~ (J +.-e,~ ~~ vC (3~ REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate one

[CHECK IF AMENDMENT TO REPORT DATED Local Committees, er :ter Date of Election

County & Local Committees, enter County 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 Notice of Dissolution is filed .)

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 same as the cash on hand at the end
of the last reporting period, or must be zero if this is first report filed .) 1,16. . .'N9 .aJ4 . . . . $

ADD TOTAL MONEY TAKEN IN THIS PERIOD

Schedule A : Cash Contributions total (Attach Schedule A) ('also see in-kind below) . . . . . . . . . . _J 6,06
Schedule F : Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d
Schedule H : Total Sales of Campaign Property (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL . . . . . $

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON HAND at the end of this reporting period (if final report, balance must
. --~ C
be zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. ~ . . . . .$

"`UNPAID BILLS (From Schedule D-Attach Schedule D) . . . . . . . . . . . . . c

am . . . . . . .. . . . .~ .U.0 . . . . . . . . . . . $

"IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . . . . . . . . . . . . ; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

'"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . 1 . . . . __0. . . . . .. . . . . . . . $

CANDIDATE COMMITTEES ONLY :

CONSULTANT BREAKDOWN (Schedule G Attached?) 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 . 06/97) RECEIPTS
(Including candidate's personal funds)
Q CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

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# y0 Y .3 1, ;r- /V/.' l-u n dr
ItaD Gr"wlf~cTicu_4ve Nit/ ST~i10
~p 1 o D'( CK# 10-
X 05 7 C,J~aslr , To  T,> & 2 ac) 3
ID#
G yb -.-Tu slr, e 4a2 ,4ll l'IgC~_
/IF 6 VA ~ke4_ 1 e j Z (p air
CK# c
15-6 30°
ID# )Ven P'q )& I%r72>1VAl l(evoc .a4ie R4s/
t
Die . ,~ ra
cK# i oalo G~,skrll
~~ -lam - 0y
ID# - L.
l~cc,h n2 ls~f~
66
CK# ~2aq 19 ~LTdil

ID# h?e ei n Gee

~o ^lam -o~ '~# l~ a ~ lceiloyy ~ ~ dd
es S Sooic
ID#
CK# 36?
r° s .s If
ID# (O p 7C) L,9t,,) PA G
CK# vv
/ t?--/,F -a es dyJrines .74 5v o~
ID# 6361 OPwN
CK# PC'. d"I Y 3
l D lr'~ -off
ID# dine C~ l<,4ily LptliC i
asp Rd-
CK# .
-04 , es -L-,4 5-0-r, i
ID# ~lo .e~ G" I,~CrnoGi~/iTlcr ~C~rri2AL m~ iT~

e .~ 5Uzs ;
SUB-TOTAL

TOTAL (If last page of this

schedule)
disclose the relationship of any relative making a contribution to the,
Disclosure law requires candidate committees to
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by of -j -
marriage) (See Page 2 of forms packet .) . If sivnnme of contributor is the. same as cnndidalp, but them is no Page
"not applicable" In the relationship colurnn . (for chedule A)
Mmilial relationship, Pnter
 FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 09/97) I EXPENDITURES

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

COMMITTEE NAME (Mu t be same as on Statement of Organization)

= t rll'

' ATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MMIDD/YR) AND PAC
CHECK
NUMBER
ID# Lo P1 wotiks G~
Ave ,

IN r~i~~
Al.eS Pasl O~feLe, M')
CK#
l b 'oZs? -d l
IN -or~VeYZtlsrn
I`r
fo a-o'f me s . z Sot i
X16

ID# pd s T Mss1-e iz.,

A .2o CK# 13F ` v
l~ -0Y /I
IN S Tct I eS
wo Ke~e I~~L

C
CK# jla 1 33 ;
" rn e s T r¢ jlXJ ro
~S

IN e-15 7A ~~~n dve Tsi ~G"3

CK# 3 l7 ~` sl l ~~
Iq N7 e .~ ,Jdc7i O
IN Co~r,~ GehTefti
PA"T /rr7/.~y
cK# % t S l a' G.- h nr.. b-ert. I ~- t vt
.
~o t »~ r l n'
kn e s 5oo 14
IN - rSToN . Aud,'Tert;
Uo Tevz- ~.hs7r~
To 05, x ~ ~
CK# P" 2 C~~.~5eCi. oZ.
lV~urf:dr97 .L CJ~2d
SUB-TOTAL $

TOTAL (if last page of this schedule) $ l `

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
organizing services must also be detail itemized on
Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, candidate's committee . (Refer to
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the
Schedule G instructions and Iowa Code 56 .6(3)(1) .)

Page
 1
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN KIND
COMMITTEE NAME (Must be same as on Statement of Organization) _(Rev. 06/97) CONTRIBUTIONS

ED CHECK THIS BOX IF

AMENDING FORM

DATE RELATIONSHIP DESCRIPTION ESTIMATED 4 IF FOR

RECEIVED NAME AND ADDRESS TO CANDIDATE OF IN KIND FAIR MARKET FUND-RAISER
M/DD/YR) OF CONTRIBUTOR ' (if applicable) CONTRIBUTION VALUE CONTRIBUTION

O Ld t~ ~8vn O ~' T' ~+ {f1912 r c,Y, j~ h

oF~
% 0 0
, L 0 ~tt s l

l .Z- AT e2# 4 4-

d - D-G.t/
$'O 1 C rz
me
s lA, L
.~ ,~00
El
Z, ©u Car-TA c rg- AT-
6 _,?6 _oy 7d O Oaf+__
yl , o D F-1
71
F-1
71
F-1
71
0
F-1

TOTAL (if last

page of this
schedule)

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

COMMITTEE NAME(Must be same as on Statement of Organization) F LOANS

(Rev. 07/03) RECEIVED
REPAID

NOTE : This sc ledule re its money loaned to the committee which is deposited in the committee account. *CHECK THIS BOX IF
AMENDING FORM
TOTAL UNPAID LOANS FROM LAST REPORTING PERIOD $ e, -

PART I - MONETARY LOANS RECEIVED THIS REPORTING PERIOD PART II - MONETARY LOAN REPAYMENTS MADE THIS REPORTING PERIOD
' (Original source of loan, such as a bank, must be shown if a thirdparty is (Loans forgiven must be reported on Schedule E- In-kind Contributions .)
involved. Include loans from candidate's personal funds.)
DATE NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT DATE PAID NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT
RECEIVED (Include Endorser's Name, If Applicable) . TO CANDIDATE OF-LOAN (MM/DDIYR) (Include Endorser's Name, If Applicable) TO CANDIDATE' REPAID
(MMIDDIYR - (if Applicable*) If Applicable)

TOTAL (PART 1) $ TOTAL CASH REPAYMENTS (PART 11) $

From Schedule E - TOTAL LOANS FORGIVEN $

TOTAL OUTSTANDING LOANS END OF REPORT PERIOD $

`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). If surname of contributor is
the same as candidate, but there is no familial relationship, enter "not applicable" in the
relationship column when it applies . Page .Iof
(for Schedule )
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

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

D I INCURRED
INDEBTEDNESS
C+ ; ~, C
(Rev . 08/98)
-
FOt, ttuleSsei - kroe5Ch C f l CHECK THIS BOX
IF AMENDING
NOTE : Debts previously reported that remain unpaid must be included on this Reset Form FORM
Schedule, as well as any new obligations incurred in this period .

An "incurred debt" is a debt for

DEBTSIOBLIGATIONS REMAINING THIS REPORTING PERIOD goods or services ordered or
(DO NOT INCLUDE LOANS -- SHOW LOANS ON SCHEDULE F) received, but not paid for by the
end of the reporting period .,
regardless of whether an invoice
has been received .
DATE DESCRIPTION OF GOODS OR BALANCE OWED AT
INCURRED NAME AND ADDRESS OF PERSON SERVICES PROVIDED OR CLOSE OF
(MMIDDIYR) TO WHOM DEBT OR OBLIGATION IS OWED PURCHASED REPORTING
PERIOD"

777 ~ss~~] ._ ~~IrGescNe~ ~

_
yr01nes k5~s1p
71$ XSIl /Joe r"lletogpoper
I
~S ~ ~ sODI~

SUB-TOTAL $

TOTAL DEBTS OWED BY COMMITTEE AT THE END OF THIS REPORTING PERIOD $

`If actual figure is unknown, show "estimated" beside the figure . Page I -of
(for Schedule D)

CANDIDATE COMMITTEES NOTE :

`Incurred indebtedness also includes each personientity with whom the candidate's committee has entered into a contract during the reporting period for future
or continuing performance . Enter the name of the consultant who provides or procures services for items such as advertising, fund-raising, polling, managing, or
organizing services. Report on Schedule G the nature of performance and the estimated performance reas onably expected of the consultant .