FOR INSTRUCTIONS.

SEE BACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 DISCLOSUI
COMMAITTEE NAME (Must be same as on Statement of Organization) (Rev. 01/2001) FIEPORT
Granzow for State House Committee For Office Use only

IMPORTANT: Indicate type of committee you are reporting for e comm. #

Indexed
( 1 )Statewide/Legislative Candidate ( 2 iStatewider PAC, ('3 )Scat#'Pa ~ )County/Local Candidate
Audited
( 5 )County PAC ( o" )Ballot Issue/FranchiseFL°orfimittee t 7 )Po4nly/Cfty Contral Committee
( e )Support Slate of Candidates Computer
CANDIDATE COMMITTEES ONLY: s.~ V 4

Candidate Name ! 20 ~ olitical Party

Polly Granzow _ -~ Republican
Office Sought - District (if Senate or House)
State House 44

(641) 939-5487 10/26/04

SIGNATURE OF TREASURER (or person filing this report) TELEPHONE DATE SIGNED

Routine Penalties Due For Late Filed Reports Range from $20 to $800
SEE INSTRUCTIONS ON HACK AND COMPLETE THE FOLLOWING SENTENCE :
I AM FILING A 10/29/04 REPORT FOR ANNA (1) ELECTION /(2)NON-ELECTION YEAR.
(report date) Indicate one

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

County & Local Committees, enter County in

0 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 9,814 .86
of the last reporting period, or must be zero if this is first report filed .) ....................... . . .......$
ADD TOTAL MONEY TAKEN IN THIS PERIOD
1,860 .00
Schedule A: Cash Contributions total (Attach Schedule A) ('also see in-kind below) .........
0 .00
Schedule F: Loans Received total (Attach Schedule F).... .......................... ................ ... ......
0 .00
Schedule H: Total Sales of Campaign Property (Attach Schedule H).............. .................. ..
(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL...... $ 11, 674 .86
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
4, 494 .27
Schedule B: Expenditures total (Attach Schedule B) (*'also see debts and loans below) ...
0 .00
Schedule F: Loan Repayments total (Attach Schedule F)
CASH ON HAND at the end of this reporting period (if final report, balance must
7,180 .59
be zero) (Attach DR-3)
0 .00
**UNPAID BILLS (From Schedule D - Attach Schedule D) . .. . ................ ..................... ... ...... ... ... ..... .. .$
0 .00
*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) ......... .. .. .. .............. .... .. ...... .. ... . $
0 .00
"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) ...... .. ........... .. ........ . ...... ........... ....$
CANDIDATE COMMITTEES ONLY:
_ YES X NO
CONSULTANT BREAKDOWN (Schedule G Attached?)
675 .00
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
 For Instructions, See Back of Form SCHEDULE
MO NI_TA P~
CON71FIEUTICNS -- MONEY TAKEN IN (Rev . 06/97) RECEIP7 ;
(Including candidate's personal funds)
[~ CHECK THIS 8QX
COMIWI iIiEE NAME (Must be same as on Statement of Organization) AMENDING F(DRrV

Granzow for State House Committee

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICAi10N1
NUMBER AND THE PAC CHEZ::< NUMBER IN THE DESIGNATED COLUMN . A UST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.

CAUTION : Section 68H.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contrihutims
for any commercial purpose by any person other than statutory political committees .

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT

RECEIVED (if applicable) TO CANDIDATE' RECEIVED ( FI
(MM/DD/YR) AND PAC CHECK (if applicable) RF
NUMBER INC

I
ID# Mrs . Cynthia Schulte
CK# 5406 1650 250th St . 35 .00
10/19/04
State Center, IA 50247
I # 6125 Iowa Realtors PAC
CK# 1370 NW 114th St . ; Suite 100
10{19{04 002392 500 .00
Clive, IA 50325
ID# IOWA LAWPAC
6070
CK# 521 East Locust St ., FL 3rd
10/19/04 3105 100 .00
Des Moines, IA 50309-1939
JID# 9075 COMMONWEALTH PAC - IOWA
10/19/04 1042 _ P .O . Box 1780 .
CK# 1000 .00
Birmingham, MI 48012
ID# 6064 Iowa F.O .R .E
Friends of Rural. Electrification
CK# 1880 8525 Douglas Ave ., Suite 48
10/19/04 100 .00
Des Moines, IA 50322
ID# Mr . or Mrs . Gary D . Walters
27716 270th Street
10/25/04 CK# .3734
Eldora, IA 50627-8216 25 .00
ID# 1381 "FAS PAC"
Fareway Stores, Inc . - PAC
10/25/04 CK# . .5110 2600 E . 8th St .
Boone, IA 50036 100 .00
ID#

CK# .

ID#

CK#

ID# I ! I I
CK#

SUB-TOTAL

TOTAL (if last page of this

- schedule) $ 1 860 .00
Disclosure taw 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 1 of 1
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
 FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
13 MONETAI
EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT (Rev. 09197) EXPENDTI

STATE PAC COMMITTEES: NOTE FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE CHECK THIS B0-^
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED. COLUMN AND THE
PAC CHECK NUMBER FOR EACH EXPENDITURE. A UST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FOR(
ETHICS & CAMPAIGN DISCLOSURE BOARD.

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

Granzow for State House Committee

CANDIDATE
ID NUMBER
(if applicable)
AND PAC
CHECK
NUMBER

TOTAL (if lastpage of this schedule) 1$ 4494 .27

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 .) .

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

(fnr Grhcri,ilc R1
 rur7 11vo I" UU I IVIVb, L7CC OHt-n Vr rurim
SCHEDULE
THIS FORM IS USED BY CANDIDATES' COMMITTEES ONLY H
(Rev . 02196) I CAMPAIGN
PROPERTY
COMMITTEE NAME (Must be same as on Statement o(OrganIza11on) ATTAGFI SCHEDULE H TO"
EACH REPORT, MAKING
Granzow for State House Committee CHANGES AS REQUIRED.

E:1 CHECK THIS BOX IF

PART 1 - ONGOING INVENTORY OF CAMPAIGN PROPERTY PART 11 - SALES OR TRANSFERS OF CAMPAIGN PROPERTY " AMENDING FORM

Date Purchased
(Schedule e) Purchase Current
or Date Received Descdption of Property Price or Est. Value at Fair Date Name and Address of Purchaser/Donee Description at Property Sold? Sale Value of
(Schedule E) Value When Madcet This (MM/DD/YR) YIN Price Donation
MM/DD/YR ) A29ulred* Report

1/3/03 Computer $685 .84 $600 .00

1/12/03 Dell Printer $140 .00 $75 .00

TOTALS $
TOTAL VALUE CAMPAIGN PROPERTY THIS REPORT $675 .00 " PROPERTY SALES & TRANSFERS TOTAL $
(TRANSFER TO SUMMARY PAGE) $
(TRANSFER TO SUMMARY PAGE) $
(Attach Addltlonal Schedules If Needed) Page "I of Pages
If estimated, show a9L beside figure . (For Schedule H)