| Viewz oIscLosurE DISCLOSURE SUMMARY PAGE (Rev, 02/96) REPORT ; cots my,» OMT TEE WANE te Basar 35 Ga Sao OTT) cnt LOZ . 5 H7I6 ACTZON PAC Indexed L IMPORTANT: Indicate type of committee you are reporting for: [2] (1 )StatewidenLegisiave Candidate (2 jStatewide PAC (3 Stale Paty ( 4 )CountyLocal Candidate (5 yCounty PAC {8 )Ballotleaue/Francrise Committee (7 }CountyiCty Central Commitee (3 }Suppor Slate of Candidates. ena herbed: HSB IGNATURE OF TREXSURER (or person filing this report) TELEPHONE | Penalties Due For Late Filed Reports Range from $10 re ny i ; SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE; oy 2 1AM FILING A Dey [4.2003 REPORT FOR ANJA (1) ELECTION /(2]NON-ELECTION YBAB= =" ‘eport dati Indicate one [Za Sa [[ecal Commies, enter Date of Election] ops (OCHECK IF AMENOMENT TO REPORT DATED {Check this i nal (ermination) report and atach Notce of Dissolution Form OR-2, | Sau Lael Cones, ete tnt in (You must continue to file reports until a Notice of Dissolution is filed.) ‘STATEMENT OF CASH ON HAND CASH ON HAND at the beginning of the reporting period. (This is the total of all monies held by the committee. This amount MUST be the fame asthe cash on hand at te end ofthe last reporting period, [86.07 (or must be zero if this is frst report fled.) a : ADD TOTAL MONEY TAKEN IN THIS PERIOD 50. od ‘Schédule A: Cash Contributions total (Ailach Schedule A)... ‘Schedule C: Fund-raising Events total (Alach Schedule C). ‘Schedule F: Loans Received total (Attach Schedule F). ‘Schedule H: Total Sales of Campaign Property (Attach Schedule H) {Schedule H applies to Candidates’ Committees Only) SUBTRACT TOTAL MONEY SPENT THIS PERIOD Schedule 8: Expenditures total (Atach Schedule 8)... Schedule F: Loan Repayments total (Attach Schedule F) 256.07 CASH ON HAND at the end of this reporting period (if final report, balance must bbe zero) (Attach DR-3) sr. UNPAID BILLS (From Schedule O - Attach Schedule 0) IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E). OUTSTANDING LOANS (From Schedule F - Attach Schedule F).... CANDIDATE COMMITTEES ONLY: CONSULTANT BREAKDOWN (Schedule G Attached?) VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)For Instructions, See Back of Form [SCHEDULE A MONETARY CONTRIBUTIONS ~- MONEY TAKEN IN (rev. 0296) | RECEIPTS (including candiéste's personal funds) 1 CHECK THIs BOX IF AMENDING FORM COMMITTEE NAME (Must be same as on Statement of Organization) Americun Ted ejation of Teach t 6 ACTION PAC STATE CANDIDATES. NOTE: IF A CONTRIBUTION i$ 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 1D NUMBERS iS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD, ° CAUTION: Section 688,32A(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 poltial committees. RELATIONSHIP “AMOUNT (applicable) TOCANDIDATE: | RECEIVED ‘AND PAC CHECK (applicable) NUMBER. ‘THOMAS 6. CARSNER 1627 COLLEGE CT PLACE Towa city, 1A 52245 THOMAS &. CARSNER 1627 COLLEGE CT PLACE JOWA city, In 52245 ‘THOMAS 6. CARSNER Teor CoLLece CT PLACE IOWA Cry, |. 52245 Tomas 5. cans HlOf[0> Tor en Ae Ree iSwacirs i. Sed ‘THOMAS G. CARSNER 4627 COLLCOE CT PLACE 5110/03 Towaccus, bs 92245 SUBTOTAL TOTAL (if last page of this schedule) “isco neu cet crtns dst sic ary lav maing crn ie aang as ste Sn ad eect sy fans 4,2 ‘tmog ne ap eame pa), aunae tab ne hen as anna es oo page ag eae familial relationship, enter “nat applicable” inthe relationship column,