FOR INSTRUCTIONS, SEE BACK OF FORM FORM

GSL,
J.',1' 4z
e6\
I
9
DR-2 1 DISCLOSURE
DISCLOSURE SUMMARY P/I
A lu (Rev . 02196) REPORT

COMMIr~EE NAME (Must be same as on Statement of Organization)

~~SSGf r 1r' .~ ? // C'P //i L It/5 c

IMPORTANT: Indicate type of committee you are reporting for:

( 1 )StatewidelLegislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate

( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee
( 8 )Support Slate of Candidates

Penalties Due For Late Filed Reports Range from $10 to $400

SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :

I AM FILING A REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR .

(report date) Indicate one 0

[]CHECK IF AMENDMENT TO REPORT DATED Local Committees, enter 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.) . .. .. . .. .. .. . .. .. . . . .. .... .. .. .. .. .. . .. ... .. ..... .. ...... . .. .. .. .. . .. .. .. ... $
ADD TOTAL MONEY TAKEN IN THIS PERIOD
C7 _?
Schedule A: Cash Contributions total (Attach Schedule A) .. .. .... . .... ... .. .. .. . .. .. .... .. ..... .. . .. .. .. .. 44
Schedule C: Fund-raising Events total (Attach 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)
SUB-TOTAL ..... $
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ........ .. .. .. .. .. . .. ... .. ..... .. .. ... .. .. .. .. ... .. . .. .... .
Schedule F: Loan Repayments total (Attach Schedule F) .. .. .. .. .. . .. .. . .. ... .. .. ..... .. .. .... ... .. . .... .. .

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

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) . .. ... .. .. .. . .. . .. ..... .. .. . .. .. .. .. .. .. . .. ..... .. .. .$
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
For Instructions, See Back of Form SCHEDULE

CONTRIBUTIONS - MONEY TAKEN IN

A MONETARY
(Rev . 02196) RECEIPTS
(Including candidate's personal funds)
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 6SB .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 ANDADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT

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

~Cf`pL'
CK# P~ . Ig~k 14- ~c
` .L sU G vdv r
ID#
L~J~ l is ~t -.~
d

CK# G

ID#

CK# 53 / llrl G. ~"l

A1`7 .
ID#

_
'6 CK# c, ga ,tr -
-.20 /4 C0
«, 3 -d 7~g
ID# ,~
Pop llo~c -r
G CK# ej 14
+n arc i
ID#
1w

c2 9- 06, CK#
n lcr'n, _ ..riC . 5 O

CK# '? c, 1 t
/clue . r
3 7 c1 7 .SU v
ID#
C ~~ ;1 Sh
;J1, CK#

ID# _.

CK# _.2

SUB-TOTAL 79

TOTAL (if last page of this schedule)

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) (See Page 2 of forms packet .). If surname of contributor is the same as candidate, but there is no Page -,~of _
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 02/96) RECEIPTS
(Including candidate's personal funds)
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

RECEIVED (if applicable) TO CANDIDATE" RECEIVED
(MM/DD/YR) AND PAC CHECK (if applicable)
NUMBER
ID#
/
~is ~ J W

ID#

ID# /
p f
CK# C,

7r- -3r
I D# /

CK#
7ra, . . .fs
ID#
/ -
-s e., 0 1r', -;,- j

ID# _
.L i ,.., ) .Sr '~ s s .t4

/ CK#

ID#

I D#

CK# ,s ~1- _S , .

ID# .- . .~/
/ j t - 07

ID#

SUB-TOTAL 33
~' r(
TOTAL (if last page of this schedule)

' 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) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page of 17
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 02196) RECEIPTS
(including candidate's personal funds)
[] 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

RECEIVED - (if applicable) - - I TO CANDIDATE' RECEIVED
(MM/DDYR) AND PAC CHECK (if applicable)
NUMBER

,~-C
,~) fLC_

CK# l¢~lV Sr .~r< .. /~V ) -4' .

'PL
1,~~- J -l1 G
/lr el
ID#

/,~- ` e~ CK# 1307

~J^G~
C/~,f~r. 1.~ . 5.. ~73z
ID#
S
CK# 16r C/ -
ID#

yr CK# 2Cc%
y -~ 0
I D#
/1527 . lle~ n .111,17f sr .,
_1iS .~,
CK# - ,7 UCH -
~.sr If , c . .:
ID#

G CK# -,
/GCj
J6~Ev ~U //n s ~U 1 Z /3
ID#
d~"G 5 r. r /j
- ,) ,/,, "" s C . '7
6 "; CK# 7 7 ."~
(, ~
ID#
6CA //7r
CK# s<~~~ zf~iyQ '`s~ ~5
3'7
ID#

CK# _?_:I //,-/ / 2 1 3<0

o ~; -lt--f
ID#
C', / ",
GO
/~- - GG I CK#

SUB-TOTAL

TOTAL (if last page of this schedule)

- 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) (See Page 2 of forn s packet .) . If surname of contributor is the same as candidate, but there is no Page of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 02196) RECEIPTS
(Including candidate's personal funds)
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

RECEIVED (if applicable) TO CANDIDATE' RECEIVED
(MMIDDYR) AND PAC CHECK I (if applicable)
NUMBER _- ._1 ..
ID#

r
1-7 Sam`
CK#

ID#

ST 3,J
CK# 7;
sec - /Gr L
1D#

-7 ',1-,fi~l<- . .~ C t.
S~J -5
CK#
~~ C o Ci Il_ . .~dt /
ID#
l~c~ Clt y ~c-~
1,2 "c-Gv CK#

ID#
L4 tlc ._,
.l .2 Z
a d'~7 .-/-s CK# ,~2 03
ID#
.'-4.3 .1, 6 .
CK# ~"f C r e. ~J r
r~ 15 o s.
ID#

CK#
41',-~ y 0 i,
ID#

ilDelyaf CK#

ID#
. le C. r
CK# /13 C~J GC

F
lr ' I'U4 CK# S~u
< . ..4* . -5 n? C i
SUB-TOTAL
S
TOTAL (if last page of this schedule)

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) (See Page 2 of forms packet.) . If sumame of contributor is the same as candidate, but there is no Page 4:~ of 7
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 02/96) RECEIPTS
(including candidate's personal funds)
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
RECEIVED (if applicable) TO CANDIDATE' RECEIVED
(MM/DDIYR) AND PAC CHECK (if applicable)
NUMBER
ID#
01
e, -0
CK# `7
i
ID#
CC rr-7 , l1cfe

J Cr

ID# .
j J,
CK#

CK# 3G~ (~, C, pl Ic- I'~ 2cc~"

ea _
ID#

CK#
f i~r , /C /A I

s, i i.
~ -dAG/
ID# / `
"~c ~ ~w. X77 vl>~"
, r . l~ ,D~
CK# lao .7
gZ k,
I D# ,~
6"ll

ID# n '
,010 1 rJ r , n r~r% tit t -,

.lc O~G l
ID#

~5 04 CK#
1 -¢
ID#
.. /77- r c -

< ~ j
e _ c.;3 -cr

SUB-TOTAL

TOTAL (if last page of this schedule)

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) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page _<~-_ of
familial relationship. enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 02196) RECEIPTS
(Including candidate's personal funds)
[] CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

s /t 1 4 4 6 rt /0j
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

RECEIVED (if applicable) TO CANDIDATE' RECEIVED
(MM/DDYR) AND PAC CHECK (if applicable)
NUMBER
ID#
e.- .a C c Loa' S
CK#

ID#

J'/ . ._
5U
CK#

~JU

ID#
~~ ~,r l/
SG r c.(
c K# G. //, ./ ./ S /.

ID#
/t r, //, ' S ~ - .
/..1 >5,-4 CK# G , l ~'4r .'e .. ." L -f l?/06>

ID#

-dy'UG CK# SCVI "lu-<<...~ h, .

S~G
3 v
ls,7 Scl
ID#
r,
~.~ 1-O0 CK# _C',
-A
ID#
5
14"):15 q CK# G G 3-4 / J<J
I D#
r, ~.-
/t)~4-U"< CK# '73S' 7-r/-- , a.ne
Tr+ . _-

/~ ~1 lG CKM ~GG
SUB-TOTAL 1
3G'c
TOTAL (if last page of this schedule)

" 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 r
marriage) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page ~,- of
familial relationship, enter "not applicable" in the relationship column . (for Schedule
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 02196) RECEIPTS
(including candidate's personal funds)
[] 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

RECEIVED (if applicable) TO CANDIDATE' RECEIVED
(MMIDDIYR) AND PAC CHECK (if applicable)
NUMBER
ID#

_ ~ GJG

ID#
(v ~s~
CK# -T
..La . -,v -~ 1 Z.
/dG r
Jrq i3 ~
ID#
~r /~

i~-~yGy CK# ~'A~r j~ I~ 4v

ID#

CK#

ID#

CK#

I D#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL

TOTAL (if last page of this schedule) $ 13

- 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) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page _ of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
 FOR INSTRUCTIONS, SEE HACK OF FORM SCHEDULE

EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT

B MONETARY
(Rev . 02/96) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES . LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE 0 CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDiTURE . A LIST OF IO NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .

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

CANDIDATE NAME AND ADDRESS TO WHOM EXPENDITURE PURPOSE AMOUNT

DATE ID NUMBER (Disbursement) WAS MADE (CANDIDATES SEE EXPENDED
EXPENDED (ii applicable) BELOW 3 ENTER
(MM/OOIYR) AND PAC 1,2,3)
CHECK NUMBER
ID#
:511)
CK# la o .x l I
( $ ,,
j7:7 C"i

ID#
,~ 5,-3 (d .~, .. , FI .r Te L lr " ` N.c I4+~

,142L,-,2 tell
10#
,j - 7
../L / c w .,
3 ll
lC c4 CK# e ., a, * "T6
ldaEi
19

Z, 421C
ID#

z
Io#

r ic

SUB-TOTAL AO
G
TOTAL (if last page of this schedule)

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Campaign funds may be used only for

(1) campaign purposes,
(2) constituency expenses, and
(3) educational and other expenses associated with duties of office .

Please insert the applicable number in the purpose column for each expenditure .

Purchases of certain campaign property costing $51]0 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions.)

Expenditures to persons/entities providing consulting, advertising . fund-raising, polling, managing, organizing services must also be detail itemized an
Schedule G by the amount . purpose, and date of each type of expenditure made by the persoNentity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 56.t3(3)(~ .) -_-
 FOR INSTRUCTIONS . SEE SACK OF FORM SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT

B MONETARY
(Rev . 02196) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES . LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .

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

, !J~LCLI , IC
CANDIDATE NAME AND ADDRESS TO WHOM EXPENDITURE PURPOSE AMOUNT
DATE ID NUMBER (Disbursement) WAS MADE (CANDIDATES SEE EXPENDED
EXPENDED (if applicable) BELOW 3 ENTER
(MM1001YR) AND PAC 1,2,3)
CHECK NUMBER

. O ° Ac '7 J
36", A
0071
I D#

AI>1u4 CK#
if.53 ~ 1 ~ r~C1 .i .c A. Z S~ia
ID#
1,/c /la . .F

G4 6 C-/- t l
l 1 .~7 S t om ._ . . _
ID#

CK# 0, o 13,A, c:~eG

rS r
.
-L- ce .1
ID#
4
CK# 041

-3 7Gr " C1 O
ID# /

CK# . 3. k %ioU
I D# /,or ci v
.
s
CK#
/Oc~cJ

SUB-TOTAL

TOTAL (if last page of this schedule) l $

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Campaign funds may be used only for.

(1) campaign purposes,
(2) constituency expenses, and
(3) educational and other expenses associated with duties of office.

Please insert the applicable number in the purpose column for each expenditure.
_,
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)

Expenditures to personslentities providing consuking, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the personlentity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code
 FOR INSTRUCTIONS. SEE BACK OF FORM SCHEDULE

EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT

B MONETARY
(Rev . 02/96) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES . LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE C CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .

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

CANDIDATE NAME AND ADDRESS TO WHOM EXPENDITURE PURPOSE AMOUNT

DATE 10 NUMBER (Disbursement) WAS MADE (CANDIDATES SEE EXPENDED
EXPENDED (if applicable) BELOW & ENTER
(MMID01YR) AND PAC 1 .2,3)
CHECK NUMBER

CK# r5'7A ~~ ,' r

ie,*_12 ( )
r 7U p .n ~r -. l
.
i a~

7, Z-4 r. h
r r
3

CK#
sue/ p k,~ /c . ,,, , 77

CK#
_-~-y4 Z
I D#
F0 C .J ." .. 1 .1

( )
1rf 4C) -
('s-r "11 i 1 . 1 I . _

I"
S-/Gi r aA 4 h /, /-I,- C I/ , 4

, .~ - Yo -3 V Fc.̀

i r,
112 , 11 ~l s , t ,c , , .>, ~._ .P
CK# i1~ 4 Nr

S r 61" ,r X14 r , .
SUB-TOTAL $ 4s'
l .is 7s1
TOTAL (if last page of this schedule) l $

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY:

Campaign funds may be used only for.
(1) campaign purposes,
(2) constituency expenses, and
(3) educational and other expenses associated with duties of office .

Please insert the applicable number in the purpose column for each expenditure .

Purchases of certain campaign property Costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions.)

Expenditures to personslentities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the personlentity on behalf of the candidate's committee. (Refer to
schedule G instructions and Iowa Code 56 .6(3)0 .)
r
 FOR INS TRucT16NS, SEE BACK OF FORM SCHEDULE
B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 02/96) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES . LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE E] CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD .

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

CANDIDATE NAME ANDADDRESS TO WHOM EXPENDITURE PURPOSE

ID NUMBER (Disbursement) WAS MADE (CANDIDATES SEE
(if applicable) BELOW 3 ENTER
AND PAC 1,2,3)
CHECK NUMBER

TOTAL (if last page of this schedule)

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY:

Campaign funds may be used only for,

(1) campaign purposes,
(2) constituency expenses, and
(3) educational and other expenses associated with duties of office .

Please insert the applicable number in the purpose column for each expenditure.

Purchases of certain campaign property costing 5500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)

Expenditures to personslentities providing consulting, advertising, fund-raising, polling, managing, organizing servicos must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the personlentity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 56 .6(3)0.)