FOR INSTRUCTIONS, SEE BACK OF F' , M

DISCLOSURE SUMMARY PAGE

CO ITT NAMYWust be s e as on Statement of Organization,

/2- ~GLS elp-
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 IssueiFranchise Committee ( 7 )County/City Central Committee
( 8 )Suppe(t Slate of Candidates

SIGNATURE OF TREASURER (or person filing this report)

Routine Penalties Due For Late Filed Reports Range from $20 to $800

SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :

I-IWO L-
I AM FILING A . 31 2490tl REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate one

7CHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election

C Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County & Local Committees, enter County in
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

3
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~tn . .....
.:. :. ..... .. .. .. .. ... $ .o,3
.
737
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) .. ... .... .. .. ... .. .. ......... .. .. ..... . . .. .. .. ...
Schedule F: Loans Received total (Attach Schedule F) .... .. ..... .. .. .. .. ... .... .. ......... .. .. ... .. .... .. .. . d
Schedule H: Total Sales of Campaign Property (Attach Schedule H) .... .. ......... .. .. ......... .. ...
JSchedule H applies to Candidates' Committees Only)
SUB-TOTAL ..... $
6~237 .o-3
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) . .. ..... . .. .. ., .. .., ..., ., ....... .. .., .... .. .. .. . . . .. .. .. .. .. .. ..$ / e1', /
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 V"'NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)
Fox Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 06/97) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX 1F
TTE NA (Must be e 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 REIrATIONSHIP AMOUNT 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
0/ ID# >

7-5: Acv d

I
CK#
G!" CC
rQQ%C _~W. ~;~s r

ID# ~, a~ 7 ~,
~~~ l~h

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

I D#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL
ll:Od
TOTAL (if last page of this
schedule)~oo,ra
sclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
,ammittee. 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

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B

(Rev. 09/97)
MONETARY
EXPENDITURES
rATE 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 ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.

COM TTEE NAME (M t be same as on Statement of Organization)

d
11
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
I D# "tatttap /0
i

CK $ 31, se/
,,
ID#
S,5 41- D~~, .

c .
ID# w
CK . ~ r9o~a a _
lb .2ed 8

~Qf#ff
C #
672 ---
- CKt-"
~7 DGCIse AO X317~ c~ JL~

CK# XI~/~~ )l
ID#
- D
CK 74u . ~.s-,~s - 1 s
ID# _Zi " e® rh~f

CK
~'o~
` SUB-TOTAL $

TOTAL-$f last page of this schedule) $

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

Page

(for Schedule B)
 FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY

(Rev. 09/97) EXPENDITURES
. FATE 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.

COMWTTEE NAME ust be sa e as on Statement of Organization)

~p
it"s
7
n

? C%'
- CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER

VC
U L 1D# -5A-/-e l~l~ Six / 'S' %cyG 4

CK#

1D#
CK#
ID#
CK#
ID#
CK#
ID#
CK#

ID#
CK#

ID#
CK#
ID#

_ CK#

SUB-TOTAL $ 3,1
TOTAL (ff last page of this schedule)
$~ se ` 1

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 .)

-' " penditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
hedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee . (Refer to
I ochedule G instructions and Iowa Code 56.6(3)(1).)

(for Schedule B)
 FOR INSTRUCTIONS. SEE BACK OF FORM SCHEDULE
D INCURRED
COMMI E NAME ;Must b same as on Statement of Organization} (Rev. 48/98)1 INDEBTEDNESS

~ e)/ & CHECK THIS BOX

IF AMENDING
NOTE: Debts previously reported that remain unpaid must be inciuded on this FORM
Schedule, as well as any new obligations incurred in this period.

An "Incurred debt' is a debt for

DEBTS/OBLIGATIONS REMAINING THIS REPORTING PERIOD goods or services ordered or
received, but not paid for by the
(DO NOT INCLUDE LOANS - SHOW LOANS ON SCHEDULE F) 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
(MMIDD/YR) TO WHOM DEBT OR OBLIGATION IS OWED PURCHASED REPORTING
PERIOD'

r ~ 7l
ll ZOO `. ~. l2S0 Z~ taJ ~~ . ~S/S~5

`~ L?
U_ ls_" _eLr

2 cc

-L2Z",) 1,61 To ujek-

4 l-
The 3~I y' 7

SUB-TOTAL $

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

r ii-'/ 7. l

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

CANDIDATE COMMITTEES NOTE:

'Incurred indebtedness also includes each personlentity 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, hind-raising, polling, managing,
or organizing services. Report on Schedule G the nature of performance and the estimated performance reasonably expected of the consultant