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FOR INSTRUCTIONS, SEE BACK(. . r-ORM
COMMITTEE NAME (Must be same as on Statement of Organization)
DISCLOSURE SUMMARY PAGE
(Rev. 07/2004)
DR-2
FORM
I
DISCLOSURE REPORT
PORTANT: Indicate by # type of committee you are reporting for. ( 1 )Statewide/LegislativelJudge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party ( 4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or Other Politi cal Subdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 10 )School Board or Other Political Subdivision PAC ( 11 ) Local Ballot Issue CANDIDATE COMMITTEES ONLY : Candidate Name Office Sought
fur Vie- Slean~ N~- LPuQ
UM ~-~33
Logged In Scanned Computer Audited
For Office Use Only Comm . #
Political Party (if applicable) District (if Senate or House)
Late reports are subject to possible civil and criminal penalties.
SIGNATURE OF PERSON FILING I AM FILING A
EPORT
S/S -- ..2V3 - 3~ti4 TELEPHONE
DATE SIGNED
/z - 30-o
V
10 LCXd_ .
(report date)
REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR . Indicate by # IT Local Committees, enter Date of Election County & Local Committees, enter County in which Election is held
HECK IF AMENDMENT TO REPORT DATED E] Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . (You must continue to file reports until a DR-3 is filed.)
CASH ON HAND at the beginning of the reporting period . (Total of all funds 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 Schedule A: Cash Contributions total (Attach Schedule A) (*also see in-kind below) ... .. ... .. Schedule F: Loans Received total (Attach Schedule F) . .. .. .. . . . . ... . .. ... .. .. .. . .. .. . . . .. .. ... . . .. ... .. .. . .. Schedule H: Total Sales of Campaign Property (Attach Schedule H) . .. .. . .... .. ... .. ... .. .. ... .. ... .. (Schedule H avolles 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 be zero) (Attach DR-3) . .. .. . .. .. . .... .. . .. .. .. . .. ..... .. ... .. ..... ... .. ... .. ... .. .. ..... .. ... . . .. .. . .. .. .. . .. .. .. ... .. .. . .. .. ... $ **UNPAID BILLS (From Schedule D - Attach Schedule D) . .. . .. .. . .. .. . .. .. ... .. .. . .. .. .. . .. . . .. .. . .. .. . . . .. .. .. . .. .. . .. .. $ *IN KIND CONTRIBUTIONS (Prom 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) $
STATEMENT OF CASH ON HAND
3q- r7
q2-30. S0
r Instructions, See Back of Form ONTRIBUTIONS -- MONEY TAKEN IN
(Including candidate's personal funds) MMITTEE NAME (Must be ame as on Statement of grganization) W _ . : SkeG -yew LbCGti( U~ ~~ x .33 ~
SCHEDULE
(Rev . 07103
A
V
MONETARY RECEIPTS
`CHECK THIS BOX IF
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 RECEIVED (MM/DD/YR) PAC ID NUMBER (ff applicable) AND PAC CHECK NUMBER
C0j ~NAME AND ADDRES,-'OF CONTRIBUTOR~~ , .
ID# r) 100q
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RELATIONSHIP TO CANDIDATE' (if, applicable)
AMOUNT RECEIVED
J IF FOR FUNDRAISER INCOME
CK#
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CK# ID#
CK#
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ID# CK# ID# CK# ID# CK# ID# cK# ~sl.'~ triarrica ~ A. L,,r~Lrlr, r l
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CK# ID#
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CK# ID#
I0 t H) ~
CK# SUB-TOTAL TOTAL (if last page of this schedule)
1
-374 ,
` Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the oommittee. 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 .
L Page (for Schedule A)
FOR INSTRUCTIONS, SEE BACK OF FORM EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS & CAMPAIGN DISCLOSURE BOARD . COMMITTEE NAME (Must be same as on Statement of Organization) ,
SCHEDULE B I MONETARY (Rev . 07/03) ~~ENDITURES CHECK THIS BOX IF AMENDING FORM
AqC R011ILW _11XM14~_ U CO ON `4yA*3, CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED (if applicable) (Disbursement) WAS MADE (MM/DDIYR) AND PAC CHECK NUMBER ID#
AMOUNT EXPENDED
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cK# ID# CKO ID#
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33 PA C !v~o'I
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SUB-TOTAL TOTAL (If last page of thIs schedule)
$ $
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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 .) 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 6t1A.402(3)(i).) Page of
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM
~ ~
t'wtM
SCHEDULE (Rev . 07/03)
EXPENDITURES
--
MONEY SPENT FROM COMMITTEE ACCOUNT
B
MONETARY EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE 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)
ECK THIS BOX IF AMENDING FORM
EZL~u~
DATE EXPENDED (MM/DD/YR)
CANDIDATE ID NUMBER (if applicable) AND PAC CHECK NUMBER
Va
NAME AND ADDRESS TO WHOM EXPENDITURE (Disbursement) WAS MADE
t ucq
PURPOSE (DESCRIBE TRANSACTION)
33
AMOUNT EXPENDED
I
ID# cK# ID#
153
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SUB-TOTAL $ TOTAL (iflast page ofthis 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.) 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 person/entity on behalf of the candidate's committee. (Refer to Schedule G instructions . and Iowa Code 68A.402(3)(i).)
(for Schedule B)
` FOR INSTRUCTIONS, SEE BACK OF FORM
SCHEDULE
(Rev .0TA
EXPENDITURES
--
MONEY SPENT FROM COMMITTEE ACCOUNT
B
MONETARY EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS & CAMPAIGN DISCLOSURE BOARD .
W CHECK THIS BOX IF AMENDING FORM
CQMMITTEE NAME (Must be same as on Statement of O anization) _P~ U
v~ tS'n
CANDIDATE ID NUMBER (if applicable) AND PAC CHECK NUMBER
/JA
DATE EXPENDED (MM/DDIYR)
NAME AND ADDRESS TO WHOM EXPENDITURE (Disbursement) WAS MADE
CO
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I
PURPOSE (DESCRIBE TRANSACTION) AMOUNT EXPENDED
fl -
gas
j1'"33 CSC C{- .
CK# Ir r~~ ID# CK# ID# CK# ID# CK# ID# CK# I D# CK# ID# CK# ID# CK# SUB-TOTAL TOTAL (if last page of this schedule)
$ 2~
$
$
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,) Expenditures to persons/entities 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 persoNentity on behalf of the candidate's committee . (Refer to Schedule G instructions and Iowa Code 68A.402(3)(i) .)
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM
COMMITTEE NAME (Must be same as on Statement of Organization)
DISCLOSURE SUMMARY PAGE
Reset Form
(Rev . 07/2004) Comm . #
DR-2
FORM
I
DISCLOSURE REPORT
H-6v f IMPORTANT: Indicate by # type of committee you are reporting for: ( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party ( 4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or Other Political Subdivision Candidate ( 8 )CPAC- ( 9 )City PAC ( 10 )School Board or Other Political Subdivision PAC ( 11 ) Local , CANDIDATE COMMITTEES ONLY:
Candidate Name Political Party (if applicable) t strict (if Senate or House)
IuM.b" '. A(4
LOW 33 P~
For Office UseOnly
Computer Audited
Logged laSU Scanned
Late reports are subject to possible civil and criminal penalties.
TELEPHONE
I AM FILING A
DATE SIGNED
10f `q'cq
(report date)
REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR . Indicate by # 1-1
OCHECK IF AMENDMENT TO REPORT DATED El Check if this is final (termination) report and attach Notice of Dissolution Form DR-3. (You must continue to file reports until a DR-3 is filed.)
Local Committees, enter Date of Election County & Local Committees, enter County in which Election is held
STATEMENT OF CASH ON HAND
CASH ON HAND at the beginning of the reporting period . (Total of all funds 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 Schedule A: Cash Contributions total (Attach Schedule A) (*also see in-kind below) . ... .. .. .. 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) (**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 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?) VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)
3(rrs~; . 2
2 -9 . 23v iP
For Instructions, See Back of Form CONTRIBUTIONS -- MONEY TAKEN IN
(Including candidate's personal funds) MMITTEE NAME (Must be same as on Statement of Qrganization) Seer, LOW4 Oil 33 PAL,
Reset Form
SCHEDULE
(Rev . 07/03)
A
MONETARY RECEIPTS
Ej CHECK THIS BOX IF 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 RECEIVED (MM/DD/YR) _ PAC ID NUMBER (if applicable) AND CHECK UMBER _
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AMOUNT RECEIVED
4 IF FOR FUNDINCOME ME
CK# ID# CK# ID#
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SUB-TOTAL TOTAL (if last page of this schedule)
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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 sumame of contributor is the same as candidate, but there is no familial relationship, enter "not applicable" in the relationship column .
Page
(for Schedule A)
FOR INSTRUCTIONS, SEE BACK OF FORM EXPENDITURES -- MONE Y SPENT FROM COMMITTEE ACCOUNT STATE PAC COMMITTEES : NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS & CAMPAIGN DISCLOSURE BOARD. COMMITTEE NAME (Must be same as on Statement of Organization)
SCHEDULE B I (Rev . 07103) MONETARY EXPENDITURES
D CHECK THIS BOX IF AMENDING FORM
DATE EXPENDED (MM/DD/YR)
ID#
l a ca4l~v~n *3314 : .~n.~~fi ~uc CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) (if applicable) (Disbursement) WAS MADE AND PAC CHECK NUMBER
AMOUNT EXPENDED
`-1f231dq CK#
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wtS6'1(br oLtt P-eo~ S O(-L('1- lYe~(J' _TA 5"( TOTAL (If 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.) Expenditures to persons/entities 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 person/entity on behalf of the candidate's committee. (Refer to Sched ule G instructions and Iowa Code 68A.402(3)(i) .) Page
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM
Reset
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT
Form SCHEDULE
(Rev . 07/03)
B
STATE PAC COMMITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE 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) CANDIDATE iD NUMBER (if applicable) AND PAC CHECK NUMBER ID# 153~ NAME AND ADDRESS TO WHOM EXPENDITURE (Disbursement] WAS MADE
MONETARY EXPENDITURES
CHECK THIS BOX IF AMENDING FORM
DATE EXPENDED (MMIDDIYR)
PURPOSE (DESCRIBE TRANSACTION)
AMOUNT EXPENDED
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SUB-TOTAL TOTAL (if 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 .) Expenditures to persons/entities 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 persordentity on behalf of the candidate's committee. (Refer to Schedule G instructions and Iowa Code 68A.402(3)(i) .)
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM
Reset Form
SCHEDULE (Rev. 07/03)
EXPENDITURES
--
MONEY SPENT FROM COMMITTEE ACCOUNT
B
MONETARY EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE PAC CHECK NUMBER FOR EACH EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS &CAMPAIGN DISCLOSURE BOARD . C MMITTEE NAME (Must be same as on Statement of O anization) CANDIDATE ID NUMBER (if applicable) AND PAC CHECK NUMBER
D
CHECK THIS BOX IF AMENDING FORM
Q /I'~-
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NAME AND ADDRESS TO WHOM EXPENDITURE (Disbursement) WAS MADE PURPOSE (DESCRIBE TRANSACTION) AMOUNT EXPENDED
DATE EXPENDED (MM/DD1YR)
aV
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SUB-TOTAL TOTAL (if 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.) Expenditures to persons/entities 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 person/entity on behalf of the candidate's committee. (Refer to Schedule G instructions and Iowa Code 68A.402(3)(i) .) $