FOR INSTRUCTIONS. SEE BACK OF FORM OAM DSC SSR a BOA piscLosune REPORT DISCLOSURE SUMMARY PAGE {COMMITTEE NAME [Hs be samo as on Sttoment ol Oana 2 ve. | meoRTANT: Inaicat typeof committe you ae reporting tor: [_] | 1 )Statowsde.ogtatve Canciate (2 )Statowide PAC (3 Stale Pary (4 )CountyiLecal Canccale | 5 )County PAC {6 )Batot ssue/Franchise Commitee {7 JCounyCiy Cental Commitee o! Canciates, wethetlay & Li niat La- 29 7- 73 9P Lb d ‘SIGNATURE ORTREASURER (or person filing t TELEPHONE DATE SIGNED Routine Penalties Due For Late Filed Reports Range from $20 to $800 EE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE: vamFUNGAa Merete 19, 200g REPORT FOR AN/A (1) ELECTION (2}NON-ELECTION YEAR. (report date) Indicate one [ /| CICHECK IF AMENDMENT TO REPORT DATED. [Local Cantons, erie Date ol Eiecton | ck if this is final (terminator tach Notic ton 3, | Coury Local Commitess, enar Coury in Ci Check i this i final (termination) report and attach Notice of Dissolution Form DR-3, | Coun § Local Coma (You must continue to file reports until a Notice of Dissolution is fled.) SE STATEMENT OF CASH ON HAND CASH ON HAND at the beginning of the reporting period. (This isthe total ofall monies held by the committee. This amount MUST be the same as ne cash on hand athe and fhe et eporing pod ‘or must be zero if ths is first report filed.) ADD TOTAL MONEY TAKEN IN THIS PERIOD ‘Schedule A: Cash Contributions total (Attach Sc hedulo A) ‘Schedule F: Loans Received total (Attach Schedule F) ‘Schedule H: Total Sales of Campaign Property (Attach Schedule H) (She les to Candi ss Onl SUB-TOTAL. SUBTRACT TOTAL MONEY SPENT THIS PERIOD Schedule B: Expenditures total (Attach Schedule 8). Schedule F: Loan Repayments total (Attach Schedule F) CASH ON HAND at the end of this reporting period (if final report, balance must bbe zero) (Attach OR-3).... UNPAID BILLS (From Schedule D - Attach Schedule D) § IN KIND CONTRIBUTIONS (From Schedule & - Attach Schedule E) $ _ OUTSTANDING LOANS (From Schedule F - Attach Schedule F) s_ _—_ CANDIDATE COMMITTEES ONLY: CONSULTANT BREAKDOWN (Schedule G Attached?) —yes __ VALUE OF CAMPAIGN PROPERTY (From Senedule H - Attach Schedule H) soCONTRIBUTIONS — MONEY TAKEN IN COMMITTEE NAME (Must be same as on Statement of Org: ipization) [SCHEDULE MONETARY 'RECEPTE Cat herria Gre, gaat Section 688.32A(6), lowa Code, prohibits the ut DATE RECEIVED NAME AND ADDRESS OF CONTRIBUTOR of information from reports and statements for soliciting contributions or for any commercial purpose by any person other than statutory political committees. "AMOUNT RECEIVED (oFo-20571/ 140-000. 100) sup-roTaL |$ TOTAL (itiestpage ofthisachedule) [Sy a 9 of. (lor Schedule A)EXPENDITURES — MONEY SPENT FROM COMMITTEE ACCOUNT — one STATE PAC COMMITTEES: NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE ORLEGISLATWE ‘CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE (0 CHECK THis BOX IF PAG CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ‘AMENDING FORM ETHICS & CAMPAIGN DISCLOSURE BOARD. ME (Must bo same as on Statement of Organization) ‘CANDIDATE. Tae AND ADDRESS TO WHOM PURPOSE, AMOUNT DATE ID NUMBER "EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED EXPENEED | applicable) (istursement) WAS MADE iwavorrR) | “AND PAC ‘CHECK NUMBER TDF treet | G2 | Coklooy Ly Measem | pneaTy nsorapente |8 25. ~ ee Preble ~ tempo agra |W ¢as | bhirtly ont uae ones 46, #71 Ibe a one (DH a SUBTOTAL |S ME 4, TOTAL Glas page otis sched) F® [THis BOX APPLIES TO CANDIDATES’ COMMITTEES ONL) Purchases of certain campaign property costing $500 or more must also be imenariadon Schedule H. (Refrto Schedule Wlnstructons Expenditures 1 personslenties providing cone [Schedule G bythe amoul purpove, and data ef Schedule G inst Cove 58.63). ng, adverising, fundraising, poling, managing; orgriring services must sis be deal temized on ch ype of expenclture made by the personfentty on beta ofthe candidate's commites. (Refer to Page. (lor Schedule 8)