SEIU Local 199 COPE Fund - 6492 - Scanned

OCT-19-2004 08 :53 P .
02
DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE

COMMITTEE NAME (Must be same as on Statement of Organization) (Rev . 05/20132) REPORT
SETU(Service Employees Int'1 Union)Local 199 COPE Fold
IMPORTANT : Indicate type of committee you are reporting for. 12

(( 51 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )CountylLocal Candidate
)County PAC ( 6 )Ballot Issue/Franchise Committee (7 )Countylgity Central Committee
( 8 )Support Slate of Candidates
District (if Senate or House)
Accountant (319)-341-0112 10- 18= 2 004

SIGNATURE OF TREASURER (or person filing this report) TELEPHONE DATE SIGNED
Routine Penalties Due For Late Filed Reports Range from $20 to $800
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :
I AM FILING A 7/15/04-10/14/04 REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR_
(report date) Indicate one 71
[JCHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election
[3 Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County & local Committees, enter County in
(You must continue to file reports until a Notice of Dissolution is filed.) which Election is held
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.) .. ....., ., .... , ..... . ..., ..$ 909 .2-1
.
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) ('also see in-kind below) ......... , - , .i53
3
.00
Schedule F: Loans Received total (Attach Schedule F) . .. .. .. .... .. .. .... . ., . ........ ........ ........ .... ....
Schedule H: Total Sales of Campaign Property (Attach Schedule H) .. ................................ -r
(Schedule H applies to Candid tes' Committees Only)

SUB-TOTAL.... .. S 4,055 .23
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ("'also see debts and loans below) ... 2 .424 .75
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) ... ........... ...... ............... .. .. .. ...... .......... . .. .. ._ ...... .... . ........., . .... . . . . . . ..... . . . .$ r
"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 -x NO

VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
OCT-19-2004 08 :54 P . 03
FOR INSTRUC710NS, SEE BACK OF FORM SCHEDULE
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT

B
(Rev, 09191)
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 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 some as on Statement of Organization)
SEIU(Service Employees Int'l Union) Local 199 COPE Fund

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
7/31/0,4 ID# SEIU (Int'1 Office) Monthly contribution 712 .50

CK# 1064 Washington DC 20005
8/25/04 ID# SEIU (Int'1 Office) Monthly contribution 826 .75
I D# Monthly contribution
9/21/04 SEIU (Int'l Office) 885 .50
I D#
CK#
ID#
CK#
I D#
CK#
i D#
C K#
10#
C K#
SUB-TOTAL $
4 2 4 7.
TOTAL (if last page of this schedule) $
~1
2_Zru_ rg
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 58 .6(3)(1) .)
Page _._,_L__- of 1
(for Schedule B)
OCT-19-2004 08 :54 P .04
For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 06/97) I RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
SEIU(Service Employees Int'l Union) Local 199 C PE Fund

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 I NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND.
(MMIOD/YR1 AND "AG CHECK (if applicable) RAISER
NUMBER INCOME
7/23/2004 Brian P Flaherty 3 .00
Direct Deposit 1122 So Seventh Ave IC IA 52245

1
7/23/2004 Annd Gtritit=Arc~ier" - - 5 .00
Direct Deposit 1744 -115th St West Liber IA 52776
7/23/2004 Cathy Singer Glasson 15.00
Direct Deposit 1920 - 2nd Ave SE CR IA 52403
7/23/2004 Matt N Loeb 2.50
Direct Deposit 470 Hawaii Ct IC IA 52246
7/23/2004 - David C Meggers 5.00
Direct Deposit 3371 Ozzie Drive NE Solon IA 52333
7/23/2004 Devin P Mehaffey 2.50
Direct Deposit 865 Camburn Ct SE CR IA 52403
7/23/2004 Kim R Miller 10 .00
Direct Deposit 805 Spencer Dr IC IA 52246
7/23/2004 Douglas L Peters 2.50
Direct Deposit 70 E Chestnut NL IA 52317
712312004 Jennifer M Poland 2,50
Direct Deposit 2040 Glass Rd NE #101 CR IA 52402
7/2312004 Kirsten A Running 2.50

Direct Deposit 1210 Highland Ave IC IA 52240
JUD-Iv1^~
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 or loans packet.) . if surname of contrihutor is the same as candidate, but there is no Psge / of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
OCT-19-2004 08:55 P . 05
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 06/97) RECEIPTS
CHECK THIS BOX IF

STATE CANDIDATES NOTE ., IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATION
DISCLOSURE BOARD.
CAUTION, Section 6BB.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
OAT" PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR;
RECEIVED of applicable) I TO CANDIDATE- RECEIVED FUND-
(MMIDD/YFi) AND "A(' CHECK (if applicable) RAISER
fit IMFIER I INCOME
7/23/2004 Rita J Sterler 5.00
Direct Deposit 2131 Plaen View Dr IC IA 52246
7/23/2004 - SaraiI C - Swisner 40_00

Direct Deposit 917 Bowe St IC IA 52240
7/23/2004 Tawny L Wilson 7 .50
Direct Deposit 1110 Conklin St IC IA 52245
7130/2004 Russell A Clark (CR Sch) 5_00
102650 4045 Chickadee Ln Hiawatha IA 52233
`7/30/2004 Harless S Clemons (CR Sch) 10.00

102650 505 Sixth St SE CR IA 52401
7/30/2004 Marshall R Clemons (CR Sch) 5_00

102650 505 Sixth St SE CR IA 52401
7/30/2004 Wm A Fiacco (CR Sch) 3.00

102650 4133 - 22nd Ave SW CR IA 52404
713012004 Jeff L Foster (CR Sch) 5.00

102650 3209 Tamara Dr SW CR IA 52404
7/30/2004 Ken D Grout (CR Sch) 2.00
102650 1037 Clifton St NE CR IA 52402
7130/2004 Gordon Kaltenbach (CR Sch) 6.00

102650 227 - 11 th St N W CR IA 52405
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 v, of
familial relationship, enter'not applicable" in the ielationship column . (fur Schedule A)
OCT-19-2004 08 " 55 P .06
For Instructions, See Back of Form J SCHEDULE
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 06/97) I RECEIPTS
Q CHECK THIS BOX IF
SEIU(Service Employees Intel Union) Local 199 C~PE Fund

DISCLOSURE BOARD.
CAUTION . Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
I
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DDIYfi1 AND '-'AC CHECK (H applicable) RAISER
NUMBER INCOME
7/30/2004 Joyce E Lucas (CR Sch) 4.00

102650 1401 B Ave Vinton IA 52349
7/3012004 Dave L Mart (CR Sch) 5.00

102650 926 - 15th Ave SW CR IA 52404
7/3012004 Chris McLees (CR Sch) 5.00

102650 411 - 27th St NE CR IA 52402
7/30/2004 Tim J Newcomb (CR Sch) 5.00

102650 726 E Ave NW CR 1A 52405
7/30/2004 Chas A Perry (CR Sch) 10.00

102650 1479 Miami Dr NE CR IA 52402
7/3012004 AL J Pospisil (CR Sch) 1 .00

102650 1619 Arizona Ave NE CR IA 52402
7/30/2004 Terry A Slickty (CR Sch) 2.50

102650 1128 Brown Ave NE CR IA 52402
7/30/2004 Lois J Bassett (CR Sch) 3.00

102651 1002 Eastern Dr SE CR IA 52403
7/30/2004 Stephanie J Lewis (CR Sch) 5.00

102651 1601 - 30th St NW #12 CR IA 52405
7/30/2004 Donald J Binegar Jr (IC Sch) 1 .50
227681 P O Box 373 N English IA 52316
JVv , v , n w
TOTAL (iflast page of this schedule)
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 surnarne of contributor is the same as candidate, but there is no Page
OCT-19-2004 08 :56 P . 07
For Instructions, See Back of Form . (SCHEDULE
A MONETARY
I
I
CHECK THIS BOX IF
SEIU(Service Employees Int'1 Union) Local 199 COPE Fund

STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE) . LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD.
CAUTION: Section 68B,32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
DATE PAC ID NUMBER I NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP I AMOUNT J IF FOR
(MM/DDIYk) AND "AC CHECK (if applicable)
NUMBER INCOME
E
7/30/2004 Kurth T Boyce (IC Sch) 1 .50

227681 4876-120 St NE Solon IA 52333
7/30/2004 Ridhard'Hannan (IC Sch) 1 .50

227681 P 0 Box 3281 Iowa City IA 52244
7/30/2004 John Hoard (IC Sch) 1-25
227681 Box 466 Hills IA 52235
7/30/2004 Ron Jensen (IC Sch) 1 .00

227681 425-320th St W Liberty IA 52776
7/3012004 Brad Kuester (IC Sch) 1 .50

227681 2821 S Riverside Dr Iowa City IA 52246
7/30/2004 Jon Lalle (IC Sch) 2.50

227681 601 Oakland Ave Iowa City IA 52240
7/30/2004 Brian J Meyer (IC Sch) 1 .50
227681 16 Metric Road Iowa City IA 52240
7/30/2004 Michel Murphy (IC Sch) 2_60

227681 315 Ellis Ave #1 Iowa City IA 52246
7/3012004 Randy Nguyen (IC Sch) 1-50
227681 48 Amber Lane Iowa City IA 52240
7/30/2004 Michael O'Connor (IC Sch) 1 .50

227681 290 Elm Ridge Drive North Liberty IA 52317
$ IlD 41-0
00)
' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
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)
OCT-19-2004 08 :56 P.08
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 06/97) RECEIPTS
CHECK THIS BOX IF
SEIU(Service Employees Int'1 Union) Local 199 C~PE Fund

STATE CANDIDATES NOTE! IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL. ACTION COMMITTEE), LISTTHE PAC IDENTIFICATION
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from. reports and statements for soliciting contributions or
(MMIDD/YR) AND "AC CHECK (if applicable) RAISER
NUMBER INCOME
7130/2004 Rodney Perdue (IC Sch)

2.50
227681 603 W Paris St W Libert IA 52776
713012004 71
Wm Salasberry (IC Sch) I
-
1 .50 . ,.
'
227681 1119 Pine St Iowa City IA 52240

7/30/2004 Kimberly Schlabach (IC Sch) 1 .50
227681 5272 Oakcrest Hill Rd Riverside IA 52246
7/30/2004 Gerald Vonstein (IC Sch)
2,50
227681 5048-210th St NE Solon IA 52333
7/30/2004 Dale Weir (IC Sch)
1-50
227681 2145 Palmer Circle Iowa Ci IA 52240
7/3012004 Jerome Wiedemeir (IC Sch)
1 .50
227681 2506 Friendship St IC IA 52245
7/30/2004 Daryl Lewis (IC Sch)
5_00
227681 216 Dartmouth Iowa Cit IA 52245
7/30/2004 Marsha Anderson (UIHC)
5 .00
1276086 1975 So Ride Dr Coralville IA 52241
7130/2004 Sandra Anfinson (UIHC)
2.00
1276086 302 North Fourth St W Branch IA 52358
7130/2004 Matt Bahl (UIHC)
5.00
1276086 245 Hickory St N Liberty IA 52358
'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 forma packet.) . If surriame of contributor is the same as candidate, but there is no Page of ^
OCT-19-2004 08" 56 P .09
A MONETARY
CHECK THIS BOX IF
SEIU(Service Employees I nt;'l Union) Local 199 CTPE Fund
STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD.
CAUTION: Section 688,32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT q IF FOR
(MM/DDNR.) AND "AC CHECK- (if applicable) RAISER
NUMBER INCOME,
7/30/2004 Michelle Bargren (UIHC) 5-00

1276086 702 Hod e St North Liberty IA 52317
7/30/2004 'Janiob Sarries (UIHC) 5.00

1276086 1021 - 20th Ave CV IA 52241
7130/2004 Rachael Barrow (UIHC) 10.00
1276086 3513 Dunham Dr SW CR IA 52404
7/30/2004 Deb Benfer (UIHC) 3.00

1275086 1683 Hemin wa Lane IC IA 52240
7/30/2004 Deb Benner-Hahn (UIHC) 5.00

1276086 1232 E Colle e St IC IA 52245
7/30/2004 Martha Bradbuly (UIHC) 2.00

1276086 1116 W Ide Green Rd IC IA 52246
7/30/2004 Jana Burkholder (UIHC) 1 .00

1276086 604 Kimbedde St Tiffin IA 52340
7130/2004 Heide Bursch (UIHC) 5.00

1276086 97 Oberlin IC IA 52245
713012004 Barry Buschelman (UIHC) 5 .00

1276086 780 Fairview Ln North Liberty IA 52317
7/30/2004 Ann Byrne (UIHC) 5.00
1276086 1302 Oak St Buffalo IA 52728
i~tu ua
g ~-- c~r_~~
Disciosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee . Relationship mull be shown to tree third degree of consanguinity (blood relatives) and affinity (reletlvef by
lL/ , of
marriage) (See Page 2 of forms packet .) . I( surname of contributor is the same as candidate, but there is no pate
familial relationship, enter "not applicable- in the relationship column . (for Schedule A)
OCT-19-2004 08:57 P .10
A MONETARY
CHECK THIS BOX IF
SE IU(Ser v ice Empl oye es I nt'l Union) Local 199 C PE Fund

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 10 NUMBERS IS AVAILABLE FROM THE IOWA ETMICS AND CAMPAIGN
0ISCLO$URE BOARD .
CAUTION : Section 68B .32A(B), Iowa Code . prohibits the use of information copied from reports and statements for soliciting contributions or
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT d IF FOR
RECEIVED (if applicable) TO CANDIDATE RECEIVED FUND-
(MM/DD/YR) ANO .'-'AC CHECK (if applirable) RAISER
NUMBER ., INCOME
7/3012004 Marjie Caruth (UIHC) 5.00

1276086 801 Alpine Dr IC IA 52245
7/30/2004 Bev CleahTian'(U1HC) ' ' 5.00
1276086 1007 Eighth St Coralville IA 52241
7/30/2004 Lynette Cooper (UIHC) 2 .50
1276086 2401 Hwy 6 E #1210 IC IA 52240
7/30/2004 Julie Davis (UIHC) 5,00
1276086 337 Normandy Dr IC IA 52246
7/30/2004 Cathy Dostal (UIHC) 2 .00
1276086 1985 South Ride Dr CV IA 52241
7/30/2004 Angela Duwa (UIHC) 5 .00
1276086 2519 J Ave Williamsburg IA 52361
7130/2004 Carolyn Elliott (UIHC) 10 .00
1276086 110 Florida Ave SW CR IA 52404
7/30/2004 Shelley Engman (UIHC) 5.00
1276086 717 Rundell St IC IA 52240
7130/2004 Elizabeth Fisher (UIHC) 2.50
1276086 1307 Carroll St IC IA 52240
7/30/2004 Anita Fite (UIHC) 5.00

1276066 133 Hillside Dr Eldrid e IA 52748
1J~L'Jtl~/h /
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page _ of
OCT-19-2004 08 :57 P. 11
SCHEDULE
For Instructions, See Back of Form
A I MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev, 06197) I RECEIPTS
CHECK THIS BOX IF

ETHICS AND CAMPAIGN
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA
DISCLOSURE BOARD
(MM/DD/Yk) AND -ACBCHECK i (if applicable) RAISER
INCOME
7/30/2004 Karlene Fuller (UIHC) 3.00
1276086 1611 -13th Street CV IA 52241

I.
7130/2004 Cindy iiui'ik . (uiHC) 3 .00
1276086 1231 Sandusk Ave IC IA 52240
7/30/2004 Joe Galbraith (UIHC) 10 .00
1276086 3021 Raven St IC IA 52245
7130/2004 Nancy Genoar (UIHC) 5.00
1276086 1252 Coll Dr IC IA 52246
7130/2004 Trisha Godard Shepherd (UIHC) 2 .50
1276086 930223rd Ave Apt C Coralville IA 52241
7130/2004 Lynda Green (UIHC) 10 .00
1276086 2075 Melrose Ave IC IA 52246
7130/2004 Melissia Greiner (UIHC) 5.00
1276086 26436 - 305th Avenue Keota IA 52248
7/30/2004 Dan Grinstead (UIHC) 7 .50
1276086 1218 Ash St IC IA 52240
7/3012004 Marcia Hahn (UIHC) 5.00
1276086 2281 Sugar Bottom Rd Solon IA 52333
7/30/2004 Terry Hamilton (UIHC) 3.00
1276086 715 N Van Buren St IC IA 52245
$5 ,'III
- Disclosure law requires candidate committees to disclose the relationship of(blood

any relative making a contribution to the
committee . Relationship must be shown to the third degree of consanguinity relatives) and affinity (relatives by
of
marriage) (See Page 2 of forms packet .) . Il surname of contributor is the same as candidate, bill there is no Page
(for Schedule A)
familial relationship, enter `not applicable- in the relationship column .
OCT-19-2004 08 :58 P .12
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev, 06/97) I RECEIPTS
COMMITTEE NAME (Must be same as on Statement of Organization)

a CHECK THIS BOX IF
AMENDING FORM
SEIU(Setvice Employees Int'1 Union) Local 199 C~PE Fund

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 69B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
(MM/DD/Yk) AND "AC CHECK (if applicable) RAISER
NUMBER INCOME
7/3012004 Lynn Hanke (UIHC) 5_00
1275086 1001 Memorial Dr SE CR IA 52403
7/30/2004 Sarah Helle (UIHC) - 5.00
1276086 1330 Upper Old H 6 Oxford IA 52322
7/30/2004 Sharon Hicks (UIHC) 2 .00
1276086 2639 - 140th Street NW Swisher IA 52338
7/30/2004 Melody Hobert-Mellecker (UIHC) 5 .00
1276086 300 Main St Hills IA 52235
7/30/2004 Claire Hockley (UIHC) 7.50
1276086 2647 Newport Rd NE IC IA 52240
7/3012004 Deb Reynolds Hubbard (UIHC) 3.00
1276086 1468 Valley View Drive CV IA 52241
7/30/2004 Shelley Jacobus (UIHC) 1 .00
1276086 6507 Boxwood Ln NE CR IA 52402
7/30/2004 Jennifer Jungen (UIHC) 5.00
1276086 P 0 Box 588 North Liberty IA 52317
7/30/2004 Norman Kalvig (UIHC) 20_00
1276086 1945 Park Ave SE CR IA 52403
713012004 Valerie Keffala (UIHC) 5.00

1276086 1109 Prairie DuChien Rd IC IA 52245
!~-rJt3-7-pFA- L- 5S~ $ r
committee . Relationship must be shown to the trllrd degree 0( Consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 7 of forms packer .) . If surname of contributor 15 the same as candidate, but there is no Pace 9 of
familial relationship, enter "not applicable" in the relationship column. (for ScFicdule A)
OCT-19-2004 08 " 58 P . 13
A ( MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 06197) RECEIPTS
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as o» Statement of Organization) AMENDING FORM

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(B), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
(MMIDDIYk) AND -AC CHECK (if applicable) RAISER
NUMBER INCOME
7/3012004 Teresa A Kingdon (UIHC) 2.50
1276086 2113 Norcor Ave Apt 4 CV IA 52241
7/30/2004 Katherin Kitelnow (OIHC) ' ' ' - - 5.00
1276086 3333 Pheasant Ct NE North Liberty IA 52317
7/3012004 Arlene Klesner (UIHC) 1 .00
1276086 1901 Earl Road IC IA 52246
7/30/2004 Amy Kruse (UIHC) 5.00

1276086 203 Fifth St #1 Coralville IA 52241
7/30/2004 Linda Krutsinger (UIHC) 10.00
1276086 2147 Plaen View Dr IC IA 52246
7130/2004 Cynthia Larew (UIHC) 1,00

1276086 P 0 Box 441 Lone Tree IA 52755
7/30/2004 Paula Laube (UIHC) 7 .50
1276086 712 Walnut St IC IA 52240
7/3012004 Raelene Lenoch (UIHC) 1,00

1276086 213 Broadway St W Branch IA 52358
7130/2004 Luanne Link (UIHC) 5.00
1276086 2215 Hickory Court IC IA 52240
7130/2004 Michael Loucks (UIHC) 5.00

1276086 1495 Falcon Ave Swisher IA 52338
S
committee Relationship mint be shown to the third degree of consanguinity (blood relatives) and affinity (relalives by
marriage) (See Page 2 of forms packet .) . If surnarne of contributor is the same as candidate, but there is no Page of
OCT-19-2004 08 :59 P. 14
A I MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev, 06197) RECEIPTS
© CHECK THIS BOX IF

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIvEO FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD
CAUTION : Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
RECEIVED (if applicable) TO CANDIDATE - RECEIVED FUND-
(MMIDD1Yk) AND "AC CHECK (if applicable) RAISER
NUMBER INCOME
7/30/2004 Wilma Macalalag (UIHC) 5.00
1276086 828 Augusta Circle North Liberty IA 52317
7/3012004 June -Masbrth:;h (UIH(;) ' 5_00
1276086 2387 - 340th St SW Tiffin IA 52340
7/30/2004 Ann Mason (UIHC) 3.00
1276086 1032 Oakcrest St IC IA 52246
7/3012004 Ruth McKeever (UIHC) 5 .00
1276086 302 Walnut St Ti ton IA 52772
7130/2004 Mary McKinney (UIHC) 3.00
1276086 506 West Seventh St Ti ton IA 52772
7130/2004 Mary Jo Meggers (UIHC) 5.00
1276086 3371 Oaie Dr Solon IA 52333
713012004 Terri Mengler (UIHC) 7.50
1276086 2215 Second St SW CR IA 52404
7/30/2004 Jean Miller (UIHC) 5.00
1275086 3755 Cottage Reserve Rd NE Solon IA 52333
7/3012004 Tara Miller (UIHC) 2.50
1276086 333 Carter St NW CR IA 52405
7/3012004 Robert Milne (UIHC) 3,00
1276086 417 Carter St NW CR IA 52405
TOTAL, (if last page of this schedule)
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by } I
marriage) (See Page 2 of forms packet .) . If surname of contributor is the sarne as candidate, but there is no Page of
familial relationship, enter "not applicable' in the relationship column . (for Schedule A)
OCT-19-2004 08 :59 P .15
For Instructions, See Back of Form . SCHEDULE
CONTRIBUTIONS - MONEY TAKEN IN

A MONETARY
(Rev . 06197) RECEIPTS
CHECK THIS BOX IF

SETU(Service Employees Ynt'l Union) Local 199 C PE Fund

DISCLOSURE BOARD.
CAUTION: Section 688 .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
RECEIVED (if applicable) TO CANDIDATE RECEIVED FUNO-
(MMIDDIYR) AND''AC CHECK (if applicable) RAISER
NUMBER INCOME
7/30/2004 Melinda Myers (UIHC) 20.00

1276086 1116 A Ave NW CR IA 52405
7/30/2004 Jan Niebes CPC)" 5 .00

1276086 17274 -15th Ave Keystone IA 52249
7/30/2004 Linda Petersen (UIHC) 2 .50

1276086 907 N Gilbert St IC IA 52.245
7/3012004 Margaret Mary Ping (UIHC) 3.00

1276085 110 Sar ert Dr West Branch IA 52358
7/30/2004 Becky Pottorff-Leaven (UIHC) 5 .00

1276086 1149 Hunter's Run IC IA 52246
7/30/2004 Mary Reidy (UIHC) 3 .00

1276086 2331 East Washington St IC IA 52245
7/30/2004 Jeffrey Rupe (UIHC) 3 .00

1276086 P O Box 218 North Liberty IA 52317
7/30/2004 Nancy Sandstrom (UIHC) 7.50

1276086 60 David Lee Court North Liberty IA 52317
7/30/2004 Dorothy Satariano (UIHC) 3 .00

1276086 3222 Shasta Ct NE CR IA 52402
713012004 Cheryl Schild (UIHC) 3.00

1276086 914 - 12th Ave CV IA 52241
:7VOw V W"L
$~
TOTAL (iflast page of this schedule)
Disclosure law requires candidate committees to disclose the relatlonship of any relative making a contribution to the
commlttec . 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
familial relationship, enter not applicable' in the relationship column . (for Schedule A)
OCT-19-2004 09 " 00 P . 16
A ~ MONETARY
CHECK THIS BOX IF

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMrFFEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF 10 NUMBERS I$ AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
CAUTION : Section 6B8 .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
RECEIVED (if applicable) O CANDIDATE' RECEIVED FUND-
(MM/DO/YR) AND'-AC CHECK (if applicable) RAISER
NUMBER INCOME
7/30/2004 Mary Schlichte (UIHC) 10_00

1276086 4490 Westover Rd SE CR IA 52403
7(30/2004 'Joyce SCKuitz (U1Hl:) ' 3.00

1276086 13023 Radcliffe Avenue IC IA 52245
7/30/2004 Shanna Seigel (UIHC) 5.00

1276086 2820 U Avenue Parnell IA 52325
7/30/2004 Jeanne Sheetz (UIHC) 5.00

1276086 120 Tartan Or North Liberty IA 52317
713012004 Karen Shickell (UIHC) 10.00

1276086 827 Dover Street IC IA 52245
7/30/2004 Anthony Shrader (UIHC) 5.00
1276086 1560 - 7th Ave SE CR IA 52403
7/3012004 Vicki Siefers (UIHC) 3.00
1276086 15 Brown Deer Knoll CV IA 52241
7/30/2004 Pam Simons (UIHC) 5.00

1276086 1310 Franklin St IC IA 52240
7/30/2004 Terry Simons (UIHC) 5.00

1276086 510 Kimberlite St Tiffin IA 52340
7/30/2004 Chris Slater (UIHC) 5.00

1276086 2760 Turkey Creek Ln NE IC IA 52240 .
TOTAL (if fastpage of this schedule)
Disclosure law requires candidate committees to disclose the relationship of any relatlve making a contribution to the
marriage) (See Page 2 of forms packet .). If surname of contributor is the same as candidate, but there is no Page , of
OCT-19-2004 09 :00 P .17
A
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 06/97)
CHECK THIS BOX IF
SEIU(Service Employees Int;'l Union) Local 199 C 1'E Fund

STATE CANDIDATES NOTE! IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT ,I IF FOR
(MM/DD/YR) AND ''AC CHECK (if applicable) RAISER
NUMBER INCOME
713012004 Mary Stessman (UIHC) 1 .00

1276086 3788 Sunaura Drive NE IC IA 52240
7/30/2004 . . Sue 5we&ihgen (UIHC) " . : . 5.00

1276086 422 Melrose Ct IC IA 52246
7/30/2004 Wanda Thackery (UIHC) 1_00

1276086 604 First Ave So Mount Vernon IA 52314
7/3012004 Trisha Turnis (UIHC) 5.00

1276086 4519 Walker St NE CR IA 52402
7/30/2004 Diane Van Ersvelde (UIHC) 1 .00
1276086 3051 Meadow Rd NE North Libel IA 52317
7/30/2004 Jo Vonderhaar (UIHC) 3.00

1276086 1023 Marc Street IC IA 52240
7/30/2004 Angela Wernke Trenkamp (UIHC) 10,00

1276086 361 Camden Rd IC IA 52245
7/3012004 Patsy Wheeler (UIHC) 7.50

1276086 2761 Rhine Creek Way NW Oxford IA 52322
713012004 Sherry Whetstone (UIHC) 5 .00

1276086 110 Swisher View Dr SW Swisher IA 52338
7/30/2004 Pat Wolf (UIHC) 1 .00

1276086 1409 Western College CR IA 52404
JUD-IV1/1L i I"
c`~l
committee, Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of lorms packet,) If surname of contributor is the same as candidate, but there is no Page of
OCT-19-2004 09 :01 P. 18
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN
(Rev . 06/97) I RECEIPTS
0 CHECK THIS BOX IF

SEIU(Service Employees Int'1 Union) Local 199 C PE Fund

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 ANO CAMPAIGN
DISCLOSURE BOARD .
CAUTION : Section 68B.32A(B) . Iowa Code, prohibits the use of information copied from repoRs and statements for soliciting Contributions or
(MM/DDIYR) AND "AC CHECK (if applicable) RAISER
Ni IlytgFR INCOME -
7/30/2004 Joan Comer Wright (UIHC) 3.00
1276086 1659 Polk Avenue NE Solon IA 52333
7/30/2004 Marisa Yoder'(t11HC) - - - 7,50 1

1276086 P 0 Box 130 Kalona IA 52247

227771 P 0 Box 373 N English 1A 52316

227771 4876-120 St NE Solon IA 52333
7/30/2004 Richard Hannan (IC Sch) 1 .50

227771 P 0 Box 3281 Iowa City IA 52244
7/30/2004 John Hoard (IC Sch) 1 .25

227771 Box 466 Hills IA 52235
7130/2004 Ron Jensen (IC Sch) 1 .00

227771 425-320th St W Liberty IA 52776
7/30/2004 Brad Kuester (IC Sch) 1 .50

227771 2821 S Riverside Dr Iowa City lA 52246
7/30/2004 Jon Lalla (IC Sch) 2 .50

227771 601 Oakland Ave Iowa Ct IA 52240

$as"15
Disclosure law requires candidate committees to disclose lrle relationship of any relative making a contribution to the
marriage) (Sea Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page I of
familial relationship, enter "not applicable" In the relationship column . (for Schedule A)
OCT-19-2804 09 :01 P .19
CONTRIBUTIONS -- MONEY TAKEN IN

A MONETARY
(Rev . 06/97) RECEIPTS
CHECK THIS BOX IF
SEIU(Service Employees Int'1 Union) Local 199 COPE Fund

STATE CANDIDATES NOTE: IF A CONTRIBUTION 15 RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COWMN 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
(MMIDDIYR) AND ''AC CHECK (if applicable) RAISER
NUMBER INCOME
7/30/2004 Michel Murphy (IC Sch) 2 .50

7/30/2004 - Randy -Nguyerf (IG Sch) - 1 .50


227771 290 Elm Ridge Drive North Liberty IA 52317
7130/2004 Rodney Perdue (IC Sch) 2 .50

227771 603 W Paris St W Liberty JA 52776
7/30/2004 Wm Salasberry (IC Sch) 1 .50

227771 1119 Pine St Iowa City 1 A 52240

7/30/2004 Gerald Vonstein (IC Sch) 2.50

227771 5048-210th St NE Solon 1 A 52333
7/30/2004 Dale Weir (IC Sch) 1 .50

227771 2145 Palmer Circle Iowa City IA 52240
7/30/2004 Jerome Wiedemeir (IC Sch) 1-50

713012004 Daryl Lewis (IC Sch) 5_00
227771 216 Dartmouth Iowa City IA 52245
"1~191" 1)~a r
committee Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (retetives by
marriage) (See Page 2 or forms packet .) . If surname of contributor is the same as candidate, but there is no
familial relationship, enter "not applicable" In the relationship column .
Page ~~~ of
(for Schedule A)
G
OCT-19-2004 09 :01 P .20
A ( MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Ray . 06197) RECEIPTS
(Including candidale's personal funds)
CHECK THIS BOX IF

COMMITTEE), LIST THE PAC IDENTIFICATION
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION
CAMPAIGN
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF 10 NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND
DISCLOSURE BOARD.
CAUTION: Section 6BB,32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
RECEIVED (if applicable) 0 CANDIDATE' RECEIVED FUND-
(MM/DDIYk) AND ''AC CHECK I (if applicable) RAISER
NUMBER INCOME
8/6/2004 Brian Flaherty 3.00
8/6/2004 Anhif Gentil=Afcher - 5 .00
Direct Deposit 1744 - 115th St West Liberty IA 52776
8/6/2004 Mickenzie Jensen 2.50
Direct Deposit 2313 Kelly St SW CR IA 52404
8/6/2004 Matt Loeb 2 .50

Direct Deposit 470 Hawaii Ct IC IA 52246
8/6/2004 David C Meggers 5 .00

8/612004 Kim R Miller 10.00
8/6/2004 Douglas L Peters 2_50
8/6/2004 Jennifer Poland 2_50

committee. Relationship must be shown to the third degrf of consanguinity (blood relatives) and affinity (relatives by
Page ~_ of
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no
OCT-19-2004 09 :02 P .21
For Instructions, See Back of Form ISCHEDULE
A MONETARY
Q CHECK THIS BOX IF

NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS 15 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
RECEIVED (If applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDONR) AND "AC CHECK (if applicable) RAISER
NUMBER INCOME=
8/6/2004 Kirsten A Running 2.50
Direct Deposit 1210 Hi hland Ave IC IA 52240
8/6/2004 Rita St6iler 5.00
Direct Deposit 2131 Plaen View Dr IC fA 52246
8/6/2004 Sarah C Swisher 40.00
Direct Deposit 917 Bowe St IC IA 52-240
8/6/2004 Tawny L Wilson 7.50
8/18/2004 Russell A Clark (CR Sch) 5.00
8/18/2004 Harless S Clemons (CR Sch) 10 .00
103803 505 Sixth St SE CR IA 52401
8/1812004 Marshall R Clemons (CR Sch) 5.00
103803 505 Sixth St SE CR IA 52401
8/18/2004 Wm A Fiacco (CR Sch) 3.00
103803 4133 - 22nd Ave SW CR IA 52404
8118/2004 Jeff L Foster (CR Sch) 5.00
103803 3209 Tamara Dr SW CR IA 52404
L
8/1812004 Ken D Grout (CR Sch) 2 .00
JUCS- I V I ML
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms packer .) . If surname of contributor is the same as candidate, but there is no Page of ~_
familial relation5hip, enter `not applicable' in the relationship column . (for Schedule A)
OCT-19-2004 09 : 02 P .22

A MONETARY
SEIU(Service Employees Int'l Union) Local 199 CIT, PE Fund

NUK48ER AND THE PAC CHECK NUMBER IN THE DESIGNATE0 COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS ANO CAMPAIGN
DISCLOSURE BOARD .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 1 IF FOR
(MM1DD/YR) AND ''AC CHECK (if applicable) RAISER
N!lr'iLLA" INCOME
8/1812004 Gordon Kaltenbach (CR Sch) 6.00
103803 227 - 11 th St NW CR IA 52405

8/18/2004 Joyce L LDcas (CR Sch) 4.00
103803 1401 B Ave Vinton IA 52349
8/1812004 Dave L Mart (CR Sch) 5.00
103803 926 - 15th Ave 13 W CR IA 52404
8/18/2004 Chris McLees (CR Sch) 5.00
103803 411 - 27th St NE CR IA 52402
8/18/2004 Tim J Newcomb (CR Sch) 5.00

103803 726 E Ave NW CR IA 52405
8/18/2004 Chas A Perry (CR Sch) 10_00
103803 1479 Miami Dr NE CR IA 52402
8/18/2004 AL J Pospisil (CR Sch) 1 .00

8/18/2004 Terry A Slickty (CR Sch) 2-50

103803 1128 Brown Ave NE CR IA 52402
103804 1002 E6stern Dr SE CR IA 52403
8/18/2004 Stephanie J Lewis (CR Sch) 5 .00

103804 1601 - 30th St NW #12 CR IA 52405
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)
OCT-19-2004 09 : 03 P .23
For Instructions, See Back of Form { SCHEDULE
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 06/97) RECEIPTS
SEIU(Service Employees Intrl Union) Local 199 C PE Fund

DISCLOSURE BOARD
CAUTION: Section 685.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
RECEIVED (f applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND ''AC CHECK (if applicable) RAISER
NUMBER INCOME
8/18/2004 Stacy King (HACAP) 20,00
cash 2123 Buckingham Dr NW #4 CR IA 52405
8118/2004 Donald J Bihegar Jr (IC Sch) 1-50 ,
228070 P 0 Box 373 N English IA 52316
228070 4876-120 St NE Solon IA 52333
8/18/2004 Richard Hannan (IC Sch) 1,50
228070 P 0 Box 3281 Iowa City IA 52244
228070 Box 466 Hills IA 52235
8/18/2004 Ron Jensen (IC Sch) 1-00
228070 425-320th St W Liberty IA 52776

228070 2821 S Riverside Dr Iowa C' IA 52246
8/18/2004 Jon Lalla (IC Sch) 2.50
8/1812004 Brian J Meyer (IC Sch) 1,50

811812004 Michel Murphy (IC Sch) 2.50

lJ:r t vv FW - _
n
r
marriage) (See Page 2 of lorms packet,), If surname of contributor is the same as candidate, but there is no Page . ( K of
OCT-19-2004 09 : 03 P .24
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev, 06/97) I RECEIPTS
CHECK THIS BOX IF

STATE CANDIDATES NOTE ; IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE) . LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD .
CAUTION ; Section 68B,32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
RECEIVED (if applicable) TO CANDIDATE- RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
8/18/2004 Randy Nguyen (IC Sch) 1 .50
8/18/2004 Michael O'Cohnbe (IC Sch) 1 .50
228070 290 Elm Ride Drive North Liberty IA 52317
8/18/2004 Rodney Perdue (IC Sch) 2.50
228070 603 W Paris St W Liberty IA 52776
8/18/2004 Kimberly Schlabach (IC Sch) 1-50
8/18/2004 Gerald Vonstein (IC Sch) 2_50
228070 5048-210th St NE Solon IA 52333
8/18/2004 Dale Weir (IC Sch) 1 .50
8118/2004 Jerome Wiedemeir (IC Sch) 1 .50
8/18/2004 Daryl Lewis (IC Sch) 5.00

8/18/2004 Marsha Anderson (UIHC) 5,00

1285845 1975 So Rid e Dr Coralville IA 52241
JUD-rvr L
TOTAL (if last page of this schedule) $ .1
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) rind affinity (relatives by
marriage) (See .Page 2 of forms packet .) . If sumame of contributor is the same as candidate, but (here is no Page ~4 I,_ of
familial relationship . enter "not applicable" in the relationship column . (for Schedule A)
OCT-19-2004 09 : 04 P .25

A MONETARY
CHECK THIS BOX IF
SEIU(Service Employees Int'l Union) Local 199 C
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE) . LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT +l IF FOR
RECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-
(MMIDOIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
8/18/2004 Sandra Anfinson (UIHC) 2,00
8/18/2004 Matt 8ahl (UCHC) . ' ' - 5 .00
1285845 24,5.. Hickory St N Liberty IA 52358
8/18/2004 Michelle Bargren (UIHC) 5 .00
1285845 702 Hodge St North Liberty IA 52317
8118/2004 Janice Barnes (UIHC) 5 .00
1285845 1021 - 20th Ave CV IA 52241
8/18/2004 Rachael Barrow (UIHC) 10.00
1285845 3513 Dunham Dr SW CR IA 52404
8/18/2004 Deb Benfer (UIHC) 3 .00
1285845 1683 Hemin a Lane IC IA 52240
8/18/2004 Deb Benfer-Hahn (UIHC) 5.00
1285845 1232 E College St IC IA 52245
8118/2004 Martha Bradbury (UIHC) 2.00
T
8/18/2004 Jana Burkholder (UIHC) 1,00
8/1812004 Heide Bursch (UIHC) 5.00

1285845 97 Oberlin IC to 52245
JUlS- I V t HL.
familial relationship, enter "not applicable' in the relationship column .
Page of b5
(For Schedule A)
OCT-19-2004 09 : 04 P .26

A I MONETARY
CHECK THIS BOX IF
SEI U(Servi c e Employees Int;'l Union) Local 199 C PE Fund

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IOENTIFICA71ON
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,3ZA(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT +IIF FOR
(MMIDOIYR) AND PAC CHECK (if applicable) RAISER
Wwny-~,- INCOME
B/18/2004 Barry Buschelman (UIHC) 5.00

8/1812004 - Afro l8yfrse (UCHC)' ' - 5.00

1285845 302 Oak St Buffalo IA 52728
8/18/2004 Marjie Caruth (UIHC) 5 .00
1285845 801 Alpine Dr IC IA 52245
8/18/2004 Bev Clearman (UIHC) 5 .00

8/1812004 Lynette Cooper (UIHC) 2.50

1285845 2401 Hw 6 E #1210 IC IA 52240
811812004 Julie Davis (UIHC) 5 .00
- 1285845 337 Normandy Dr IC IA 52246
811812004 Cathy Dostal (UIHC) 2,00

8118/2004 Angela Duwa (UIHC) 5-00
1285845 2519 J Ave Williamsbur IA 52361
8/18/2004 Carolyn Elliott (UIHC) 10-00

811812004 IShelley Engman (UIHC) 5.00

1285845 717 Rundell St IC IA 52240

$
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution tc the _
Committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by `- r
marfiage) (See Page 2 of farms packet .) . If surname of contributor is the same as candidate, but there is no fags ~ of
farrffial relationship, enter 'not applicable ' in the relationship column . (for Schedule A)
OCT-19-2004 09 : 05 P.27

A
I
MONETARY
CHECK THIS BOX IF
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.
RECEIVED if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
8118/2004 Elizabeth Fisher (UIHC) 2 .50
1285845 1307 Carroll St IC IA 52240
8118/2004-, ' 'Ardia Fite (UIHC) 5.00 1
8/18/2004 Karlene Fuller (UIHC) 3 .00
1285845 1611 - 13th Street CV 1 A 52241
8/18/2004 Cindy Funk (UIHC) 3 .00
1285845 1231 Sandusk Ave IC IA 52240
8/18/2004 Joe Galbraith (UIHC) 10_00
1285845 3021 Raven St IC IA 52245
8/18/2004 Nancy Genoar (UIHC) 5.00
1285845 1252 Coll Or IC IA 52246
8118/2004 Trisha Godard Shepherd (UIHC) 2.50
1285845 930-23rd Ave Apt C Coralville IA 52241
8/18/2004 Lynda Green (UIHC) 10,00
1285845 2075 Melrose Ave IC IA 52246
8/18/2004 Melissia Greiner (UIHC) 5,00
8/18/2004 Dan Grinstead (UIHC) 7_50
1285845 1218 Ash St IC IA 52240

.I
committee . Relationship mtist 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 of ('05
OCT-19-2004 09 : 05 P .28
A MONETARY
CHECK THIS BOX IF
SEIU(Service Employees Int'l Union) Local 199 C~PE Fund
DISCLOSURE BOARD.
CAUTION : Section 688,32A(6), Iowa Code . prohibits the use of information copied from reports and statements for soliciting contributions or
NUMBER INCOME
8/18/2004 Marcia Hahn (UIHC) 5.00
8/18/2004 ' . .1 Terry Hamilion (UIHC) ' 3.00
8/18/2004 Lynn Hanke (UIHC) 5_00
8/1812004 Sarah Helle (UIHC) 5.00
8/18/2004 Sharon Hicks (UIHC) 2.00
8/18/2004 Melody Hobert-Mellecker (UIHC) 5.00
1285845 300 Main St Hills IA 52235
8/18/2004 Deb Reynolds Hubbard (UIHC) 3.00
8118/2004 Shelley Jacobus (UIHC) 1,00
8/18/2004 Jennifer Jungen (UIHC) 5.00

1285845 P 0 Box 588 North Liberty IA 52317 _
S UB -TOTAL

Es
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page -of ~~
OCT-19-2004 09 : 05 P .29
MONETARY
CHECK THIS BOX IF
DISCLOSURE BOARD.
CAUTION : Section 68B .32A(6), Iowa Code . prohibits the use of information copied from reports and statements for soliciting contributions or
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT -4 IF FOR
(MM/DDYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
8/18/2004 Norman Kalvig (UIHC) 20.00
1285845 1945 Park Ave SE CR 1 A 52403
8/18/2004 Valerie Keffala (UIHC) 5 - 00
8/18/2004 Teresa A Kingdon (UIHC) 2.50
8/18/2004 Katherine Kleinow (UIHC) 5 .00
8/18/2004 Arlene Klesner (UIHC) 1 .00
1285845 1901 Earl Road IC IA 52246
8/18/2004 Amy Kruse (UIHC) 5.00
1285845 203 Fifth St 41 Coralville IA 52241
8/1812004 Linda Krutsinger (UIHC) 10.00
8/18/2004 Cynthia Larew (UIHC) 1 .00
1285845 P 0 Box 441 Lone Tree IA 52755
8/18/2004 Paula Laube (UIHC) 7 .50
1285845 712 Walnut St IC IA 52240
8/18/2004 Raelene Lenoch (UIHC) 1 .00
marriage) (See Page 2 of forms packet .) . If surnarne of contributor is the same as candidate, but there is no
familial relationship, enter "not applicable - in the relationship column .
Page of
(for Schedule A)
G5
OCT-19-2004 09 : 06 P.30
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev, 06197) RECEIPTS
LJ CHECK THIS BOX IF

DISCLOSURE BOARD,
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT -4 IF FOR
(MMIDDfYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
8/18/2004 Luanne Link (UIHC) 5.00
8/1812004 Michael Loucks -(UIHC) 5.00
8/18/2004 Wilma Macalalag (UIHC) 5 .00
8/18/2004 June Masbruch (UIHC) 5.00

1285845 2387 - 340th St SW Tiffin IA 52340
8/18/2004 Ann Mason (UIHC) 3.00
1285845 1032 Oakcrest St IC 1A 52246
8/18/2004 Ruth McKeever (UIHC) 5 .00
8/18/2004 Mary McKinney (UIHC) 3 .00
8/18/2004 Mary Jo Meggers (UIHC) 5 .00
1285845 3371 Ozzie Dr Solon IA 52333
8/18/2004 Terri Mengler (UIHC) 7.50

1285845 2215 Second St SW CR 1 A 52404

65
Disclosure law requires Candidate committees to disclose the relationship of any relative making a Contribution to the
committee . Relationship must be shown to the lnlfd 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)
OCT-19-2004 09 : 06 P .31

MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 06)90 RECEIPTS
0
CHECK THIS BOX IF

DISCLOSURE 90AR0 .
CAUTION : Section 68B .32A(6) . Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
RECEIVED (if applicable) TO CANDIDATE` RECEIVED FUND-
(MM/OD/YR) I AND PAC CHECK (if applicable) RAISER
Nt IMRFR INCOME
8118/2004 Tara Miller (UIHC) 2.50
1285845 333 Carter St NW CR IA 52405
8/18/2004 - ' , ` . 4. . . . . R'6trert Wrie (UIHC) " - " " 3.0G .
1285845 417 Carter St NW CR IA 52405
8118/2004 Melinda Myers (UIHC) 20_00
1285845 1116 A Ave NW CR IA 52405
8118/2004 Jan Niebes (UIHC) 5.00
1285845 7274 - 15th Ave Keystone IA 52249
8/1812004 Linda Petersen (UIHC) 2.50
1285845 907 N Gilbert St IC 1A 52245
8/1812004 Margaret Mary Ping (UIHC) 3 .00
811812004 Becky Pottorff-Leaven (UIHC) 5.00
1285845 1149 Hunter's Run IC IA 52246
8/18/2004 Jeffrey Rupe (UIHC) 3 .00
8/18/2004 Nancy Sandstrom (UIHC) 7 .50
8/1812004 Dorothy Satariano (UIHC) 3.00

1285845 3222 Shasta Ct NE CR IA 52402
* Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
marriage) (See Page 2 of lorms packet .) . If surname of contributor is the same as candidate, but there is no
familial relationship, enter "not applicable" in the relationship column .
OCT-19-2004 09 : 07 P .32
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 06197) l RECEIPTS
CHECK THIS BOX IF
SEIU(Service Employees Int'1 U n i o n) L ocal 199 C~PE Fund
DISCLOSURE 80ARD.
CAUTION : Section 6BB_32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
(MMIDDfYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
8/18/2004 Cheryl Schild (UIHC) 3.00
1285845 914 - 12th Ave CV IA 52241
8/18i2004 ' Niary Schlichte'(UIHC) - r 1o.bd "
8/18/2004 Joyce Schultz (UIHC) 3 .00
8/18/2004 Shanna Seigel (UIHC) 5.00
8/18/2004 Jeanne Sheetz (UIHC) 5.00 .
1285845 120 Tartan Dr North Liberty IA 52317
8/18/2004 Karen Shickell (UIHC) 10.00
8/18/2004 Anthony Shrader (UIHC) 5_00
1285845 1560 - 7th Ave SE CR IA 52403
8/18/2004 Vicki Siefers (UIHC) 3.00
1285845 1310 Franklin St IC IA 52240
8/18/2004 Terry Simons (UIHC) 5 .00

- 1 ML
r'- I
" 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 Ic no Page fit_ of
familial relationship, inter "not applicable" in the relationship column . (ior Schedule A)
OCT-19-2004 09 : 07 P .33
1-or instructions, aee tsacK Dr turn! o" .ncv%J L. c
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev, 06197) I RECEIPTS
D CHECK THIS BOX IF
SEIU(Service Employees Int'l Union) Local 199 C(I PE Fund

DISCLOSURE BOARD.
CAUTION . Section 68a .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
(MMIDDIYR) AND PAC CHECK (If applicable) RAISER
INCOME
1285845 2760 Turkey Creek Ln NE IC IA 52240
8/1111?004 ,. . Mary Stessman-(UIHC)
8/18/2004 Sue Swearingen (UIHC) 5.00
1285845 422 Melrose Ct IC 1A 52246
8/18/2004 Wanda Thackery (UIHC) 1 .00
811812004 Trisha Turnis (UIHC) 5.00
1285845 4519 Walker St NE CR IA 52402
1285845 3051 Meadow Rd NE North Liberty IA 52317
8/18/2004 Jo Vonderhaar (UIHC) 3 .00

1285845 1023 Marc Street IC IA 52240
8/18/2004 Angela Wernke Trenkarnp (UIHC) 10 .00

1285845 351 Camden Rd IC IA 52245
8/18/2004 Patsy Wheeler (UIHC) 7.50

811812004 Sherry Whetstone (UIHC) 5.00

auto- I V IhL-
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) Find affinity (relatives by
marriage) (See Page 2 of forms packet) . If surname of contributor is the same as candidate, but there is no Page ~JO of
(for Schedule A)
familial relationship, enter 'not applicable' in the relationship column .
OCT-19-2004 09 : 08 P .34
SCHEDULE
A I MONETARY
Q CHECK THIS BOX IF
AMENDING FORM
SEID(Service Employees Int'1 Union) Local 199 C PE Fund

NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF 10 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
RECEIVED
(MMIDDIYR)
(if applicable)
AND PAC CHECK
NUMBER
I TO CANDIDATE'
(if applicable)
RECEIVED FUND-
RAISER
INCOME
8/18/2004 Pat Wolf (UIHC) 1 .00

8/1-8/2004 - " ' - - " ` Joan Cbmbr Wright (UIHC) ' 3.00
8/18/2004 Marietta Yoder (UIHC) 7.50

1285845 P 0 Box 130 Kalona IA 52247

Direct Deposit 1683 Hemin wa Lane IC IA 52240
8/20/2004 Brian Flaherty 3.00

8/20/2004 Anne Gentil-Archer 5.00
8/20/2004 Cathy Singer Glasson 15,00

8/20/2004 Linda L Hagen 10.00

Direct Deposit 375 Mormon Trek Blvd #7 IC IA 52246
8/20/2004 Mickenzie Jensen 2_50
Direct Deposit 2313 Kelly St SW CR IA 52404
8/2012004 David C Meggers 5.00

$561
1
Page of ~~
marriage) (See Page 2 of forms packer .) . If surname of contributor is the same as candidate, but there is no
OCT-19-2004 09 : 08 P .35
For Instructions, See t3ack oT rorm Jk_f1tUULC
A MONETARY
(including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE: NAME (Must be same as on Statement of Organization) AMENDING FORM

NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COWMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
DATE PAC 10 NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
NUMBER INCOME
8/20/2004 Devin P Mehaffey 2-50
'si2O/2004
1
1
;
. Kim PC IViilrer" - ' " 'rU .OU
Direct Deposit 70 E Chestnut NIL IA 52317
8/20/2004 Jennifer Poland 2.50
8/20/2004 Sarah D Simpson 10.00
Direct Deposit 3025 Hidden Meadow Dr Riverside IA 52327
8/20/2004 Gary D Smith 2-50
8/20/2004 Rita Sterler 5.00
8/20/2004 Sarah C Swisher 40,00
812012004 Tawny L Wilson 7.50
Direct Deposit 1110 Conklin St IC IA 52 245
SUM-If IAL
contmlitee . Relationship must be shown to the third degree or 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)
OCT-19-2004 09 :09 P .36
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 06197) I RECEIPTS
CHECK THIS BOX IF
ACTION COMMITTEE), LIST THE PAC IDENTIFICATION

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL
THE IOWA ETHICS AND CAMPAIGN
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN, A LIST OF ID NUMBERS IS AVAILABLE FROM
DISCLOSURE BOARD
CAUTION: Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting
contributions or
PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR

DATE
RECEIVED ('if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDDIYR) AND PAC CHECK I (if applicable) RAISER
NUMBER INCOME
9/3/2004 Deb Benfer (UIHC) 3 .00
Direct Deposit 1683 Hemin a Lane IC IA 52240
9/3/2004 l - Brian Fiaherty t 3_00
Direct De "!osit 1122 So Seventh Ave IC IA 52245
9/3/2004 Anne Gentil-Archer 5.00
9/3/2004 Linda L Hagen 10.00
9/3/2004 David C Meggers 5.00
Direct Deposit 3371 Oz:zie Drive NE Solon IA 52333
9/3/2004 Kim R Miller 10.00
9/3/2004 Michel Murphy (IC Sch) 2.50
Direct De osit 315 Ellis Ave #1 Iowa Cit IA 52246
91312004 Douglas L Peters 2.50
" Disclosure taw requires candidate committees to disclose the relationship of any relative making a contribution to the
Commhlee Relationship must be shown to the third degree of consangulnlty (blood relatives) and affinity (relatives by
of '«--J
marriage) (See Page 2 of forms packet .) . If surname or contributor is the Same as candidate, but there is
no Page
(for Schedule A)
tamilial relationship, enter "not applicable" in the relationship column,
OCT-19-2004 09:09 P .37
For Instructions, See Back of Form . SCHEDULE
A MONETARY
CHECK THIS BOX IF

STATE CANDIDATES NOTE; IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD.
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
DATE PAC Id NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
(MM1DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
913/2004 Kirsten A Running 2.50
Direct Deposit 1210 Hi hland Ave IC IA 52240

"
9/3/2004 Shah D Sirhpson 161 00
9/312004 Gary D Smith 2.50
Direct Deposit 917 Bowery St IC IA 52240
9/3/2004 Rita Sterler 5.00
913/2004 Sarah C Swisher 40.00
Direct Deposit 917 Bower St IC IA 52240
9/3/2004 Tawny L Wilson 7_50
9/1612004 Russell A Clark (CR Sch) 5 .00
9/1612004 Harless S Clemons (CR Sch) 10 .00
104389 505 Sixth St SE CR IA 52401
9/16/2004 Marshall R Clemons (CR Sch) 5.00
104389 505 Sixth St SE CR IA 52401
9116/2004 Wm A Fiacco (CR Sch) 3.00
104389 4133 - 22nd Ave SW CR IA 52404

r ~D
TOTAL (if last page of this Schedule)
$-
E i
committee. Relationship must be shown to the third degree of consangu)nity (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)
OCT-19-2004 09 : 10 P .38

A MONETARY
D CHECK THIS BOX IF
SEIU(Service Employees Int'1 Union) Local 199 C'T"

PE Fund
THE PAC IDENTIFICATION
STATE CANDIDATES NOTE ; IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST
CAMPAIGN
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND
DISCLOSURE BOARD.
(MM/DD1YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
9/16/2004 Jeff L Foster (CR Sch) 5.00
104389 3209 Tamara Dr SW CR IA 52404
9/1612004 . Ken D Grout (CR Sch) 2-.00
9116/2004 Gordon Kaltenbach (CR Sch) 6 .00
104389 227 - 11 th St NW CR IA 52405
9/16/2004 Joyce E Lucas (CR Sch) 4 .00
104389 1401 B Ave Vinton IA 52349
9/16/2004 Dave L Mart (CR Sch) 5.00
104389 926 - 15th Ave SW CR IA 52404
9/16/2004 Chris McLees (CR Sch) 5 .00
104389 411 - 27th St NE CR IA 52402
9/16/2004 Tim J Newcomb (CR Sch) 5 .00
104389 726 E Ave NW CR IA 52405
9/16/2004 Chas A Perry (CR Sch) 10_00
104389 1479 Miami Dr NE CR IA 52402
9/16/2004 Terry A Slickty (CR Sch) 2.50
104389 1128 Brown Ave NE CR IA 52402
committee . Relationship must be shown to the third degree of consanguinity (blood n=_IativLs) 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
OCT-19-2004 09 : 10 P .39
A MONETARY

NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF 10 NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR

I
DATE PAC ID NUMBER
(MMIDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
9/16/2004 ( Stephanie J Lewis (CRSch) 5:00
104390 1601 - 30th St NW #12 CR 1A 52405
228156 P 0 Box 373 N English IA 52316
228156 4876-120 St NE Solon IA 52333
228156 P 0 Box 3281 Iowa City 1 A 52244
228156 Box 466 Hills IA 52235
228156 425-320th St W Liberty IA 52776
9/16/2004 Jon Lalla (IC Sch) 2_50
67
228156 16 Metric Road Iowa Cit IA 52240
TOTAL (if last page of this schedule) 1
` 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 consangulnlty (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
OCT-19-2004 09 :10 P.40

A ( MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . W97) RECEIPTS
CHECK THIS BOX IF
SEIU(Service Employees Int'l Union) Local 199 PE Fund
STATE CANDIDATES NOTE : IF A CONTRIBUTION 15 RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD
(MMlDDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
9/16i2004 Michael U'Connor (IC Sch) 1 .50J
9/16/2004 Rodney Perdue (IC Sch) 2_50

9116/2004 Wm Salasberry (IC Sch) 1 .50


9/15/2004 Gerald Vonstein (IC Sch) 2_50

228156 5048-210th St NE Solon IA 52333
9/1612004 Dale Weir (IC Sch) 1 .50
9/16/2004 Jerome Wiedemeir (IC Sch) 1 .50
9/16/2004 Daryl Lewes (IC Sch) 5.00

9116/2004 Donald J Binegar Jr (IC Sch) 1 .50

228515 P 0 Box 373 N English 1 A 52316
marriage) (See Page 2 of forms packet.) If surnarne of contributor is the same as candidate, but there is no Page
OCT-19-2004 09 :11 P .41
6L;HlzUULt_
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 06197) I RECEIPTS
CHECK THIS 130X IF

DISCLOSURE BOARD .
CAUTION: Section 68B.32A(6), Iowa Code . prohibits the use of information copied from reports and statements for soliciting contributions or
NUMBER INCOME
9/16/2004 Kurth T Boyce (IC Sch) 1-50
228515 4876-120 St NE Solon IA 52333

I.
9/16/2004 Richar6'Hannan (IC Sch)' ' 1 :50
228515 P 0 Box 3281 Iowa City IA 52244
228515 Box 466 Hills IA 52235
228515 425-320th St W Liberty IA 52776
9/16/2004 Jon Lalla (IC Sch) 2_50
228515 601 Oakland Ave Iowa Ci IA 52240
228515 16 Metric Road Iowa City to 52240
9/16/2004 Rodney Perdue (IC Sch) 2.50

~-1 V IAL
TOTAL. (if last page of this schedule) r-
' Disclosure law requires candidate committees to disclose tire relationship o9 any relative making a contribution to the
ma(riage) (See Page 2 of forms packet .), If surname of contributor is the same as candidate, but there is no Page ~~ of
familial relationship, enier'not applicable' in the relationship column . (tor,Schedule A) +
OCT-19-2004 09 : 1 1 P.42
For Instructions, See BACK of corm -bUrleuULt
A I MONETARY
J CHECK THIS BOX IF
7

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 15 AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD.
NUMBER INCOME
228515 1119 Pine St Iowa C' IA 52240
` 9/16f2004 Kimberly Schlabach (IC Sch) ` 1_b0
9/16/2004 Gerald Vonstein (IC Sch) 2.50
228515 5048-210th St NE Solon IA 52333
9/16/2004 Dale Weir (IC Sch) 1 .50
9/16/2004 Marsha Anderson (UIHC) 5.00
9/16/2004 Sandra Anfinson (UIHC) 2_00
9/16/2004 Matt Bahl (UIHC) 5.00
L
1305260 245 Hickory St N Liberty IA 52358
911612004 Michelle Bargren (UIHC) 5.00

1305260 702 Hod e St North Liberty IA 52317
JUo-iLJ I ML
6s
Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to Im
39
committee. Relationship must be shown to the third degree of consanguinlfy (blood relatives) and affnily (relatives by
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Fage of
familial relationship, enter "not applicable" in the relationship column . Schedule A)
(for
OCT-19-2004 09 : 1 2 P .43
For Instructions, See Back of Form JC.HtUULt
A MONETARY
(Includlng candidate's personal funds)
CHECK THIS BOX IF
SEIU(Service Employees Int'1 Union) LoCal 199 C PE Fund
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF IO NUMBERS IS AVAILABLE FROM THfi 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
(MM/D01YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
9/16/2004 Janice Barnes (UIHC) 5.00
1305260 1021 - 20th Ave CV IA 52241
9/16/2004 Ftachael Barrow (UIHC) 1-0.00
1305260 3513 Dunham Dr SW CR IA 52404
1305260 1232 E College St IC IA 52245
9/16/2004 Martha Bradbury (UIHC) 2.00
1305260 1116 W Ids Green Rd IC IA 52246
9/1612004 Jana Burkholder (UIHC) 1 .00
9/16/2004 Heide Bursch (UIHC) 5_00
1305260 97 Oberlin IC IA 52245
9/16/2004 Barry Buschelman (UIHC) 5 .00
9/16/2004 Ann Byrne (UIHC) 5 .00
9/16/2004 Marjie Caruth (UIHC) 5.00
1305260 801 Alpine Dr IC IA 52245
911612004 Bev Clearman (UIHC) 5_00

ouo- I U 1 AL_ v
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 Oof _
OCT-19-2004 09 : 1 2 P .44
For Instructions, See Back of Form I SCHEDULE

A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . G6/97) I RECEIPTS
CHECK THIS BOX IF

DISCLOSURE BOARD .
CAUTION : Section 68B .32A(6) . Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUNO-
NUMBER INCOME
9/1612004 Lynette Cooper (UIHC) 2.50
1305260 2401 H 6 E #1210 IC IA 52240
9/i612004' Julie Davis (UIHC) - 5,Oiy '
9/16/2004 Cathy Dostal (UIHC) 2_00
9/16/2004 Angela Duwa (UIHC) 5 .00
1305260 2519 J Ave Williamsburg IA 52361
9/16/2004 Carolyn Elliott (UIHC) 10 .00
1305260 717 Rundell St IC IA 52240
9/1612004 Elizabeth Fisher (UIHC) 2.50
1305260 1307 Carroll St IC IA 52240
9/16/2004 Anita Fite (UIHC) 5.00
1305260 1611 - 13th Street CV 1A 52241
911612004 Cindy Funk (UIHC) 3 .00
1305260 1231 Sandusk Ave IC IA 52240

QUO- r v I ru.
familial relationship, enter "not applicable" in the felationship column . (for Schedule A)
OCT-19-2004 09 : 1 3 P .45
For Instructions, See Back of Form S[, ;HtUULt
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 06/97) I RECEIPTS
CHECK THIS BOX IF
SEZU(Service Employees Int'l Union) Local 199 C PE Fund

STATE CANDIDATES NOTE IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD .
CAUTION : Section 6i3B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
DATE PAC 10 NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
RECEIVED I (if applicable) I TO CANDIDATE' RECEIVED I FUND-
(MMIDDNR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
9/16/2004 Joe Galbraith (UIHC) 10 .00
1305260 3021 Raven St IC IA 52245
"" 9/16r2004 - ' NanCy Genoar (UIHC)
1305260 1252 Coll Dr IC IA 52246
9/16/2004 Trisha Godard Shepherd (UIHC) 2 .50
1305260 930-23rd Ave A t C Coralville IA 52241
9/16/2004 Lynda Green (UIHC) 10 .00
1305260 2075 Melrose Ave IC IA 52246
9/16/2004 Melissia Greiner (UIHC) 5_00
9/16/2004 Dan Grinstead (UIHC) 7_50
1305260 1218 Ash St IC 1A 52240
9/16/2004 Terry Hamilton (UIHC) 3.00
9/16/2004 Lynn Hanke (UIHC) 5_00
9/16/2004 Sarah Helle (UIHC) 5.00
2
-71ru--1 VIAL X
$ t
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page q~ of los
OCT-19-2004 09 : 1 3 P .46
A MONETARY
(including candidale's personal funds)
CHECK THIS BOX IF
SEIU(Service Employees Int'1 Union) Local 199 PE Fund

DISCLOSURE BOARD.
for any commercial purpose by any person other than statutory political committees,
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
If applicable)
RECEIVED TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (If applicable) RAISER
NUMBER INCOME
9/16/2004 Sharon Nicks (UIHC) 2.00
' 9/`16/2004 ` " . ~ MerodyHdbert-Mellecker (UIFiC) ' '5,00
1305260 300 Main St Hills IA 52235

9/16/2004 Deb Reynolds Hubbard (UIHC) 3.00

9/16/2004 Jennifer Jungen (UIHC) 5 .00

1305260 1945 Park Ave SE CR IA 52403
9/1612004 Valerie Keffala (UIHC) 5 .00

9/16/2004 Teresa A Kingdon (UIHC) 2_50

9/1612004 Katherine Klelnow (UIHC) 5 .00

1 At .
$5 . DO
TOTAL (if last page of this schedule) S r
marriage) (See Page 2 of forms packet .) . If surname or contributor is the same as candidate, but there is no Page _~of
OCT-19-2004 09 : 14 P .47

A MONETARY
CHECK THIS BOX IF
FROM THE IOWA ETHICS AND CAMPAIGN
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN, A LIST OF ID NUMBERS IS AVAILABLE
DISCLOSURE BOARD .
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND.
(MM1DDNR) AND PAC CHECK (if applicable) RAISER
NUMBER I INCOME
9/16/2004 Arlene Klesner (UIHC) 1 .00
1305260 1901 Earl Road IC IA 52246
- 9/16i2004 . . . . .,° AmyKruse (UIHC)
9/16/2004 Linda Krutsinger (UIHC) 10,00
9/16/2004 Cynthia Larew (UIHC) 1_00
1305260 P 0 Box 441 Lone Tree IA 52755
9/16/2004 Paula Laube (UIHC) 7.50
1305260 712 Walnut St IC IA 52240
9/16/2004 Michael Loucks (UIHC) 5.00
9/16/2004 Wilma Macalalag (UIHC) 5.00

9/16/2004 June Masbruch (UIHC) 5.00
1305260 2387 - 340th St SW Tiffin IA 52340

5it)L~JI!IIaL
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and Fffinity (relatives by
famllial relationship, enter "not applicable" in the relationship column,
Page A4- of
(for Schedule A)
OCT-19-2004 09 : 1 4 P .48

A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 06197) RECEIPTS
Q CHECK THIS BOX IF
AMENDING FORM
DISCLOSURE BOARD .
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from . reports and statements for soliciting contributions or
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUNO-
NUMBER INCOME
9/16/2004 Ann Mason (UIHC) 3 .00
1305260 1032 Oakcrest St IC IA 52246
9/15/2004 Itth McKeever (UIHC) - - -- 5.00 '
9/16/2004 Mary McKinney (UIHC) 3.00
1305260 506 West Seventh St Tipton IA 52772
9116/2004 Mary JO Meggers (UIHC) 5_00
1305260 3371 Ozzie Dr Solon IA 52333
9116/2004 Terri Mengler (UIHC) 7.50
1305260 2215 Second St SW CR IA 52404
911612004 Jean Miller (UIHC) 5_00
9/16/2004 Tara Miller (UIHC) 2.50
1305260 333 Carter St NW CR IA 52405
9116/2004 Robert Milne (UIHC) 3.00
1305260 417 Carter St NW CR IA 52405
9/16/2004 Melinda Myers (UIHC) 20.00
1305260 1116 A Ave NW CR IA 52405
9/16/2004 Jan Niebes (UIHC) 5.00
1305260 7274 -15th Ave Keystone IA 52249

-UAL
TOTAL (if lest page of this schedule)
- Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the _
Page of
familial relationship, enter 'not applicable' in the relationship column, (for Schedule A)
OCT-19-2004 09- 1 5 P .49
For Instructions, See baCK oT t-orm Jt.NtUULC
A MONETARY
0 CHECK THIS BOX IF
AMENDING FORM
SEIU(Service Employees Int'l Union) Loc al 199 C PE Fund
COMMITTEE), LIST THE PAC IDENTIFICATION

STATE CANDIDATES NOTE= IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION
DISCLOSURE BOARD,
(if applicable) TO CANDIDATE' RECEIVED FUND-
RECEIVE0
AND PAC CHECK I (If applicable) RAISER
(MM/DD/YR)
NUMBER INCOME
9/16/2004 Linda Petersen (UIHC) 2.50
1305260 907 N Gilbert St IC IA 52245
=' 911E/2Gt74'. .- . - Wmrgar6t Mary Ping (UIHC) ` ' 3'00 .
9/16/2004 Becky Pottorff-Leaven (UIHC) 5.00
1305260 1149 Hunter's Run IC IA 52246
9/16/2004 Carolyn Poulakos (UIHC) 5_00
1305260 404 Sixth St #D6 Coralville IA 52241
9116/2004 Jeffrey Rupe (UIHC)
9/16/2004 Nancy Sandstrom (UIHC) 7.50
9/16/2004 Dorothy Satariano (UIHC) 3.00
1305260 3222 Shasta Ct NE CR 1A 52402
9/1612004 Steven Schaefer (UIHC) 20.00
1305260 3946 Mehaffe Ln NE Solon IA 52333
9/16/2004 Cheryl Schild (UIHC) 3.00
1305250 914 - 12th Ave CV IA 52241
911612004 Mary Schlichte (UIHC) 10 .00

*AAWA-T
~ "I
committee Relationship must be shown to the third d=_gree of consanguinity (blood relatives) and affinity (relatives by
Page of
marriage;) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no
familial relationship, enter not applicable" in the relationship column . (for Schedule A)
OCT-19-2004 09 : 15 P .50

A MONETARY
CHECK THIS BOX IF
DISCLOSURE BOARD .
CAUTION, Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
(MM/DD/YR) AND PAC CHECK ( (if applicable) RAISER
NUMBER INCOME
9/16/2004 Joyce Schultz (UIHC) 3 .00
1305260 3023 Radcliffe Avenue IC 1A 52245
9/1612604 Shanna Seigel (UIHC) 5_00
9/16/2004 Jeanne Sheetz (UIHC) 5 .00
1305260 120 Tartan Dr North Liberty 1A 52317
9/16/2004 Karen Shickell (UIHC) 10_00
9/16/2004 Anthony Shrader (UIHC) 5 .00
1305260 1560 - 7th Ave SE CR 1A 52403
9/16/2004 Vicki Siefers (UIHC) 3 .00
1305260 1310 Franklin St IC IA 52240
9/16/2004 Terry Simons (UIHC) 5 .00
1305260 2760 Tur~e Creek Ln NE IC IA 52240
9/16/2004 Mary Stessman (UIHC) 1 .00

marriage) (SEe Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page ~ of
familial retaliorlship, enter "not applicable" ill the relationship column . (for Schedule A)
OCT-19-2004 09 :15 P .51

A I MONETARY
CHECK THIS BOX IF
Organization) AMENDING FORM
COMMITTEE NAME (Must be same as on Statement of
SEJU(Servic e Emp loyees Int' 1 Union) Local 199 C PE Fund

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A 5TATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
CAMPAIGN
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND
DISCLOSURE BOARD .
CAUTION : Section 688 .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 41 F FOR

DATE
(if applicable) I TO CANDIDATE' RECEIVED FUND-
RECEIVED
(if applicable) RAISER
(MMIDD/YR) AND PAC CHECK
NUMBER INCOME
9/16/2004 Sue Swearingen (UIHC) 5.00
1305260 422 Melrose Ct IC IA 52246
9/16i2004 - Wanda Thackery (UIHC) 1 .00
1305260 604 First Ave So Mount Vemon IA 52314
9116/2004 Trisha Turnis (UIHC) 5.00
1305260 4519 Walker St NE CR IA 52402
1305260 3051 Meadow Rd N1= North Liberty IA 52317
9/16/2004 Jo Vonderhaar (UIHC) 3.00
1305260 1023 Marc Street IC IA 52240
9/16/2004 Angela Wemke Trenkamp (UIHC) 10.00
1305260 361 Camden Rd IC IA 52245
9/16/2004 Patsy Wheeler (UIHC) 7.50
9/1612004 Sherry Whetstone (UIHC) 5.00
9116/2004 Pat Wolf (UIHC) 1 .00
911612004 Joan Comer Wright (UIHC) 3_00

TOTAL- (if last page of this schedule)
Disclosure taw requires candidate committees to disclose the relationship of any relative making a contribution to the
Page I ~~ Of
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no (for Schedule A)
OCT-19-2004 09 :16 P .52

MONETARY
(Including candidate's parsonalfunds)
C] CHECK THIS BOX IF

DISCLOSURE BOARD .
for any commercial purpose by any person other than statutory political Committees_
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT -d IF FOR
RECEIVED (if applicable) I I TO CANDIDATE - RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (f applicable) RAISER
NUMBER INCOME
9/16/2004 Marietta Yoder (UIHC) 7_50
1305260 P 0 Box 130 Kalona IA 52247
9/1712004 . ' Deb Benfer (UIHC) - 3-00 1
9/17/2004 Julie Bryant 10 .00
Direct Deposit 1 Bella Vista Place IC IA 52245
9/1712004 Brian Flaherty 3.00
9117/2004 Anne Gentil-Archer 5,00
9/17/2004 Cathy Singer Glasson 15_00
9/17/2004 Linda L Hagen 10 .00
Direct De osit 375 Mormon Trek Blvd #7 IC IA 52246
9/17/2004 David C Meggers 5.00
9117/2004 Kim R Miller 10.00

JUrS-I =AL $
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 la
familial relationship, enter "not applicable" in the relationship column . (far Schedule A)
OCT-19-2004 09:16 P .53
A I MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 06197) 1 RECEIPTS
DISCLOSURE BOARD
(MM/00/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
Direct Deposit 315 Ellis Ave #1 Iowa City IA 52246
911712004 Douglas L Peters 2.50
-Direct Deposit 70 E Chestnut NL IA 52317
Direct Deposit 1210 Hithland Ave IC IA 52240
911712004 Sarah D Simpson 10.00
9/17/2004 Gary D Smith 2 .50
Direct Deposit 917 Bower St IC lA 52240
9/17/2004 Rita Sterler 5 .00
9117/2004 Sarah C Swisher 40_00
9117/2004 Tawny L Wilson 7.50
9/3012004 Donald J Binegar Jr (IC Sch) 1 .50
228601 P 0 Box 373 N English IA 52316
913012004 Kurth T Boyce (IC Sch) 1 .50
228601 4876-120 St NE Solon IA 52333
TOTAL (if last page of this schedule) r
marriage) (See Page 2 of forms packet .) . If sufname of contributor is the same as candidate, but there is no
Page 5O of
(for Schedule A)
OCT-19-2084 09 :17 P .54
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev_ 06/97) I RECEIPTS
CHECK THIS t30X IF
STATE CANDIDATES NOTE : IF A CONTRIBUTION 15 RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD.
for any commercial purpose by any person other than statutory political committees-
NUMBER INCOME
228601 P 0 Box 3281 Iowa City IA 52244
9130/2Uu4 John Hoard (IC Sch) 1 .25
228601 Box 466 Hills IA 52235

228601 425-320th St W Liberty IA 52776

9/30/2004 Jon Lalla (1C Sch) 2,50
9/3012004 Brian J Meyer (IC Sch) 1 .50

913012004 Michael O'Connor (IC Sch) 1 .50
9130/2004 Rodney Perdue (IC Sch) 2,50
913012004 Wm Salasberry (IC Sch) 1_50
TOTAL (if lest page of this schedule) $
" Disclosure taw 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 affiniry (relatives by
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page _t~ L_ of
familial relationship, enter not applicable" in the relationship column . (for Schedule A)
OCT-19-2004 09 :17 P .55
A MONETARY
CHECK THIS BOX IF
SEZU(Service Employe es I n t'l Union) Local 199 C PE Fund

DISCLOSURE BOARD.
CAUTION : Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for solciting contributions or
OATS PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT q IF FOR
(MM1DDtYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
9/3012004 Kimberly Schlabach (IC Sch) 1-50
9/30/2004 * ; " Gerald Vonstein (IC Sch) ' 2:80
228601 5048-210th St NE Solon IA 52333
9/30/2004 Dale Weir (IC Sch) 1 .50
228601 2506 Friendship St IC 1A 52245

10/1/2004 Julie Bryant 10 .00
Direct Deposit 1 Bella Vista Place IC IA 52245
1011/2004 Brian Flaherty 3 .00
10/1/2004 Anne Gentil-Archer 5 .00
10/112004 Cathy Singer Glasson 15,00

SU[t-IUIAL
' Disclosure law requires candidate committees to di5r-lose the relationship of any relative making e contribution to the
marriage) (See Page 2 of lorms packet .) . If 5urnaME of conliibutor is the same as candidate, but there is no
familial relationship, enter 'not applicable" in the relationship column . (for , Schedule A)
OCT-19-2004 09 :18 P .56
ror 1n5tructions, aee oacr. ut rurrtt SC;HEUULE I
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev, 06/97) RECEIPTS
CHECK THIS BOX IF
SEIU(Service Employees Int;'l Union) Local 199 C PE Fund

NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN, A LIST OF 10 NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD .
CAUTION : Section 66B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting Contributions or
(MMIDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
10/1/2004 Linda L Hagen 10_00

I
101112004 David C Meggers 5:U0 !
10/112004 Devin P Mehaffey 2,50
10/112004 Kim R Miller 10_00
Direct Deposit 315 Ellis Ave #1 Iowa City IA 52246

Direct De osit 70 E Chestnut NL IA 52317

1011/2004 Kirsten A Running 2 .50
10/112004 Sarah D Simpson 10.00
Direct De osit 3025 Hidden Meadow Dr Riverside IA 52327
10/112004 Gary D Smith 2.50
101112004 Rita Sterler 5.00

U - I U I r+t_
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 S3 of
(for Schedule A)
familial relationship, enter `not applicable" in the relationship column .
OCT- 19-2004 09 :18 P .57
A MONETARY
D CHECK THIS BOX IF
SEIU(Service Employees Int'1 Union) Local 199
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICA4 ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD.
CAUTION : Section 6B8 .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 . "
RECEIVED (if applicable) TO CANDIDATE" RECEIVED FUND-
(MMlDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
10/112004 Sarah C Swisher 40.00
1011 /2004 w Tawny L` ilson 7:50
10/13/2004 Russell A Clark (CR Sch) 5_00
10113/2004 Harless S Clemons (CR Sch) 10.00
105572 505 Sixth St SE CR IA 52401
10113/2004 Marshall R Clemons (CR Sch) 5.00
105572 505 Sixth St SE CR IA 52401
10/1312004 Wm A Fiacco (CR Sch) 3.00
105572 4133 - 22nd Ave SW CR IA 52404
10/1312004 Jeff L Foster (CR Sch) 5 .00
105572 3209 Tamara Dr SW CR lA 52404
10/13/2004 Ken D Grout (CR Sch) 2 .00
10/13/2004 Gordon Kaltenbach (CR Sch) 6 .00
105572 227 - 11th St NW CR IA 52405
10/13/2004 Joyce E Lucas (CR Sch) 4.00
105572 1401 B Ave Vinton IA 52349

!L111IlL:v L~r
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
familial relationship, enter `not applicable" in the relationship column .
Page 151 4 of
(for Schedule A)
OCT-19-2004 09 " 19 P .58
A I MONETARY
CHECK THIS BOX IF

DISCLOSURE BOARD,
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR REI-ATIONSHIP AMOUNT 4 IF FOR
(MMlDD1YR) I AND PAC CHECK I (if applicable) RAISER
Nl1MSER INCOME
10/13/2004 Dave L Mart (CR Sch) 5 .00

105572 926 - 15th Ave SW CR IA 52404
1 D/ 13/ 004- ' . Chris McL>res (CR Sch) _ - 5.00
105572 411 - 27th St NE CR IA 52402
10/13/2004 Tim J Newcomb (CR Sch) 5 .00

105572 726 E Ave NW CR IA 52405
10/13/2004 Chas A Perry (CR Sch) 10 .00

105572 1479 Miami Dr NE CR IA 52402

10113/2004 Terry A Slickly (CR Sch) 2_50

105572 1128 Brown Ave NE CR IA 52402
10/13/2004 Lois J Bassett (CR Sch) 3_00
10/13/2004 Stephanie J Lewis (CR Sch) 5 .00
105573 1601 - 30th St NW #12 CR IA 52405
10/13/2004 Marsha Anderson (UIHC) 5 .00
10113/2004 Sandra Anfinson (UIHC) 2.00

aUE5-I UI ^L-
marrioge) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page
OCT-19-2004 09 :19 P .59
For Instructions, See Back of Form . ISCHEDULE

A MONETARY
Q CHECK THIS BOX IF
SEIU(Service Employees Int'l Union) Local 199 C~PE Fund

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 .
(M1wDD1YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
10/13/2004 Matt Bahl (UIHC) 5_00
1322782 245 Hicko St N Liberty IA 52358
10/13/2004 Michelle Bargren (UIHC) 5.00
1322782 702 Hodge St North Liberty IA 52317
10/13/2004 Janice Barnes (UIHC) 5.00
1322782 1021 - 20th Ave CV 1A 52241
10/13/2004 Rachael Barrow (UIHC) 10 .00
1322782 3513 Dunham Dr SW CR IA 52404
1322782 1232 E College St IC IA 52245
10/13/2004 Martha Bradbury (UIHC) 2_00
10/13/2004 Jana Burkholder (UIHC) 1 .00
1322782 604 Kimberlfte St Tiffin IA 52340
10/13/2004 Heide Bursch (UIHC) 5 .00
1322782 97 Oberlin IC IA 52245
10/13/2004 Barry Buschelmon (UIHC) 5.00
1011312004 Ann Byme (UIHC) 5.00

QUO-v ..I
0
--
TOTAL . (if last page of this schedule)
Disclosure law requires candidate committees to disclose the relationship of any relalive making a contribution to the
marriage) (See Page ? of forms packet .) . If surname of contributor is the sarrle as candidate . but there is no
familial relationship, enter'not applicable" in the relationship column . (for Schedule A)
OCT-19-2004 09 :19 P .60
VI IIIDU 4aUV .IJ~ Vrv emu_ v . . v . . . . .7Vr1CV V1.C
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev, 05/97) RECEIPTS

NUMBER AND THE PAC CHECK NUMBER IN THE OESIGNATF0 COLUMN, A LIST Of ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD .
NUMBER INCOME
10/13/2004 Marjie Caruth (UIHC) 5.00

1322782 801 Alpine Dr IC IA 52245
. 1011312.004 . .. FJ.ev Clearman (UIHC) t. . °..5_OOf
10/13/2004 Lynette Cooper (UIHC) 2_50

1322782 2401 H 6 E #1210 IC IA 52240
10/13/2004 Julie Davis (UIHC) 5.00

10/1312004 Cathy Dostal (UIHC) 2_00
10/13/2004 Angela Duwa (UIHC) 5_00

1322782 2519 J Ave Williamsbur IA 52361
10/13/2004 Carolyn Elliott (UIHC) 10,00

1322782 717 Rundell St IC IA 52240
10/13/2004 Elizabeth Fisher (UIHC) 2.50

1322782 1307 Carroll St IC IA 52240
10/13/2004 Anita Fite (UIHC) 5.00

VVV- . V nn v

is ---
marriage) (See Page 2 of forms packet,), If Surname of contributor is the Same as candidate, but thurE IS no Page- of
OCT-19-2004 09 :20 P .61
A MONETARY
C] CHECK THIS BOX IF

STATE CANOIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
IOWA ETHICS AND CAMPAIGN
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS I$ AVAILABLE FROM THE
DISCLOSURE BOARD.
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIOUTOR RELATIONSHIP AMOUNT J IF FOR
TO CANDIDATE' RECEIVED FUND-
I
RECEIVED (if applicable)
(MM/DDIYR) AND PAC CHECK (If applicable) RAISER
NI IMRFR INCOME

1322782 1611 - 13th Street CV IA 52241
10i I3il004 Cindy Funk'(UIHC) 3.00
1322782 1231 Sandusk Ave IC IA 52240
10/13/2004 Joe Galbraith (UIHC) 10_00
1322782 3021 Raven St IC IA 52245
10/13/2004 Nancy Genoar (UIHC) 5,00

1322782 1252 Coll Dr IC IA 52246
10/13/2004 Trisha Godard Shepherd (UIHC) 2_50

1322782 930-23rd Ave Apt C Coralville IA 52241
10/1312004 Lynda Green (UIHC) 10.00

1322782 2075 Melrose Ave IC IA 52246
10/13/2004 Melissia Greiner (UIHC) 5.00

10/13/2004 Dan Grinstead (UIHC) 7 .50

1322782 1218 Ash St IC IA 52240

10/1312004 Terry Hamilton (UIHC) 3 .00

Ju u' I -., -
of ~
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no Page
familial relationship, enter "not applicable" In the relationship column, (for, Schedule A)
OCT-19-2004 09 :20 P .62
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN , (Rev 06197) 1
CHECK THIS BOX IF
DISCLOSURE BOARD.
CAUTION: Section 688.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
RECEIVED I (if applicable) TO CANDIDATE' RECEIVED FUND-
NUMBER INCOME
10/13/2004 Lynn Henke (UIHC) 5.00

I t)/1372004 - 'Sarah rlelle (UIHC) 5.00
1322782 1330 Upper Old H 5 Oxford IA 52322 .
10/13/2004 Sharon Hicks (UIHC) 2.00

10/13/2004 Melody Hobert-Mellecker (UIHC) 5.00

1322782 300 Main St Hills IA 52235
10/1312004 Claire Hockley (UIHC) 7 .50
1011312004 Deb Reynolds Hubbard (UIHC) 3 .00


10/1312004 Jennifer Jungen (UIHC) 5.00

1322782 1945 Park Ave SE CR IA 52403
10/13/2004 Valerie Keffala (UIHC) 5_00

-~~t;a~~>rral
EEL
$J `"
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)
OCT-19-2004 09 :21 P .63
A MONETARY
CHECK THIS BOX IF
AMENDING FORM
SEIU(Service Employees Int'l Union) Local 199 C'T,

PE Fund
PAC IDENTIFICATION
STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE) . LIST THE
AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF 10 NUMBERS IS
DISCLOSURE BOARD.
CAUTION ; Section 688.32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
(MMlOD/YR) AND PAC CHECK (if applicable) RAISER
LIMBER INCOME
10/13/2004 Teresa A Kingdon (UIHC) 2 .50
1322782 2113 Norcor Ave t 4 CV IA 52241
i01 - 114004 Katherine Kleinow (UIHC) -1 5.00
10113/2004 Arlene Klesner (UIHC) 1 .00
1322782 1901 Earl Road IC 1A 52246
10/13/2004 Amy Kruse (UIHC) 5.00

10/13/2004 Linda Krutsinger (UIHC) 10.00
1322782 2147 Plaen View Or IC IA 52246
10/1312004 Cynthia Larew (UIHC) 1 .00
1322782 P 0 Box 441 Lone Tree IA 52755
10/13/2004 Paula Laube (UIHC) 7.50
1322782 712 Walnut St IC IA 52240
1322782 2215 Hicko Court IC IA 52240
10/1312004 Michael Loucks (UIHC) 5.00

TOTAL (if last page of this schedule) r

$
* Disclosure law requires candidate committees to disdose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relative$) 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 (on, of ~,
(for Schedule A)
OCT-19-2004 09 :21 P .64
For Instructions, See Back of Form ISf;HEDULE
A l MONETARY
CHECK THIS BOX IF

DISCLOSURE BOARD.
(MMIDDIYR) AND PAC CHECK (f applicable) RAISER
NUMBER INCOME
10/13/2004 Wilma Macalalag (UIHC) 5 . 00
1322782 828 Au usta Circle North Liberty IA 52317

10/13/2004 June I0asbruch (UIHC) 5.00
1322782 2387 - 340th St SW Tiffin IA 52340
10/13/2004 Ann Mason (UIHC) 3,00

1322782 1032 Oakcrest St IC IA 52246
10/13/2004 Ruth McKeever (UIHC) 5.00
1322782 302 Walnut St Tipton IA 52772
10/13/2004 Mary McKinney (UIHC) 3 .00
10/13/2004 Mary Jo Meggers (UIHC) 5 .00
1322782 3371 Ozzie Dr Solon IA 52333
1, 0/1312004 Terri Mengler (UIHC) 7 .50
1322782 2215 Second St SW CR 1 A 524.04

10113/2004 Tara Miller (UIHC) 2_50
1322782 333 Carter St NW CR IA 52405
10/1312004 Robert Milne (UIHC) 3.00

1322782 417 Carter St NW CR IA 52405
J
TOTAL (if last page of this schedule) I

Page
Disclosure taw requires candidate committees to disclose the relationship of any relative making a contribution to the
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as candidate, but there is no of
familial relationship, enter 'not. applicable" in the relationship column . (for . Schedule A)
OCT-19-2004 09 :22 P .65
A I MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev, 06/97) 1 RECEIPTS
CHECK THIS BOX IF
SEIU(Service Employees Int;'1 Union) Local 199 COPE Fund

DISCLOSURE BOARD.
RECEIVED (if applicable) TO CANDIDATE' -RECEIVED FUND-
(MM1DO1YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
10/13/2004 Melinda Myers (UIHC) 20 .00

1322782 1116 A Ave NW CR IA 52405
I
10113/2004 Jan Niebes (UIHC) 5.00
1322782 7274 - 15th Ave Keystone IA 52249
10/1312004 Linda Petersen (UIHC) 2.50

1322782 907 N Gilbert St IC IA 52245
10/13/2004 Margaret Mary Ping (UIHC) 100
10/13/2004 Becky Pottorff-leaven (UIHC) 5.00
1322782 1149 Hunter's Run IC IA 52246
10/13/2004 Carolyn Poulakos (UIHC) 5.00
1322782 404 Sixth St #D6 Coralville IA 52241
10113/2004 Jeffrey Rupe (UIHC) 3 .00
1322782 P 0 Box 218 North Liberty JA 52317

10/13/2004 Nancy Sandstrom (UIHC) 7 .50
10/13/2004 Dorothy Satariano (UIHC) 3 .00
1322782 3222 Shasta Ct NE CR IA 52402

10/1312004 Steven Schaefer (UIHC) 20.00
1322782 3946 Mehaffey Ln NE Solon 1A 52333
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 "naL applicable" in the relationship column . (for Schedule A)
OCT-19-2004 09 :22 P .66
For Instructions, See Back of Form (SCHEDULE
MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev, 06197) l RECEIPTS
Q CHECK THIS 50X IF

STATE CANDIDATES NOTE : IF A CONTRIBUTION I$ RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD .
CAUTION : Section 688 .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT ~ IF FOR
NUMBER INCOME
10/13/2004 Cheryl Schild (UIHC) 3 .00

1322782 914 - 12th Ave CV IA 52241
' 10/13/2004 Mary Schlichte (UIHC) 10 .00
10/13/2004 Joyce Schultz (UIHC) 3.00
10/13/2004 Shanna Seigel (UIHC) 5_00

1322782 2820 U Avenue Pamell IA 52325
10/13/2004 Jeanne Sheetz (UIHC) 5.00

1322782 120 Tartan Dr North Liberty 1A 52317
10/13/2004 Karen Shickell (UIHC) 10 .00

10/13/2004 Anthony Shrader (UIHC) 5_00
1322782 1560 - 7th Ave SE CR IA 52403
10/13/2004 Vicki Siefers (UIHC) 3.00

10/13/2004 Pam Simons (UIHC) 5.00
1322782 1310 Franklin St IC IA 52240
1011312004 Terry Simons (UIHC) 5 .00

J Ut3- I U I nL
TOTAL (if fast page of this schedule)
cornmiltee . Relationship must be shown to the third degree of consangulnlty (blood relatives) end affinity (relatives by
marriage) (See Page 2 of forms packet .) . If surname of contributor is the seine as candidate, but there is no Page of
OCT-19-2004 09 :23 P . 67
A I MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 06/97) I RECEIPTS
0 CHECK THIS BOX IF

COMMITTEE NAME (Must be same as on Statement of 0rganization) AMENDING FORM

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 66B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or
(MM/DDfYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
10/13/2004 Chris Slater (UIHC) 5_00
1322782 2760 Turke Creek Ln NE IC IA 52240
10/13/2004 Mary Stessman (UIHC) 1 .00
10/13/2004 Sue Swearingen (UIHC) 5 .00
1322782 422 Melrose Ct IC IA 52246
10/13/2004 Wanda Thackery (UIHC) 1 .00
10/13/2004 Trisha Turnis (UIHC) 5 .00
1322782 4519 Walker St NE CR 1A 52402
1322782 3051 Meadow Rd NE North Liberty IA 52317
10/13/2004 Jo Vonderhaar (UIHC) 3 .00
1322782 1023 Marc Street IC IA 52240
10/13/2004 Angela Wernke Trenkamp (UIHC) 10 .00
1322782 361 Camden Rd IC IA 52245
10/13/2004 Patsy Wheeler (UIHC) 7_50
10/13/2004 Sherry Whetstone (UIHC) 5.00

Jv u- I V ML
$ ++Iv., .l
Disclosure law requires candidate Committees to disclose the rolatlonshlp of any relative making a contributlon to the
commillee . Relationship must be shown to the third degree of Consanguinity (blood relative$) and affinity (relatives by
marriage) (See Page 2 of forms packet .) . IF surname or contributor is the same as candidate, but there is no page -of
OCT-19-2004 09 :23 P . 68
For Instructions, See Back of t"orm W.1-ILUULt
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . ()6197) RECEIPTS
CHECK THIS BOX IF

STATE CANDIDATES NOTE= IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
DISCLOSURE BOARD.
RECEIVED (if applicable) TO CANDIDATE` RECEIVED FUND-
(MWDDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
10/13/2004 Pat Wolf (UIHC) 1 .00
1322782 1409 Westem College CR IA 52404

10/13/2004 Joan Comer Wright (UIHC) 3.00
10/13/2004 Marietta Yoder (UIHC) 7.50
1322782 P 0 Box 130 Kalona IA 52247
ouo-ivr.
$ llrti/L/
TOTAL (if last page of this schedule) /
" Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
marriage) (See Page Z of forms packE[.) . 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)
TOTAL P .68

SEIU Local 199 COPE Fund - 6492 - Scanned

Transféré par

Informations du document

Titre original

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

SEIU Local 199 COPE Fund - 6492 - Scanned

Transféré par

Droits d'auteur :

Formats disponibles

OCT-19-2004 08 :53 P .

DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE

IMPORTANT : Indicate type of committee you are reporting for. 12

District (if Senate or House)

Accountant (319)-341-0112 10- 18= 2 004

STATEMENT OF CASH ON HAND

(Schedule H applies to Candid tes' Committees Only)

CONSULTANT BREAKDOWN (Schedule G Attached?) YES -x NO

FOR INSTRUC710NS, SEE BACK OF FORM SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT

STATE PAC COMMITTEES : NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE

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

SEIU(Service Employees Int'l Union) Local 199 COPE Fund

7/31/0,4 ID# SEIU (Int'1 Office) Monthly contribution 712 .50

8/25/04 ID# SEIU (Int'1 Office) Monthly contribution 826 .75

CK# 1065 Washington DC 20005

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

SEIU(Service Employees Int'l Union) Local 199 C PE Fund

7/23/2004 Brian P Flaherty 3 .00

Direct Deposit 1122 So Seventh Ave IC IA 52245

Direct Deposit 1744 -115th St West Liber IA 52776

7/23/2004 Cathy Singer Glasson 15.00

Direct Deposit 1920 - 2nd Ave SE CR IA 52403

7/23/2004 Matt N Loeb 2.50

Direct Deposit 470 Hawaii Ct IC IA 52246

7/23/2004 - David C Meggers 5.00

Direct Deposit 3371 Ozzie Drive NE Solon IA 52333

7/23/2004 Devin P Mehaffey 2.50

Direct Deposit 865 Camburn Ct SE CR IA 52403

7/23/2004 Kim R Miller 10 .00

Direct Deposit 805 Spencer Dr IC IA 52246

7/23/2004 Douglas L Peters 2.50

Direct Deposit 70 E Chestnut NL IA 52317

712312004 Jennifer M Poland 2,50

Direct Deposit 2040 Glass Rd NE #101 CR IA 52402

7/2312004 Kirsten A Running 2.50

TOTAL (if last page of this schedule)

SEIU(Service Employees Int'l Union) Local 199 C PE Fund

7/23/2004 Rita J Sterler 5.00

Direct Deposit 2131 Plaen View Dr IC IA 52246

7/23/2004 - SaraiI C - Swisner 40_00

7/23/2004 Tawny L Wilson 7 .50

Direct Deposit 1110 Conklin St IC IA 52245

7130/2004 Russell A Clark (CR Sch) 5_00

102650 4045 Chickadee Ln Hiawatha IA 52233

`7/30/2004 Harless S Clemons (CR Sch) 10.00

7/30/2004 Marshall R Clemons (CR Sch) 5_00

7/30/2004 Wm A Fiacco (CR Sch) 3.00

713012004 Jeff L Foster (CR Sch) 5.00

7/30/2004 Ken D Grout (CR Sch) 2.00

102650 1037 Clifton St NE CR IA 52402

7130/2004 Gordon Kaltenbach (CR Sch) 6.00

TOTAL. (if last page of this schedule)

SEIU(Service Employees Intel Union) Local 199 C~PE Fund

7/30/2004 Joyce E Lucas (CR Sch) 4.00

7/3012004 Dave L Mart (CR Sch) 5.00

7/3012004 Chris McLees (CR Sch) 5.00

7/30/2004 Tim J Newcomb (CR Sch) 5.00

7/30/2004 Chas A Perry (CR Sch) 10.00

7/3012004 AL J Pospisil (CR Sch) 1 .00

7/30/2004 Terry A Slickty (CR Sch) 2.50

7/30/2004 Lois J Bassett (CR Sch) 3.00

7/30/2004 Stephanie J Lewis (CR Sch) 5.00