10/16/2004 08 :23 5159654237 JAMES BAKER PAGE 01

FOR INSTRUCTIONS, SEE BACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 I DISCLOSURE
(Rev . 07/2004) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization)

Iowa Association of McDonald's Operators PAC #6386 Comm .

IMPORTANT: Indicate by* type of committee you are reporting for: EZ= Logged In
( 1 )StatewIdelLeglalative/Judge Standing for Retention Candidate (2 )State PAC (3 )Slate Party Scanned
(4 )County Central Committee (5 )County Candidate (e )City Candidate (7 )School Board or Other
Political Subdlvlelon Candidate (9 )County PAC (9 )City PAC (10 )School Board or Other Political Computer
Subdivision PAC (11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES ONLY:
Political Party (If applicable)
Late reports are sub)ect to
possible civil and criminal
Office Sought District (if Senate or House) penalties .

LECTION /(2)NON-ELECTION YEAR .

(report date) prate by #

Local Committees, enter Date of Election

FICHECK IF AMENDMENT TO REPORT DATED.

0 Check if this is final (termination) report and attackN County & Local Committees, enter County In
(You must continue to file reports until a DR- which Election Is held

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period. (Total of all funds held by the
committee. This amount MUST be the same as the cash on hand at the end 4307.51
of the last reporting period or must be zero if this Is first report filed,) ... ... ... ... ..... ... ..... ... . . . .. . $
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) ('also see in-kind below) . ... ..... . 5.43
Schedule F: Loans Received total (Attach Schedule F) .... ........... ... ...... ... ...... .. ... ..... ... ... ...... 0.00
Schedule H: Total Sales of Campaign Properly (Attach Schedule H) ..... . ... .. . .. ... ... ... .. ... ..... . 0.00
f_hedule Hapalles to Candldat~a'Committees Only
SUB-TOTAL . .... S 431 3 .36
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ("also see debts and loans below) .... 0.00
Schedule F: Loan Repayments total (Attach Schedule F) ..... . ..... ... ...... ... . .... . ..... . .. ... ... ..... .... 0.00
CASH ON HAND at the end of this reporting period (If final report balance must
be zero) (Attach DR-3) ... . .. ... .. . .. ... ..... .............. .. ... . ... ..... ...... ... ... ... ... ........ . .. ....... . . ... ... .. ... .. .... . $ 4313 .36

'"'UNPAID BILLS (From Schedule D - Attach Schedule D) . ... ... ..... ... ... ... . ... . . . .. .. . ...... ... ... ... .. ... ..... ... .. . . $ 0.00
"IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .- ...... .., ... ... ... ... ..... ... .. ..., .. .. ... . $ 0.00
-OUTSTANDING LOANS (From Schedule F - Attach Schedule F) .... . ... ..... .... ..... ...... ........ ... ... ..... . .. . $ 0 .00
COM_M_ICOMMITTEES

2 D$
CANDIDATE ONLY:
CONSULTANT BREAKDOWN (Schedule G Attached?) DYES Q N0
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Sch dD ~=-E

OCT 1 6 20004
 JAMES BAKER PAGE 02
10/16/2004 08 :23 5159654237

For Instructions, See Back of Form

A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev.07/03) RECEIPTS
(Including candidate's peroonel funds)
L1 CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Iowa Association of McDonald's Operators PAC #6386

PAC IDENTIFICATION
STATE CANDIDATES NOTE. IF A CONTRIBUTION I$ RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE AND CAMPAIGN
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS 19 AVAILABLE FROM THE IOWA ETHICS
DISCLOSURE BOARD,

Soliciting contributions or
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of Information copied from reports and statements for
for any commercial purpose by any person other than statutory political committees .

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
(If applicable) TO CANDIDATE" RECEIVED FUND-
RECEIVED
(MM/DDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME

ID#
City State Hank- Grimes, IA 50111
No Relation $5 .43
9/30/2004 CK# Interest Income

El
II?#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL

TOTAL (if last page of this schedule)

Disclosure law squires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relotlonshlp must be shown to the third degree of conaengulnlty (blood relatives) and affinity (relatives by
. 1f surname of contributor lathe same as candidate, but there IS no
marriage) Page of _
familial relationship, enter "not applicable" In the relationship column. (for Schedule A)