associated general contractors of iowa pac6004scanned

8/7/2019 Associated General Contractors of Iowa PAC__6004__scanned

1/18

FOR I NSTRUCTI ONS, SEE BACK OF FORM

DI SCLOSURE SUMMARY PAUs - '.COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f O r g a n i s a t i o n )~ J GI MPORTANT : I n d i c a t e t y p e o f c o mmi t t e e y ou a r e r e p o r t i n g f o r :( 1 ) S t a t e w i d e / L e g i s l a t i v e C a n d i d a t e ( 2 ) S t a t e w i d e PA C ( 3 ) S t a t e P a r t y ( 4 ) C o u n t y / L o c a l C a n d i d a t e( 5 ) C o u n t y PAC ( 6 ) B a l l o t I s s u e / F r a n c h i s e C o mmi t t e e ( 7 ) C o u n t y / C i t y C e n t r a l C o mmi t t e e( 8 ) S u p p o r t S l a t e o f C a n d i d a t e s

S I GNA TU OF TREASURER ( o r p e r s o n f i l i n g t h i s r e p o r t )P e n a l t i e s Du e F o r L a t e F i l e d Re po r t s R a n g e f r o m $ 1 0 t o $ 4 0 0

SEE I NSTRUCTI ONS ON BACK AND COMPLETE THE FOL LOWI NGSENTENCE:I AMF I L I NG A . l J l u / S' Dr Y- ~ . . t ? I ) e ~

( r e p o r t d a t e )MCHECK I F AMENDMENT TOREPORT DATED

MC h e c k i f t h i s i s f i n a l ( t e r mi n a t i o n ) r e p o r t an d a t t a c h N o t i c e o f D i s s o l u t i o n F o r m DR - 3 .( Y o u mus t c o n t i n u e t o f i l e r e p o r t s u n t i l a N o t i c e o f D i s s o l u t i o n i s f i l e d . )

STATEMENT OF CASH ON HAND

I n d i c a t e o n e

UNPA I D BI L L S ( F r o m Sc h ed u l e D - A t t a c h Sc h ed u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $I N KI ND CONTRI BUTI ONS ( F r o m Sc h e du l e E - A t t a c h Sc h ed u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $OUTSTANDI NG LOANS ( F r o m Sc h e du l e F - A t t a c h Sc h ed u l e F ) . . . . . . . . . . . . . . . . . . . . . . , . . . . , . . . . . . . . . . , . . . . . . . . . . . . . $

FORMDR- 2( R e v . 0 2 / 9 6 )

F o r O f f i c e Us e On lCo mm . #I n d e x eA u d i t e dC o mp u t e r

REPORT FORA N/ A ( 1 ) ELECT I ON / ( 2 ) NON- EL ECT I ON YEAR.

L o c a l C o mmi t t e e s , e n t e r D a t e o f E l e c t i o nC o u n t y & L o c a l C o mmi t t e e s , e n t e r C o u n t y i nw h i c h E l e c t i o n i s h e l d

DI SCLOSUREREPORT

CASHON HAND a t t h e e n d o f t h i s r e p o r t i n g p e r i o d ( i f f i n a l r e p o r t , b al a nc e mu s t d 9b e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ - ~ D 2 - _ ? J 7 -

CANDI DATE COMMI TTEES ONLY :CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) YES NOVALUE OF CAMPAI GN PROPERTY ( F r o m Sc h ed u l e H - A t t a c h S ch e d ul e H ) $

CASH ON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d . ( T h i s i s t h e t o t a lo f a l l mo n i e s h e l d b y t h e c o mmi t t e e . T h i s amo u n t MUST b e t h es ame a s t h e c a s h o n h a n d a t t h e e n d o f t h e l a s t r e p o r t i n g p e r i o d , *o r mus t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ . - - ~ 0 6 ` 7ADD TOTAL MONEY TAKEN I N THI S PER I OD 3 1dSc h ed u l e A: C a s h C o n t r i b u t i o n s t o t a l ( A t t a c h Sc h ed u l e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . fSc h ed u l e C : F u n d - r a i s i n g E v e n t s t o t a l ( A t t a c h S ch e du l e C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h ed u l e F : L o a n s Re c e i v e d t o t a l ( A t t a c h S ch e d ul e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h ed u l e H: T o t a l S a l e s o f C ampa i g n P r o p e r t y ( A t t a c h S c he d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( S c h ed u l e H a p p l i e s t o Ca nd i d at e s ' Co mmi t t e e s On l y ) 079SUB- TOTAL . . . . . $ - ) 9 ( a + 3 1SUBTRACT TOTAL MONEY SPENT THI S PER I OD . , . , tS ch e d ul e B : E x p e n d i t u r e s t o t a l ( A t t a c h Sc h ed u l e B ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . / $3 ( 7 4 - 70/S ch e d ul e F : L o a n Re p a y me n t s t o t a l ( A t t a c h S c he d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,


2/18

o r I n s t r u c t i o n s , Se e Ba c k o f F o r mONTRI BUTI ONS - MONEY TAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t eme n t o f O r g a n i z a t i o n )

, / - t a i e W r r . . 1 Cd . , " ~ J , , i S ~ . 7 4 . Ta 4J a 1 1 ~4CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) . L I S T THE PAC I DE NT I F I CA T I O NAND THE PAC CHECK NUMBER I N THE DESI GNATEDCOLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNSCLOSURE BOARD .

UTI ON : Se ct i o n 6 8 B . 3 2 A ( 6 ) , I o wa Code , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s a n d s t a t e me nt s f o r s o l i c i t i n g c o n t r i b u t i o n s o ro r a n y c omme r c i a l p u r p o s e b y an y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

c l o s u r e l a w r e q u i r e s c a n d i d a t e c o mmi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e mak i n g a c o n t r i b u t i o n t o t h emi t t e e . R e l a t i o n s h i p mus t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l ) o d r e l a t i v e s ) an d a f f i n i t y ( r e l a t i v e s b ya r r i a g e ) ( S e e Page 2 o f f o r ms p a c k e t ) . I f s umame o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o Pa g e , - o f _ , Z , -r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l umn . ( f o r Sc h e d ul e A)

SCHEDULEA MONETARY

( Re v . 0 2 / 9 6 ) RECE I PTS/ 0 CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNTRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED( MM/ OD/ YR) AND PAC CHECK ( i f a p p l i c a b l e )NUMBERI D# ~~

l - CK# e ; ! ~ ~ k l 4 8 i P _` , . S , " e 3o~ . ~UOdt .

I D#

. 3 0 4 CK# r ' A/ j u t s - 7 3e " , 4 ~ . . , . i . _I D# _we. I I S "

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SUB- TOTAL ~ ' 3$ ,TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) 353 ' 7 4 -


3/18

FORI NSTRUCTI ONS, SEE BACK OF FORMEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI T TEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLATI VECANDI DATES . L I S T THE CANDI DATE I DENTI F I CAT I ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBE R FOR EACH EXPENDI TURE. A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWAETHI CS & CAMPAI GN DI SCL OSURE BOARD .COMMI T T EE NAME ( Mu s t b e s ame a s o n St a t eme n t o f O r g a n i z a t i o n )

SCHEDULEMONET ARY( R e v . 0 2 J 9 6 ) EXPENDI TURES

QCHECK T HI S BOX I FAMENDI NG FORM

SUB- TOTAL $ l ad s 1T OTA L ( i f l a s t p a g e o f t h i s s c h e d ul e ) I S

THI S BOX APPL I ES TO CANDI DATES' COMMI TT EES ONLY :Campa i g n f u n d s may b e u s e d o n l y f o r( 1 ) c amp a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x pe ns e s , a n d( 3 ) e d u c a t i o n a l an d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .P l e a s e i n s e r t t h e a p p l i c a b l e nu mbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x p e n d i t u r e .- YPu r c h a s e s o f c e r t a i n c ampa i g n p r o p e r t y c o s t i n g 5 5 0 0 o r mo r e mus t a l s o b e i n v e n t o r i e d o n Sc h edu l e H . ( R e f e r t o Sc h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s l e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma na g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e m i z e d oSc h e d u l e G b y t h e amo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n / e n t i t y a n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e rSc hed u l e G i n s t r u c t i o n s an d I o wa Code 5 & . 6 ( 3 ) 0 . )

CANDI DATE NAME AND ADDRESS TO WHOM EXPENDI TURE PURPOSE AMOUNTDATE I D NUMBE R ( Di s b u r s e me n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BEL OW& ENTER( MMJ DO/ YR) A ND P AC 1 , 2 , 3 )

CHECK NUMBE R

D#G J 7 3 y p

I D# i ~ o ml - ! T a r f ~ ~ . f . -i ~ . i s l , / / S - c S ` e e , oD# / / 1 1 9 ~ ~ J I L A! ! r . ! F u s T l ~ i H- l 1-3 4 CK# " 7

f - 0 fI D# ~ _

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6/18

FOR I NSTRUCTI ONS, SEE BACK OF FORMEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNTPAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VEDI DATES . L I ST THE CANDI DATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THEC CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF I D NUMBERS I S AVAI LABLE FROMTHE I OWAI CS & CAMPAI GN DI SCLOSURE BOARD .

COMMI TTEE NAME ( M u s t b e s ame a s o n S t a t e me n t o f O r g a n i z a t i o n )

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e )

SCHEDULEMONETARY( R e v . 0 2 / 9 6 ) EXPENDI TURES

CHECK THI S BOX I FAMENDI NG FORM

THI S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY :Camp a i g n f u n ds ma y b e u s e d o n l y f o r .( 1 ) c a mp a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , a n d( 3 ) e d u c a t i o n a l a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .Pl e a s e i n s e r t t h e a p p l i c a b l e n um b e r i n t h e p u r p o s e c o l u mn f o r e a c h e x pe n d i t u r e .- YPu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g S500 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n Sc h e d u l e H. ( R e f e r t o S c h e du l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e m i z e d o nSc h e d u l e G b y t h e a mo u n t , p u r p o s e , a nd d at e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e rSc h e d u l e G i n s t r u c t i o n s a n d I o wa Co d e 5 6 . 6 ( 3 ) ( 1 . )

CANDI DATE NAME AND ADDRESS TOWHOMEXPENDI TURE PURPOSE AMOUNTDATE I D NUMBER ( D i s b u r s e me n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BELOW& ENTER( MM/ DD/ YR) AND PAC 1 , 2 , 3 )CHECK NUMBER

64 CK# 9 ' . 42 - 3

CK# 4 4 AS 6 ) 6 )I D# 1- ? , ~ ~ I k F~ . St ~

7 4 . 61 0 #C K# C/ U ( )1 D#CK#I D#

r SGUI D# A ~ f ~ Sy . f d v ~ `7


7/18

FOR I NSTRUCTI ONS, SEE BACK OF FORM

EXPENDI TURES - MONEY SPENT FROM COMMI TT EE ACCOUNTSTATE PAC COMMI T TEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI DATES . L I ST THE CANOI OATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COL UMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF 1 0 NUMBERS I S AVA I LABLE FROM THE I OWAETHI CS 3 CAMPAI GN DI SCL OSURE BOARD .

COMMI T T EE NAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g an i z a t i o n)

SUB- TOTAL

T OT AL ( i f l a s t p a g e o f t h i s s c h ed u l e )

D F / ( p

THI S BOX AP PLI ES T O CANDI DATES' COMMI T TEES ONL Y :Camp a i g n f u n ds may b e u s ed o n l y f o r .( 1 ) c a mp a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , a n d( 3 ) e d u c a t i o n a l a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .P l e a s e i n s e r t t h e a p p l i c a b l e n umbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x p e n d i t u r e .- YPu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g S500 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n Sc h e d u l e H . ( R e f e r t o Sc h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s l e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s must a l s o b e d e t a i l i t e mi z e d o nSc h e d ul e G b y t h e amoun t , p u r p o s e , a nd d a t e o f e a c h t y p e o f e x pe n d i t u r e made b y t h e p e r s o n l e n t i t y a n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e rSc h e d ul e G i n s t r u c t i o n s a n d I o wa Co d e 5 0 - x ( 3 ) ( 0 . )

SCHEDULEMONET ARY

( R e v . 0 2 J 9 6 ) EXPENDI TURESCHECK T HI S BOX I F

AMENDI NG FORM

CANDI DATE NAME AND ADDRESS TO WHOM EXPENDI TURE PURPOSE AMOUNTDATE I D NUMBER ( D i s b u r s e me n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BEL OW& ENTER( NI Ml 0 0 1 YR) AND PAC 1 , 2 , 3 )CHECK NUMBER

CK# - 7 1 4I D# / 3 - 4 / Sa mt / " - " , / J , 7AI D#

1 D#1- 2 CK#

I D# I f I _

I D#4

1 -7-


8/18

FOR I NSTRUCTI ONS, SEEBACK OF FORMiEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI DATES . L I ST THE CANDI DATE I DENT I F I CAT I ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWAETHI CS & CAMPAI GN DI SCL OSURE BOARD .COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t emen t o f Or g a n i z a t i o n )

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) $

THI S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY :Campa i g n f u n d s may b e u s e d o n l y f o r .( 1 ) c ampa i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , an d( 3 ) e d u c a t i o n a l a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .P l e a s e i n s e r t t h e a p p l i c a b l e n u mbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x pe nd i t u r e .

_YPu r c h a s e s o f c e r t a i n c amp a i g n p r o p e r t y c o s t i n g S5 0 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n Sc h e d u l e H . ( R e f e r t o Sc h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e m i z e d o nSc h e d u l e G b y t h e amo u n t . p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e rSc h e d u l e G i n s t r u c t i o n s a n d I o wa Co d e 5 & . 5 ( 3 ) 0 . )

SCHEDULEB MONETARY( R e v . 0 2 J 9 6 ) EXPENDI TURES

2 _ CHECK THI S BOX I FANl ENDI NG FORM

CANDI DATE NAME AND ADDRESS TOWHOM EXPENDI TURE PURPOSE AMOUNTDATE I D NUMBER ( Di s b u r s e me n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BELOW& ENTER( MM/ DD/ YR) AND PAC 1 , 2 , 3 )CHECK NUMBERD#CK#L / S_ C- - Y I V7 - 7 -I D# ./ f . r

I D#" / d 04 CK# ~ ~- y , _ ,l orVSr .. 7 i - r r _

I D# l 3 ~C 7 S~ ~ V C c ; s f . , . s y < ~ ~CK# . 1 1 - 7 l 0 ~ ~ ' ~ 5 ( ) ' sl s r . L . ~ 7 , S "CK# ~- 7D#

U/ t f i t . . ; s Ga m' - ) d o eI D#0 - 1 -

CK# . ~ ra i ~L. . r y 2 . s ( ) G


9/18

FOR I NSTRUCTI ONS, SEE BACK OF FORMEXPENDI TURES - - MONEY SPENT FROMCOMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E GI S L A T I V ECANDI DATES . L I S T THE CANDI DATE I D EN T I F I C A T I O N NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWAE T H I C S & CAMPAI GN DI SCLOSURE BOARD .COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t eme n t o f O r g a n i z a t i o n )

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h e d ul e )

THI S BOX APPL I ES TO CANDI DATES' COMMI TT EES ONLY :Ca mp a i g n f u n d s may b e u s e d o n l y f o r( 1 ) c a m p a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , a n d( 3 ) e d u c a t i o n a l a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .P l e a s e i n s e r t t h e a p p l i c a b l e nu mbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x p e n d i t u r e .P u r c h a s e s o f c e r t a i n c a m p a i g n p r o p e r t y c o s t i n g 5 5 0 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H . ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l i t e m i z e d o nS c h e d u l e G b y t h e a mo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e rS c h e d u l e G i n s t r u c t i o n s a n d I o w a Co d e 5 6 . 6 ( 3 ) ( i ) . )

SCHEDULEB MONETARY

( R e v . 0 2 1 9 6 ) EXPENDI TURESCHECK THI S BOX I FAMENDI NG FORM

CANDI DATE NAME AND ADDRESS TOWHOMEXPENDI TURE PURPOSE AMOUNTDATE I D NUMBER ( D i s b u r s e m e n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BELOW& ENTER( MM/ DD/ YR) AND PACCHECK NUMBERI D# 6 , yCK# X0

. ~ a f / . ? Gn f r l . . , ~DsUI D#1 7 a-27 I 4 C~

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I D# I S-17

- L 7 1 7 a 20I D# / S t i4 1 7 2 - ?3d


10/18

FOR I NSTRUCTI ONS, SEE BACK OF FORMEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MACE TO STATEWI DE OR LEGI SLAT I VECANDI DATES L I ST THE CANDI DATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWAETHI CS & CAMPAI GN DI SCLOSURE BOARD .COMMI TTEENAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g a ni z a t i o n)

, , / , - 1 / A- / a -

THI S BOX APPLI ES TOCANDI DATES' COMMI TTEES ONLY :Camp a i g n f u n ds ma y b e u s e d o n l y f o r .( 1 ) c a mp a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , a nd( 3 ) e d u c a t i o n a l a nd o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .

e 7 ' 7 ' . 1 - d --

Pl e a s e i n s e r t t h e a p p l i c a b l e numbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x pe n d i t u r e .

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) ( t

- YPu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g S50 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n Sc h e d u l e H . ( R e f e r t o Sc h e d ul e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s J e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , man a g i n g , o r g a n i z i n g s e r v i c e s must a l s o b e d e t a i l i t e m i z e d oSc h e d ul e G b y t h e amoun t , p u r p o s e , a nd d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n i e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e rSc h e d ul e G i n s t r u c t i o n s a n d I o wa Code 5 & . 5 ( 3 ) 0 . )

SCHEDUL EB MONETARY

( R e v . 0 2 / 9 6 ) EXPENDI TURESS CHECK T HI S BOX I FAMENDI NG FORM

CANDI DATE NAME AND ADDRESS TOWHOMEXPENDI TURE PURPOSE AMOUNTDATE I D NUMBER ( Di s b u r s e me n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BELOW& ENTER( MM/ DOI YR) AND PAC 1 , 2 , 3 )

CHECK NUMBERD#

73 s v^ s " e o . .I D# ~G4 ~, , / , ` ~ . ~ f

1 D#

D#CK# 324Z , 4 5 6 6 ,

3aao _l o #

4 CK# / o 9 Z / ~ ~ ~ " s y7 1 r r i , . L c + r GD#( ) 3e o c ,

7


11/18

FOR i r i s r RUCT r 6 NS, SEE BACK OF FOPNfEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TT EES : NOTE : FOR CONTR I BUT I ONS MADE T O ST ATEW10 E OR L EGI S LAT I VECANDI DATES . L I S T THE CANOI OATE I DENT I F I CAT I ON NUMBER I N T HE DESI GNATED COLUMN ANC THERAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF 1 0 NUMSERS I S AVA I LABLE FROM T HE I ONI AETHI CS 3 CANI PAI GN DI SCLOSURE 3CARC .COMMI TT EE NAME ( N f u s t b e s ame a s o n S t a t eme n t o f O r g a n i z a t i o n )

do c ~ ~ r - 4~ 6 4' -J 6 l r f c 7 - 1 l .

TOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e )

SCHEDULEB( R e v 0 2 ) 9 6 )

MONETARYEXPENDI TURES

0 CHECK T HI S Bo x I FA1N) ENDI NG FORNI

SUB- TOTAL

T HI S BOX APPLI ES TO CANDI DATES' COMMI TT EES ONLY :Campa i g n f u n d s may b e u s e d o n l y f o r( 1 ) c ampa i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , an d( 3 ) e d u c a t i o n a l an d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .P l e a s e i n s e r t t h e a p p l i c a b l e n u mbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x p e n d i t u r e .. YPu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g S S Ot 7 o r mo r e mu s t a l s o b e i n v e n t o r i e d a n Sc h e du l e H . ( R e f e r t o Sc h e d u l e H i n s t r e t o n s . )E x p e n d i t u r e s t o p e r s o n s l e n t i b e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , man a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e m i z e d aSc h e d ul e G b y t h e a mo un t , p u r p os e . a n d d a t e o f e a c h t y p e c f e x p e n d i t u r e mad e b y t h e p e r s o r V e n t i t y a n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e rSc h e d ul e G i n s t r u c t i o n s an d I o wa Co d e 5 0 . 0 " ( 3 ) ( I . )

CANDI DATE NAME AND ADDRESS T O ' Al i OM EXPENDI TURE PURPOSE AMOUNTDATE I D NUMBER ( Di s b u r s e me n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BELOW& ENTER( MM ; D0 / Y R) AND PACCHECK NUMBER

` - C K , * l l e - - f , Y C . S" -~I D#

f " 42,04 cK#I D#

I D# Ta L - . 5~, ~ ~r < ~r s

/ G

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0' - 64 C K# 5GO


12/18

FOR i r i s T RUCT I ONS , SEC BACK OF FORNfEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUT I ONS MADE TO STATEWI DE OR LEGI S LAT I V ECANDI DATES L I S T T HE CANDI DATE I DENT I F I CAT I ON NUMBER I N THE DES I GNATED COLUMN AND THEPAC CHECK NUMBER FOREACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROMT HE 1 0 ' N AETHI CS & CAMPAI GN DI SCLOSURE BOARD .COMMI TT EE NAME ( ~ ^ M u s t b e same a s o n S t a t e me n t o f O r g a n i z a t i o n )

t o 4 / 1 1 6 - K ~ ' o e f e - Z~- t . J -

T HI S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY :Camp a i g n f u n d s ma y b e u s e d o n l y f o r .( 1 ) c a mp a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , a n d( 3 ) e d u c a t i o n a l a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .P l e a s e i n s e r t t h e a p p l i c a b l e n umb e r i n t h e p u r p o s e c o l u mn f a r e a c h e x p e n d i t u r e .

SUB- TOTAL

TOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e )

- YPu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c a s t i n g SSQO o r mo r e mus t a l s o b e i n v e n t o r i e d a n Sc h e d u l e H . ( R e f e r t o Sc h e du l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s l e n t i t i e s p r o v i d i n g c o n s u i t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o ' a e d e t a i l i t e m e d aSc h e d u l e G b y t h e a mo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e mad e b y t h e p e r s o n l e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmf t e e . ( R e e f e rSc h e d u l e G i n s t r u c t i o n s a n d I o wa C o d e / D + ' F- / - ~~

SCHEDULEB MONETARY( Re v . 0 2 J 9 6 ) EXPENDI TURESQCHECK T HI S BOX I F

AMENDI NG F O R " 1 4 1

CANDI DATE NAME AND ADDRESS TO V 1 4 - i G M EXPENDI TURE PURPOSE AMOUNTDATE I D NUMBER ( D i s b u r s e me n t ) WAS MADE ( CANDI DATES SEE EXPENDED

EXPENDED ( i f a p p l i c a b l e ) BELOW& ENTER( MMI DOI YR) AND PAC 1 , 2 , 3 )CHECK NUMBERI D # ~7

' l v ~ 04 CKn ?F?G ~~ A. . ~ .004 CK#

D# / G9

C / i CK#I D# ~a3

D# ~ -

. - TI D# 2ZC K KJ - ~v 1 2 " I s e lD#

04 CK# , o , ~ , a 3r ~ G3S- 1 0 0 "


13/18

FOR I NSTRUCTI ONS, SEE BACK OF FORNfEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE FOR CONTRI BUTI ONS NAOE TO STATEW10 E OR LEGI SLAT I VECANDI DATES . L I S T THE CANDI DATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THEP . A C CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF I D NUNI SERS I S AVA I LABLE FROM THE I OWAETHI CS 3 CAMPAI GN DI SCLOSURE BOARDCOMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n ), i 4 f 5 e c ( f e d : / 6 a r 1' , -

SCHEDULE

( R e v . x 2 1 9 6 )MONETARYEXPENDI TURES

CHECK THI S BOX I FANI ENDI NG FORNI

SUB- TOTAL STOTAL ( i f l a st page o f t h i s s c h e du l e ) I S

THI S BOX APPLI ES TOCANDI DATES' COMMI TTEES ONLY :Camp a i g n f u n d s may b e u s e d o n l y f o r .( 1 ) c a mp a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , a n d( 3 ) e d u c a t i o n a l a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .P l e a s e i n s e r t t h e a p p l i c a b l e n u mbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x p e n d i t u r e .Pu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g S500 o r mo r e mus t a l s o b e i n v e n t o r i e d o n Sc h e d u l e H . ( R e f e r t o Sc h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s l e n t i t i e s p r o v i d i n g = ns u f i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , org a n i z i n g s e r v i c e s mu s t a l s o b e d e t a i l i t e m i z e d aSc h e d u l e G b y t h e amo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n l e n t t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e e f e rSc h e d u l e G i n s t r u c t i o n s a n d I o wa Code 5 6 . 5 ( 3 ) 0 . ) r rl a . ~

CANDI DATE NAME ANO ADDRESS TOWHOM EXPENDI TURE PURPOSE AMOUNTGATE I D NUMBER ( Di s b u r s e me n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BELOW& ENTER( NI MI DDI YR) AND PACCHECK NUMBERI D# / . ? / 7 ~ u n i 1 1 1 ~ ' -r

d od - 1 3 - o4 C K j ' 7 e - 7( D # 1F4

71

6 ' b e 'O. CK# 3 ) 1 3

1 b V , 1 j . ~ _ ? . . _ a c am . . /JI D #C K# p l J 4 / . :, rf: , , 0 . ? ) I y4117 e - I ' k-

I D # Q~ -I

Z I l e , - s C,CK# -7 1 4D# .


14/18

FOR I NSTRUCTI ONS, SEE BACK OF FORMiEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEN1OE OR LEGI SLAT I VECANDI DATES . L I S T THE CANDI DATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF I D NUNI SERS I S AVA I LABLE FROM THE I OWAET HI CS & CAMPAI GN DI SCLOSURE BOARD .COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n )Af < < ` - ~ r - 1 C9',?,i-/ a . ' ! f / < c

THI S BOX APPLI ES TO CANDI DATES' COMMI TT EES ONLY :Camp a i g n f u n d s may b e u s e d o n l y f o r .( 1 ) c a mp a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , a n d( 3 ) e d u c a t i o n a l a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .P l e a s e i n s e r t t h e a p p l i c a b l e n u mb e r i n t h e p u r p o s e c c l u mn f a r e a c h e x p e n d i t u r e .- Y

TOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e )

SCHEDULE"B( R e v . 0 2 1 5 6 )

MONET ARYEXPENDI TURES

CHECK THI S BOX i r -ANI ENDI NG FORM

SUB- TOTAL

Pu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g S500 o r mo r e mu s t a l s o b e i n v e n t o r i e d a n Sc h e d u l e H . ( R e f e r t o Sc h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s J e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , man a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e m i z e d aSc h e d u l e G b y t h e a mo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x pe n d i t u r e made b y t h e p e r s o n l e n t t y a n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e rSc h e d u l e G i n s t r u c t i o n s a n d I o wa Co d e 5 0 . 5 ( 3 ) 0 . ) 1 e ~ - 01= 1 6

CANDI DATE NAME AND ADDRESS TOWHOMEXPENDI TURE PURPOSE ANI CUNTDATE I D NUMBER ( D i s b u r s e me n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BELOW3 ENTER( NI MI ODI YR) AND PAC 1 , 2 , 3 )CHECK NUMBERI D# ' ]

7 ( . 6 A 6 1I D # T


15/18

FOR I NSTRUCTI ONS, SEE BACK OF FORMEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MACE TO STATEWI DE OR LEGI SLATI VECANDI DATES . L I S T THE CANDI DATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COLUMN ANC THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF I D NUMBERS I S AVA I LABLE FROMTHE I OWAETHI CS b CANI PAI GN DI SCLOSURE BOARDCOMMI TTEE NAME ( , . , l u s t b e s ame a s o n St a t e me n t o f Or g a ni z a t i on )

SSG' C : - f e , / e I " , t O n / " a i f G . , ' { - , f /

SCHEDULE

( R e v 0 7 / 9 6 )MONETARYEXPENDI TURES

7 CHECK T HI S BOX I FANI ENCI NG FORM

SUB- TOTAL I $. -TOTAL ( i f l a s t page o f t h i s s c h e du l e ) I S

THI S SOX AP PL I ES TO CANDI DATES' COMMI TTEES ONLY :Camp a i g n f u n d s ma y b e u s e d o n l y f o r( 1 ) c a mp a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , a n d( 3 ) e d u c a t i o n a l a nd o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .P l e a s e i n s e r t t h e a p p l i c a b l e number i n t h e p u r p o s e c . - l u m n f o r e a c h e x p e n d i t u r e .Pu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i r g SSCO o r mo r e mu s t a l s o b e i n v e n t o r i e d a n Sc h e d u l e H . ( R e f e r t o Sc h e d u l e H i n s t r u c t J o n s . )E x p e n d i t u r e s ; o p e r s o n s l e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , man a g i n g , o r g a n i z i n g s e r v i c e s mu s t a l s o be d e t a i l i t e m i z e d oSc h e d u l e G b y t h e amoun t . p u r p o s e , a n d d a t e o f e a c h t y p e o f e x pe n d i t u r e made b y t h e p e r s c n l e n t i t y a n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e ( R e f e rSc h e d u l e G n s t n : d i o n s a n d I o wa Code 13 ~ , .F

CANDI DATE NAME AND ADDRESS TO ' NHOMEXPENDI TURE PURPOSE AMOUNTDATE I D NUMBER ( D i s b u r s e me n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BELOW&ENTER( MM/ CO/ YR) AND PAC 1 , 2 , 3 )CHECK NUMBERD# / 3 y . 2 - Gl 3 - ~ s f _ t ~ ~~~.

~~ C K# SIl ee . - ~~ / Do o -

0 4 0 4 CK#C1 0 # ~ ~

4- 7 IT~ - C d n i L _ ~ ~ . . , 5f J0D# ~

6 1 4 CK# ~ , . , ~ . i g 7 ( ) ~a~ID#

q CK- - I D Y - 2D#

I ~. r+ 34~ e . l ( p ~ f : n 7 I ~ . . sP- e . r ~ F5 S" a a


16/18

FOR I NSTRUCTI ONS, SEE BACK OF FOPNfEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TTEES NOTE : FOR CONTRI BUTI ONS MACE TO STATEWI DE OR L EGI S L AT I VECANDI DATES L I ST THE CANDI DATE I CENT I F I CATI ON NUMBER I N THE DES I GNAT ED COLUMN AND THEPA C CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUNI SERS I S A VA I L A BL E FROM THE I C V ` i AETHI CS & CAMPAI GN DI SCLOSURE BOARD .COMMI TT EE NAME ( N f u s t b e s ame a s o n St a t e me n t o f Or g an i z a t i o n)

L a r ! / / L t A/ Q O~ . / c ~

THI S BOX APPLI ES TO CANDI DATES' COMMI TT EES ONLY :Camp a i g n f u n d s ma y b e u s e d o n l y f o r .( 1 ) c a mp a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , a n d( 3 ) e d u c a t i o n a l a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .

SCHEDUL E( R e v . 0 2 1 9 6 )

MONETARYEXPENDI TURES

QCHECK T HI S BOX I FAMENDI NG F OR , ' , j l

SUB- TOTALTOTAL ( i f l a s t page o f t h i s s c h e d u l e )

P l e a s e i n s e r t t h e a p p l i c a b l e n u mbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x p e n d i t u r e .-YPu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g SSQO o r mo r e mu s t a l s o b e i n v e n t o r i e d o n Sc h e d u l e H . ( R e f e r t o Sc h e d u l e H i n s t r u c t i e r i s . )

E x p e n d i t u r e s t o p e r s c n s l e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p e i l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e m i z e d aSc h e d u l e G b y t h e amo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s e n / e n t i t y d o b e h a l f o f t h e c a n d i d a t e ' s c c r n mi t t e e . ( R e f e rSc h e d u l e G i n s t r u c t i o n s a n d I o wa Co d e S o . 6 ( 3 ) ( ~ . ) 6 - .(- 4

CANDI DATE NAME AND AOORESS TO ' 4 1 1 H OM EXPENDI TURE PURPOSE AMOUNTGATE I D NUMBER ( D i s b u r s e m e n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BELOW&ENTER( NI M/ OO/ YR) ANO PAC 1 , 2 . 3 )CHECK NUMBER

~. 7 1 ' / 6Go%3 - 2 GI d s , - , ~

- - 6 2 A; . _` f i g 1 4 r 1 . ~ c t u ! JI D # 113 /- 0 4 C K# f / 4 _ 4 , / S 40I D#0 1 , f - C K# 1

1 D#4r J S - 3 1 - 7 Il Oui r S . , , : , / SGG

I D# ~< 4 / 1 11 f / t ' c / S~ a 7 f ~ l F r ~Zed , p o Ta. ~- OoG ~Do4

CK# I V . 4 U, - 7


17/18

FOR I NSTRUCT I ONS, SEE BACK OF FORMEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUT I ONS MACE TO STATEMOE OR L EGI S L AT I V ECANDI DATES . L I ST THE CANDI DATE I DENTI F I CATI ON NUMBER I N THE DES I GNATED COLUMN AND THEPA C CHECK NUNI BER FOR EACH EXPENDI TURE . A L I ST OF 1 0 NUMBERS I S AVA I L ABLE FROM THE I OWAETHI CS & CAMPAI GN D I SCLOSURE BOARD .COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f O r g a n i z a t i o n )

THI S BOX APPLI ES TO CANDI DATES' COMMI TT EES ONLY :Camp a i g n f u n d s ma y b e u s e d o n l y f o r .( 1 ) c a mp a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , a n d( 3 ) e d u c a t i o n a l a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .P l e a s e i n s e r t t h e a p p l i c a b l e n umbe r i n t h e p u r p o s e c o l u mn f o r e a c h e x p e n d i t u r e .

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e )

Pu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g S 5 0 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d a n Sc h e d u l e H . ( R e f e r t o Sc h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s l e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , man a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e m i z e d eSc h e d u l e G b y t h e amo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x pe n d i t u r e made b y t h e p e r s o n d e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e rSc h e d u l e G i n s t r u c t i o n s a n d I o wa Co d e v o ' . 5 ( 3 ) ( ~ . )

SCHEDULEMONET ARY

( R e v . 0 2 ) 9 6 ) EXPENDI TURES" CHECK T HI S BOX I FAMENDI NG F O R I l j l

CANDI DATE NAME AND ADDRESS TO WHOM EXPENDI TURE PURPOSE AN I OUNTDATE I D NUMBER ( D i s b u r s e me n t ) WAS MACE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BEL OW& ENTER( N I NUDO/ YR) AND PAC 1 , 2 , 3 )CHECK NUMBER

1 D# J / ~.< < ~ c % ~ - S~ / P r y ,

V - uq C K#I D# G r " Zl - .

' e 1 7 - e c 4 - 1- t 2 . 2 3 c e i i O_ 4- 2 - ~

D# j c " - l_ 0? - 2 l , L t ' rD#

i ~ _ ? l a , ; ~ U v dI D# / ' 6 e1 01 CK#


18/18

FOR I S I S TRUCTI ONS, SEE BACK OF FOPMIEXPENDI TURES - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CCNTRI BUTI ONS MADE TO STATE+410EOR LEGI SLATI VECANDI DATES . L I S T THE CANDI DATE I DENT I F I CATI ON NUMBER I N THE DESI GNATED COLUL I N AND THEPA C CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF 1 0 NUMSERS I S AVAI L ABLE FROM THE I 0 NAETHI CS 3 CAMPAI GN DI SCLOSURE BOARD .COMMI TTEE NAME ( N f u s t b e s ame a s a n St a t e me n t o f Or g a n i z a t i o n )

/ l S~ GL i Q I ~ - ~ Gr - 1 7r / ~ C d I l e e l ~

THI S BOX APP L I ES TOCANDI DATES' COMMI TTEES ONLY :Camp a i g n f u n d s ma y b e u s e d o n l y f o r .( 1 ) c a mp a i g n p u r p o s e s ,( 2 ) c o n s t i t u e n c y e x p e n s e s , a n d( 7 ) e d u c a t i o n a l a n d o t h e r e x p e n s e s a s s o c i a t e d w i t h d u t i e s o f o f f i c e .P l e a s e i n s e r t t h e a p p l i c a b l e n umb e r i n t h e p u r p o s e c o l u mn f o r e a c h e x p e n d i t u r e .

T " . L _ 41A 1 Y l

TOTAL ( i f f a s t p a g e o f t h i s s c h ed u l e )

SCHEDULE( Re v 0 2 1 9 6 ) MCNETARYEXPENDI TURES

CHECK T HI S BOX I FANI ENDI NG FORI NI

Pu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g SSCO o r mo r e mu s t a l s o b e i n v e n t o r i e d a n Sc h e d u l e H . ( R e f e r t o Sc h e d ul e H i n s t r u c t i o n s . )

CANDI DATE N A 4 1 4 1 E AND ADDRESS TOWHOMEXPENDI TURE PURPOSE AMOUNTDATE I D NUMBER ( Di s b u r s e me n t ) WAS MADE ( CANDI DATES SEE EXPENDEDEXPENDED ( i f a p p l i c a b l e ) BELOW& ENTER( MM/ D01 YR) AND PAC 1 , 2 , 3 )

CHECK NUMBERI D#

I D# i ~ - J f 1 6 Fe l ~ G

I D# C~ . M ~. , N L T~~U>o4 CKmD # 1 . C 7 7 1 / 1 ` 7CK# ; > j r

CK r . 2 Nr J 4 ( )a 3 aI D# ~ sCK# / 3I D#

v . . . CK# - 3 1 ' ~

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