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C o n t r i b u t i o n s - Money T a k e n I n X 0 0 1

Co mmi t t e e Name :Co mmi t t e e t o E l e c t Ci n d y Go l d i n g2 3 2 7 S p r i n g b r o o k DrC e d a r R a p i d s , I A 52411 3 1 9- 3 9 3 - 0 9 40

S c h e d u l e A( R e v 0 6 / 9 7 )

Mo n e t a r yR e c e i p t s

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P a g e 1 o f 2

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D a t e PA C I D Number Name & A d d r e s s o f R e l a t i o n s h i p Amoun t X i f f o rR e c e i v e d ( i f a p p l i c a b l e ) C o n t r i b u t o r T o C a n d i d a t e R e c e i v e d F u n d r a i s e r

( MM/ DD / YY a n d PA C C h e c k ( i f a p p l i c a b l e ) $ I n c o meNumbe r

1 0 / 1 9 / 0 1 I D# C i n d y G o l d i n g s e l f . 4 0 0 . 0 0

CK# 7 0 0 0 Towe r T e r r a c e Rd

C e d a r R a p i d s , I A 5 2 4 1 11 1 / 0 2 / 0 1 I D# Mi k e H u g h e s 1 0 0 . 0 0

CK# RR# 1 9 8 0 1 Mo r r i s H i l l s RdT o d d v i l l e , I A 5 2 3 4 1 - 9 8 0 1

1 1 / 0 6 / 0 1 I D# D o r o t h y H u g h e s 1 0 0 . 0 0

CK# RR # 1 9 8 0 1 Mo r r i s H i l l s Rd

T o d d v i l l e , I A 5 2 3 4 1 - 9 8 0 1

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T o d d v i l l e , I A 5 2 3 4 11 1 / 2 0 / 0 1 I D# H a r v e y & B o n n i e F a s c h e r 1 0 . 0 0

CK# 5 6 3 0 Hi g h wa y 1 3 / PO Bo x 1 3 7C o g g i n , I A 5 2 2 1 8

1 1 / 2 4 / 0 1 B r e t t & C h e r y l F o l e y 5 0 . 0 0

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3 0 5 9 B r i t t a n y C i r c l e

C e d a r R a p i d s , I A 5 2 4 1 1

1 1 / 2 8 / 0 1 J a m e s & Ma j o r i e H e n d e r s e n 2 5 . 0 0

3 4 4 9 F e a t h e r R i d g e RdT o d d v i l l e , I A 5 2 3 4 1 - 9 7 8 0

1 2 / 0 4 / 0 1 N o r b e r t & G e r a l d i n e S c h w a r t z 2 5 . 0 0

2 9 5 5 De e r Av e SE

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1 1 / 2 4 / 0 1 J i m Ha g e r ma n 1 0 0 . 0 0

3 7 2 2 T o d d v i l l e RdT o d d v i l l e , I A 5 2 3 4 1

1 2 / 0 5 / 0 1 M a r t h a Ha n d l e - , 2 5 . 0 03 3 7 7 F e a t h e r R i d g e RdT o d d v i l l e , I A 5 2 3 4 1 1

1 2 / 0 8 / 0 1 C u r t & G a y l e Z i n g u l a r 2 5 . 0 0

1 6 5 7 F a l c o n RdMa r i o n I A 5 2 3 0 2

S u b - t o t a l 1 , 1 8 5 . 0 0



P a g e 2 o f _ 2

( F o r s c h e d u l e A)

Co n t r i b u t i o n s - Mon ey T a k e n I n 2 0 0 1 _ Sc h e d u l e A Mo n e t a r y

Co mmi t t e e Name :~ ~N i

Co mmi t t e e t o E l e c t C i n d yC i n d y Go l d i nGo l d i n6 UuI .

( Re v 0 6 / 9 7 ) R e c e i p t s

2327 Sp r i n g b r o o k Dr

C e d a r Ra p i d s , I A 52411 3 1 9- 3 93 - 0 9 - 4 0

' Ch ec k i f a me n d i n g f o r m

1 2 / 1 1 / 0 1 J o h n &M i c h e l l e Mo r a n

4 Bo u l d e r Rd .

M a s o n C i t y , I A 5 0 4 01 - 2 5 0 3

100 . 0 0

1 2 / 1 2 / 0 1 J o h n &Ci n d y Sa p p

4617 B l a r n e y Dr

C e d a r R a p i d s , I A 5 2 411

5 00 . 0 0

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3 110 No r ma n Dr

C e d a r R a p i d s , I A 5 2 4 1 1

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C e d a r R a p i d s , I A 5 2 4 1 1

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3149 F a l c o n Dr NE

C e d a r R a p i d s , I A 5 2402

2 5 . 0 0

1 2 / 2 4 / 0 1 Mi c h a e l &Pa u l a Cu f r2 9 5 5 Dee r Av e SE

C e d a r R a p i d s , I A 5 2 4 0 3

2 5 . 0 0

1 2 / 3 1 / 0 1 T i m&N a n c y Da u g h er t y

2109 Wi n d i n g Wo o d s Dr

L i b e r t y , MO64088

S i s t e r - i n - l a w 1 0 0 . 0 0

S u b - T o t a l 900 . 0 0

T o t a l 2 0 8 5 . 0 0



k i 1 ?Y E , 2 + j ' W

T HI S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY :

P ur 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 $ 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 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 pe nd 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 n

Sc h e d u l e G b y t h e a mo un t , p u r p o s e , a n d d at e o f e a c h t y p e o f e x pe nd 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 r t o

Sc 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 . 6 ( 3 ) ( 1 ) . )

( f o r Sc h e d u l e B)

FOR I NSTRUCTI ONS, SEE BACK OF FORM SCHEDULE

EXPENDI TURES B MONETARY- - MONEY SPENT FROMCQI M" TTEE ACCOUNT ( Re v . 0 9 1 9 7 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DEOR L EGI S L AT I V ECANDI DATES, L I ST THE CANDI DATE I DENT I F I CATI ON NUMBER I N THE DES I GNATED COLUMN AND THE CHECKTHI S BOXI F

PACCHECKNUMBER FOR EACH EXPEND I TURE A L I ST OF I D NUMBERS I S AVAI L ABL E FROMTHE I OWA AMENDI NGFORMETHI CS & 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 )

C: oMo n I t c i n , ~ , e - c ' T

CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNT

DATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED

EXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WASMADE

( MM/ DD/ YR) AND PACCHECK

NUMBER

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FOR I AI STRUCTJONS . SCEBACKOF 3M_ .

I N' SCLOSUF?ESUmMARYPAGE

COMMI TEE NAME ( } M u s t b e same s o n St a t eme n t o f O r g a n i z a t i o n ) 1

h 1 YV l

1&

i h ! ~ ~ ~ l rO r i t 1 i r l

I 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 or t i n g f o r :

( 1 ) S t a t e wd e / L eg i s l a t i v e Ca nd i d a t e ( 2 ) S t a t e wi d e PAC ( 3 ) S t a t e P a r r y ( 4 ) Co u n t y / L o c al Ca nd i d a t e( 5 ) Co u nt y PAC ( o ) B a l l o t I s su e i F r a n ch i s e Co mmi t t e e ( 7 ) C o u n t y i C i t y Ce n t r a i Co mmi t t e e

I ( 8 ) Su p p or t S l a t e o f Ca n d i d a t e s

CANDI DATE COMMI TTEES ONLY :Ca nd i d a t e Name P o l i t i c a l P a r t y

O f f i c e So u g h t D i s t r i c t ( i f Se n a t e o r H o u s e )

~ J v r

SI GNATURE OF TREASURER ( o r p e r s o n t i l i n g t h i s r e p o r t ) TELEPHONE DATE SI GNED

R o u t i n e 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 Range f r o m $20 t o $8 0 0

SEE I NSTRUCTI ONS ON HACKAND

COMPLETE THE FOLLOWI NG SENTENCE :I AM F I L I NG A REPORT FOR AN/ A ( 1 ) ELECT I ON / ( 2 ) NON- EL ECT I ON YEAR .

I n d i c a t e o n e a( r e p o r t d a t e )

CHECK I F AMENDMENT TO REPORT DATED

[ ] Ch e c k i f t h i s i s f i n a l ( t e r m i n a t i o n ) r e p o r t a n 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 must 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 . )

CASH ONHAND 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 l o f a l l mo n i e s h e l db y t h e c o mmi t t e e . T h i s amou n t MUST b e t h e same a s t h e c a s h o n h a n d a t t h e e n do 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 mu s 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

ADD TOTAL MONEY TAKEN I N THI S PERI OD

Sc h e d u l e A: Cash 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 e d u l e A ) ( * a l s o s e e i n - k i n d b e l o w ) . . . . . . . . .

Sc h e d 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 Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Sc h e d u l e H : T o t a l Sa l e s o f Campa i g n P r o p e r t y ( A t t a c h Sc h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h ed u l e H a o v l l e s t o Ca nd i d a t e s ' Commi t t e e s On i v l

SUBTRACT TOTALMONEY SPENT T HI S PERI OD

STATEMENT OF CASH ON HAND

SUB- TOTAL. . . . . $

Sc h e d u l 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 e d u l e B ) ( * * a l s o s e e d e b t s a n d l o a n s b e l o w ) . . .

Sc h ed u l 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 Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .CASH ONHAND 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

b e z e r o ) ( A t t a c h DR- 3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

: t i RM

DI SCLGSURE

( Re v . 0 1 1 2 0 0 1 ) I R- EPCRT

F o r O f f i c e s Use On l y

Comm. # _q

/

I n d e x ed

Au d i t e d

Comput e r

L o c a l Co mmi t t e e s , e nt e r Da t e o f E l e c t i o n

Co u n t y & L o c a l Co mmi t t e e s , e n t e r Co u n t y i n

wh i c h E l e c t i o n i s h el d

* * UNP AI D BI L L S ( F r o m Sc h ed u l e D - A t t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

* I N KI ND CONTRI BUTI ONS ( F r o m Sc h ed u 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 ed u l e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

CANDI DATE COMMI TTEES ONLY :

CONSULTANT BREAKDOWN ( S c h e d u l e GA t t a c h e d ? ) YES NO

VALUE OF CAMPAI GNPROPERTY ( F r o m Sc h e d u l e H - A t t a c h Sc h ed u l e H)



P a g e 2 o f _2_

t F nr c r h p t i n 1 p A)

AN1 0 2 0 0 1

1 2 / 1 1 / 0 1 J o h n &Mi c h e l l e Mo r a n

4 Bo u l d e r Rd .

Mas o n C i t y , I A 5 0 4 01 - 2 5 0 3

1 0 0 . 0 0

1 2 / 1 2 / 0 1 J o h n &Ci n d y S a p p

4 6 1 7 B l a r n e y Dr

C e d a r Ra i d s , I A 52411

5 00 . 0 0 ' + )

1 2 / 1 5 / 0 1 K e l l y &R a c h e l l e B a i e r

3110 No r ma n Dr

C e d a r Ra i d s , I A 52411

1 0 0 . 0 0

1 2 / 1 5 / 0 1 E l me r &C h a r l o t t e Ol s e n

670 9 Oa k Gr o v e Rd

Ce d a r Ra i d s , I A 52411

5 0 . 0 0

1 2 / 1 9 / 0 1 S t e v e n & S u z a n n e C a v e s

3149 F a l c o n Dr NE

C e d a r R a p i d s , I A 5 2 4 02

2 5 . 0 0

1 2 / 2 4 / 0 1 Mi c h a e l &Pa u l a Cu f r

29 5 5 De e r Av e SE

C e d a r R a p i d s , I A 52403

2 5 . 0 0

1 2 / 3 1 / 0 1 T i m&N a n c y Da u gh e r t y

2109 Wi n d i n g Wo o d s Dr

L i b e r t y , MO 6 4 0 8 8

S i s t e r - i n - l a w 100 . 0 0

S u b - T o t a l 9 00 . 0 0

T o t a l 2085 . 0 0

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