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8/7/2019 Halferty Maggie__1601__scanned

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FOR I NSTRUCT I ONS, S EE B A CK OF F ORMDI SCL OSURE S UMMARY PAGE

COMMI T T EE NA ME ( Mu 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 )

I MPORTANT : I n d i c a t e b y # t y p e o f c o mmi t t e e y o u 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 / J u d g e S t a n d i n g f o r R e t e n t i o n C a n d i d a t e ( 2 ) S t a t e PAC ( 3 ) S t a t e P a r t y( 4 ) C o u n t y C e n t r a l C o mm i t t e e ( 5 ) C o u n t y C a n d i d a t e ( 6 ) C i t y C a n d i d a t e ( 7 ) S c h o o l B o a r d o r O t h e r P o l i t i c a lS u b d i v i s i o n C a n d i d a t e ( 8 ) C o u n t y PAC ( 9 ) C i t y PA C ( 1 0 ) S c h o o l B o a r d o r O t h e r P o l i t i c a l S u b d i v i s i o n PAC( 1 1 ) L o c a l B a l l o t I s s u eCANDI DATE COMMI TT EES ONLY:C a n d i d a t e Na me , , P o l i t i c a l P a r t y ( i f a p p l i c a b l e )

O f f i c e S o u g h t

L a t e r e p o r t s a r e s u b j e c t t o p o s s i b l e c i v i l a n d c r i m i n a l p e n a l t i e s . P u r s u a n t t o I o w a Code s e c t i o n 6 8 8 . 3 2 A ( 7 ) t h e c a n d i d a t e , f o r a c a n d i d a t e ' s c o m m i t t e e ,a n d t h e c h a i r p e r s o n , f o r a n y o t h e r t y p e o f c o mm i t t e e , i s t h e i n d i v i d u a l r e s p o n s i b l e f o r f i l i n g t i me l y a n d a c c u r a t e r e p o r t s .

S I GNATU O PERSON F I L I , REPO

I AM F I L I NG A 2 - C` ~ DL, /( r e p o r t d a t e )

QCHEC K I F AMENDMENT T O REPORT DATEDCh 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 DR- 3 i s f i l e d . )

F ORMDR- 2 DI SCLOSURE( Re v . 1 2 1 2 0 0 5 ) REPORTF o r O f f i c e Us e O n l yCo mm . # ~ ~L o g g e d I r L 1 l \ 1S c a n n e dC o mp u t e rA u d i t e d

3 2 -T EL EPHONE DATE S I GNED

REPORT FOR ( 1 ) ELECT I ON / ( 2 ) NON- EL ECT I ON YEAR.I n d i c a t e b y #0

ST AT EMENT OF CASH ON HANDCASH 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 o t a l o f a l l f u n d s h e l d b y t h ec o mmi t t e e . T h i s amou n t MUS T 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 must 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 T HI S PERI ODS c 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 du 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 ul 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 c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e H : T o t a l S a l e s o f Camp a i g n P r o p e r t y ( A t t a c h S c h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h ed u l e H a p p l i e s t o Ca n d i d a t e s ' Co mmi t t e e s O n l y )SUB- TOTAL . . . . . . . . . . . . . $

SUBTRACT TOTAL MONEY SPENT T HI S PERI ODSc h 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 e du 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 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 h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON 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 a l a n c e mu s tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

* " UNPAI D B I L L S ( F r o m Sc h e du l e D - A t t a c h Sc h e du l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* I N K I ND CONTRI BUT I ONS ( F r o m S c h e d u l e E - A t t a c h Sc h e du l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* * OUTSTANDI NG L OANS ( F r o m S c h e d u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CONSULT ANT BRE AK DOWN ( S c h e d u l e G A t t a c h e d ? ) -YES -NOCANDI DATE COMMI TT EES ONLY :VALUE OF CAMPAI GN PROPERT Y ( F r o m S c h e d u l e H- A t t a ch Sc h e du l e H )STATE COMMI T T EES : S u b mi t a r e c o n c i l e d c a mp a i g n a c c o u n t b a n k s t a t e m e n t i n J a n u a r y o f e a c h y e a r .

L o c a l C o m m i t t e e s , e n t e r D a t e o f E l e c t i o n

C 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

' . b

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Fo r I n s t r u c t i o n s , Se e Ba c k o f F o r mCONTRI 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 )

STATE CANDI DA TES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PA C ( P OL I T I C A L ACT I ON C OMMI T T E E ) , L I S T T HE P AC I D EN T I F I C A T I O NNUMBER AND T HE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A V AI L A B L E FROM THE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD .CA U T I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Co d e, p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s an d s t a t e m e n t 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 rf o r an y commer c i a l p u r p o s e b y a ny p er 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 ommi t t e e s .

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

D i s c l o s ur e l a w r e q u i r e s c a n d i d a t e c o mm i 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 m a k i n g a c o n t r i b u t i o n t o t h ec o mm i t t e e . R e l a t i o n s h i p m u s 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 o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) . I f s u r n ame 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 Page / o ff a m i l i a l 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 u mn . ( f o r S c h e d u l e A )

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECE I P TS0 CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTR I BUTOR RE LAT I ONSH I P AMOUNT J I F FORRECE I VED ( i f a p p l i c a b l e ) T O CANDI DATE ' R E CE I V E D FUND-( MM/ DD/ Y R) AND PAC CHECK ( i f a p p l i c a b l e ) RA I SERNUMBER I NCOME

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7~y~CDS . CK#/ ~55 s . c . y/ ~ stmPf. T i p 5 i n2! - 3E; yI D# , ( f i r c r r y ~ . TOt s y r x s G r l ~ l a < i r /CK# / o r s . 5 5. , = E : / /,,I D# E l l c ' r t i ~ ~ r r r P . - - , f i r -l rh / Zvw5 CK# 1 , 2 go 1 2 - 5 , 7 0 0I D#

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Fo r I n s t r u c t i on s , Se e Back o f Fo r mCONTRI BUTI ONS - - MONEYTAKEN 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 S t a t e me n t o f O r g a n i z a t i o n )

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PAC ( P O L I T I C A L ACTI ON C OMMI T T E E ) , L I S T THE PAC I D EN T I F I C A T I ONNUMBER AND THE PAC CHECK NUMBER I N T HE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I OWA E T H I C S AND CAMPAI GNDI SCLOSURE BOARD .CAU T I ON : S e c t 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 m a 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 m e n t 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 rf o r a n y c o mme r c i a l p u r p o s e by a ny 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 .

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

* D i 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 es 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 ma l d n g a c o n t r i b u t i o n t o t h ec o mmi t t e e. R e l a t i o n s h i p mus t b e s h ow 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 o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b ym a r r i a g e ) I f s u r n a me o f c o n t r i b u t o r i s t h e s a m e a s c a n d i d a t e , b ut t h e r e i s n of a m i l i a l 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 u mn . ( f o r S c he d u l e A)

SCHEDULEA MONETARY( Re v . 0 7 1 0 3 ) RECEI PTS

CHECKT HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTR I BUTOR RELAT I ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-( MM/ DD/ Y R) A ND P AC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

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I C ZG D CK# 3 o S / _ / O NE / YCi z e t e i ( r . l 25 UC), z A - /I D# / l 1 % , e z % / J 2 QZ , ~Gl ~ c i ~I D#

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Fo r I n s t r u c t i on s , S e e Back o f Fo r mCONTRI BUTI ONS - - MONEYTAKEN 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 on S t a t e me n t o f O r g a n i z a t i o n )

i i iSTATE CAND I DATES NOTE : I F A CONTRI BUT I ON I S R E CE I V E D FROM A STATE PAC ( P O L I T I C A L ACTI ON C OMMI T T E E ) , L I S T THE PAC I D EN T I F I C A T I ONNUMBER AND THE PA C CHECK NUMBER I N T HE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I O WA E T H I C S AND CAMPAI GNDI SCLOSURE BOARD.CAU T I ON : S e c t 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 m a 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 m e n t 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 rf o r a ny c o mme r c i a l p ur p o s e b y a n 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 .

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

' D i 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 mm i 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 m a k i n g a c o n t r i b u t i o n t o t h ec o mm i t t e e . R e l a t i o n s h i p m u s 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 o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b ym a r r i a g e ) I f s u r n a me o r c o n t r i b u t o r i s t h e s a me a s c a n d i d a t e , b u t t h e r e i s n of a m i l i a l 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 u mn . ( f o r S c h e d u l e A )

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECEI PTSa CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTR I B UTOR REL AT I ONSH I P AMOUNT V I F FORRECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MM/ DDi YR ) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME-/ j J " ~ Gl ~CCC~i ~

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( 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 TTEENAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g a n i z a t i o n)

STATECANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROMASTATE PAC ( P OL I T I CA L ACT I ON COMMI TTEE) , L I S T THEPAC I DENTI F I CATI ONNUMBER ANDTHE PAC CHECKNUMBER I N THE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68B . 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 and s t a t e me n t 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 rf o r an y c o mme r c i a l p u r p o s e b y an y p e r s o n ot h er t h an 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 .

TOTAL ( i f l a s t page o f t h i s s c h e d u l e )* D i s c l o s u r e l aw r e q u i r e s c a n d i d a t e c ommi 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 an y r e l a t i v e ma l d n g a c o n t r i b u t i o n t o t h ec o mmi t t e e R e l a t i o n s h i p mus t be s hown 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 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 byma r r i a g e ) . I f s u r n a me 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 ut t h e r e i s n of a mi l i a l 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 u mn .

SUB- TOTAL

Page 4 Of( f o r Sc h e d u l e A)

SCHEDULEA MONETARY

( Re v 0 7 / 0 3 ) RECEI PTSQ CHECK T HI S BOX I FAMENDI NGFORM

DATE PACI D NUMBER NAME AND ADDRESSOF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE* RECEI VED FUND-( MM/ DD/ YR) ANDPAC CHECK ( i f a p p l i c a b l e ) RAI S ER

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l L 7e ~ . o~~20 2 ' 1 Lo 8l 1I D#10 1 / 6 / 0 5 CK# 3 2 y 6 / D1C / - 7 f E" c r a m ' r = t -Cl ~`

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6/11

Fo r I n s t r u c t i o ns , See Back o f Fo r mCONTRI BUTI ONS- - MONEYTAKENI 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 TTEENAME( Mu s t b e s ame a s o n S t a t e me n t o f Or g a ni z a t i o n)

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I CA L ACTI ON COMMI TTEE) , L I S T THE PAC I DENTI F I CATI ONNUMBER AND THE PACCHECKNUMBER I N THEDESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHEI OWA ETHI CS AND CAMPAI GNDI SCL OSURE BOARD .CAUTI ON : Se c t i o n 68B. 3 2 A ( 6 ) , I o wa Code, p r o h i b i t s t h e us 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 an 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 rf o r an y c o mme r c i a l p u r p o s e by an y p e r s o n ot 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 ommi t t e e s .

SUB- TOTALTOTAL ( i f l as t page o f t h i s s c h e du l e )

` D i 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 commi t t ees 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 any 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 ec ommi t t e e . R e l a t i o n s h i p must be shown 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 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 yma r r i a g e ) . I f s u r n ame o f c o n t r i b u t o r i s t h e same a s c a n d i d a t e , b u t t h er e i s n of a mi l i a l 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 co l umn . ( f o r Sc h e d ul e A)Page ` -

5~ o f

SCHEDULEA MONETARY( Re v . 0 7 / 0 3 ) RECEI PTS

CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESSOF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE" RECEI VED FUND-( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# ' ~t

PI 1 471 CS CK# Z c / 3Jr 727 A/ , AV' Z' r " 1 1 ' C J _ Dv, Ce- ' - z -W. S o e ~ z / - w 2 ~I D# ~7er l e G- Gt ~c~b4 ' / 1/l l 1 3 c ' l , ) 5 CK# 5 ' L G - f i t . - r r c c . v r ~~D~~ J r r , r z . 1 , 4I D# ~~Cne

t l l i v k 5 CK# / / / 3I D# Ch~2 c' , ~ t TP/ 7 L c zr So~7

' ~~J1J / 75 M", o r b ' . ,CK# o 2 e y ZZ l V LVc / i e4 , 2 5 l r e c r d C- f ,Cj ~ ~ / CSC75 y l Cedar / + ' , E' s - , rq , 3 z ~ / c 7 2 - - Z~ i 1I D# CDCI I ~y ' / ~ ~r k7 ~Q' L 7

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7/11

F o r I n s t r u c t i on s , Se e Back o f Fo r mCONTRI BUTI ONS - - MONEYTAKEN 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 e me n t o f Or g a n i z a t i o n )

t a i - 11 ' z e n~ A)' , . / / o t / l e . - -JSTATECANDI DATES NOTE : I F A C ON T RI B UT I O N I S R ECEI VED FROMA S TATE PA C ( P OL I T I C A L A CT I ON COMMI TTEE) , L I S T TH E PAC I DE NT I F I CA T I ONNUMBER ANDTHE PACCHECKNUMBER I N THEDESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A VA I L A BL E FROMT HE I O WA E T HI CS AND CAMPAI GND I S CLO S URE BOARDCAUTI ON : Se c t i o n 68B. 3 2 A ( 6 ) , I o wa C o d e , p r o h i b i t s t h e u s e o f i n f o r mat i on c o p i e d f r o m r e p o r t s and s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o n s o rf o r any c o mme r c i a l p u r p o s e b y any p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e es .

SUB- TOTALTOTAL ( i f l as t page o f t h i s s c h e du l e )

' D i s c l o s u r e l aw r e q u i r e s c a n d i d a t e c o mmi t t e es 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 ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p mu s t be 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 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 yma r r i a g e ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s a me a s c a n d i d a t e , b u t t h e r e i s n of a mi l i a l 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 u mn ( f o r Sc h e du l e A)P a g e4O-o f

SCHEDULEA MONETARY( Re v . 0 7 / 0 3 ) RECEI PTSQCHECK T HI S BOX I F

AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESSOF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE" RECEI VED FUND-( MM/ D D/ Y R) AND PAC CHECK ( i f a p p l i c a b l e ) R AI S ERNUMBER I NCOMEI D#

l D l 7 ~ a J r CK# 33 t : ~ 3 - ~ , ~t l . Tj h 6e r r z Q ~ r %v ~ " ODf a 8 1r . 4 n . , ~ zA 5vv2i - - s ' Yi iI D# . ~ J GZ r ~ f~1. 3 ~~5 CK#~y 5 L ~ / y ~ N ~ ~ C ~ z s l ~ f t ~ . - t ~ 4ur f l l ~ C t " o ~ >. _ - v s a_ r r - v &/ y

I D# j / E , ~1 , ~ 1 h , BCl r f ~ 22 . Ss~ r / a 5 1 a 5 CK# Di Gx k %- J : 4 52$ aiI D# , l ~ Gs u 9 / h l e 2 ~e , y e eee&. h72 / VL

J ' W 5_4 > 0 2 - 1I D# 4 2 , 9 4 e , - ' f - r a - J e - c - e e / 77 ~ Z ~ 1 0 , 5 CK# 7 2 - N, E , ~ r V" A A / a v r ' r ~

e I Z . L - TA . J ~ e _ , 0 1I D#7 11 5 l v 5 CK# l e e 1 0 0

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I D# 7 ~ r r r 9 ~ ~ e C ~ ~ ~ z n ~7 1 Z 3 1 0 5 CK# Zz3 St el es ~ t ' r , ~ ~' vE Gz VI D# ! 1 ? a i z ; , Tui i r aa~exe, - ,

~ J o%7v ; ~ on I - 3~ / - A/ 4' 7/ ZI DOl t ~b/ / a 5` CK# / 00s_/ Wo " f z" 60 / ~


8/11


( 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 on S t a t e me n t o f O r g a n i z a t i o n )

Z- / ?S l , ~PrSTATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S REC E I V E D FROM A STATE PAC ( P O L I T I C A L AC T I ON C OMMI T T E E ) , L I S T THE PA C I D EN T I F I C AT I ONNUMBER AND THE PA C CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD.CAU T I ON : S e c t 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 m a 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 m e n t 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 rf o r a ny 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 .

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 )

D i 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 mm i 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 m a k i n g a c o n t r i b u t i o n t o t h ec o mm i t t e e . R e l a t i o n s h i p m u s 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 o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) . I f s u r n ame 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 Page 7 o ff a m i l i a l 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 u m n . ( f o r S c h e d u l e A )

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECEI PTS0 CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTR I BUTOR RELAT I ONSH I P AMOUNT V I F FORRECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE" RECE I VED FUND-( MM/ DD/ YR ) A ND P AC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# QGnP~~

1 0 1 1 6 1 4 1 5 CK# I ZZS ZlI D#

l a 1 Z P l o 5 CK#&, 5 - . f / A t / c e ' y " " a " " " , e r i r -, ~DZ3 - S c ~ Z ! 1I D # i om ~ v ~ t s> / ~ 5 1 0 5 c K# 7c ~ 5 N ~ ~ - , ~ e a Y e = , r ' ~ ' ~ 2 5 D, o d7 2 3 /I D# S f c ' v ~~ E,u I Qj _ . S ~ L c ~CK# ' Vo / 2 1 4 - - Y 56 - 410s p a X2 3 /I D# T i r ' n ~n 3 ' - 7 , v 7

I D # , v l r V e Pb 6 7 u t / 1 e Sl 0 1 l 5 / e rr CK# 7 2 5 / I t / . W 29V 5 1 - , l e e l 10D" ~ a i /- 7 - 4 , 5 " 7 0 1 4 ' - : F e Z/I D # T a W 1 9 1

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y t ' ~ r d y5 CK# j 3 Y 7 i v I b ' / + , ' k l r y 1 y - s ~ - - l Zc p~3 ~OC v ~ . i - l ~ r r / OC. D~ vC ~ i ~ r r r w - ~r f z 5a l - ca57

I D#l v / . S l o g I / Y ; rJf Y c - m~~ t A- , r G Y l z ~ i - - i i i - , /CK#

I D# . 3 r i y ~J Nc : / J i J / l s fCK#


9/11


( 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 as on S t a t e me n t o f O r g a n i z a t i o n )

f i Z~>nS JVrSTATE CAND I DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROM A S T AT E PA C ( P O L I T I C A L ACTI ON C OMMI T T E E ) , L I S T T HE PA C I D EN T I F I C A T I ONNUMBER AND T HE PA C CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A V AI L A B L E FROM THE I OWA E T H I C S AND CAMPAI GNDI SCLOSURE BOARD .CAU T I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa Co d e , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s an d s t a t e m e n t 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 rf o r an y c o mme 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 .

SUB- TOTAL ~D. CdM~~CTOTAL ( i f l a s t p a g e o f t h i s s c h e du l e )D i 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 mm i 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 m a k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p mu s t b e s h o wn 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 o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b ym a r r i a g e ) . I f s u r n ame 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 Page o ff a m i l i a l 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 u mn . ( f o r S c h e d u l e A)

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECEI P T SCHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAMEANDADDRESS OF CONTR I BUTOR RELA T I ONSHI P AMOUNT V I F FORRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE ' R EC EI V E D FUND-( MM/ DD/ YR ) AND PAC CHECK ( i f a p p l i c a b l e ) R AI S ERNUMBER I NCOMEI D#

y ~l 5/ 05 CK # t Sh P3/ ' 7 A- 4 / , v c t , C' ~ c ~o~ Dr , AI Ms - -noz~CK# / ~/ DO l LoS~ f i ' " CGi K 1 ~ ~ " - Sz 1 . p l J a70 Z 5 '

/ J l wl o S CK# 3Y2z ~ l S r / ' ~ S r ~ - r n e , < ~ i ~ >~ / ' l v ~ o~. 5 " 7 0 3 ~ek I s L 4r t c ~ . z -G ( 0 1 20 /I D# Y~e / 1 r ~ r r l a r ~ Vl ~ / z L~ / v S CK#~ ww i - s 7 ' ~ r I c e , 4 1 d~Fn s4 many1I D# 37 l CK# ; ~~; i ' r 3 ` 1 5 t i X/ m o t e l ?I D# 9 ' . . ~Dy l eCK# 1 1 2y / 3 5 - / % 4 1 / c i ? ~ 1 .s l r l , i 1 . 1 i a 5 ' v v 2 / S j S ~ r a . ~ dI D# L r r ' f f f . L k P ~ -b 1CK# ~c~Dl / v , l v i 7 ~ ~ r , - ' 1 ~K' Oc >

1 rr l ~ u = . I / 1 ~ 7 J U ~ 1 - >

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3~Z6 . ~n r ~ , r i r - 5z w" ? / - y a/ d~I D# , ( ' o r j / " , K / f l l ~P/

/ / / x / 01 AV 73 l oo' CI OCK# ~~. ~A ~` I J p, Z3


10/11

T HI S BOX APPL I ES TO CANDI DATES' COMMI TTEES ONLY :P u 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 $ 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 mu 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 r t oS 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 6 8 A. 4 0 2 ( 3 ) ( i ) . )

Page o f

( f o r S c h e d u l e B )

FOR I NSTRUCT I ONS , SEE BACK OF FORM Re se t F ' SCHEDULEEXPENDI TURES B MONET ARY- - MONEY SPENT FROM COMMI TTEE ACCOUNT ( R e v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E GI S L AT I V ECANDI DATES, L I S T THE CANDI DATE I D E NT I F I C A T I O N NUMBER I N T HE DESI GNATED COLUMN AND T HE D CHECK T HI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NG FORMETHI 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 )

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11/11

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

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E GI S L AT I V ECANDI DATES, L I S T THE CANDI DATE I D EN T I F I C A T I 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

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

SCHEDULEB MONETARY( R e v . 0 7 / 0 3 ) I EXPENDI TURESCHECK THI S BOX I FAMENDI NG FORM

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 )

CANDI DATE NAME AND ADDRESS TOWHOM PURPOSEDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON)EXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADE( MM/ DD/ YR) AND PACCHECKNUMBER

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5 , ; 1 q , 2 5 , 0&THI S BOX APPL I ES TO CANDI DATES' COMMI TTEES ONLY: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 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 ns 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 , m a n 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 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 mm i t t e e . ( R e f e r t oS 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 Code 6 a A . 4 0 2 ( 3 ) ( i ) . )

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