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COMMI TTEE NAM ( Mu s t b e s ame a s o n a t em n t o f O a n i z L i o n~)LI MPORTANT : I n d i c a t e t y p e o f c o mmi t t e e yo u a r e r e po r t i n g f o r D( I ) 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 PAC ( 3 ) S t a t e P a r t y ( s ) 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 ( f ) 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 t ) S u p p o r t S , o f e s

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Ch 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 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 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 . )

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 lo f a l l mon i e s h e l d by t h e c ommi t t e e . T h i s amou n t MUST be t h es ame a s t h e c a s h o n h a n d a t t h e en 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 Ne d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

CASH ON HAND a t t h e en 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 mus tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

UNPA I D BI L L S ( F r o m Sc h e d u l e D - A t t a c h Sc h e d ul e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $I N KI ND CONTR I BUT I ONS ( F r o m S c he d ul e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $OUTSTANDI NG LOANS ( F r o m Sc h ed u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI TTEES ONLY :CONSULTANT BREAKDOWN ( Sc h ed u l e G A t t a c h e d ? )VALUE OF CAMPAI GN PROPERTY ( F r o m Sc h e d u l e H - A t t a c h Sc h e d u l e H ) $

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SUB- TOTAL . . . . . . $SUBTRACT TOTAL MONEY SPENT THI S PERI ODS c he 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 d u l e B ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c he 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 Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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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

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ADD TOTAL MONEY TAKEN I N THI S PERI ODS c he d ul 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c he d ul e F : L o a n s Re c ei v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c he d ul e H: T o t a l Sa l e s o f Camp a 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 p - O l i e s t o Cand i d a t e s ' Commi t t e e s On I V )

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CONTRI BUTI ONS - MONEYTAI CEN I N-( I n c l u d i n g c a nd i d a t e s v e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t b e t h e s ame a s o n Sh b a ms n t o f O r g a n i z a t i o n )

L a n s i n g f o r H o u s e D i s t r i c t # 4 5

SCHEDULE MONETARYA I u E C E I t v T S( R e v . o t " nCHECK T HI S BOXAMENDI NGFORM

STATE CANDI DATES NOTE : I F A CONTRI BUI ON I S RECEI VEDFROMASTATE PAC ( POL I T I CAL ACTI ON COMMr r TEE) L I ST THEPAC I DENT I F I CAT I ONNUMBERANDTHE PAC CHECKNUMBERI N THEDESI GNATED COLUMN . A L I S T OF I D NUMBER I SAVA I LABLE FROMTHE I OWA ETH I CS ANDCAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se c t i o n 6 8 B. 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 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 rs o l i c i t i n g c o n t r i b u t i o n s o r f o r a n y c o m m e r c i a l p u r 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 mm i t t e e s .

SUB TOTAL $ 7 2 5 . 0 0TOTAL ( i f l a s t p a g e 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 a w r e q u i r e s c a n d i d a t e c o m m 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 ma k i n g a c o n t r i b u t i o n t o t h ec o m m i t t e e . R e l a t i o n s h i p my b e s h o w t o t h e t h i r d dWr o 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 ) ( S e e P a g e 2 o f f o r m s p a c k e t . ) I f S u r n a me o f c o n t r i ' l x r 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 o f a m i l i a lr e l a t i o n s h i p , e n t e r ` S h 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 e o h n u n .P a g e -__o r~( f o r Sc n e d u i s A )

DATERECEI VED( N I I N D D V YR )PI

I D NUMBERa p p i c a U s )PAC CHEUMBER

NAMEANDADDRESS OF CONTRI BUTOR REL ATI ONSWPTOCANDI DATE'

( i f a p p i c a b l e )AMOUNTRECEI VED "

I F FORFUND-RAI SERI NCOMEI D # L a r r y T . W i l s o n8 / 2 4 / 0 1 Ck # 6 1 0 0 3 0 8 K o s e r I o w a C i t y , I A 5 2 2 4 6 $ 5 0 . 0 0 XI D # D a v i d C. B a k i u s8 / 2 4 / 0 1 CK# 5 9 8 3 4 N 7 t h I o w a C i I A 5 2 2 4 5 $ 5 0 . 0 0 XI D # H a r r y R . Wo l f

8 / 2 4 / 0 1 CK# 8 0 9 4 2 N . H i g h C r . NEI o w a C i t y , I A 5 2 2 4 0 $ 5 0 . 0 0 XI D # D a v i d L . R u s t8 / 2 4 / 0 1 CK# 7 2 6 9 9 1 5 E. B l o o m i n g t o n S t .I o w a C i I A 5 2 2 4 5 $ 1 0 0 . 0 0 XI D # M i c h a e l R . H u b e r8 / 2 4 / 0 1 CK# 1 1 2 6 B o x 5 3 0 1 C o r a l v i l l e I A 5 2 2 4 1 $ 1 0 0 . 0 0 XI D # N a n c y Wi l l i a ms8 / 2 4 / 0 1 CK# 2 4 5 0 1 9 2 9 H a f o r I o w a C i I A 5 2 2 4 6 $ 1 0 0 . 0 0 XI D # P a t r i c i a V u n d e r i n k8 / 2 4 1 0 1 CK# 6 0 1 1 5 2 H u n t e r s RunI o w a C i t y , I A 5 2 2 4 6 $ 1 0 0 . 0 0 XI D # R . E . M y e r s8 / 2 4 / 0 1 CK# 3 1 4 7 9 Wo o d l a n d H e i g h t sI o w a C i t y , I A 5 2 2 4 0 $ 1 0 0 . 0 0 XI D # M a r y Neu8 / 2 4 / 0 1 CK# 3 6 2 9 2 1 2 F e r s o n I o w a C i t y , I A 5 2 2 4 6 $ 3 5 . 0 0 XI D # M a r g a r e t P . Wi n e g a r d e n8 / 2 4 / 0 1 CK# 9 3 7 6 2 6 K e n s i n g t o n C t .I o w a C i t y , I A 5 2 2 4 5 $ 4 0 . 0 0 XI D #

CK#

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FOR I NSTRUCT I ONS , SEE . BACK OF FORM

CONTRI BUTI ONS - MONEYTAI MN 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 TT EE NAME ( Mu a b e t h e t wo a s a n St demt o f O r p a d z a t i o n )L e n s i n g f o r H o u s e D i s t r i c t # 4 5

SCHEDULE MONETARYA RFCE : P r S( R e v . 0 6 / 9 7 )CHECK T HI S BOX I FAMENDI NG FORM

STATECANDI DATESNOTE : I F A CONTRI BUI ON I S RBCENEDFROMA STATE PAC ( POL I TTCAL ACTI ONCOMMI TTE E) L I ST THEPAC I DENT I F I CAT I ON NUMBERANDTHEPAC CHECKNUMBER I NTHEDES I GNATEDCOLUMN . A L I ST OF I D NUMBER I SAVA I L AB L E FROMTHE I OWA ETHI CS ANDCAMPAI GNDI SCLOSUREBOARD.CAUTI ON: S e c t i o n 6 8 B . 3 2 Af 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 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 rs o l i c i t i n g c o n t r i b u t i o n s o r f o r a n y c o m me r c i a l p u r 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 mm i t t e e s .

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 )SUB TOTALI $ 4 0 0 . 0 0 I -

* 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 m m 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 ma 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 my b e s h o w 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 ) ( S e e Pa g e 2 o f f o r m s p a c k e t . ) I f Su 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 u t t h e r e i s n o f a m i l i a lr 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 e o l mu n . P a g e - 3 - o f A_( f o r S c h e d u l e A )

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DAT E' RE CE I VE D FUND-( MMI D D / Y R ) ANDPAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

I D # Mi c h a e l J . L e n s i n g4 1 1 E . F a i r c h i l d8 / 2 4 / 0 1 CK# 5 7 5 4 I o w a C i t y , I A 5 2 2 4 5 E x - h u s b a n d $ 5 0 . 0 0 XI D # C a r r i e Z . N o r t o n9 2 0 G i n t e r8 / 2 4 / 0 1 CK# 6 3 0 1 I o w a C ' I A 5 2 2 4 0 $ 5 0 . 0 0 XI D # T h oma s A. J e p s o n1 0 0 3 9 t h8 / 2 4 / 0 1 CK# 8 0 8 1 K a l o n a I A 5 2 2 4 7 $ 5 0 . 0 0 XI D # J o h n A G r o s s4 B r i c k w o o d K n o l l8 / 2 4 / 0 1 CK# 2 5 6 2 I o w a C i t y , I A 5 2 2 4 0 $ 5 0 . 0 0 XI D # Ed wi n J Z a s t r o w9 S . Mt . V e r n o n D r i v e8 / 2 4 / 0 1 CK# 4 2 8 4 I o w a C i t y , I A 5 2 2 4 5 $ 5 0 . 0 0 XI D # R o b e r t E D v o r s k y4 1 2 6 t h S t r e e t8 / 2 4 / 0 1 CK# 2 2 0 0 C o r a l v i l l e I A 5 2 2 4 1 $ 2 5 . 0 0 XI D # A Ros s Wi l b um1 9 1 7 T a y l o r D r i v e8 / 2 4 / 0 1 CK# 3 4 9 5 I o w a C i t y , I A 5 2 2 4 0 $ 2 5 . 0 0 XD # T h oma s H B a l d r i d g e9 1 5 O a k c r e s t S t No . 1 68 / 2 4 / 0 1 CK# 4 8 9 3 I o w a C i t y , I A 5 2 2 4 6 $ 2 5 . 0 0 XI D # V i c t o r i a L T h i e d e9 5 8 We s t s i d e D r i v e

8 / 2 4 / 0 1 CK# 3 5 6 7 I o w a C i t y , I A 5 2 2 4 6 $ 2 5 . 0 0 XI D # Veme K e l l e y3 7 6 Ko s e r Av e n u e8 / 2 4 / 0 1 CK# 4 1 5 1 I o w a C i t y , I A 5 2 2 4 6 $ 2 5 . 0 0 XI D# Ma r y Ma s h e r4 0 Gr y n C o u r t8 / 2 4 / 0 1 CK# 9 9 8 8 I o w a C i t y , I A 5 2 2 4 6 $ 2 5 . 0 0 X

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FOR I N STRUCT I ONS, SEE . B ACK OF FORMCONTRI BUI TONS - MONEY T AI { EN 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 TTEENAME ( Mu s t b e t h e same a s o n S t a t e me n t o f 5 Ft i z a t b n )L en s i n g f o r Ho u s e D i s t r i c t # 4 6

SCHEDULE MONETARYA( RA V .0M

CHECKT HI S BOXI FAMENDI NGFORM

STATE CANDI DATES NOTE: I FACONTRI BUTON I S RECEI VED FROMASTATEPAC ( POL I T I CA L ACTI ON COMMI TTEE) L I S T THEPAC I DENTI FI CATI ONNUMBER ANDTHEPACCHECKNUMBER I N THEDESI GNATED COL UMN . AL I S T OF I D NUMBER I SAVAI LABLE FROMTHE I OWA ETHI CSANDCAMPAI GN DI SCLOSURE BOARD.C AU T I ON : S e c t i o n 6 8 &3 2 A ( 6 ~ I o w a 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 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 rs o l i c i t i n g c o n t r i b u t i o n s o r f o r a n y c o mm e r c i a l p u r 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 mm i t t e e s .

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 )' 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 eo a mm i t t e e . R e l a t i o n s h i p my b e s h o w 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 ) ( S e e P a g e 2 o f f o r m s p a c k e t . ) I f S u r n a m e 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 u t t h e r e i s n o f 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 m u n . Page 3 - _ o f 4 1 _( f o r S C h e d u f " A )

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RE L A T I ON SHI P AMOUNT I F FORRE C E I V E D ( i f a p p l i c a b l e ) TO CANDI D ATE ' RECE I VED FUND-( MN I DDI YR) AND PAC CHECK ( i f a p p l i c a b l e ) RA I S E RNUMBER I NCOME

I D # J o s e p h L . B o l k c o m7 2 8 2 n d A v e n u e8 / 2 4 / 0 1 CK # 2 5 9 9 I o w a C I A 5 2 2 4 5 $ 2 5 . 0 0 XI D # H a r r y L . Se e l ma n2 4 5 1 I WV Rd . SW8 / 2 4 / 0 1 CK # 9 8 3 2 O x f o r d I A 5 2 3 2 2 $ 1 0 . 0 0 XI D # D o r o t h y M. P a u l6 0 8 L a r c h L a n e8 / 2 4 / 0 1 CK # 8 5 3 2 I o w a C i t y , I A 5 2 2 4 5 $ 1 5 . 0 0 XI D # D e b o r a h G i l l8 0 8 - 8 t h A v e n u e8 1 2 4 / 0 1 CK# 1 1 3 9 9 C o r a l v i l l e I A 5 2 2 4 1 $ 2 0 . 0 0 XI D # D a v i d P . R e d l a w s k2 6 G a l l u p P l a c e8 / 2 4 / 0 1 CK# 9 7 3 2 I o w a C i t y , I A 5 2 2 4 6 $ 2 0 . 0 0 XI D #

J o a n H u n t l e y1 5 0 1 We s t v i e w8 / 2 4 / 0 1 CK# 6 8 2 1 C o r a l v i l l e I A 5 2 2 4 1 $ 2 0 . 0 0 X

I D # S a l l y S t u t s m a n3 7 1 4 - 5 0 0 t h S t SW8 / 2 4 / 0 1 CK# 1 5 7 4 5 R i v e r s i d e I A 5 2 3 2 7 $ 2 5 . 0 0 XI D # P . A . C a n c i l l a2 2 5 7 S u g a r B o t t o m Road NE8 / 2 4 / 0 1 CK# 6 6 9 1 S o l o n I A 5 2 3 3 3 $ 2 5 . 0 0 XI D # Ro d S u l l i v a n2 3 2 6 E . C o u r t S t r e e t8 / 2 4 / 0 1 CK# c a s h I o w a C i t y , I A 5 2 2 4 5 $ 4 0 . 0 0 XI D #

Mi k e P a r t r i d g e1 2 2 0 V i l l a g e R o a d , A p t 98 / 2 4 / 0 1 CK# c a s h I o w a C i t y , I A 5 2 2 4 0 $ 2 0 . 0 0 XI D # J o Mc C a r t y5 3 6 S Summi t S t r e e t8 / 2 4 / 0 1 CK# c a s h I o w a C i t y , I A 5 2 2 4 0 $ 2 0 . 0 0 X

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FOR I NSTRUCT I ONS, SEE - BACK OF FORM

CONTRI BUTI ONS - MONEYTAIMI 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 t h e s ame a s o n S t a t e me n t aOr g a t c a d o n )

L en s i n g f o r Hous e Di s t r i c t #45

SCHEDULE MONETARYA RECEI PTS( t - . o s "

CHECK T HI S BOX I FAMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUTON I S RECEI VED FROMA STATE PAC ( P OL I T I CAL ACT I ON COMMI TTEE ) L I ST THEPAC I DENT I F I CA TI ON NUMBERAND THEPACCHECKNUMBER I N THE DESI GNATED COLUMN . A L I ST OF I D NUMBER I SAVA I L A BLE FROMTHE I OWA ETH I CS AND CAMPAI GN D I SCLOSURE BOARD .CAUTI ON: S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa C o d e , p r o l u 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 rs o l i c i t i n g c o n t r i b u t i o n s o r f o r a n y c o m m e r c i a l p u r 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 mm i t t e e s .

SUBTOTAL $ 5 0 7 . 7 0h i s s c h e d u l e ) ? 7 e ' 0 0TOTAL ( i f l a s t p a g e o f t

' 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 ma k i n g a c o n t r i b u t i o n t o t h ec o m m i t t e e . R e l a t i o n s h i p my b e s h o w 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 ) ( S e e P a g e 2 o f f o r m s p a d c e t . ) I f Su r n ame o f c o n t h i 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 o f a m i l i a lr 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 mu n . P a g e 1 4 o f z 4( f o r Sc h e d u l e A )

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT I F FORRECEI VED ( i f~~) TO CAND I DATE ' RECE I VED FUND-( MMI DDI YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

C h a r l i e E a r l h a mI D # 1 1 5 2 E C o u r t8 / 2 4 / 0 1 CK# c a s h I o w a C i t y , I A 5 2 2 4 0 $ 2 0 . 0 0 X

I D #8 1 2 4 / 0 1 CK# c a s h V a r i o u s - l e s s t h a n $ 2 5 . 0 0 e a c h $ 1 4 5 . 0 0 XD a v i d R . U l r i c kI D # 5 1 4 T e r r a c e R o a d9 / 1 4 / 0 1 CK# 1 0 1 6 I o w a C i t y , I A 5 2 2 4 5 $ 4 0 . 0 0C h a r l e s A . S k a u g s t a dI D # 5 2 4 W P a r k R o a d9 / 1 4 / 0 1 CK# 8 0 4 3 I o w a C i t y , I A 5 2 2 4 6 $ 1 0 0 . 0 0I o w a C o m m i t t e e o f A u t o m o t i v e R e t a i l e r sI D # 6 0 5 9 1 1 1 1 O f f i c e P a r k R o a d1 0 / 2 4 / 0 1 CK# 2 1 6 0 Wes t D e s Mo i n e s I A 5 0 2 6 5 $ 1 0 0 . 0 0T e d T o w n s e n dI D # 2 4 2 5 H u b b e l l1 2 1 7 / 0 1 CK# 7 0 9 8 D e s Mo i n e s I A 5 0 3 1 7 $ 1 0 0 . 0 0

D #8 / 0 1 , 1 0 / 0 11 1 / 0 1 , 1 2 / 0 1 CK# I n t e r e s t $ 2 . 7 0I D#CK#I D #CK#I D#CK#

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T HI S BOX APP L I E S TO CANDI DATES ' COMMI TT EES ONL Y :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 pe 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 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 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 5 6 . 6 ( 3 ) ( 1 ) . )

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

FOR I NSTRUCTI ONS, SEE BACK OF r ' M SCHEDULEEXPENDI TURES B MONETARY- - MONEY SPENT FROM COMMI TT EE ACCOUNT ( R e v 0 9 / 9 7 ) EXPENDI TURES

STATE PAC COMMI TT EES : 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 E NT I F I C A T I O N NUMBER I N THE DESI GNATED COLUMN AND THE OCHECK THI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I OWA AMENDI NG FORME T H I C S & CAMPAI GN DI SCLOSURE BOARDCOMMI TTEE NAME ( M u s t b e s am e 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 )

k e' AS 1 ~4 - t c ( ~ e N14 I c f " , -CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( M M / D D/ Y R ) AND PACCHECKNUMBER

I D#

CK# C) S y e t v - ~~ e . $ 06I D# ,I I ~C 1 y o c 7CK#G S , ~0 L ~wa C r 1 Zz oI D# r sI ~ C t f CK# 1 ) U5 ; S 9, 1 p ~~I D# I FYr 5~ 3

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FOR I NSTRUCT I ONS, SEE BACK OF FORMCOMMI TTEENAM( Mu s t be same a s o n St a t o f Or g" r a b on) ~~ e r n -

SUB- TOTAL

TOTAL ( i f l o s tp a g e o f t h i s

s c h ed u l e )

' Di s c l os ur e l a w r e q ui r es c a nd i d at e s t o d i s c l os 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 ma k i n g a n i n k i n d c o n t r i b u t i o n t o t h ec o mmi t t e e Re l a t i o ns h i p mu s t b e shown t o t h e t h i r d d e gr e e o f c o ns a ng ui n i t y ( b l oo d r e l a t i v e s ) and a f f i n i t y ( r e l a t i v e sby ma r r i a ge ) . _ ( S ee Page 2 o f f o r ms p a c k e t . ) i f sur name o f c o n t r i b u t o r i s t h e s ame a s c a nd i d a t e , b u t t h e r e i s nof a m i l i a l r e l a t i o n s h i p , e nt e r ' n o t a pp l i c a bl e ' i n t h e r e l a t i o n s h i p c o l u mn .

SCHEDULEE I N KI NDRev . A 6/ 9 7 CONTRI BUTI ONS

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