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8/7/2019 Nemecek Emma__1618__scanned

1/11

S I G , TURE OF PERSON F I ~ A I G REPORT

AM F I L I N G A

FOR I NSTRUCTI ONS, SE E BACK OF FORMDI SCLOSURE SUMMARY PAGE

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 )C i t i z e n s f o r Emma A . Ne r n e c e kI 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 mmi 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 rP o l i t i c a l S 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 PAC ( 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 lS 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 TTEES ONLY :C a n d i d a t e NameEmma A Nemec e k

O f f i c e So u g h tS t a t e Re p r e s e n t a t i v e

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 )Re p u bl i c a n

D i s t r i c t ( i f Se n a t e o r H o u s e )H o u s e 2 9 t h

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 mi 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 Co d e s e c t i o n 6 8 B . 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 mmi 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 mmi t t e e , i s t h ei 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

( r e p o r t d a t e )[ Z ] CHECK I F AMENDMENT TO REPORT DATED 0 5 / 0 9 / 0 6

0 Che 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( Y o u mu s 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 DR- 3 i s f i l e d . )

Re s e t F a r m

TELEPHONE DATE SI GNED

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

FORMDR- 2 DI SCLOSURE( R e v 1 2 / 2 0 0 5 ) REPORTF o r Of f i c e Us e On l yComm. #L o gg e dl n - - - - - - - - - - - - - - - - - - - - - -ScannedComp u t e r _ _ _ _ _ _ _A u d i t e d - O 6 ,- -

F i l e w i t h :I o w a E t h i c s a n d Campa i g nD i s c l o s u r e B o a r d5 1 0 E . 1 2 ` " , S t e . 1 ADes Mo i n e s , I o w a 5 0 3 1 9F a x : 5 1 5 - 2 8 1 - 3 7 0 1

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 nf 1 . ' F o r m ' D R- 3 . C o u n t y & L o c a l C o mmi t t e e s , e n t e r Co u n t y i n

j ~ w h i c h E l e c t i o n i s h e l d

STATEMENT SASHON HANDCASH 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 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 amoun t MUST b e t h e same a s t h e c a s h o n h an 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 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 THI S PERI ODSc h ed 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 R e 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 Sc h e d u l e H ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . .

( Sc h e du 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 On l y )SUB - TOTAL . . . . . . . . . . . . . . . . . . . . . . . $

SUBTRACT TOTAL MONEY SPENT THI S PERI ODS c 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 S c he 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 ) . . . . . . . . . . .S c h e d u l e F : L o a n Rep a y men t s t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . .

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 a l a n c e mustb e z e r o ) ( A t t a c h D R- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . , . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

" UNPAI D B I L LS ( F r o m S c h e d u l e D - A t t a c h S c he d u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $' I N KI ND CONTRI BUTI ONS ( F r o m S c h e d u l e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $" ` OUTSTANDI NG LOANS ( 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) _CANDI DATE COMMI TT EES ONLY :VALUE OF CAMPAI GN PROPERTY ( F r o m S c h e d u l e H - A t t a c h S c h e d u l e H ) $STATE COMMI TT EES : Su bmi t a r e c o n c i l e d c amp a i g n a c c o u n t b a n k s t a t e me n t i n J a n u a r y o f e a c h y e a r .

4 , 7 2 3 . 9 3

1 , 8 5 7 . 0 0

6 , 5 8 0 . 9 3

3 , 1 0 3 . 3 0

3 , 4 7 7 . 6 3

5 0 0 . 0 0

YES V NO


2/11

Fo r I n s t r u c t i o n 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 as o n S t a t e me n t o f O r g a n i z a t i o n )C i t i z e n s f o r Emma A N e t n e c e kSTATECANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I CA L ACTI ON COMMI TTEE) , L I S T THE PAC I DE NT I F I CA TI ONNUMBER AND T HE P AC CHECK NUMBER I N THE DES I GNATED COLUMN A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA E THI CS AND CAMPAI GNDI SCLOSURE BOARD .NOTE ANY PERSON, OTHER THAN AN I N D I V I D U A L , THAT CONTRI BUTES MORE THAN $ 7 5 0 TO YOURCAMPAI GN MAY HAVE F I L I N GRESPONS I B I L I T I ES AND SHOULD I MMEDI ATELY CONTACT THE BOARDCAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , 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 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 r f o r an yc 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 .

SCHEDULE .A MONETARY( R e v . 0 7 / 0 3 ) RECEI PTSCHECK T HI S BOX I FAMENDI NG FORM

DATE PA C I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT I F FRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE` RECEI VED FUND( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RA I SNUMBER I NCOD#0 4 / 0 7 / 0 6 J a m i e S c o t t e r $ 2 0 . 0 0CK# M a r i o n , 1 A 5 2 3 0 2

D#0 4 / 0 7 / 0 6 Da n & A l t h e a H a s s e 1 5 . 0 0CK# 1 2 6 6 C o u n t y Ho me R o a dS r i n v i l l e I A 5 2 3 3 6I D# V i r g i n i a B a i l y0 4 / 0 7 / 0 6 C K# 1 2 3 7 7 4 t h S t NE 1 0 0 . 0 0C e d a r R a i d s , I A 5 2 4 0 2

I D#0 1 / 0 5 / 0 6 CK# T e r r y J N em e c e k h u s b a n d 1 0 0 . 0 01 6 8 9 B l i s s Rd

t i A II D#CK#

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SUB- TOTAL $ 2 3 5 . 0 0TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) I$ 1 8 5 7 . 0 0' 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 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 y 5 5ma 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 Sc h e d u l e A )


3/11

MF , Y ' - 9 - 2 0 0 6 0 2 : 0 9P F ROM : UE ZI NA ASSOCI ATES

FOR I NSTRUCTI ONS, SEE- HACK OFFORMDI SCLOSURE SUMMARY PAGE

COMMI TTEE NAME ( Mu s t b e s a r n o a s o n S t a l o r n o n t o f Or g a n i z a t i o nCI L z e n s f o r 1?mma A Nemec kI MPORTANT: I n d l c a l e b y 4 t y p e o r 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 / 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 Ca n( 4 ) C o un t y C e n t r a l Co mmi t t e e ( 5 ) C o un t y Ca nd l d a t A ' f 1P o l i t i c a l S u b d i v i s i o n Ca n d i d a t o ( 8 ) Go u n l y , EAS u b d i v i s i o n PAC ( 1 1 ) L o c a l B e l l - 1 1

Ca n d i d a t e Na meEmma A Nemec k

O f f i c e S o u g h tS t a t e Re pr e s en t a t i v e

AM F I L I NG A Ma y 1 4 1 0 6( r e p o r t d a l e )

[ - ] CHECK I F AMENDMENT TO REPORT DATED

b e z e r o ) ( A t t a c h OR - 3 )

755

ADDTOTAL MONEY TAKEN I N THI S PERI OD

3 1 9 3 6 3 9 3 2 0

R e s e t Fo r m

I d e t e ( 2 ) S t a t e PAC ( 3 ) S t a t e P a r t yCa nd i d a t e ( 7 ) S c h o o l B o ar d o r Ot h e r( 1 0 ) S c h o o l B o ar d o r Ot h e r P o l i t i c a l

P o l i t i c a l P a r t y ( i t a p p l i c a b l e )Re p ub l i c a n

D i s t r i c t ( i f Se n a t e o r Hou s e )2 9 t h

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 ' i f i v ` i I 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 wa C o d e s e c t i o n 6 8 B . 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 mmi 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 mmi t t e e , i s t h ei 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 m e l y a n d a c c u r a t e r e p o r t s

-Nsw2 \ - 3 1 9 " - 1 c ! ~ - qglwSI GNATURE OF PERSON I ON. R ORT TELEPHONE

[ 1 C h e c k ! 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 .( Yo u mu s 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 DR - 3 i s f i l e d . )

STATEMENTOFCASHONHANDCASH 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 ds h e l d b y t h e

c o mmi t t e e T h i s am o u n t MUST b e t h e s a m e a s t h e c a s h o n h a n d a t t h e e n d ~ ( , 4 4 ~ l t l , 3 0o 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 er o i t t h i s i s f i r s t r e p o r t f i l e d . ) . , . . . . . . . . . . , . . . . . . . . . . , . . . . . . . . . . $

Sc h e d u l e A: Ca 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 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 Ca mp 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 e du l e H a pp l i e s t o Ca n d i d a t e s ' Co mmi t t e e s On l y )SUB- TOTAL . . . . . . . . . . . . . . . . . . . . . . . S

SUBTRACT TOTAL MONEY SPENT THI S PERI ODSCh e d u l e 8 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 8 ) ( " a l s o s e e d e bt s a n d l o a n s b el o w) . . . . . . . . . .Sc h e d 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 ) . . . . . ~ ~ . , US . ~ . r . . ~ ' . b l } ~. .

G AS H ON HA ND 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 t f i n a l r e p o r t b a l a n c e mu s t

T O : 1 5 1 5 2 81 3 7 0 1 P . 1

Comm pL o g g e d I nk! - - -S c a n n e dCo mp u t e r l l ~ lAu d i t e d

F i l e w i t h :I o wa E t h i c s a n d Ca mp a i g nD i s c l o s u r e B oa r d5 1 0 E 1 2 " ' , St e 1 ADe s Mo i n e s , I o wa 5 0 3 1 9Fa x : 5 1 5 - 2 8 1 - 3 7 0 1

REPORT FOR( 1 ) E LECT I ON l ( 2 ) NON- E LE CT I ON YEAR.I n d i c a t e b y # # F7

s - 9 _ . ; 2 0 0 N 1 *DATE S I GNED

L o c a l Co mmi t t e e s . e n t 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 nwh i c h E l e c t i o n i s h e l d

4 , 8 23 9 3

3 , 1 0 3 . 3 0

" UNPAI D B I 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 u l e D) . . . . . . , . . . . . . . . . . . . . . . . . . . . $ _' I N K I ND CONTRI BUT I ONS ( F r o m Sc h e d u l e E - A t t a c h Sc h e d u l e E ) . . . . . . . . . . . . , . . . . . . $ 5 0 0 , 0 0" OUTSTANDI NG LOANS ( F r o m Sc h e d u l e F - A t t a c h Sc h e d i d e F) , . . . . . . . . . . . $ _CONSULTANT BREAKDOWN ( Sc h e d u l e G At t a c h e d ?) - YES 6" NOCANDI DATE COMMI TTEES ONLY :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 )STATE COMMI TTEES: S u bmi t a r e c o n c i l e d c a mp a i g n a c - p u n t b a n k s t a t e me n t i n J a n u a r y o f e a c h y e a r

' ? S " 7 UO


4/11

I ' l AY- 9 - 2 00 6 OE : 0 9 F FROr 1 : UEZ I NA ASSOCI ATES 3193639320 TO : 1 5 1 52 813701 F . 2

Fo r I n s t r u c t i o n s , Se e Back o f Fo 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 emen t o f O r g a n i z a t i o n )C i t i z e n f o r E n i n i a A . NCn l e CCI C

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P O L I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I DENTI F I CAT I ONNUMBER AND T HE PAC CHECKNUMBER I N TH E DESI GNATED COLUMN A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE 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 ma t i o n c op 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 a n y c o mme r c i a l p u r p o s e b y an y p er 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- TOTAL

TOTAL ( 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 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 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 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 I 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 u t t h e r e i s n o Page^ -_o ff 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 d u l e A)

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

DATE PA C I D NUMBER NAME AND ADDRESS OF CONTRI 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-( MMI DQ/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RA I SERNUMBER I NCOME

I D# D a n i e l Ha s s e $ 1 0 0 0O 1 / 3 1 i 0 6 CK# 1 2 6 6 Co u n t y Home RdS p r i n g v i l l c , I A 5 2 3 3 6I D# J ames H a s s e $1 0 . 0 00 1 / 3 1 / 0 6 CK# 1 2 6 6 Co u n t y I - I o i n c RdS p f i i i R v i l l e , I A 5 2 3 3 61 0 # D a n i e l l e Mac e 5 1 0 . ( ) 00 1 / 3 1 / 0 6 CK# 1 2 6 6 Co u n t y I - t o m e RdS r i n v i l e , I A 5 2 3 36I D# K i m Mo r e n o 8 2 ( 1 . 0 00 1 / 3 1 / 0 6 C K#I D# So n i a l 3 1 i o n e l a 1 3 e m i e j o $5 0 . 0 0 v0 1 / 0 9 / 0 6 CK# 3 9 3 2 Oak } t i l l Av e

I , o s A r t e l e s , CA 9 0 ( ) 3 2 - 1 4 4 6I D# Gene R . o r S a n d r a J B r o d e r c h t $1 0 . 0 0i l l / 1 6 ' 0 0 : CK# 1 0 6 2 9t h S I C I .Man o u , I A 5 2 3 0 2I D# C e c i l a 1 3 Havmr an $ 2 0 , 0 0( 1 1 / 2 9 / 0 6 CK# 2 0 1 C a n d a l l Dr NECedar R a p i d s , l a 5 2 4 ( 1 2D# T i m o r Me l a n n V i s l i s e l 5 , 5 0 . 0 00 1 1 01 / 0 6 CK# 1 5 0 1 V i s l i s e l RdCedar R a p i d s , 1 1 5 2 4 0 3I D# Da v i d A &J e i r u e K Vaud i $ 5 0 , 0 ( 10 2 / 1 9 / 0 6 CK # 1 7 1 5 5 4 2 n d S t r e e c lWf ) e s Mo i n p - . I A 5 0 2 6 - i 7 7 ~I D# Do n a l d & J o s e p h i n e l 3 c r c n d s

$3 0 . ( ) 0 r2 / 2 2 / 0 6 CK# 2 0 0 2 I - I i g l i Dr . SECedar R a p i d s , I A 5 2 4 0 3


5/11

MA T ' - 9 - 2 0 0 6 0 2 : 1 0 F F ROM : VEZ I NA ASSOC I ATES 3 1 9 3 6 3 9 3 2 0 7 0 : 1 5 1 5 28 1 3 7 0 1 F . 3

F o r I n s t r u c t i o n s , Se e B a c k o f F o r mCONTRI BUT I 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 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 )C i t i z e n f o r Emma A. Nemec ek

STATE CA NDI DA T ES N OT E : I F A CONTR I BUT I ON I S RECE I V ED FROM A STA TE PA C ( P OL I T I C AL A CT I ON COMMI TTEE ) , L I S T T HE PAC I DE NT I F I CA TI ONNUMBER AND THE PAC CHECK NUMBER I N T HE DES I GNATED COLUMN A L I S T OF I D NUMBERS I S AVA I L A BL E FROM T HE I OWA E T HI CS AND CAMPAI GNDI SCLOSURE BOARDCAUTI ON: Se c t i o n 68B . 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 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 o mo 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 ur p o s e b y an y p er s o n o t h er 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 es

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 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 mmi t t e e . R e l a t i o n s h i p must 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 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 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

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

$ 7 2 5 . 0 0

P age o f( f o r S c h ed ul e A)

SCHEDULEA MONETARY( R e v , 0 7 / 0 3 ) R E CE I P T Sa CHECK T HI S BOX I F

AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR R EL A T I ON SH I P AMOUNT ~ I I F FORR E CE I V E D ( i f a p p l i c a b l e ) T O C AN DI DA T E ` RECEI VED 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# R i c } t c a r d 1 ' . o r H e t s y A . A l l d r c d gc $ 5 0 . 0 0U 3 / 1 0 / U 6 CK# 2 1 0 1 R t d g e wa y Dr SLC e d a r Ra p i d s , I A 5 2 4 0 3I D# Pe t c A b o l i n s $ 2 5 , 0 00 4 / 0 7 / 0 6 CK# 5 9 1 5 F l a g s t o n e Dnve NI _

C e d a r Ra i d s , I A 5 2 4 0 : 3I D# Ca t h e r i n e Cr r a we $ 2 5 . 0 00 4 / 0 4 / 0 6 CK# 1 9 ( 1 8 S o u t h r i d g e D rC o r a l v l l l e , I A 5 2 2 4 1I D#

Mar y & R o b e r t B owman $ 5 0 . 0 00 4 / 0 4 / 0 6 CK # 7 0 0 3 B r e n t wo o d Dr N 1 3C e d a r Ra p i d s , I A 5 2 4 0 2I D# Wi l l i a m v e m o n $ 5 0 . 0 0( 1 4 / 0 8 / 0 6 CK# 3 2 6 2 3 Dr S t SEC e d a r Rai d s I A 5 2 4 0 3I D# Da l e &I - o l a I ' e r t e r s o n $ 5 0 , 0 00 4 / 0 7 / 0 6 CK# 3 2 2 5 S h a mr o c k DrI o w a , Ci t y 5 2 2 4 5I D# Mar y Da y $ 2 5 , 0 00 4 / 0 7 / 0 6 CK# 3 4 5 N 1 2 t h Av e

1 - h a wa t h a , I A 5 2 2 3 3I D# C u r t Ha r r i es $ 3 0 0 , 0 00 4 / 0 4 / 0 6 C K# 1 1 . 0 Bo x 2 1 7Ma r i o n I A 5 2 3 0 2I D# D a n i e l A b o h n s $ 5 0 . 0 00 4 / 0 8 / 0 6 CK# 6 3 0 T C I I U r i d e T r a i lMa r i o n 1 A 5 2 3 0 2

I D#V i r g i n i a I b i l c y $ 1 0 0 . 0 00 3 / 2 3 / 0 6 CK# 1 2 3 7 7 4t h St . NT :C e d a r R a p i d s , l A 5 24 02


6/11

MA1 ' - 9 - 2 ! ~ 6 0 2 : 1 0 0 P FRON : VEZ I NA ASSOCI ATES 3 1 9 3 6 3 9 3 2 0 TO : 1 5 15 2 8 13 7 0 1 P . 4

Fo r I n s t r u c t i o n s , Se e Ba c k o f Fo 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 TT 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 )C i t i z e n f o r Emma A Ncmec e k

R e s e t r a m i

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

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON i s RECEI VED FROM A STATE PAC ( P O L I T I C AL ACTI ON COMMI TTEE) L I S T THE PAC I DENT I F I CAT I ONNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON : S e c t i o n 6 aB . 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 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 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 m i n i t l e e s .

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 l t o 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 l i l e e . R e l a t i o n s h i p mu s t b e s h o w n t o t h e t h i r d d e g r o e o f r o n s a n g u l n l 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 y 3m 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 ame a s c a n d i d a t e , b u t t h e r e i s n o P a g e -_-_ 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 PTSQ CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSH I 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-( MMI DDI YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# Ca r o l s Bo d d l c k e r $ 7 . 0 00 3 / 2 9 / 0 6 CK# 1 8 4 Be l v e d e r Dr i v e NWCeda r R a p i d s , I A 5 2 4 0 51 D# Da l e o r A l b e r t S t ame k $ 2 5 . 0 0

( ) 4 / 0 6 / 0 6 CK# 3 9 0 2 J u l i e LnCeda r Ra i d s , I A 5 2 4 0 4I D# Ro s ema r y & James T h o t T t s o n $ 2 5 . 0 00 4 / 0 7 / 0 6 CK# 2 2 2 ( 1 T i mh e r Cr e e k DrMa r i o n , I A 5 2 3 0 2I D# Da v i d o r M. 1 G r o e f f $ 2 5 . 0 00 4 / 0 7 / 0 6 CK# 5 1 2 9 t h Av e Dr . SW

Ceda r Ra i d s 1 A 5 24 0 4I D# James &M a r i l y ' n F e l k e r $ 3 0 . 0 0 r0 4 / 0 7 / 0 6 CK# 1 8 5 1 5 t h Av e Cf

Hi a wa t h a , 1A 5 2 2 3 3I D# Samue l &K r i s t i n L an g h ol z $ 5 0 . 0 00 4 / 0 7 / 0 6 CK# 1 6 0 8 Wi n t e r Dr i v v eI o wa C i t y , I A 5 2 2 4 6

I D# J a n e t J o h n s o n SI H0( ) 4 / 0 7 / 0 6 CK# 1 3 0 0 Oa k l a n d Rd N I "_Ceda r R a p i d s , I A 5 2 4 0 2I D# Ro n Semi e r $ 1 0 0 . 0 00 4 / 0 7 / 0 6 CK# 3313 J 3 Av e NW4 FC e d a r R a p i d s , I A 5 2 4 0 3I D# Geen o r S an d r a l l r n d r e c h t 2 5 . 0 00 4 / 0 7 / 0 6 CK# 1 6 0 2 8 1 . 1 1 S I CtMa r i o n , t o 52 30 2I D# Se g u n d o B a b e l $ 2 0 . 0 0 r0 4 / 0 7 / 0 6 CK# 3535 E Av e NWCeda r R a p i d s , l A 5 2 4 0 5


7/11

NAY=S - 2 0 0 6 0 2 : 1 1P F R O h l : VEL I NA ASSOCI ATES 3 1 9 3 6 3 9 3 2 0 T0 : 1 5 1 5 26 1 3 70 1 F . 5

Fo r I n s t r u c t i o n s , Se e B a c k o f Fo 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 same 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 i t i z e n s f o r Emma A . Ne r n e c e k

R e s e t Fo r m

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 )

STATE CANDI DATES NOTE : F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P O L I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I DENTI FI CATI ONNUMBER AND THE PAC CHECKNUMBER I N THE DESI GNATED COLUMN A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARDCAUTI ON : S e c t i o n 6 8 B . 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 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 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 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 .

' 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 r n m l t l e e s t o d i s c l o s e t h e r o l a t i o n s h l 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 mu 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 y 4m 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 same a s c a n d i d a t e , b u t t h e r e i s n o Pa ge o f _-- -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 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 PTSO CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT v I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

I D# E l s i e F o r s i n c r $ 2 5 . 0 00 4 / 0 4 / 0 6 CK# 8 Gl e n da l e Tc r a n c eI o w a C i t y , I A 5 2 2 4 5I D # Ro n a l d & C a r l y l n 1 3 i t ( n e r $ 50 . 0 00 4 / 0 3 / 0 5 CK# 21R5 Ro b e r t C rM a r i o n , I A 5 2 3 0 2I D # A r l e t t e Qu i n n $ 5 0 . 0 0 r0 4 / 0 7 ! 0 6 CK# 1 2 5 St o n e y P ( Rd NW

Ceda r Ra i d s , I A 5 2 4 0 5I D# Da n i e l Hasse $ 30 . 0 00 4 / 0 7 / 0 6 CK# 1 2 6 6 Co u n t y Home RdS r i n v i l e T A 5 2 1 3 6I D# Ka r e n & J a s o n 1 3 e s l e r $ 5 0 , 0 ( )0 4 / 0 7 / ( 1 6 CK# 9 3 5 Wes t woo d Dr NWCeda r R a p i d s , 1 A 5 2 4 0 6I D# Cy n t h i a H e c k f l $ 2 0 . 0 0 d0 4 / 0 7 / 0 6 CK# 5 5 0 6 A n y k e r D r i v eCeda r R a p i d s , f A 5 2 4 1 1I D # V i r g i n i a B a i l e y 5 1 0 . 0 0 r0 4 / 0 7 / 0 6 CK# 1 2 3 7 7 4 1 1 , S 1 NECeda r R a p i d s , I A 5 2 4 0 2I D# Se g u n t o 1 3 a j e l $ 1 0 , 0 00 4 ! 0 0 7 ! 0 6 CK# St o n e y P o i n t RdCeda r R a p i d s , I A 5 2 4 0 2I D # S a l l y Or r 5 5 0 . 0 00 4 / 0 7 ! 0 6 CK# 8 2 1 h u r e s t H i l l Rd

C o r a l v i l l e . I A 5 2 2 4 1I D# L o n n i e & An g e l a 1 - l o o s e 5 2 5 . 0 0 r0 4 / 0 7 / 0 6 CK# 1 4 0 Ho r i z o n Av eF a i r f a x , I A 5 2 2 2 8


8/11

MAY- q - 2 1 2 1 0 6 0 2 : 1 1P FROM: VEZI NA ASSOCI ATES 3193639320 T0 : 1 5 1 52913701 P . l =

Fo r I n s t r u c t i o n s , Se e B a 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 s 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 )C i t i z e n s f o r Fmma A . Nemec ek

R e s e t F or m

SUB- TOTAL

SCHEDULE

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 )

A MONETARY( R e v 0 7 / 0 3 ) RECEI PTSDCHECK T HI S BOX I FAMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CA L ACTI ON COMMI TTEE) . L I S T THE PAC I DENT I F I CA TI ONNUMBER AND TI C PAC CHECK NUMBER I N THE DESI GNATED COLUMN A L I S T OF I D NUMBERS I S A VA I L A B LE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARDNOTE : ANY PERSON, OTHER THAN AN I N D I V I D U AL , THAT CONTRI BUTES MORE THAN $ 7 5 0 TO YOUR CAMPAI GN MAY HAVE F I L I N GRESPONSI B I L I T I ES AND SHOULD I MMEDI ATELY CONTACT 1 HE BOARDCAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , 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 r f o r a n yc 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 mmi t t e e s

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 mu 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 ng 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 y 5 im a r r i a g e ) I f s u r n ame o f c o n t r i h u l o r i s t h e s amA a s c a n d i r l a t r i , h i l t t h e r e I s n o Page - - - o f `_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 pp 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 )

DATE PAC { D N ( I N T 1 8 E R - _ - ~ ~ 1 _ l d d J t l ~ t 7 _ I " l " 1 ". 1 ' ~ 3~ 75" I 7 . 1 1 : 7 1 1 I L ( ~ 7 I _ _ ; " 1 k t f . 9 a ' s l i T O vI F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND( MMI DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI DO J a mi e S c o l l e r $ 2 1 1 , 0 00 4 / ( 1 7 / ( ) ( , CK#D# Da n & A l t h e a I ; r i s e $ 1 5 . ( 1 ( )0 4 / ( 1 7 / 0 6 CK# 1 2 6 6 ; Co u n l y Home Reed

" 523I D# V i r g l n a R a l l y $ 1 0 0 . 0 00 4 / 0 7 1 0 6 CK# 1 2 3 7 7 4 t h S t N1Ceda r Ra i d s , I A 5 2 4 0 2I D#

CK#I D#CK#I D#CK#I D # F -7CK#I D#CK#I D#CK#I D#CK#


9/11

M A ' ) , - 9 - 2 0 06 0 2 : 1 2P FROM : VEZ I NA ASSOCI ATES 3 1 9 3 6 3 9 3 2 0 TO : 1 5 1 5 28 1 3 70 1 F . 8

T H I S BOX APPL I ES TO CANDI DATES' COMMI TTEES ONL Y :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 p e nd 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 r e s mus t a l s o b e d e t a i l i t e mi 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 , e n d d a t e o f e a c h t y p e o f e x p en d i t u r e ma d e 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 oSc 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 6 6 A . 4 0 2 ( 3 ) ( i ) . )

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

FOR I NSTRUCTI ONS, SEE BACK OF FORM R e s e t h a r m SCHEDUL EEXPENDI TURES B MONET ARY- - MONEY SPENT FROM COMMI T T EE ACCOUNT ( Re v 0 7 / 0 3 ) EXPENDI TURES

S T A T E PAC COMMI TT EES : NOTE : FOR CONTRI RI I T I O NS MAn F T O S T A T F WI DE nR L EGI S LAT I V ECANDI DATES, L I ST THE CAND I DATE I DENTI F I CATI ON NUMBER I N THE DESI GNATED COL UMN AND THE CHECK THI S BOX I FPAC CHECK NUMBER FOR EACH EXPEND I TURE . A L I S T OF I D NUMBE RS I S AVA I L A B L E FROMT HE I OWA AMENDI NG FORMETHI CS & CAMPA I GN D I SCLOSURE BOARDCOMMI TTE E NAME ( Mu s t b e s am e 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 )C i t i z e n s f o r Emma A Nemeek

CANDI DATE NA ME AND ADDRESS T O WHOM P URPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( D ESCRI B E TRANSACT I 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 MAD E( MM/ DD f YR) A ND P A C

CHECKNUMBER

I D# We l l s Fa r g o Rank S e r v a c s C h a r g e s0 1 / 0 9 / 0 6 CK# 6 6 6 Wa l n u t S t r e e t $ 7 . 3 5De s Mo i n e s l a . 5 0 3 0 9

I D#We l l s F a r g o R a n k S e r v i c e s C h a r g e s0 2 / 0 7 / 0 6 CK# 6 6 6 Wa l n u t S t r e e t 2 . 1 0De s Mo i n e s l a 5 0 3 0 9

I D# We l l s F a r g o B a n k Se r v i c e s C h a r g e s0 3 / 0 7 / 0 6 6 6 6 Wa l n u t S t r e e t 2 . 1 0CK# De s Mo i n e s l a 5 0 3 0 9I D# We l l s h a r g o H a n k S e r v i c e s C h a r g e s0 4 / 0 7 / 0 6 CK# 6 6 6 Wa l n u t S t r e e t 2 . 1 0De s Mo i n s e I : a 5 0 3 0 9I D# We l l s F o r g o R a n k S e r v i c e s Ch a r g e s

0 5 / 0 7 ' 0 6 CK# 6 66 Wa l n u t S t r e w 2 . 1 0De s Mo i n s e l a 5 0 3 0 91 D l t ~K c q ~ ~ a 1 ~~0 2 / ( ) 3 , 1 0 6 CK# 1 0 J e t P? 1 ) O- . . r oS 1 0 0 . 0 0TI D # N e t I ma g e No t e P mi e s & L o g o CD P a l m Ca a r d

0 2 1 1 5 / 0 6 CK# 2 2 0 0 NW 1 5 9 t H S t 5 1 0 . 0 0S u i t e PMH 3 1 7 tD# C r e a t i v e K c a l We b Ma i l e n c c &P r i n t i n g( 1 3 1 0 6 1 0 6 1 0 0 1 O t l i c e P a r k R o a d Su i t e 1 2 1 2 1 0 5 t 1CK#, We s t De s Mo i n e s t a r 8 ( 1 2 6 5

SUB- TOTAL $ 8 - 1 6 . 2 5 - "TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) $


10/11

r 1 A ` I = 9 - 2 0 0 6 0 2 : 1 3 P FROM : UE ZI NA ASSOCI ATES 3 1 9 3 6 3 9 3 2 0 7 0 : 1 5 1 5 2 81 3 7 0 1 P . 9

T HI S BOX APP L 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 m o r e m u 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 e 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 mi 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 ) . )

P a g e 2 ` - - - o f( f o r S c h e d u l e B )

FOR I NSTRUCTI ONS, S EE BACK OF FORM R e s e t I ' o r n 1 SCHEDULEEXPENDI TURES B MONETARY- - 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 EN T I F I C AT I ON NUMBER I N THE DESI GNATED COLUMN AND THE 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 TH E I OWA AMENDI NG FORMETHI CS B CAMPAI GN DI SCLOSURE BOARDCOMMI TTEE NAME ( Mu s t b e s am e 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 )C i t i z e n s f o r T r r i n a A Neme c k

CANDI DATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI LURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D ) s b u r s e r n e n l ) WAS MADE( MMI DD/ YR) AND PACCHECKNUMBERD# Re p u b l i c an 1 ' : my o f I o w a Ca n di d a t e Sc h oo l0 3 1 5 6 / 0 0 CK# 6 2 1 E 9 t h $ 5 0 , 0 ( 1De s M 0 1 1 1 c s l a 5 0 3 0 9

I D#I l o t e l F o r t De s Mo i n e s Ca n d i d a t e S c h o o l0 3 / 2 4 / 0 0 CK# \ Wa l n u t S t r e e t 1 1 6 . $ 8De s Mo i n e s I n 5 0 3 0 9

I D# V i c t o o r y S t o r e P o l y 1 3 a g S i g n s & Wi r e0 3 / 3 1 , 0 6 5 2 0 0 0 SW3 0 t h S h i p p i n g & H a n d l i n g 2 1 0 0 . 1 7CK# Da v e n p o r t l a 5 2 8 0 2I D#CK#

I D#CK#D#

C K#I D#C K#I D#C K#

SUB- TOTAL $ 2 2 6 7 . 0 5TOTAL ( i f l a s t p a g e o f t h i s s c he d u l e ) $ 3 1 0 3 . 3 0


11/11

h 1 A ` r ' - g - 2 0 0 6 3 2 : 1 3P FROM : VEZ I NA ASSOCI ATES 3 1 9 3 6 3 9 3 2 0 TO : 1 5 1 5 28 1 3 70 1 P . 1 1

FOR I NSTRUCT I ONS, SEEBACK OF FORMCOMMI TTEE NAME ( M u s t b e s e i n e 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 )

C i t i z e n s f o r E r n r r a A Nemec k

R e s e tForm

SCHEDULEE 1 N - K I N D( R e v . 0 6 ( 9 7 ) CONTRI BUTI ONS

Ej CHECK T HI S BOX I FAMENDI NG FORM

' 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 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 n i n k i n d c o n t r i b u t i o n t o t h e P a g e ) 1c o mmi t t e e Re l a t i o n s h i p m u s t b e s h own 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 ( f o r S c h e d u l e E )b y ma 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 sumame 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 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

DATERECEI VED( MM/ DD/ YR) NAME AND ADDRESSOFCONTRI BUTORRELATI ONSHI PTO CANDI DATE( i f a p p l i c a b l e )

DESCRI PTI ONOF I N K I N DCONTRI BUTI ONESTI MATEDF AI R MARKETVALUE

4 I F FORFUND- RAI SERCONTRI BUTI ON

0 4 / 0 7 / 0 ( , A r l e t l e Qu i n n1 0 5 S l o n e y P o i n t R u a dCe d ar Ra p i d s l a 5 2 4 0 5

F u n d R a i s e r $ 5 t 1 ( ? . 0 ( ) aa0aaaa0a

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