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8/7/2019 Reeder Jackie__1342__scanned

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FOR I NSTRUCT I ONS, SEE BACK OF, ?M

DI SCLOSURE SUMMARY PAGE J AN 2 2 2 0 0 27 4 c k " - e -C MI TTEE NAME ( Mu s t b e s ame a s o n St a t e me n t o r O r g a n i z a t i o n )

t ' , ~ C. C t r n 1 1I MPORTANT: I n d i c a t e t y pe o f c o mmi t t e e y o u a r e r e p or t i n g f o r : 7 1

( 1 ) S t a t e w i d e / L e g i s l a t i v e Ca n d i d a t e ( 2 ) S t a t e wi d e PAC ( 3 ) S t a t e P a r t y ( 4 ) Co u n t y / L o c al Ca n d i d a t e( 5 ) Co un t y PAC ( 6 ) B a l l o t I s s u e / F r a nc h i s e Co mmi t t e e ( 7 ) C ou n t y / Ci t y Ce n t r a l Co mmi t t e e( 8 ) Su p p or t S l a t e o f Ca n d i d a t e s 1 2 - 2 - 7 3 - 3 0 0 ( oSI dNATURE OF T EASURER r p e r s o n f i l i n g t h i s r e p o r t ) TELEPHONERou 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 p or t s R a n g e f r o m $ 2 0 t o $ 8 0 0

SEE I NSTRUCT I ONS ONBACK AND COMPLETE THE FOLLOWI NG SENTENCE :I AM F I L I NG A j f l r t i t LQ t ~ t , \ 1 Z 4 ' - ( 2 02 - REPORT FOR A N/ A ( 1 ) ELECT I ON / ( 2 ) NON- EL ECT I ON YEAR .' j I j r - 0 7S4 PPL Ct n f A1 i i 4 1L 4e por t d at e ) S ~ v C L c ( . L E C e . C t i n n -OCHECK 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 an d a t t a c h N o t i c e o f D i s s o l u t i o n F or 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 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 . )

I n d i c a t e on e

STATEMENT 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 h i s i s t h e t o t a l

o f a l l mon i e s h e l d b y t h e c ommi t t e e . T h i s amoun t MUST b e t h es ame a s t h e c a s h o n h a n d a t t h e e n d o f t h e l a s t r e p o r t i n g p e r i o d ,o r mus t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ADD TOTAL MONEYTAKEN I N T HI S PERI ODSc h e du 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e du 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 du l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e du 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 du l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

SUBTRACT TOTAL MONEYSPENT T HI S PERI ODSc h e du 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 du l e B ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e du l e F : L o an Re p ay me n t s t o t a l ( A t t a c h Sc h e du 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

FORMDR- 2 DI SCLOSURE( Re v . 0 1 / 9 8 ) REPORT

Comm. #I n d ex e dAu d i t e dComp u t e r

1 - 1 7 - 0 2 -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

UNPA I D BI 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 BUTI ONS ( F r o m Sc h e du l e E - A t t a c h Sc h e du l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 55 - 7 ~ 7 1OUTSTANDI NG LOANS ( F r o m Sc h e d u l e F - A t t a c h Sc h e du 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 YNOVALUE OF CAMPAI GN PROPERTY ( F r o m Sc h e du l e H - A t t a c h Sc h e du l e H)


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Fo r I n s t r u c t i on 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 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 at i on )

t - c t [ c r - cam, L~RSTATE CANDI DATES NOTE: I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D EN T I F I C AT 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 : Se c t i o n 6 8B . 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 op i e d f r om r e p o r t s an 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 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 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 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 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 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 ) ( Se e Page 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 b u t o r i s t h e s ame as 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 . Pag e _I o f( f o r Sc h e d u l e A)

SCHEDULEA MONETARY( Re v . 0 6 / 9 7 ) RECE I PTSQ CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT V I F FRECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUN( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SNUMBER I NCOI D# Te r mi ni - At r i c h _CK#5 1 7 2 8 - t o 6 2 - $ 2 5 , 0 0

1 2 1 - 2 2 1 oI D# b e t ) bahz "5 i J Aq Q.l CK# - 2 _s t n r < 1 ~ . ~ , ~ A 5 ~ ~ ` l ~ 25 . 0I D# aht ha An . a o t l ^ S U1 1 .c K# _ 9 . 3 - 1 31 S- t Z5 . c cA 0 L n L S Z- A J0~i 2

1 0 2 -I D# Pad RZ r ~ - e _ SK ACK# - l y 5 ' 1 u ". TA 5 2 ) qZ 1. 5 . U( )e

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3/12

Fo r I n s t r u c t i b n s , Se e Ba c k 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 TTEE NAME ( Mu s t b e s ame a s on St a t e men t o f Or g a n i z a t i on )Reeder Carnpa,qs a,

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D EN T I F I C AT I ONNUMBER AND THEPAC CHECK NUMBER I N TH E DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM TH E I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .CAUTI 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 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 a ny c ommer c i a l p u r p o se 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 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 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 yma r r i a g e ) ( S e e Pa ge 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 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 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 )Pa g e 2 o f

SCHEDULEA MONETARY( R e v . 0 6 / 9 7 ) RECEI PTSCHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FRECEI 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 SNUMBER I NCOI D# Qut 1 n e , r a r n dCK#~i ' 7 2 1 1 Av e . I V , E- 5~ . ao0

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Fo r I n s t r u c t i o n s , See Back o f Fo r mCONTRI BUTI ONS - - MONEYTAKEN I N

( I n c l u d i n g c a nd i d a t e ' s p e r s o n a l f u n ds )COMMI TTEENAME ( Mus t b e s ame a s o n St a t emen t o f Or g a n i z a t i o n )

SCHEDULEA MONETARY( Re v . 0 6 / 9 7 ) I RECEI PTSQCHECK T HI S BOX I FAMENDI NG FORM

STATE CANDI DATES NOTE . I F ACONTRI BUT I ON I S RECEI VED FROMA STATE PAC ( POL I T I CA L ACT I ON COMMI TTEE) , L I S T THEPAC I DENT I F I CATI ONNUMBER ANDTHEPACCHECKNUMBER I N THEDESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHEI OWA ETHI CSANDCAMPAI GNDI SCL OSURE BOARD.CAUTI ON : Se c t i o n 68 B . 3 2 A( 6 ) , I o wa Code, p r oh 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 or 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 bu 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 by any 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 .

Di s c l o s u r e l a w r e q u i r e s c a n di 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 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 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 byma r r i a ge ) ( Se e P a g e 2 o f f o r ms p a c k e t . ) . I f su r 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 n di d at e , bu t t h e r e i s n o P a g e 3 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 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 . ( f o r Sc h e d u l e A)

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I FRECEI VED ( i f a pp l i c a bl e ) TO CANDI DATE' RECEI VED FUN( MM/ DD/ YR) ANDPACCHECK ( i f a p p l i c a b l e ) RAI SNUMBER I NCO

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Fo r I n s t r u c t i o n s , See 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 )COMI ) k I T TEE NAME ( Mu s t b e same a s o n St a t e me n t o f Or 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 OL I T I C AL ACTI ON COMMI TTEE) , L I S T THE PAC I D E NT I F I C A T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .CAUTI ON : Se 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 men 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 mmer c i a l p u r p o s e by 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 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 mm i 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 y ~ ~ma r r i a g e ) ( Se e Pa ge 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 b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o Pa g e-~-o 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)

SCHEDULEA MONETARY( R e v . 0 6 / 9 7 ) RECE I PTSCHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT , ( I F FRECE I 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 SNUMBER I NCO

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6/12

Fo r I n s t r u c t i o n s , Se e Back 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 S t a t e me n t o f O r g a n i z a t i o n )

t - . t r Ca1 y k . PaL8 r \. .STATE CAND I DATES NOTE : I F A C ON T R I B U T I O N I S R E CE I V E D FROM A S T A T E PAC ( P OL I T I C AL A CT I O N C OMMI T T E E ) , L I S T T HE P AC I D E NT I F I C A T I ONNUMBER AND THEPAC CHECK NUMBER I N T H E D ES I GN AT E D COLUMN . A L I S T OF I D NUMBERS I S A VA I L A B L E FROM THE I OWA E T HI C S AND CAMPAI GND I SCLOSURE BOARD .C AU T I 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 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 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 m m i 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 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 ) ( 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 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 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 .

S U B - TOT A LTOTAL ( i f l a s t p a g e o f t h i ss c h e du l e )

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SCHEDULEA MONETARY( Re v . 0 6 1 9 7 ) R EC EI P T SCHECKTHI S BOX I FAMENDI NG FORM

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7/12

F o 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 ( M u s t b e same a s o n S t a t e m e n t o f O r g a n i z a t i o n )

l . L - A C k r r " L a l , ( 3 YLS T A T E C A ND I D A T E S NOTE : I F A C O NT R I B U T I O N I S R EC E I V E D FROM A S T A T E P A C ( P O L I T I C A L A C T I O N C O MMI T T E E) , L I S T T HE P A C I D E NT I F I C AT I O NN U M B E R AND T H E P A C CHECK NUMBER I N T H E D E S I G NA T E D C O L U M N . A L I S T OF I D N U M B E R S I S A V AI L A B L E FROM T H E I O WA E T HI C S AND C A M PA I G ND I S C L O SU R E B O A R DCAUTI 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 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 mmi t t e e s

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i ss 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 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 m m 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 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 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 6 / 9 7 ) RECEI PTS

CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I FRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUN( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SNUMBER I NC

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8/12

Fo r I n s t r u c t i o n s , 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 TTEE NAME ( Mu s t be s ame a s on St a t e men t o f Or g a n i z a t i on )

. (1m~0. L~i r LSTATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROMA STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D E NT I F I C AT 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 E T HI C S AND CAMPAI GNDI SCLOSURE BOARD .CAUTI 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 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 a ny c ommer c i a l p u r p os e by 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 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 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 mmi t t e e . R e l a t i o n s h i p mu 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 b ym a r r i a g e ) ( Se e Pa 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 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 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 ul e A)Pa ge I -o f

SCHEDULEA MONETARY( Re v . 0 6 / 9 7 ) RECEI PTSCHECK T HI S BOX I FAMENDI NG FORM

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9/12

Fo r I n s t r u c t i o n s , 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 TTEE NAME ( Mu s t be s ame a s on S t a t e me n t o f Or g a n i z a t i on )8t k ? _ At r CaCAP0. l 30 . .

STATE CANDI DATES NOTE: I F A CONTR I BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I D E NT I F I C AT 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 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 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 a n y c o mme r c i a l p u r p o s e by 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 o mmi t t e es .11 k , 5 ' 1 ~

SUB- TOTALTOTAL ( 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 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 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 ) 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 ge 2 o f f o r m s p a c k e t . ) . I f s umame o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o Pa g e o 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( Re v . 0 6 / 9 7 ) RECE I PTS

CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT J I F FRECE I VED ( i f a p p l i c a b l e ) TOCANDI DATE' RECE I VED FUND( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI S- - NUMBER I NCO' I D# 9 4 , 5 3 A / e . r N ~ , , r r t OGr o Ne i we i ^ ~ ro

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10/12

FOR I NSTRUCT I ONS, SEEBACK OF FORMEXPENDI TURES - - MONEY SPENT FROM COMMI TT EE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUT I ONS MADE TO STATEWI DE OR 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 THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWAETHI CS & CAMPAI GN DI SCLOSURE BOARD .

SCHEDULEMONETARY( Re v . 0 9 / 9 7 ) I EXPENDI TURES

CHECK T HI S BOX I FAMENDI NGFORM

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/ 273, 2THI S BOX AP PL I E S TO CANDI DATES' COMMI TTEES ONLY :P ur c h as e s o f c e r t a i n c amp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e must a l s o b e i n v e n t o r i e d o n Sc h e du l e H . ( R e f e r t o Sc h e du l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s / e n t i f i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , man a g i n g , o r g a n i z i n g s e r v i c e s must a l s o b e d e t a i l i t e m i z e d o nSc h e du l e G b y t h e amo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e n d i t u r e made b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e r t oSc h e du l e G i n s t r u c t i o n s an d I o wa Code 5 6 . 6 ( 3 ) ( i ) . )

( f o r S ( " h n r l i i l P R )

CAND I DATE NAME AND ADDRESS TOWHOM PURPOSEDATE I D NUMBER EXPENDI TURE ( D E SCRI 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( MMI DD/ YR) AND PACCHECKNUMBER


11/12

F O R ~ I N S T R U C T I O N S , S E E B A C K O F F O R MCOMMI TT EE NAME ( Mu s t b e s ame as o n S t a t eme n t o f O r g a n i z a t i o n )

C. x QY L 1 ( L t _ 1 L

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

s c h e du l e )

SCHEDULEE I I N K I ND( Re v . 0 6 1 9 7 ) CONTRI BUTI ONS

CHECKT 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 an 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 Page o f 2-c 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 ( f o r S c h ed u l e E )b y ma r r i a g e ) . ( Se e Pa ge 2 o f f o r ms p a c k e t . ) 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 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 .

DATE RELATI ONSHI P DESCRI PT I ON EST I MATED d I F FORRECEI VED NAME AND ADDRESS TO CANDI DATE OF I N KI ND FAI R MARKET FUND- RA I SER( MM/ DD/ YR) OF CONTRI BUTOR ' ( i f a p p l i c a b l e ) CONTRI BUTI ON VALUE CONTRI BUTI ON~ 0 s - , a1 2 / 1 S l o Ay e N ~ , ~ . Sw Q u ` a c: . 21. 20

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12/12

FOR I NSTRUCTI ONS, SEE BACK OF FORMC MMI TTEE NAME ( Mu s t b e same as o n St a t eme n t o f O r g a n i z a t i o n )/ e e d P_ r ~ . a I n P a i 9 r k -

SUB- TOTAL

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s c h ed u l e )

SCHEDULEE I I N K I ND

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