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  • 8/7/2019 Verizon Iowa Good Government Club__6038__scanned

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    FOR INSTRUCTIONS, SEE BACK OF FORM

    DISCLOSURE SUMMARY PAGECOMMITTEE NAME

    CANDIDATE COMMITTEES ONLY:

    Candidate Name

    Office Sought

    Political Party (if applicable)

    District (If Senate or House)

    Comm. #

    Logged in

    Scanned

    Computer

    For Office Use Only

    FORM

    DR-2(Rev. 12/2005)

    DISCLOSUREREPORT(Must be same as on Statement of Organization)

    IMPORTANT: Indicate by # type of committee you are reporting for:(1)Statewide/Legislative/Judge Standing for Retention Candidate (2)State PAC (3)State Party(4) CountyCentral Commiittee (5)County Candidate (6)City Candidate (7)School Board or OtherPolitical Subdivision Candidate (8)County PAC (9)City PAC (10) School Board or Other Political

    SIGNATURE OF PERSON FILING REPORT TELEPHONE DATE SIGNED

    I AM FILING A REPORT FOR (1) ELECTION /(2) NON-ELECTION YEAR.

    CHECK IF AMENDMENT TO REPORT DATED

    (Check if this is final (termination) report and attach Notice of Dissolution Form DR-3.(You must continue to file reports until a DR-3 is filed.)

    (report date) Indicate by #

    Local Committees, enter Date of Election

    County & Local Committee, enter County inwhich Election is held

    STATEMENT OF CASH ON HAND

    CASH ON HAND

    MUST

    at the beginning of the reporting period. (Total of all funds held

    by the committee. This amount be the same as the cash on hand at the endof the last reporting period, or must be zero if this is first report filed.)

    ADD TOTAL MONEY TAKEN IN THIS PERIOD

    Schedule A: Cash Contributions total (Attached Schedule A) (*also see in-kind below)

    Schedule F: Loan Received total (Attach Schedule F)

    Schedule H: Total Sales of Campaign Property (Attach Schedule H)Schedule H applies to Candidates' Committees Only)

    SUB-TOTAL

    CASH ON HAND at the end of this reporting period (if final report, balance mustbe zero)(Attach DR-3)

    SUBTRACT TOTAL MONEY SPENT THIS PERIOD

    Schedule B: Expenditures total ( Attach Schedule B) (**also see debts and loans below)

    Schedule F: Loans Repayments total (Attach Schedule F)

    **UNPAID BILLS

    *IN KIND CONTRIBUTIONS

    **OUTSTANDING LOANS

    CANDIDATE COMMITTEES ONLY:

    CONSULTANT BREAKDOWN

    VALUE OF CAMPAIGN PROPERTY

    (From Schedule D - Attach Schedule D)

    (From Schedule E - Attach Schedule E)

    (From Schedule F - Attach Schedule F)(Schedule G Attached ?)

    (From Schedule H - Attach Schedule H)

    YES NO

    $

    $

    $

    $

    $

    $

    $

    2

    Verizon Iowa State Good Government Club

    07/15/2008 - 10/14/2008

    1

    X

    20,258.56

    2,054.50

    0.00

    0.00

    22,313.06

    17,300.00

    0.00

    5,013.06

    0.00

    0.00

    0.00

    0.00

    Audited

    STATE COMMITTEES: Submit a reconciled campaign account bank statement in January of each year.

    Late reports are subject to possible civil and criminal penalities. Pursuant to Iowa Code section 68B.32A(7)the candidate, for a candidate's committee and the chairperson, for any other type of committee, is theindividual responsible for filing timely and accurate reports.

    File WithIowa Ethics and Campai nDisclosure Board510 E. 12th, Ste. 1ADes Moines, Iowa 50319fax: 515-281-3701

    Subdivision PAC (11)Local Ballot Issue

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    ID#

    CK#

    07/18/2008 $5.00

    Cedar Rapids, IA 52405-4537

    60 Clive Drive NorthwestAppleby, Anna

    ID#

    CK#

    08/01/2008 $5.00

    Cedar Rapids, IA 52405-4537

    60 Clive Drive NorthwestAppleby, Anna

    ID#

    CK#

    08/15/2008 $5.00

    Cedar Rapids, IA 52405-4537

    60 Clive Drive NorthwestAppleby, Anna

    ID#

    CK#

    08/29/2008 $5.00

    Cedar Rapids, IA 52405-4537

    60 Clive Drive NorthwestAppleby, Anna

    ID#

    CK#

    09/12/2008 $5.00

    Cedar Rapids, IA 52405-4537

    60 Clive Drive NorthwestAppleby, Anna

    ID#

    CK#

    09/26/2008 $5.00

    Cedar Rapids, IA 52405-4537

    60 Clive Drive NorthwestAppleby, Anna

    ID#

    CK#

    10/10/2008 $5.00

    Cedar Rapids, IA 52405-4537

    60 Clive Drive NorthwestAppleby, Anna

    ID#

    CK#

    07/18/2008 $5.00

    Cedar Rapids, IA 52411-7757

    6616 Ashwood Court NortheastBrady, Scott

    ID#

    CK#

    08/01/2008 $5.00

    Cedar Rapids, IA 52411-77576616 Ashwood Court Northeast

    Brady, Scott

    ID#

    CK#

    08/15/2008 $5.00

    Cedar Rapids, IA 52411-7757

    6616 Ashwood Court NortheastBrady, Scott

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $50.00

    371

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    ID#

    CK#

    10/10/2008 $5.00

    Marion, IA 52302-1781

    1645 Charleston DriveBrown, Scot

    ID#

    CK#

    07/18/2008 $2.00

    Cumming, GA 30028-8103

    4510 Sloan RidgeBrubaker, John

    ID#

    CK#

    08/01/2008 $2.00

    Cumming, GA 30028-8103

    4510 Sloan RidgeBrubaker, John

    ID#

    CK#

    08/15/2008 $2.00

    Cumming, GA 30028-8103

    4510 Sloan RidgeBrubaker, John

    ID#

    CK#

    08/29/2008 $2.00

    Cumming, GA 30028-8103

    4510 Sloan RidgeBrubaker, John

    ID#

    CK#

    09/12/2008 $2.00

    Cumming, GA 30028-8103

    4510 Sloan RidgeBrubaker, John

    ID#

    CK#

    09/26/2008 $2.00

    Cumming, GA 30028-8103

    4510 Sloan RidgeBrubaker, John

    ID#

    CK#

    10/10/2008 $2.00

    Cumming, GA 30028-8103

    4510 Sloan RidgeBrubaker, John

    ID#

    CK#

    07/18/2008 $15.00

    North Liberty, IA 52317-9412115 Elm Ridge Drive

    Childs, Amanda

    ID#

    CK#

    08/01/2008 $15.00

    North Liberty, IA 52317-9412

    115 Elm Ridge DriveChilds, Amanda

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $49.00

    373

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    ID#

    CK#

    08/15/2008 $15.00

    North Liberty, IA 52317-9412

    115 Elm Ridge DriveChilds, Amanda

    ID#

    CK#

    08/29/2008 $15.00

    North Liberty, IA 52317-9412

    115 Elm Ridge DriveChilds, Amanda

    ID#

    CK#

    09/12/2008 $15.00

    North Liberty, IA 52317-9412

    115 Elm Ridge DriveChilds, Amanda

    ID#

    CK#

    09/26/2008 $15.00

    North Liberty, IA 52317-9412

    115 Elm Ridge DriveChilds, Amanda

    ID#

    CK#

    10/10/2008 $15.00

    North Liberty, IA 52317-9412

    115 Elm Ridge DriveChilds, Amanda

    ID#

    CK#

    07/18/2008 $2.50

    GRINNELL, IA 50112-1347

    1428 REED STREETCHRISTINSON, CHERYL

    ID#

    CK#

    08/01/2008 $2.50

    GRINNELL, IA 50112-1347

    1428 REED STREETCHRISTINSON, CHERYL

    ID#

    CK#

    08/15/2008 $2.50

    GRINNELL, IA 50112-1347

    1428 REED STREETCHRISTINSON, CHERYL

    ID#

    CK#

    08/29/2008 $2.50

    GRINNELL, IA 50112-13471428 REED STREET

    CHRISTINSON, CHERYL

    ID#

    CK#

    09/12/2008 $2.50

    GRINNELL, IA 50112-1347

    1428 REED STREETCHRISTINSON, CHERYL

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $87.50

    374

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    ID#

    CK#

    09/26/2008 $2.50

    GRINNELL, IA 50112-1347

    1428 REED STREETCHRISTINSON, CHERYL

    ID#

    CK#

    10/10/2008 $2.50

    GRINNELL, IA 50112-1347

    1428 REED STREETCHRISTINSON, CHERYL

    ID#

    CK#

    07/18/2008 $2.00

    GRINNELL, IA 50112-1328

    1221 PRINCE STREETCLOYED, CYNTHIA

    ID#

    CK#

    08/01/2008 $2.00

    GRINNELL, IA 50112-1328

    1221 PRINCE STREETCLOYED, CYNTHIA

    ID#

    CK#

    08/15/2008 $2.00

    GRINNELL, IA 50112-1328

    1221 PRINCE STREETCLOYED, CYNTHIA

    ID#

    CK#

    08/29/2008 $2.00

    GRINNELL, IA 50112-1328

    1221 PRINCE STREETCLOYED, CYNTHIA

    ID#

    CK#

    09/12/2008 $2.00

    GRINNELL, IA 50112-1328

    1221 PRINCE STREETCLOYED, CYNTHIA

    ID#

    CK#

    09/26/2008 $2.00

    GRINNELL, IA 50112-1328

    1221 PRINCE STREETCLOYED, CYNTHIA

    ID#

    CK#

    10/10/2008 $2.00

    GRINNELL, IA 50112-13281221 PRINCE STREET

    CLOYED, CYNTHIA

    ID#

    CK#

    07/18/2008 $3.00

    Marion, IA 52302-4992

    540 S 22nd StreetCombs, Beth

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $22.00

    375

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    ID#

    CK#

    08/01/2008 $3.00

    Marion, IA 52302-4992

    540 S 22nd StreetCombs, Beth

    ID#

    CK#

    08/15/2008 $3.00

    Marion, IA 52302-4992

    540 S 22nd StreetCombs, Beth

    ID#

    CK#

    08/29/2008 $3.00

    Marion, IA 52302-4992

    540 S 22nd StreetCombs, Beth

    ID#

    CK#

    09/12/2008 $3.00

    Marion, IA 52302-4992

    540 S 22nd StreetCombs, Beth

    ID#

    CK#

    09/26/2008 $3.00

    Marion, IA 52302-4992

    540 S 22nd StreetCombs, Beth

    ID#

    CK#

    10/10/2008 $3.00

    Marion, IA 52302-4992

    540 S 22nd StreetCombs, Beth

    ID#

    CK#

    07/18/2008 $5.00

    Marion, IA 52302-6166

    4185 Willowbrook DriveCranny, Daniel

    ID#

    CK#

    08/01/2008 $5.00

    Marion, IA 52302-6166

    4185 Willowbrook DriveCranny, Daniel

    ID#

    CK#

    08/15/2008 $5.00

    Marion, IA 52302-61664185 Willowbrook Drive

    Cranny, Daniel

    ID#

    CK#

    08/29/2008 $5.00

    Marion, IA 52302-6166

    4185 Willowbrook DriveCranny, Daniel

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $38.00

    376

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    ID#

    CK#

    09/12/2008 $5.00

    Marion, IA 52302-6166

    4185 Willowbrook DriveCranny, Daniel

    ID#

    CK#

    09/26/2008 $5.00

    Marion, IA 52302-6166

    4185 Willowbrook DriveCranny, Daniel

    ID#

    CK#

    10/10/2008 $5.00

    Marion, IA 52302-6166

    4185 Willowbrook DriveCranny, Daniel

    ID#

    CK#

    07/18/2008 $2.75

    Malcom, IA 50157-8033

    1408 Old 6 Rd.CUMMINGS, JOY

    ID#

    CK#

    08/01/2008 $2.75

    Malcom, IA 50157-8033

    1408 Old 6 Rd.CUMMINGS, JOY

    ID#

    CK#

    08/15/2008 $2.75

    Malcom, IA 50157-8033

    1408 Old 6 Rd.CUMMINGS, JOY

    ID#

    CK#

    08/29/2008 $2.75

    Malcom, IA 50157-8033

    1408 Old 6 Rd.CUMMINGS, JOY

    ID#

    CK#

    09/12/2008 $2.75

    Malcom, IA 50157-8033

    1408 Old 6 Rd.CUMMINGS, JOY

    ID#

    CK#

    09/26/2008 $2.75

    Malcom, IA 50157-80331408 Old 6 Rd.

    CUMMINGS, JOY

    ID#

    CK#

    10/10/2008 $2.75

    Malcom, IA 50157-8033

    1408 Old 6 Rd.CUMMINGS, JOY

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $34.25

    377

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    ID#

    CK#

    07/18/2008 $1.50

    GRINNELL, IA 50112-2639

    1617 REEDDAVIS, LINDA

    ID#

    CK#

    08/01/2008 $1.50

    GRINNELL, IA 50112-2639

    1617 REEDDAVIS, LINDA

    ID#

    CK#

    08/15/2008 $1.50

    GRINNELL, IA 50112-2639

    1617 REEDDAVIS, LINDA

    ID#

    CK#

    08/29/2008 $1.50

    GRINNELL, IA 50112-2639

    1617 REEDDAVIS, LINDA

    ID#

    CK#

    09/12/2008 $1.50

    GRINNELL, IA 50112-2639

    1617 REEDDAVIS, LINDA

    ID#

    CK#

    09/26/2008 $1.50

    GRINNELL, IA 50112-2639

    1617 REEDDAVIS, LINDA

    ID#

    CK#

    10/10/2008 $1.50

    GRINNELL, IA 50112-2639

    1617 REEDDAVIS, LINDA

    ID#

    CK#

    07/18/2008 $2.00

    GRINNELL, IA 50112-8220

    174 380 AVE.DUDLEY, CINDY

    ID#

    CK#

    08/01/2008 $2.00

    GRINNELL, IA 50112-8220174 380 AVE.

    DUDLEY, CINDY

    ID#

    CK#

    08/15/2008 $2.00

    GRINNELL, IA 50112-8220

    174 380 AVE.DUDLEY, CINDY

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $16.50

    378

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    ID#

    CK#

    10/10/2008 $4.00

    GRINNELL, IA 50112-8348

    3630 90TH STEDELEN, SUSAN

    ID#

    CK#

    07/18/2008 $25.00

    W. DES MOINES, IA 50265-2213

    1024 21STFLANNERY, JOHN

    ID#

    CK#

    08/01/2008 $25.00

    W. DES MOINES, IA 50265-2213

    1024 21STFLANNERY, JOHN

    ID#

    CK#

    08/15/2008 $25.00

    W. DES MOINES, IA 50265-2213

    1024 21STFLANNERY, JOHN

    ID#

    CK#

    08/29/2008 $25.00

    W. DES MOINES, IA 50265-2213

    1024 21STFLANNERY, JOHN

    ID#

    CK#

    09/12/2008 $25.00

    W. DES MOINES, IA 50265-2213

    1024 21STFLANNERY, JOHN

    ID#

    CK#

    09/26/2008 $25.00

    W. DES MOINES, IA 50265-2213

    1024 21STFLANNERY, JOHN

    ID#

    CK#

    10/10/2008 $25.00

    W. DES MOINES, IA 50265-2213

    1024 21STFLANNERY, JOHN

    ID#

    CK#

    07/18/2008 $2.00

    Vinton, IA 52349-94815673 22nd Avenue Trail

    Gerber, Tom

    ID#

    CK#

    08/01/2008 $2.00

    Vinton, IA 52349-9481

    5673 22nd Avenue TrailGerber, Tom

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $183.00

    3710

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    ID#

    CK#

    09/26/2008 $3.00

    GRINNELL, IA 50112-2021

    1421 4TH AVEGOODIN, MICHELE

    ID#

    CK#

    10/10/2008 $3.00

    GRINNELL, IA 50112-2021

    1421 4TH AVEGOODIN, MICHELE

    ID#

    CK#

    07/18/2008 $6.00

    Grinnell, IA 50112-8007

    1003 Old 6 RdGOODRICH, ANN

    ID#

    CK#

    08/01/2008 $6.00

    Grinnell, IA 50112-8007

    1003 Old 6 RdGOODRICH, ANN

    ID#

    CK#

    08/15/2008 $6.00

    Grinnell, IA 50112-8007

    1003 Old 6 RdGOODRICH, ANN

    ID#

    CK#

    08/29/2008 $6.00

    Grinnell, IA 50112-8007

    1003 Old 6 RdGOODRICH, ANN

    ID#

    CK#

    09/12/2008 $6.00

    Grinnell, IA 50112-8007

    1003 Old 6 RdGOODRICH, ANN

    ID#

    CK#

    09/26/2008 $6.00

    Grinnell, IA 50112-8007

    1003 Old 6 RdGOODRICH, ANN

    ID#

    CK#

    10/10/2008 $6.00

    Grinnell, IA 50112-80071003 Old 6 Rd

    GOODRICH, ANN

    ID#

    CK#

    07/18/2008 $4.00

    TAMA, IA 52339-2208

    700 GARFIELD STGRAFF, ELLEN

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $52.00

    3712

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    ID#

    CK#

    09/12/2008 $2.00

    Sioux City, IA 51106-4115

    4824 Lorraine AvenueGraham, Jean

    ID#

    CK#

    09/26/2008 $2.00

    Sioux City, IA 51106-4115

    4824 Lorraine AvenueGraham, Jean

    ID#

    CK#

    10/10/2008 $2.00

    Sioux City, IA 51106-4115

    4824 Lorraine AvenueGraham, Jean

    ID#

    CK#

    07/18/2008 $8.00

    KELLOGG, IA 50135-1116

    121 ADAIR STGUTHRIE, TRACI

    ID#

    CK#

    08/01/2008 $8.00

    KELLOGG, IA 50135-1116

    121 ADAIR STGUTHRIE, TRACI

    ID#

    CK#

    08/15/2008 $8.00

    KELLOGG, IA 50135-1116

    121 ADAIR STGUTHRIE, TRACI

    ID#

    CK#

    08/29/2008 $8.00

    KELLOGG, IA 50135-1116

    121 ADAIR STGUTHRIE, TRACI

    ID#

    CK#

    09/12/2008 $8.00

    KELLOGG, IA 50135-1116

    121 ADAIR STGUTHRIE, TRACI

    ID#

    CK#

    09/26/2008 $8.00

    KELLOGG, IA 50135-1116121 ADAIR ST

    GUTHRIE, TRACI

    ID#

    CK#

    10/10/2008 $8.00

    KELLOGG, IA 50135-1116

    121 ADAIR STGUTHRIE, TRACI

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $62.00

    3714

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    ID#

    CK#

    07/18/2008 $5.00

    Marion, IA 52302-6162

    1905 Sugaridge DriveHall, Janan

    ID#

    CK#

    08/01/2008 $5.00

    Marion, IA 52302-6162

    1905 Sugaridge DriveHall, Janan

    ID#

    CK#

    08/15/2008 $5.00

    Marion, IA 52302-6162

    1905 Sugaridge DriveHall, Janan

    ID#

    CK#

    08/29/2008 $5.00

    Marion, IA 52302-6162

    1905 Sugaridge DriveHall, Janan

    ID#

    CK#

    09/12/2008 $5.00

    Marion, IA 52302-6162

    1905 Sugaridge DriveHall, Janan

    ID#

    CK#

    09/26/2008 $5.00

    Marion, IA 52302-6162

    1905 Sugaridge DriveHall, Janan

    ID#

    CK#

    10/10/2008 $5.00

    Marion, IA 52302-6162

    1905 Sugaridge DriveHall, Janan

    ID#

    CK#

    07/18/2008 $5.00

    Iowa City, IA 52246-8697

    1325 Phoenix DriveHalverson, Michelle

    ID#

    CK#

    08/01/2008 $5.00

    Iowa City, IA 52246-86971325 Phoenix Drive

    Halverson, Michelle

    ID#

    CK#

    08/15/2008 $5.00

    Iowa City, IA 52246-8697

    1325 Phoenix DriveHalverson, Michelle

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $50.00

    3715

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    ID#

    CK#

    08/29/2008 $5.00

    Iowa City, IA 52246-8697

    1325 Phoenix DriveHalverson, Michelle

    ID#

    CK#

    09/12/2008 $5.00

    Iowa City, IA 52246-8697

    1325 Phoenix DriveHalverson, Michelle

    ID#

    CK#

    09/26/2008 $5.00

    Iowa City, IA 52246-8697

    1325 Phoenix DriveHalverson, Michelle

    ID#

    CK#

    10/10/2008 $5.00

    Iowa City, IA 52246-8697

    1325 Phoenix DriveHalverson, Michelle

    ID#

    CK#

    07/18/2008 $30.00

    Cedar Rapids, IA 52402-3355

    1526 Matterhorn Drive NortheastHandley, Lori

    ID#

    CK#

    08/01/2008 $30.00

    Cedar Rapids, IA 52402-3355

    1526 Matterhorn Drive NortheastHandley, Lori

    ID#

    CK#

    08/15/2008 $30.00

    Cedar Rapids, IA 52402-3355

    1526 Matterhorn Drive NortheastHandley, Lori

    ID#

    CK#

    08/29/2008 $30.00

    Cedar Rapids, IA 52402-3355

    1526 Matterhorn Drive NortheastHandley, Lori

    ID#

    CK#

    09/12/2008 $30.00

    Cedar Rapids, IA 52402-33551526 Matterhorn Drive Northeast

    Handley, Lori

    ID#

    CK#

    09/26/2008 $30.00

    Cedar Rapids, IA 52402-3355

    1526 Matterhorn Drive NortheastHandley, Lori

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $200.00

    3716

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    ID#

    CK#

    10/10/2008 $30.00

    Cedar Rapids, IA 52402-3355

    1526 Matterhorn Drive NortheastHandley, Lori

    ID#

    CK#

    07/18/2008 $4.00

    Chicago, IL 60622-2111

    1705 W Le Moyne Street Apt. AHodges, Bruce

    ID#

    CK#

    08/01/2008 $4.00

    Chicago, IL 60622-2111

    1705 W Le Moyne Street Apt. AHodges, Bruce

    ID#

    CK#

    08/15/2008 $4.00

    Chicago, IL 60622-2111

    1705 W Le Moyne Street Apt. AHodges, Bruce

    ID#

    CK#

    08/29/2008 $4.00

    Chicago, IL 60622-2111

    1705 W Le Moyne Street Apt. AHodges, Bruce

    ID#

    CK#

    09/12/2008 $4.00

    Chicago, IL 60622-2111

    1705 W Le Moyne Street Apt. AHodges, Bruce

    ID#

    CK#

    09/26/2008 $4.00

    Chicago, IL 60622-2111

    1705 W Le Moyne Street Apt. AHodges, Bruce

    ID#

    CK#

    10/10/2008 $4.00

    Chicago, IL 60622-2111

    1705 W Le Moyne Street Apt. AHodges, Bruce

    ID#

    CK#

    07/18/2008 $5.00

    BROOKLYN, IA 52211-86021498 OLD 6 RD

    HODINA, ERIC

    ID#

    CK#

    08/01/2008 $5.00

    BROOKLYN, IA 52211-8602

    1498 OLD 6 RDHODINA, ERIC

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $68.00

    3717

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    ID#

    CK#

    08/15/2008 $5.00

    BROOKLYN, IA 52211-8602

    1498 OLD 6 RDHODINA, ERIC

    ID#

    CK#

    08/29/2008 $5.00

    BROOKLYN, IA 52211-8602

    1498 OLD 6 RDHODINA, ERIC

    ID#

    CK#

    09/12/2008 $5.00

    BROOKLYN, IA 52211-8602

    1498 OLD 6 RDHODINA, ERIC

    ID#

    CK#

    09/26/2008 $5.00

    BROOKLYN, IA 52211-8602

    1498 OLD 6 RDHODINA, ERIC

    ID#

    CK#

    10/10/2008 $5.00

    BROOKLYN, IA 52211-8602

    1498 OLD 6 RDHODINA, ERIC

    ID#

    CK#

    07/18/2008 $7.50

    Cedar Rapids, IA 52402-7033

    4710 Coventry Lane NortheastHoward, William

    ID#

    CK#

    08/01/2008 $7.50

    Cedar Rapids, IA 52402-7033

    4710 Coventry Lane NortheastHoward, William

    ID#

    CK#

    08/15/2008 $7.50

    Cedar Rapids, IA 52402-7033

    4710 Coventry Lane NortheastHoward, William

    ID#

    CK#

    08/29/2008 $7.50

    Cedar Rapids, IA 52402-70334710 Coventry Lane Northeast

    Howard, William

    ID#

    CK#

    09/12/2008 $7.50

    Cedar Rapids, IA 52402-7033

    4710 Coventry Lane NortheastHoward, William

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $62.50

    3718

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    ID#

    CK#

    08/01/2008 $5.00

    Cedar Rapids, IA 52404-7709

    3405 Blue Pointe Court SouthwestJakoubek, Paula

    ID#

    CK#

    08/15/2008 $5.00

    Cedar Rapids, IA 52404-7709

    3405 Blue Pointe Court SouthwestJakoubek, Paula

    ID#

    CK#

    08/29/2008 $5.00

    Cedar Rapids, IA 52404-7709

    3405 Blue Pointe Court SouthwestJakoubek, Paula

    ID#

    CK#

    09/12/2008 $5.00

    Cedar Rapids, IA 52404-7709

    3405 Blue Pointe Court SouthwestJakoubek, Paula

    ID#

    CK#

    09/26/2008 $5.00

    Cedar Rapids, IA 52404-7709

    3405 Blue Pointe Court SouthwestJakoubek, Paula

    ID#

    CK#

    10/10/2008 $5.00

    Cedar Rapids, IA 52404-7709

    3405 Blue Pointe Court SouthwestJakoubek, Paula

    ID#

    CK#

    07/18/2008 $2.50

    BROOKLYN, IA 52211-9728

    616 MAIN STKRIEGEL, KIMBERLY

    ID#

    CK#

    08/01/2008 $2.50

    BROOKLYN, IA 52211-9728

    616 MAIN STKRIEGEL, KIMBERLY

    ID#

    CK#

    08/15/2008 $2.50

    BROOKLYN, IA 52211-9728616 MAIN ST

    KRIEGEL, KIMBERLY

    ID#

    CK#

    08/29/2008 $2.50

    BROOKLYN, IA 52211-9728

    616 MAIN STKRIEGEL, KIMBERLY

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $40.00

    3720

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    ID#

    CK#

    09/12/2008 $2.50

    BROOKLYN, IA 52211-9728

    616 MAIN STKRIEGEL, KIMBERLY

    ID#

    CK#

    09/26/2008 $2.50

    BROOKLYN, IA 52211-9728

    616 MAIN STKRIEGEL, KIMBERLY

    ID#

    CK#

    10/10/2008 $2.50

    BROOKLYN, IA 52211-9728

    616 MAIN STKRIEGEL, KIMBERLY

    ID#

    CK#

    07/18/2008 $2.50

    GRINNELL, IA 50112-7600

    15415 N 75TH AVE EKRUMM, SHARON

    ID#

    CK#

    08/01/2008 $2.50

    GRINNELL, IA 50112-7600

    15415 N 75TH AVE EKRUMM, SHARON

    ID#

    CK#

    08/15/2008 $2.50

    GRINNELL, IA 50112-7600

    15415 N 75TH AVE EKRUMM, SHARON

    ID#

    CK#

    08/29/2008 $2.50

    GRINNELL, IA 50112-7600

    15415 N 75TH AVE EKRUMM, SHARON

    ID#

    CK#

    09/12/2008 $2.50

    GRINNELL, IA 50112-7600

    15415 N 75TH AVE EKRUMM, SHARON

    ID#

    CK#

    09/26/2008 $2.50

    GRINNELL, IA 50112-760015415 N 75TH AVE E

    KRUMM, SHARON

    ID#

    CK#

    10/10/2008 $2.50

    GRINNELL, IA 50112-7600

    15415 N 75TH AVE EKRUMM, SHARON

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $25.00

    3721

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    ID#

    CK#

    07/18/2008 $10.00

    Shellsburg, IA 52332-0829

    PO Box LLarimer, Audra

    ID#

    CK#

    08/01/2008 $10.00

    Shellsburg, IA 52332-0829

    PO Box LLarimer, Audra

    ID#

    CK#

    08/15/2008 $10.00

    Shellsburg, IA 52332-0829

    PO Box LLarimer, Audra

    ID#

    CK#

    08/29/2008 $10.00

    Shellsburg, IA 52332-0829

    PO Box LLarimer, Audra

    ID#

    CK#

    09/12/2008 $10.00

    Shellsburg, IA 52332-0829

    PO Box LLarimer, Audra

    ID#

    CK#

    09/26/2008 $10.00

    Shellsburg, IA 52332-0829

    PO Box LLarimer, Audra

    ID#

    CK#

    10/10/2008 $10.00

    Shellsburg, IA 52332-0829

    PO Box LLarimer, Audra

    ID#

    CK#

    07/18/2008 $3.00

    MALCOM, IA 50157-8101

    4098 90TH STMANATT, PATRICIA

    ID#

    CK#

    08/01/2008 $3.00

    MALCOM, IA 50157-81014098 90TH ST

    MANATT, PATRICIA

    ID#

    CK#

    08/15/2008 $3.00

    MALCOM, IA 50157-8101

    4098 90TH STMANATT, PATRICIA

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $79.00

    3722

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    ID#

    CK#

    08/29/2008 $3.00

    MALCOM, IA 50157-8101

    4098 90TH STMANATT, PATRICIA

    ID#

    CK#

    09/12/2008 $3.00

    MALCOM, IA 50157-8101

    4098 90TH STMANATT, PATRICIA

    ID#

    CK#

    09/26/2008 $3.00

    MALCOM, IA 50157-8101

    4098 90TH STMANATT, PATRICIA

    ID#

    CK#

    10/10/2008 $3.00

    MALCOM, IA 50157-8101

    4098 90TH STMANATT, PATRICIA

    ID#

    CK#

    07/18/2008 $2.50

    MALCOM, IA 50157-8014

    4370 HIGHWAY 63, BOX 8MC CAIN, SUSAN

    ID#

    CK#

    08/01/2008 $2.50

    MALCOM, IA 50157-8014

    4370 HIGHWAY 63, BOX 8MC CAIN, SUSAN

    ID#

    CK#

    08/15/2008 $2.50

    MALCOM, IA 50157-8014

    4370 HIGHWAY 63, BOX 8MC CAIN, SUSAN

    ID#

    CK#

    08/29/2008 $2.50

    MALCOM, IA 50157-8014

    4370 HIGHWAY 63, BOX 8MC CAIN, SUSAN

    ID#

    CK#

    09/12/2008 $2.50

    MALCOM, IA 50157-80144370 HIGHWAY 63, BOX 8

    MC CAIN, SUSAN

    ID#

    CK#

    09/26/2008 $2.50

    MALCOM, IA 50157-8014

    4370 HIGHWAY 63, BOX 8MC CAIN, SUSAN

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $27.00

    3723

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    ID#

    CK#

    10/10/2008 $2.50

    MALCOM, IA 50157-8014

    4370 HIGHWAY 63, BOX 8MC CAIN, SUSAN

    ID#

    CK#

    07/18/2008 $7.50

    Cedar Rapids, IA 52402-6801

    3007 Old Orchard Road NortheastMike, Donna

    ID#

    CK#

    08/01/2008 $7.50

    Cedar Rapids, IA 52402-6801

    3007 Old Orchard Road NortheastMike, Donna

    ID#

    CK#

    08/15/2008 $7.50

    Cedar Rapids, IA 52402-6801

    3007 Old Orchard Road NortheastMike, Donna

    ID#

    CK#

    08/29/2008 $7.50

    Cedar Rapids, IA 52402-6801

    3007 Old Orchard Road NortheastMike, Donna

    ID#

    CK#

    09/12/2008 $7.50

    Cedar Rapids, IA 52402-6801

    3007 Old Orchard Road NortheastMike, Donna

    ID#

    CK#

    09/26/2008 $7.50

    Cedar Rapids, IA 52402-6801

    3007 Old Orchard Road NortheastMike, Donna

    ID#

    CK#

    10/10/2008 $7.50

    Cedar Rapids, IA 52402-6801

    3007 Old Orchard Road NortheastMike, Donna

    ID#

    CK#

    07/18/2008 $2.50

    Lyndhurst, OH 44124-25335037 Bristol Court

    Nadar, Anand

    ID#

    CK#

    08/01/2008 $2.50

    Lyndhurst, OH 44124-2533

    5037 Bristol CourtNadar, Anand

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $60.00

    3724

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    ID#

    CK#

    08/15/2008 $2.50

    Lyndhurst, OH 44124-2533

    5037 Bristol CourtNadar, Anand

    ID#

    CK#

    08/29/2008 $2.50

    Lyndhurst, OH 44124-2533

    5037 Bristol CourtNadar, Anand

    ID#

    CK#

    09/12/2008 $2.50

    Lyndhurst, OH 44124-2533

    5037 Bristol CourtNadar, Anand

    ID#

    CK#

    09/26/2008 $2.50

    Lyndhurst, OH 44124-2533

    5037 Bristol CourtNadar, Anand

    ID#

    CK#

    10/10/2008 $2.50

    Lyndhurst, OH 44124-2533

    5037 Bristol CourtNadar, Anand

    ID#

    CK#

    07/18/2008 $5.00

    GRINNELL, IA 50112-1751

    1108 SUMMER STPEASE, LINDA

    ID#

    CK#

    08/01/2008 $5.00

    GRINNELL, IA 50112-1751

    1108 SUMMER STPEASE, LINDA

    ID#

    CK#

    08/15/2008 $5.00

    GRINNELL, IA 50112-1751

    1108 SUMMER STPEASE, LINDA

    ID#

    CK#

    08/29/2008 $5.00

    GRINNELL, IA 50112-17511108 SUMMER ST

    PEASE, LINDA

    ID#

    CK#

    09/12/2008 $5.00

    GRINNELL, IA 50112-1751

    1108 SUMMER STPEASE, LINDA

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $37.50

    3725

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    ID#

    CK#

    09/26/2008 $5.00

    GRINNELL, IA 50112-1751

    1108 SUMMER STPEASE, LINDA

    ID#

    CK#

    10/10/2008 $5.00

    GRINNELL, IA 50112-1751

    1108 SUMMER STPEASE, LINDA

    ID#

    CK#

    07/18/2008 $10.00

    Cedar Rapids, IA 52403-4355

    4225 Dalewood Avenue SoutheastRay, Jane

    ID#

    CK#

    08/01/2008 $10.00

    Cedar Rapids, IA 52403-4355

    4225 Dalewood Avenue SoutheastRay, Jane

    ID#

    CK#

    08/15/2008 $10.00

    Cedar Rapids, IA 52403-4355

    4225 Dalewood Avenue SoutheastRay, Jane

    ID#

    CK#

    08/29/2008 $10.00

    Cedar Rapids, IA 52403-4355

    4225 Dalewood Avenue SoutheastRay, Jane

    ID#

    CK#

    09/12/2008 $10.00

    Cedar Rapids, IA 52403-4355

    4225 Dalewood Avenue SoutheastRay, Jane

    ID#

    CK#

    09/26/2008 $10.00

    Cedar Rapids, IA 52403-4355

    4225 Dalewood Avenue SoutheastRay, Jane

    ID#

    CK#

    10/10/2008 $10.00

    Cedar Rapids, IA 52403-43554225 Dalewood Avenue Southeast

    Ray, Jane

    ID#

    CK#

    07/18/2008 $2.00

    Amana, IA 52203-8202

    824 31st AvenueRotter, Karmela

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $82.00

    3726

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    ID#

    CK#

    08/01/2008 $2.00

    Amana, IA 52203-8202

    824 31st AvenueRotter, Karmela

    ID#

    CK#

    08/15/2008 $2.00

    Amana, IA 52203-8202

    824 31st AvenueRotter, Karmela

    ID#

    CK#

    08/29/2008 $2.00

    Amana, IA 52203-8202

    824 31st AvenueRotter, Karmela

    ID#

    CK#

    09/12/2008 $2.00

    Amana, IA 52203-8202

    824 31st AvenueRotter, Karmela

    ID#

    CK#

    09/26/2008 $2.00

    Amana, IA 52203-8202

    824 31st AvenueRotter, Karmela

    ID#

    CK#

    10/10/2008 $2.00

    Amana, IA 52203-8202

    824 31st AvenueRotter, Karmela

    ID#

    CK#

    07/18/2008 $3.00

    Cedar Rapids, IA 52405-2838

    4552 Orchard Drive NorthwestSafley, Thomas

    ID#

    CK#

    08/01/2008 $3.00

    Cedar Rapids, IA 52405-2838

    4552 Orchard Drive NorthwestSafley, Thomas

    ID#

    CK#

    08/15/2008 $3.00

    Cedar Rapids, IA 52405-28384552 Orchard Drive Northwest

    Safley, Thomas

    ID#

    CK#

    08/29/2008 $3.00

    Cedar Rapids, IA 52405-2838

    4552 Orchard Drive NorthwestSafley, Thomas

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $24.00

    3727

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    ID#

    CK#

    09/12/2008 $3.00

    Cedar Rapids, IA 52405-2838

    4552 Orchard Drive NorthwestSafley, Thomas

    ID#

    CK#

    09/26/2008 $3.00

    Cedar Rapids, IA 52405-2838

    4552 Orchard Drive NorthwestSafley, Thomas

    ID#

    CK#

    10/10/2008 $3.00

    Cedar Rapids, IA 52405-2838

    4552 Orchard Drive NorthwestSafley, Thomas

    ID#

    CK#

    07/18/2008 $3.00

    Cedar Rapids, IA 52404-5201

    27 Dartmouth Street SouthwestSalven, Timothy

    ID#

    CK#

    08/01/2008 $3.00

    Cedar Rapids, IA 52404-5201

    27 Dartmouth Street SouthwestSalven, Timothy

    ID#

    CK#

    08/15/2008 $3.00

    Cedar Rapids, IA 52404-5201

    27 Dartmouth Street SouthwestSalven, Timothy

    ID#

    CK#

    08/29/2008 $3.00

    Cedar Rapids, IA 52404-5201

    27 Dartmouth Street SouthwestSalven, Timothy

    ID#

    CK#

    09/12/2008 $3.00

    Cedar Rapids, IA 52404-5201

    27 Dartmouth Street SouthwestSalven, Timothy

    ID#

    CK#

    09/26/2008 $3.00

    Cedar Rapids, IA 52404-520127 Dartmouth Street Southwest

    Salven, Timothy

    ID#

    CK#

    10/10/2008 $3.00

    Cedar Rapids, IA 52404-5201

    27 Dartmouth Street SouthwestSalven, Timothy

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $30.00

    3728

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    ID#

    CK#

    07/18/2008 $1.50

    GRINNELL, IA 50112-1026

    1820 PRINCE STSAUNDERS, MIRIAM

    ID#

    CK#

    08/01/2008 $1.50

    GRINNELL, IA 50112-1026

    1820 PRINCE STSAUNDERS, MIRIAM

    ID#

    CK#

    08/15/2008 $1.50

    GRINNELL, IA 50112-1026

    1820 PRINCE STSAUNDERS, MIRIAM

    ID#

    CK#

    08/29/2008 $1.50

    GRINNELL, IA 50112-1026

    1820 PRINCE STSAUNDERS, MIRIAM

    ID#

    CK#

    09/12/2008 $1.50

    GRINNELL, IA 50112-1026

    1820 PRINCE STSAUNDERS, MIRIAM

    ID#

    CK#

    09/26/2008 $1.50

    GRINNELL, IA 50112-1026

    1820 PRINCE STSAUNDERS, MIRIAM

    ID#

    CK#

    10/10/2008 $1.50

    GRINNELL, IA 50112-1026

    1820 PRINCE STSAUNDERS, MIRIAM

    ID#

    CK#

    07/18/2008 $10.00

    Cedar Rapids, IA 52411-7601

    4039 Cedar Grove Court NortheastSchramp, Kyle

    ID#

    CK#

    08/01/2008 $10.00

    Cedar Rapids, IA 52411-76014039 Cedar Grove Court Northeast

    Schramp, Kyle

    ID#

    CK#

    08/15/2008 $10.00

    Cedar Rapids, IA 52411-7601

    4039 Cedar Grove Court NortheastSchramp, Kyle

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $40.50

    3729

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    ID#

    CK#

    10/10/2008 $10.00

    Cedar Rapids, IA 52411-7601

    4039 Cedar Grove Court NortheastSchramp, Philip

    ID#

    CK#

    07/18/2008 $2.50

    GRINNELL, IA 50112-2343

    510 PEARL STSCHULTZ, BARBARA

    ID#

    CK#

    08/01/2008 $2.50

    GRINNELL, IA 50112-2343

    510 PEARL STSCHULTZ, BARBARA

    ID#

    CK#

    08/15/2008 $2.50

    GRINNELL, IA 50112-2343

    510 PEARL STSCHULTZ, BARBARA

    ID#

    CK#

    08/29/2008 $2.50

    GRINNELL, IA 50112-2343

    510 PEARL STSCHULTZ, BARBARA

    ID#

    CK#

    09/12/2008 $2.50

    GRINNELL, IA 50112-2343

    510 PEARL STSCHULTZ, BARBARA

    ID#

    CK#

    09/26/2008 $2.50

    GRINNELL, IA 50112-2343

    510 PEARL STSCHULTZ, BARBARA

    ID#

    CK#

    10/10/2008 $2.50

    GRINNELL, IA 50112-2343

    510 PEARL STSCHULTZ, BARBARA

    ID#

    CK#

    07/18/2008 $2.50

    GRINNELL, IA 50112-81384266 20TH ST

    SMITH, JUDITH

    ID#

    CK#

    08/01/2008 $2.50

    GRINNELL, IA 50112-8138

    4266 20TH STSMITH, JUDITH

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $32.50

    3731

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    ID#

    CK#

    08/15/2008 $2.50

    GRINNELL, IA 50112-8138

    4266 20TH STSMITH, JUDITH

    ID#

    CK#

    08/29/2008 $2.50

    GRINNELL, IA 50112-8138

    4266 20TH STSMITH, JUDITH

    ID#

    CK#

    09/12/2008 $2.50

    GRINNELL, IA 50112-8138

    4266 20TH STSMITH, JUDITH

    ID#

    CK#

    09/26/2008 $2.50

    GRINNELL, IA 50112-8138

    4266 20TH STSMITH, JUDITH

    ID#

    CK#

    10/10/2008 $2.50

    GRINNELL, IA 50112-8138

    4266 20TH STSMITH, JUDITH

    ID#

    CK#

    07/18/2008 $5.00

    GRINNELL, IA 50112-0926

    PO BOX 926STANEK, KATHY

    ID#

    CK#

    08/01/2008 $5.00

    GRINNELL, IA 50112-0926

    PO BOX 926STANEK, KATHY

    ID#

    CK#

    08/15/2008 $5.00

    GRINNELL, IA 50112-0926

    PO BOX 926STANEK, KATHY

    ID#

    CK#

    08/29/2008 $5.00

    GRINNELL, IA 50112-0926PO BOX 926

    STANEK, KATHY

    ID#

    CK#

    09/12/2008 $5.00

    GRINNELL, IA 50112-0926

    PO BOX 926STANEK, KATHY

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $37.50

    3732

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    ID#

    CK#

    09/26/2008 $5.00

    GRINNELL, IA 50112-0926

    PO BOX 926STANEK, KATHY

    ID#

    CK#

    10/10/2008 $5.00

    GRINNELL, IA 50112-0926

    PO BOX 926STANEK, KATHY

    ID#

    CK#

    07/18/2008 $3.00

    Grinnell, IA 50112-1336

    1131 Reed StSTORY, NICOLE

    ID#

    CK#

    08/01/2008 $3.00

    Grinnell, IA 50112-1336

    1131 Reed StSTORY, NICOLE

    ID#

    CK#

    08/15/2008 $3.00

    Grinnell, IA 50112-1336

    1131 Reed StSTORY, NICOLE

    ID#

    CK#

    08/29/2008 $3.00

    Grinnell, IA 50112-1336

    1131 Reed StSTORY, NICOLE

    ID#

    CK#

    09/12/2008 $3.00

    Grinnell, IA 50112-1336

    1131 Reed StSTORY, NICOLE

    ID#

    CK#

    09/26/2008 $3.00

    Grinnell, IA 50112-1336

    1131 Reed StSTORY, NICOLE

    ID#

    CK#

    10/10/2008 $3.00

    Grinnell, IA 50112-13361131 Reed St

    STORY, NICOLE

    ID#

    CK#

    07/18/2008 $2.50

    SULLY, IA 50251-8658

    12695 S 92ND AVE EVAN SOELEN, KAREN

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $33.50

    3733

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    ID#

    CK#

    08/01/2008 $2.50

    SULLY, IA 50251-8658

    12695 S 92ND AVE EVAN SOELEN, KAREN

    ID#

    CK#

    08/15/2008 $2.50

    SULLY, IA 50251-8658

    12695 S 92ND AVE EVAN SOELEN, KAREN

    ID#

    CK#

    08/29/2008 $2.50

    SULLY, IA 50251-8658

    12695 S 92ND AVE EVAN SOELEN, KAREN

    ID#

    CK#

    09/12/2008 $2.50

    SULLY, IA 50251-8658

    12695 S 92ND AVE EVAN SOELEN, KAREN

    ID#

    CK#

    09/26/2008 $2.50

    SULLY, IA 50251-8658

    12695 S 92ND AVE EVAN SOELEN, KAREN

    ID#

    CK#

    10/10/2008 $2.50

    SULLY, IA 50251-8658

    12695 S 92ND AVE EVAN SOELEN, KAREN

    ID#

    CK#

    07/18/2008 $5.00

    MONTEZUMA, IA 50171-8412

    238 Horseshoe DrWALKER, DEBORAH

    ID#

    CK#

    08/01/2008 $5.00

    MONTEZUMA, IA 50171-8412

    238 Horseshoe DrWALKER, DEBORAH

    ID#

    CK#

    08/15/2008 $5.00

    MONTEZUMA, IA 50171-8412238 Horseshoe Dr

    WALKER, DEBORAH

    ID#

    CK#

    08/29/2008 $5.00

    MONTEZUMA, IA 50171-8412

    238 Horseshoe DrWALKER, DEBORAH

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $35.00

    3734

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    ID#

    CK#

    09/12/2008 $5.00

    MONTEZUMA, IA 50171-8412

    238 Horseshoe DrWALKER, DEBORAH

    ID#

    CK#

    09/26/2008 $5.00

    MONTEZUMA, IA 50171-8412

    238 Horseshoe DrWALKER, DEBORAH

    ID#

    CK#

    10/10/2008 $5.00

    MONTEZUMA, IA 50171-8412

    238 Horseshoe DrWALKER, DEBORAH

    ID#

    CK#

    07/18/2008 $5.00

    GRINNELL, IA 50112-8139

    179 WALNUT ROADWEAVER, DAVID

    ID#

    CK#

    08/01/2008 $5.00

    GRINNELL, IA 50112-8139

    179 WALNUT ROADWEAVER, DAVID

    ID#

    CK#

    08/15/2008 $5.00

    GRINNELL, IA 50112-8139

    179 WALNUT ROADWEAVER, DAVID

    ID#

    CK#

    08/29/2008 $5.00

    GRINNELL, IA 50112-8139

    179 WALNUT ROADWEAVER, DAVID

    ID#

    CK#

    09/12/2008 $5.00

    GRINNELL, IA 50112-8139

    179 WALNUT ROADWEAVER, DAVID

    ID#

    CK#

    09/26/2008 $5.00

    GRINNELL, IA 50112-8139179 WALNUT ROAD

    WEAVER, DAVID

    ID#

    CK#

    10/10/2008 $5.00

    GRINNELL, IA 50112-8139

    179 WALNUT ROADWEAVER, DAVID

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $50.00

    3735

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    ID#

    CK#

    07/18/2008 $2.75

    NEWTON, IA 50208-2215

    317 E 9TH ST NWEBSTER, DIANA

    ID#

    CK#

    08/01/2008 $2.75

    NEWTON, IA 50208-2215

    317 E 9TH ST NWEBSTER, DIANA

    ID#

    CK#

    08/15/2008 $2.75

    NEWTON, IA 50208-2215

    317 E 9TH ST NWEBSTER, DIANA

    ID#

    CK#

    08/29/2008 $2.75

    NEWTON, IA 50208-2215

    317 E 9TH ST NWEBSTER, DIANA

    ID#

    CK#

    09/12/2008 $2.75

    NEWTON, IA 50208-2215

    317 E 9TH ST NWEBSTER, DIANA

    ID#

    CK#

    09/26/2008 $2.75

    NEWTON, IA 50208-2215

    317 E 9TH ST NWEBSTER, DIANA

    ID#

    CK#

    10/10/2008 $2.75

    NEWTON, IA 50208-2215

    317 E 9TH ST NWEBSTER, DIANA

    ID#

    CK#

    07/18/2008 $5.00

    GRINNELL, IA 50112-8306

    256 NEWBURG ROADWELLS, JOANN

    ID#

    CK#

    08/01/2008 $5.00

    GRINNELL, IA 50112-8306256 NEWBURG ROAD

    WELLS, JOANN

    ID#

    CK#

    08/15/2008 $5.00

    GRINNELL, IA 50112-8306

    256 NEWBURG ROADWELLS, JOANN

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Section 68B.32a(6), prohibits the use of information copied from reports and statements for soliciting contributions orfor any commercial purpose by any person other than statutory political committees.

    DATERECEIVED

    (MM/DD/YR)

    IFU

    RAINC

    AMOUNTRECEIVED

    RELATIONSHIPTO CANDIDATE*

    (if applicable)

    NAME AND ADDRESS OF CONTRIBUTORPAC ID NUMBER (ifapplicable) AND

    PAC CHECKNUMBER

    a

    Verizon Iowa State Good Government Club

    * Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to thecommittee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives bymarriage). If surname of contributor is the same as candidate, but there is no familial relationship, enter "notapplicable" in the relationship column.

    TOTAL (if last page of this schedule)

    SUB-TOTAL $

    $

    Page ________of ________ (for Schedule A)

    $34.25

    3736

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    ID#

    CK#

    08/29/2008 $5.00

    GRINNELL, IA 50112-8306

    256 NEWBURG ROADWELLS, JOANN

    ID#

    CK#

    09/12/2008 $5.00

    GRINNELL, IA 50112-8306

    256 NEWBURG ROADWELLS, JOANN

    ID#

    CK#

    09/26/2008 $5.00

    GRINNELL, IA 50112-8306

    256 NEWBURG ROADWELLS, JOANN

    ID#

    CK#

    10/10/2008 $5.00

    GRINNELL, IA 50112-8306

    256 NEWBURG ROADWELLS, JOANN

    63.00Unitemized Contributions10/14/08 ID#

    CK#

    $

    For Instructions, See Back of Form

    CONTRIBUTIONS -- MONEY TAKEN IN

    (Including candidate's personal funds)

    COMMITTEE NAME (Must be same as on Statement of Organization)

    SCHEDULE

    A(Rev. 07/03)

    MONETARYRECEIPTS

    CHECK THIS BOX IFAMENDING FORM

    STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATIONNUMBER AND THE PAC CHECK NUMBER IN THE DESIGNTAED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGNDISCLOSURE BOARD.

    CAUTION: Secti