r r

G :~9A N-° ~onn :on fro . =.nnln~; ~ Zonn ;n,~. %o, (; 784 P. 1 1

FOR INSTRUCTIONS . SEE SACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
(Rev 07/2004) REPORT
COMMITTEE NAME (Must he some as on Statement of Organization)

For Office Use Only

Comm . x

IMRCRTANT : Indicate by 9 type of committee yotare reporting ror i -n J Logged In

f I )Statowida:Logi--Iative/Judge Standing for Retention Candidate ( 2 )State PAC (3 )State Party Scanned
( 4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidste (7 )School Board or Other
Political Subdivision Candidate ( 8 )County PAC (9 )City PAC ( 10 )School Board or Other Political Computer
Subdivision PAC ( 11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES ONLY :

Can date Name _ C Polit Party (if applicable)

Late reports are subject to
l ~ifO v'r~ . 4ela possible civil and criminal
Office Sought District (if Senate or House) penalties .

=rr/+ /?U Q

NATURE OF PERSON FILING REPORT TELEPHONE DATE SIGNED

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

" , in q6 fely #

Local Committees, enter Date of Election

EICHECK IF AMENDMENT TO REPORT DATEID
y _ oy

9-C"'heck if this is final (termination) report and a}t~tch Notice of Dissolution Form DR-1 . County E Local Committees ; enter County in
_
which Election is held
(You must continue w file reports untl a,,DR-3 is filed )

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (Total of all funds held by the
committee . This amount MUST be the same as the cash on hand at the end
of the last reporting period or must be zero if this is first report filed.) . . . . ., . . y. .~- ~3
. , ., . $
ADD TOTAL MONEY TAKEN IN THIS PERIOD

Schedule A: Cash Contributions total (Attach Schedule A) (`also see in-kind below) . . ~~r=C ~cfa 6)

Schedule F Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . .. . ... . .. ..

Schedule H. Total Sales of Campaign Property (Attach Schedule H) .,, . . . . . . . .

(Schedule H applies to Candidates' Commlttees Only)

SUB-TOTAL . . . ..$

SUBTRACT TOTAL MONEY SPENT THIS PERIOD

. i
.S -3 .
Schedule B: Expenditures total (Attach Schedule B) ("also see debts and loons below) ., . Je .9"

Schedule F, Loan Repayments total (Attach Schedule F) . . . . . . . . ., . , . . . . . . . . . ., . . . . . . . .

CASH ON HAND at the end of this reporting period (f final report balance must
be zero) (Attach DR-3) . . . .. , . ., . . . .

'"UNPAID BILLS (From Schedule D -Attach Schedule D) . .. . . . . .,  , . . . . . .. . .. . .. . . . . $

'IN KIND CONTRIBUTIONS (From Schedule E -Attach Schedule E) . . . . . . . . . .. .. .. . . . . . .. .. . $

"OUTSTANDING LOANS (From Schedule F-Attach Schedule F) . ., . . . . . . . . . . ., . . . . . . $

Tpa ns
Post-it" Fax Note 7671 Date
l
eo /

70 e
,-e //l,c//Pf,~- S
CarDopt.

Phone ti
Fhone b

Fax z
Fax 4
 h~la.v . t3 . ~()(!5 ~1 : 1 ' ~'~~i ;ohnson !~~, ' a.nn ~ n r~ Zonn ~ n "u

FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

B MONETARY
EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 07/03) I EXPENDITURES

STATE PAC COMMITTEES ; NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE

CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE 0 CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.

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

CANDIDATE NAME AND ADDRESS TO WHOM ,yLRPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESC' == `R~N~QTION) EXPENDED
EXPENDED (if applicable) (Disbursomont) WAS MADE
(MMiOD/YR) AND PAC ,
CHECK _
NUMBER
1D#
Sv~O~ f r-~
crJ
S-17-O5~ CK# 7 v
/03 17 q Al C^\ $

s,)
S-i7-US` CK# ~~r q y~brJ 30,E

ID#

CK# ~~ J

I D#

C K#

I D#

C K#

1D#

CK#

ID#

CK#

I D#

C K#

SUB-TOTAL $ -

TOTAL (if last page of this schedule) $

. S a.

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Purchases of certain campaign property costing S500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions )

ag, polling, managing, organizing services must also be detail itemized on

lade by the personlentlty on behalf of the candidate's committee . (Refer to
Post-it" Fax Note 7671 Date
Pa °
e&I

To From
Page of
CoJDePt. Co
ai a~~ Gh J :rwCJS
Phone si Pnehe to

Fax ti Fax a
(for Schedule B)