For Instructions, See Back of Form SCHEDULE

A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 07/03) RECEIPTS
(Including candidate's personal funds)

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

D CHECK THIS BOX IF
AMENDING FORM

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

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

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (ifapplicable) TO CANDIDATE* RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID# J G i~ a t-v S A ltd
l D fl2/c>~ ~ M v . ~° A/ T~ ~lybc a
CK# I -) Z.,
~LfAL~iz .w .~-dNJA
'
ID#

2-/0'-5 CK# :3 3,s.5 J ~' Z 4 `'V y ti/ft /6u~r

1= -t . Tasv a
/Lt ~ " ~ = r~a N

ID#
- /r ~% ~' z lk A/// e..
Z~ ~ Z
ID#
1'/j
CK#

J O (~ L,/',
CK# 3 3E co , o iti .1.1s .~L .rte N / o ti. S
ID#
YJ v .rl r~ 2 rz I ti Spa .tJ
CK# ,5 J 1 3 L 7 s h ,b .L~ .r ti P l.n
It T. .~ AC t Sd ~ ~1~ W.i
ID# W A tin b C,J h : -f- Is l7 shy ,
~ s .,~ 4A Jr A- --A--,,
CK# 6
ID# Jvhrv s~~sil 6~
CK# -2 L/ /10
i1n4~?Ir~,,/
ID# ~
1 =~ 6' 6-
C vl 3 3- 7 Y C L r.. 6 L~1 tiu
CK# 3 7 1$
d ~l/4
ID#
,a C c s o T7`~ ~3-
< <7 a!J ,is N N~
CK# f 7 ! ~J
l ol~-~1~~
.2r o t SO
SUB-TOTAL

TOTAL (iflast page of this schedule)

* Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) . If surname of contributor is the same as candidate, butthere is no Page I of -71
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
For Instructions, See Back of Form SCHEDULE
Reset Fonn

CONTRIBUTIONS -- MONEY TAKEN IN

A MONETARY
(Rev . 07/03) RECEIPTS
(including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
re11 707- fs6
~--1 ti GV 1 N G

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

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

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
I D#
/w b' u ~L
(6 l 1 3 6 -2--Z 2 v iJ'v ~S
CK# Y" O

1- CK# .~ s :!,g
- - 11 0

ID#
S ~ lI 2 N /n
`6 1 .1 LS 5 rLJ~ .S(~v /~
1 1 ~.3 ~ Jw /v '~ vi>c'c
ID#
w. ,~ /k d h rte'
CK# `2 `) e8' .3 0 1 1a Sam`- N U
-f "A L' AS a AJ u'b

1v
45' I D#

`C7Z HrG /c-A I

lL / .b r:.r
~l~ llr /J2 /V~4 U 'X
CK#
L~/ (S, !. Y!. :::~ L"t6
I D# ;
ft )J o
I

ID#
1Z " L' t'ts~ls Pka
CK# iv /,s

ID#
ec( l_ elf' ~ ~ Nr ,~
Iti,'J SGa G
C
K# '~ _ 4t '1
ICk~T
ID# L,~n.ny k tjl~ly N
!o / CK# $' 7 / -Z l Y r Ivd i2.?!, fv :t L' R- . `''
41r-, r
I D#

~l 1-6/cs CK#

SUB-TOTAL

TOTAL (if last page of this schedule)

* Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) . If surname of contributcK,i&the same as candidate, but there is no Page o2 of
familial relationship, enter "not applicable` III the relationship column . (for Schedule A)
 FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY

(Rev . 07/03) EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE 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 NAME (Must be same as on Statement of Organization)

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
ID

C K# ~

CK#
Cr't' , /,nil rS _

CK# at- fcst' - .

ID#
rs . d, , . ~r fr'r

ID#
1 22 L x, Yy
.
t'-T
ID#
ht~ ..v St s Q.~~ / ~' ,tf l
c1 CK#

ID#

CK#

I D#

C K#

SUB-TOTAL
TOTAL (if last page of this schedule)

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 68A.402(3)(i) .)

Page of_

(for Schedule B)
 978 00001 01 PAGE : 1
`r- r Madison ACCOUNT :
DOCUMENTS :
4654544 10/21/2005
P.O . Box 329, Avenue G & 7th St. . Fort Iviaa isaii , 1A - dw~7 0
www .fortmadisonbank.own
email : bank@rfortmadisonbank .corn

HELLING FOR MAYOR COMMITTEE

JAMES G HELLING
ROSIE D HELLING
3322 AVENUE H
FORT MADISON IA 52627-3555

FREE CHECKING ACCOUNT 4654544

LAST STATEMENT 10/14/05 .00

2 CREDITS 575 .00
DEBITS .00
THIS STATEMENT 10/21/05 575 .00
- - - - - - - - - - DEPOSITS - - - - - - - - - -
P'RF # . . . . . DATE . . . . . . AMOUNT REF # . . . . . DATE . . . . . . AMOUNT REF # . . . . . DATE . . . . . . AMOUNT
10/14 435 .00 10/17 140 .00
- - - - - - - - DAILY BALANCE - - - - - - - -
DATE . . . . . . . . . . . BALANCE DATE . . . . . . . . . . . BALANCE DATE . . . . . . . . . . . BALANCE
10/14 435 .00 10/17 575 .00
- END OF STATEMENT -

NOTICE : SEE REVERSE SIDE FOR IMPORTANT INFORMATION

 maciison 978 00001 01
ACCO 4654544
PAGE : 1
11/21/2005
P.O. Box 329, Avenue G & 7th St ., Fort gthiEa isr~r~, Lri1. 52621
31 9-37'2-S y C:4 DOCU _~~ 0
www.fortmadisonbzsni<.com
emaii : bank@fortmadisortbttrij ..coi .a

HELLING FOR MAYOR COMMITTEE

JAMES G HELLING
ROSIE D HELLING
3322 AVENUE H
FORT MADISON IA 52627-3555

F I N A L S T A T E M E N T

FREE CHECKING ACCOUNT 4654544

LAST STATEMENT 10/21/05 575 .00

3 CREDITS 215 .50
4 DEBITS 790 .50
THIS STATEMENT 11/21/05 .00

- - - - - - - - - - DEPOSITS - - - - - - - - - -
REF ## . . . . . DATE . . . . . . AMOUNT REF # . . . . . DATE . . . . . . AMOUNT REF # . . . . . DATE . . . . . . AMOUNT
10/25 30 .00 10/27 150 .00 11/04 35 .50

- - - - - - - - - - CHECKS - - - - -
CHECK # . .DATE . . . . . . AMOUNT CHECK # . .DATE . . . . . . AMOUNT CHECK # . .DATE . . . . . . AMOUNT
*10/27 413 .02 *11/03 244 .80 11/09 128 .56

INDICATES A GAP IN CHECK NUMBER SEQUENCE

- - - - - - - - - OTHER DEBITS - - - - - - - - -
DESCRIPTION DATE AMOUNT
CLOSING WITHDRAWAL 11/16 4 .12

- - - - - - - - DAILY BALANCE - - - - - - - -
DATE . . . . . . . . . . . BALANCE DATE . . . . . . . . . . . BALANCE DATE . . . . . . . . . . . BALANCE
10/25 605 .00 11/03 97 .18 11/09 4 .12
10/27 341 .98 11/04 132 .68 11/16 .00

- END OF STATEMENT -

NOTICE : SEE REVERSE SIOF FOR IMPORTANT (NFOEN1ATtON