FOR INSTRUCTIONS, SEE BACK OF `RM

DISCLOSURE SUMMARY PAGE

COMMITTEE NAME (Must same as n Stat ent of O zation)
r 6 ~Pr ~ar6~'V ~n ~ ~` - For Office Use Onl

Comm . # 0
IMPORTANT: Indicate type of committee you are reporting for: Ffl
(1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate
Indexed
1 77 L_
( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee Audited / -,41/7

( 8 )Support Slate of Candidates

Computer
CANDIDATE COMMITTEES ONLY :
Candidate Name Political Party

~~MEI~iD
Office Sought District (if Senate or House)
MAY 15 2002

SIGNATURE OF THE URER (or person filing this ort) TELEPHONE DATE SIGNED rf ~

Routine Penalties Due For Late Filed Reports Range from $20 to $800
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :
I AM FILING A .REPORT FOR AN/A (1) ELECTION ON-ELECTION YEAR .
IT~`
(report date) Indicate one

FICHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election

F1 Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . County & Local Committees, enter County in
which Election is held
(You must continue to file reports until a Notice of Dissolution is filed .)

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (This is the total of all monies 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 .) .. .. .. .. .. . . . .. .. .. .. .. .. .. .. . .. $
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) (*also see in-kind below) .. . . . .. ..
Schedule F : Loans Received total (Attach Schedule F) .. . . . .. .. .. .. .. .. .. .. . . . .. .. .. .. .. .. .. .. . . . .. .. .. .. .. ..
Schedule H : Total Sales of Campaign Property (Attach Schedule H) . .. .. ... . . .. .. .. .. . . . .. .. .. .. .. ..
(Schedule H applies to Candidates' Committees One
SUB-TOTAL .....$ , ~N
9,-3
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) (**also see debts and loans below) .. .
Schedule F: Loan Repayments total (Attach Schedule F) . .. .. . . . .. .. .. .. .. .. .. .. . . . .. .. .. .. .. .. .. .. . . . .. .. .
CASH ON HAND at the end of this reporting period (if final report, balance must '(7 -2
be zero) (Attach DR-3) . .. . . . .. .. . . .. .. . . .. .. . . . .. .. .. .. . . .. .. .. . . . .. .. .. .. . . .. .. . . .. ... .. .. .. . . .. .. .. .. . .. .. .. . . .. .. .. .. . . . .. .. . $ 110 kj ~4 1

~
**UNPAID BILLS (From Schedule D - Attach Schedule D) .. .. .. .. .. .. .... ... .. .. .. .. .. .. .. .. .. . . . .. .. .. .. .. .. . .. .. .. .. .. . $ 1~ d d
*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .. .. .. .. Ij> . .. .. .E~.. .3
.3 . . . .. .. .. .. .. .. ..... $
**OUTSTANDING LOANS (From Schedule F - Attach Schedule F) .. .. .. .. .. .. .. . .. .. .. . . .. .. .. .. .. ... .. .. .. .. .. .. .. . $
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
 FOR INSTRUCTIONS, SEE BACK OF FORM
SCHEDULE
D INCURRED
COMMITTEE NAME (Must be same as on Statement of Organization)

r,kiFud) Sre r11_qrr MULL-Wt

(Rev . 08/98)1 INDEBTEDNESS

Q CHECK THIS BOX

NOTE : Debts previously reported that remain unpaid must be included on this IF AMENDING
Schedule, as well as any new obligations incurred in this period . FORM

An "incurred debt" is a debt for

DEBTS/OBLIGATIONS REMAINING THIS REPORTING PERIOD goods or services ordered or
(DO NOT INCLUDE LOANS -- SHOW LOANS ON SCHEDULE F) received, but not paid for by the
end of the reporting period .,
regardless of whether an invoice
has been received
DATE DESCRIPTION OF GOODS OR BALANCE OWED AT
INCURRED NAME AND ADDRESS OF PERSON SERVICES PROVIDED OR CLOSE OF
(MM/DD/YR) TO WHOM DEBT OR OBLIGATION IS OWED PURCHASED REPORTING
PERIOD*

l
~I b 0 ~i K

SUB-TOTAL $

TOTAL DEBTS OWED BY COMMITTEE AT THE END OF THIS REPORTING PERIOD $

Jb-6o

*If actual figure is unknown, show "estimated" beside the figure . Page -~ of-
(for Schedule D)

CANDIDATE COMMITTEES NOTE :

*Incurred indebtedness also includes each person/entity with whom the candidate's committee has entered into a contract during the reporting period for future
or continuing performance . Enter the name of the consultant who provides or procures services for items such as advertising, fund-raising, polling, managing, or
organizing services . Report on Schedule G the nature of performance and the estimated performance reasonably expected of the consultant .
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev . 06/97)I CONTRIBUTIONS
1^
E 10
Q CHECK THIS BOX IF
AMENDING FORM

DATE RELATIONSHIP DESCRIPTION ESTIMATED IF FOR

RECEIVED NAME AND ADDRESS TO CANDIDATE OF IN KIND FAIR MARKET FUND-RAISER
(MM/DDNR) OF CONTRIBUTOR * (if applicable) CONTRIBUTION VALUE CONTRIBUTION

7 01 U FA
Q (~ 5(f_.1 Gc m-e-t $

, W,04 eL

TOTAL (if last

page of this
schedule)

"`Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page of L
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule E)
by marriage) . (See Page 2 of forms packet .) If surname of contributor is the same as candidate, but there is no
familial relationship, enter "not applicable" in the relationship column .
FCR WSTRUCTIONS, SEE BACK OF FORM
INCURRED
COMMITT
T-EEE (Must be same as on Statement of Organization) )I INDEBTEDNESS

Friends dPCarolyn Riley x CHECK THIS BOX

IF AMENDING
NOTE : Debts previously reported that remain unpaid must be included on this
FORM
Schedule, as well as any new obligations incurred in this period .

An "incurred debt" is a debt for

DEBTS/OBLIGATIONS REMAINING THIS REPORTING PERIOD goods or services ordered or
(DO NOT INCLUDE LOANS -- OW LOANS ON SCHEDULE F) received, but not paid for by the
end of the reporting period .,
regardless of whether an invoice
has been received .
DATE '' DESCRIPTION OF GOODS OR BALANCE OWED AT
INCURRED NAME AND ADDRESS OF PERSON SERVICES PROVIDED OR CLOSE OF
(MM/DD/YR) TO WHOM DEBT OR OBLIGATION IS OWED PURCHASED REPORTING
PERIOD*
Carter Printing Cowboy Informational Cards $1104 .50
7/31/2000 1739 East Grand Avenue
Des Moines, IA 50316

Carter Printing Postcards, Mailings $286 .88

1739 East Grand Avenue
09/08/2000 Des Moines, IA 50316

Advertising for Jewish Press $50 .00

10/14/2000 1<6d
LU
'U
Carter Printing Service Charge $37 .59
10/27/2000 1739 East Grand Avenue
Des Moines, IA 50316

Carter Printing Yard Signs $1033 .50

1739 East Grand Avenue
10/27/2000 Des Moines, IA 50316

Carter Printing Service Charge $37 .59

1739 East Grand Avenue
10/29/2000 Des Moines, IA 50316

SUB-TOTAL $

TOTAL DEBTS OWED BY COMMITTEE AT THE ND OF THIS REPORTING PERIOD $2550 .63
6 16 a95`D , 10 10
*If actual figure is unknown, show "estimated" beside the figure . Page 1 - of 1_
(for Schedule D)

CANDIDATE COMMITTEES NOTE :

*Incurred indebtedness also includes each person/entity with whom the candidate's committee has entered into a contract during the reporting period for future
or continuing performance . Enter the name of the consultant who provides or procures services for items such as advertising, fund-raising, polling, managing, or
organizing services. Report on Schedule G the nature of performance and the estimated performance reasonably expected of the consultant .