F,--)P 1KSTRUCiIONS, SEE BACK OF FORM FORM

.DISCLOSURE SU, 4ARY RAGE DR-2 DISCLOSURE

COMMITTEE NAME (Must be same as on tatement of .organization) (Rev. 01/2001) REPORT
i C!~ /,~ l~ 01/ c r t ct- f-e For Office Use Only
1

IMPORTANT: Indicate type of committee you are reporting for: Comm . # -7,

Indexed - -------- -
( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate
( 5 )County PAC ( 6 )Ballot Issue/Franchise Committee ( 7 )County/City Central Committee Audited
( 8 )Support Slate of Candidates Computer
CANDIDATE COMMITTEES ONLY :

S
Candidate Name Political Party
TEU~
Office Sought District (if Senate or House)

Z
DATE S1GED

Routine Penalties Due For Late Filed Reports Range from $20 to $800
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :
I AM FILING AFt~t . '12 9 O -I `7 -0 1 REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) ` Indicate one
CHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election

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

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) .. . .. . .~". . .:-.d . ...... ....
(Schedule H applies to Candidates' Committees Only)

SUB-TOTAL......$ _0 D .
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) (**also see debts and loans below) . .. ,~ 650 . '&S'
Schedule F: Loan Repayments total (Attach Schedule F) ............. .. ... ....... .. .... .. ... .., .. ..... .. ...

qsq, /S-
CASH ON HAND at the end of this reporting period (if final report, balance must r,
be zero) (Attach DR-3) .............. .. . .. . . . .. ...... .. .. ..... . .. .. .. .. ..... .............. ... .. .. . . .. .. %b . ... .$

**UNPAID BILLS (From Schedule D - Attach Schedule D) .. ........ ........ .... ... .. ... .. ..... .. .. .. .. .. . ... .. ..... .. ....$ I . -=~~ est
*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . .. .. .. ........ .. ... ...... . . ... . .. .. .. ... .. ..$ 0
*"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) 1 16 ' 0
5 $ _ Sry
 For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev. 06/9 RECEIPTS
(Including candidate's personal funds)
[,CHECK THIS BOX IF
I COMMITTEE NAME (Must be same as on Statement of Organization) 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 statuto Utcal committees.
"
DATE PAC ID NUMBER NAME A(D ADDRESS'OF CONTRIBUTOR RELATIONSHIP AMOUNT q IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
-4 9
CK#
Win te.~ t.'4 $
-5- 0,7 -3 I
-~oj, Ca .S QY Tref,tJ C0. , ' i

CK# 'W ;ri~e1.5e",~Z45627Y 0- ve

ID#

cK#
Qv' a ~,~ rein [
4
ID#
330` v-tQ
rn 1,1 46 3-110 ~

2
CK#
10can 4- tleeei e~ e e-
' ( jl aY~rttS ~ J0 b
1D# 6 03 A/rU)4ad st' 6, o~
to PeeN~ec~ I
'2
cK#
da ~e C~ Oein 0 crfa fS
ID#

CK# ~eea -r~~~4 Yet vl 2- S

~/) t#~
ID# -

CK#

ID#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL
~ tJ
TOTAL (if last page of this
schedule) $ q(
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) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
 )40R. INSTRUCTIONS, SEE BACK OF FORM

,'EXPENDITURES, .- MONEY SPENT FROM COMMITTEE ACCOUNT

'(Rev . 08/97)` EXPENDITURES
STATE PAC COMMITTEES: NOTE : , FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE '-
CANDIDATES, LIS, THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE CHECK THIS DOX :IF
' PAC CHECK NUMBER FOR EACH EXPENDITURE . . A LIST OF ID NUMBERS IS AVAILABLC FROM THE IOWA
ETHICS & CAMPA!GN DISCLOSURE BOARD .

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

CANDIDATE NAME ANQf ADDRESS WHOM

DATE ILI NUMBER RE
;s EXPENDED (if applicable) (Disbursement) WAS MADE
(M NJDD/YR) :'., . AND PAC
CHECK
NUMBER ..

I CK#

ID#

1 CK#

Ur ct0,- Au.
r S+uo.ef Za M20
CK#

,ID# .

~CK# .

Ab,( za SoooJ
i ~c=c ( IG15
w
i C~ ' ~? e Ce~S
2)r. 1st .lve i

3h3 FIN
i s`U 00
KcV

1~~- ehelle O Ow
. SUS-TOTAI_

TOTAL (it lastpage caf this schedule) '

S

THIS BOX APQLIES TO CANDIDATES' COMMITTEES ONLY :

Purchases of certain campaign ;roporby cbst ng $500 or more must also be invento^od on Schedule H. (Refer to Schedule instructions .),
Expenditures to personsientitles providing consulting, advertising, fund-raising, peiling, managing, organizing services must also be detail itemized on
Scnedule G by ;he amount, purpose, and data of each type of ,oendilure made by the person/entity on behalf of the candida ;e's committee . (Rater ro j
Schedule G instnictions and Iowa Code 56.6(3}(?) .} !
 FOR INSTRUCTIONS, SEE R-1 CK OF FORM
! scr -

EX PE3\;'-I 1TU ME S -- IV;0N17:Y S PFN'T FR0V,,'C 0M V, 7T~-:F~ ACC0 !J!~I

NCMW FO? CON - MUTIONS IMADE TO S7A-rEW1'--)'!: 0?, LEO! ILATIVE

CATY0.-N77S, L!! ;TTY,`--' CANDMAI MENMRCAPM N`jMSER IN T'-I=_ OESiGNAT 72C
,
-
PAC CM NUMER AW EACH EAPEN09USE A WS7 OF II
COLUVMANDTHF-
I N-LYV3EIQS iS AVA:!-'T-c ;
0 w- A UAM wN 9 N DIMAMR E BOARD . r--C'A THE
In :VA

(Altust b~ spme~ !s on Statement of Orcorizadlog'

~ ~~ 1. h~tl ~~ ~ ~~><
!~'-.Mwwm
- ~4,ND!'DATE c-J207151_,alto
0 WHOM 700577 --
7 ,~V,~'- ~SACTICN) ~

;"'b PAC

SUB-TOTAL -7S- S-,

.~

T07-/V, (if hq~~'pvge of III-- fv'Vvx~'r ;!'~? C)

THS r-
,PX APPUSS Tq,CANOtOATES! C0MMli.TTr---Tm c,,1-y
. ,

OP 3clledful 9 H. f?efrir to SCII.Odule H lnstrue-".n^s .'~~

i funI-rals!ng, polling, crqzmi7-'rg servicas must $!s

.- be : - ci :-
:t'+d.hid alo of acph lyzr , owdZum mAr) by Phapc~rv.) .Varitiiy an bqna!f of the Cardi&.,Ze's com-
~ wo " VOMMMM any wan Mly me Am 1 ~ :
FOR INSTRUCTIONS, SEE BACK OF FORM

THIS FORM IS USED BY CANDIDATES' COMMITTEES ONLY

COMMITTEE NAME (Must be same as on Statement of Organization) ATTACH SCHEDULE H TO -

EACH REPORT, MAKING
CHANGES AS REQUIRED .

Q CHECK THIS BOX IF

PART I - ONGOING INVENTORY OF CAMPAIGN PROPERTY PART il - SALES OR TRANSFERS OF CAMPAIGN PROPERTY ** AMENDING FORM

Date Purchased
(Schedule B) Purchase ` Current
or Date Received Description of Property Price or Est . Value at Fair Date Name and Address of Purchaser/Donee Description of Property Sold? Sale Value of
(Schedule E) Value When Market This (MM/DD/YR) YIN Price Donation
(MM/DDNR) Acquired* Report

TOTAL VALUE CAMPAIGN PROPERTY THIS REPORT PROPERTY SALES & TRANSFERS TOTAL TOTALS
(TRANSFER TO SUMMARY PAGE) $ -~ (TRANSFER TO SUMMARY PAGE) $

* If estimated, show est. beside figure . (Attach Additional Schedules if Needed) Page of Pages
(For Schedule H)
 FOR, INSTRUCTIONS SEE BACK OF ' 7M FORM
DISCLOSURE SUmMARY PAGE DR-2 DISCLOSURE
COMMITTEE NAME (Must be same as on 8tatement o rganization) (Rev. 0112001) REPORT
FEB 1 8 2002
he ( (2v tor For Office Use Onl
IMPORTANT: Indicate type of committee you are reporting for: 17 Comm . # `5 7
-
Indexed
( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )County/Local Candidate
(5 )County PAC (6 )Ballot Issue/Franchise Committee (7 )County/City Central Committee Audited ;Z . a II . d1 .)-- _.
( 8 )Support Slate of Candidates Computer ~L1f
CANDIDATE COMMITTEES ONLY:
Candidate Name Political Party
cS+ e ~.~
Office Sought ~ District (if Senate or House)

.
S15 !Z&2 , 14
TELEPHONE DATE SIGNED

Routine Penalties Due For Late Filed Reports Range from $20 to $800
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :
I AM FILING At5e-L'1 2 9 OQ a
.2-15- -0- REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) SgplerrenQ Indicate one
[]CHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election

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

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) .... .. ... 90 a
Schedule F: Loans Received total (Attach Schedule F) .. .......... .. ................. ....... ...... ........ 20 5,5
Schedule H: Total Sales of Campaign Property (Attach Schedule H) . .. . .. .... ...... ... ............... 0
(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL......$ _vo ss
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
be zero) (Attach DR-3) ............... .. .. ... ....... .... .......... ........... .. .. .... .. .... .. .....4... ..~~.~ :.~5.... .$

**UNPAID BILLS (From Schedule D - Attach Schedule D) . .. ................. .... .. .. .... ....... .. .... .. . .. ... ...... .. ...$ Ln _=-- "~.st
'IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) ... ............ ............. .. ... ... ...... .. ...$
00
**OUTSTANDING LOANS (From Schedule F - Attach Schedule F) ........ ........... ................ .. ......... .. ...$ 1~ 0 -5,5-
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) S $ --5_X3
 For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev . 06/97) 1 RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

'S ~ .e t e. .
0
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 Ical committees .

DATE PAC ID NUMBER NAME A ADDRESS~OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR

RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
L, ID#
X3.0
CK# w
1 - 11 ..Q 0.
I D#

CK#

ID#

CK#
lea Yf?oH (av' reinc~ ~J
r (~
I D#

CK# af" ~7fS

10 can 4- (/e d'ii ~~e
02° 2. LD e J`~OD
I D# '

^ cK#
2 14A ce Co ,~ em v c rfa fS 75
I D#

ID#

CK#

I D#

CK#

ID#

CK#

ID#

CK#
I ~ I I I I 1
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) (See Page 2 of forms packet.) . If surname of contributor is the same as candidate, but there is no Page of
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
 FOR INSTRUCTIONS, SEE BACK OF FORM

eXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT"

II

L
STATE FAC' COMMITTEES . NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
GANDIQATES, .USTTHE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND'THE 2` CHECK THIS 9n-X' IF
PAC CHECK NUMBER FOR EACH EXPENDITURE .- LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING F0 'M' 7

ETHICS & CAMPAIGN DISCLOSURE BOARD . '

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

CANDIDATE N~AMMAN WHOM

DATE I ID NUMBER' . f RE
FFXPENDED I (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) .I, .. AND PAC:
CHECK
I NUMBER

TOTAL (if last page of this schedule)

" f

THIS BOX ALIES TO CANDIDATES' COMMITTEES ONLY :

,PUrchwes of certi~°campaign properly cbsting $500 or more must also be inventoried on Schedule H. (Refer to Schedule '= instructions.,

Expenditures to persons/entitles 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 vpenditure made by the porson/entity on behalf of the candidate's committee. (Refer to
Schedule instructions and Imve Code 5l',,B(3)(i),)

(for NS'Priaduis 8)
 ,,FOR INSTRUCTIONS, SEE BACK OF FORM

EXPENDITURES =MONEY SPENT FROM COMMrrTEF ACCOUNT `

MONETA ` ;
~' (Rev . D9I0)
STATE PAC COMMITTEES : NOTE:. FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, UST THE CANDIDATE IDENTIF!CAT'C?N NUMBER IN THE DESIGNATED COLUAaN AND THE
PAC CHECK NUMBER :FOR, EACH EXPENDITURE. A UET OF ID NUMBERS 1S AVA! .'. .?' FRRC" M THE IOWA
E'!'HICS & CAMPAIGN DISCLOSURE BOARD . ,

.;t +l (Must be sum !a on Statement of Organization)

n

,ANDIDATE NAI41E : h ;DDBE O WHOM PURPOSE

DATlH l ID NUMBER ; 0GI ' .,"T LIRE (DESCRIBE TRAP,°SACTION)
EXPENDED.. (It applimble) .. (Disbu :emen,,, YYVA 3 MALL
(WDONIZI)' AND PACs
CHECK

14 t

ID#

CK#

CK#

SUIT-TOTAL ,,

T07AL (lf lllwtpago of Mfs rcanedule) D 310

AIpuEq TQ CA DAi CCNVfM#S CMI Y

P

also be Inventoried on Schedul~, i; (RWrto;Schedule F! Instruc"ats` .L, .

s(~s itl ~~ t pvi?i,` ronsu< rlg; aet~m t; incl, furl-raising, polln9., manaong, organizlrgseryc9s.must;also be cll;: I - 1W . sC ,_w
..-wditure made by the ¬-p6drsorda> on beh4u oft48 ~~Ssndtdat8°S . QS~fT! . i`l": . . e .,. fo ., ;
rt tu r trl c ,
L. e o :x., ',_Srasrus ;J~, .o
t¢Iw ~ '"uirl#r1~~7 "YS ~;rs ;t~+r+k2"~~ 5y . .;U i'1
_ ..r .. ., .~ ..._.. ..-.-.~__..-_. .."".""'"' . . . } _"`_.... . _
_ ` ..
Pa".
 FONT INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
INCURRED
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev. 08/98) INDEBTEDNESS

A .e_ //9- V for se i? a. l - ~P 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

DEBTSIOBLIGATIONS 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'

~A uiY" G 1- ree fI^e5~'

( o$ ~rsb~zQ~-~'u5fr~
~_
~-02- Gre-~,h ~t ec 1A Icy ick er+IzeMQAJ-

CqU Hr f r.. Cc, . O cl J 2l'er

m,,« P C) a Z~ 3 3
7`'
~o FS
( Qtrt O rcti
T_ 0
.. 5 a ~ Gam` l ZeYIJ e

SUB-TOTAL $

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

/ 20
1

'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 -
COMMITTEE NAME(Must be same as on Statement of Organization) F LOANS
(Rev . 08/96) RECEIVED .
be_ r~ -~a r S'Qt, & REPAID

This schedule reports money loaned to the committee which is deposited in the committee account . CHECK THIS BOX IF
AMENDING FORM
TOTAL UNPAID LOANS FROM LAST REPORTING PERIOD $

PART I - MONETARY LOANS RECEIVED THIS REPORTING PERIOD PART If - MONETARY LOAN REPAYMENTS MADE THIS REPORTING PERIOD
(Original source of loan, such as a bank, must be shown if a third party is (Loans forgiven must be reported on Schedule E -- In-kind Contributions.)
involved. Include loans from candidate's personal funds.)
DATE NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT DATE PAID NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT
RECEIVED , (Include Endorser's Name, If Applicable) TO CANDIDATE OF LOAN (MM/DD/YR) (Include Endorser's Name, If Applicable) TO CANDIDATE* REPAID
(MM/DDIYR) If A Ilcable* If Applicable)

S s~vouse_
S~~v 4 She ll

TOTAL (PART/) TOTAL CASH REPAYMENTS (PART H)

From Schedule E --TOTAL LOANS FORGIVEN

TOTAL OUTSTANDING LOANS END OF REPORT PERIOD

*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) . (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 when it applies . Page__ - of - I
(for Schedule F)
FOR INSTRUCTIONS, SEE BACK OF FORM

THIS FORM IS USED BY CANDIDATES' COMMITTEES ONLY

COMMITTEE NAME (Must be same as on Statementof Organization) ATTACH SCHEDULE H TO

EACH REPORT, MAKING
S he~1e o CHANGES AS REQUIRED .

CHECK THIS BOX IF

PART 1- ONGOING INVENTORY OF CAMPAIGN PROPERTY PART II - SALES OR TRANSFERS OF CAMPAIGN PROPERTY ** AMENDING FORM
Date Purchased
(Schedule t3) Purchase Current
or Date Received Description of Property Price or Est. Value at Fair Date Name and Address of Purchaser/Donee Description of Property Sold? Sale Value of
(Schedule E) Value When Market This (MM/DD/YR) Y/N Price Donation
(MM/DDNR) Acquired* Report

a 0%

TOTAL VALUE CAMPAIGN PROPERTY THIS REPORT ** PROPERTY SALES & TRANSFERS TOTAL TOTALS
(TRANSFER TO SUMMARY PAGE) $ (TRANSFER TO SUMMARY PAGE) $
" If estimated, show esL beside figure. (Attach Additional Schedules if Needed) Page -of - ( Pages
_ (For Schedule H)