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Disclosure Summary Page Ell/ DR-2 I
Disclosure Summary Page Ell/ DR-2 I
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SIGN OF PERSON FILING REPORT TELEPHONE DATE SIGNED
0 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 DR-3 is filed .)
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"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
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 10 NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
FM
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ID# ri) TD C. Jf'L ~ /tO7 c' r Uf 7 QA
7) M $
CK# Cpl C .S4rf
/C/~ I(-,, c ki i I<-
ID#
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CK# 1 SC-7.
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CK# ~- ~Zd AUe
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SUB-TOTAL
' 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) . tf 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 SCHEDULE
A I MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 07/03) RECEIPTS
(Including candidate's personal funds)
LEF CHECK THIS BOX IF
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 statutory political committees .
DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID# arr~ l7C~l irrP
CK# 1 ~s l 300,3 rJ
61 171.3 - n 5
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CK#
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CK# 1535'e
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CK# a S-,o
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SUB-TOTAL
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
mamage) . If surname of contributor is the same as candidate, but there is no Page C~l of
familial relationship, enter 'not applicable' in the relationship column . (for Schedule A)
- For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 07103) RECEIPTS
llncluding candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
STATE CANDIDATES NOTE . IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (PCLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED CCLUMN . A LIST CF !D NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BCARD.
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 IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
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CK# .~ 7yl
ID#
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' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribubon 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. but there is no Page of
familial relationship . enter'not applicable' in the relationship column . (for Schedule A)
` For Instructions, See Back of Form SCHEDULE
Reset Form
A MONETARY
CONTRIBUTIONS - MONEY TAKEN IN (Rev. 07103) RECEIPTS
(Including candidate's personal funds)
'Q_CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM
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 v IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DDNR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID# 7~ I'.i Y f- I-- hc~_ rct d e
cK# P V- I r C~-
I D#
CK# ~ _
S rr t!- ~4 L`l5
ID#
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CK# %~10/l l~v~
CK# lS -5- T- en 4
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I D#
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ID#
CK#
ID#
CK#
I D#
CK#
ID#
CK#
ID#
CK#
SUB-TOTAL
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
. If surname of contributor is the same as candidate, but there is no
manage) Page of
familial relationship, enter 'not applicable' in the relationship column . (for Schedule A)
FOR INSTRUCTIONS, SEE BACK OF FORM Rrid fiqm SCHEDULE
CK Temi
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ID# .~~s t ~zl
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SUB-TOTAL $
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TOTAL (if last page of this schedule $
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)
Expenditures to personslentities 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 personlentity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 68A.6(3)(i) .)
Page - / -_ of _.
(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form SCHEDULE
ID#
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CK# C,
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CK# Keck
>s k 5 a Y t~ c d tal/ry
1D#
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SUB-TOTAL $ /S
TOTAL (if last page of this schedule) $
Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions .)
Expenditures to personsientities 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
a
Schedule G instructions and Iowa Code 68A.6(3)(i)-)
(for Schedule B)