PAGE 0"21

05/11/1999 17 :39 515-951 -1025 ~-~ir,RREN C0 SHERIFF

FOR INSTRUCTIONS, SEE

MCK OF FORM
DISCLOSURE SUMMARY
PAGE
COMIMT7t NAME (Must be soma as on Sfatoman(of
OMgnfzatlon)

TOm 111`YlmavLCacShe~
;~
Iwf: Indiana by N typeof conmlmsu you me mpordrv for:
vAdWLogaWf6%WJodao Sbndfnp for Crmvideta (2 Pad* PAC (3)Stete Party
ty C~ernnri CornrkW ( 6 )CorsFty C and, . .' ; ndbace ( 7 )School Board or Other
tadifical Subd"lon Candidaba (e )County PAC (9 . . , ;t ; !Board or other PoRticat
Subdivision PAC (11) Local Ballot taeue i
CANDIDATE COMMITTEES ONLY :
Candidate Name
Late reports are subject to
WI-fl maa..1 possible civil and criminal
penalbes.

I AM FILING A 1 i `--~U 1 REPORT FOR (1) ELECTION l(2 ONeLECTIoN YEAR.

(,.Port date) InclIcale oy 7F

HECK IF AMENDMENT TO REPORT DATED

hoot If this Is final (termination) report and attach Notice of Dissolution Form DR-3 .
(You must continue to the reports unill a DR-3 Is Mod .)

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (Total of oil lunds hold by the
committee . This amount MUST be the same as the cash on hand et the end
of the lost reporting period or must be zero If this Is first report filed .) .. . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . $
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Conbibudorls total (Attach Schedule A) ('also see Imklnd below) . ... ... . . . '30 Litu -E*-
Schedule F: Loans Received total (Attach Schedule F) . .. . . . . . . . .. . .. . .. . . . . . . . ... . . . . . . . . .. . . . . . . . . . . . . . .. . .
Schedule H: Total Sales of Campaign Property (Attach Schedule H) ...... ... ....................... ..
lftb2odula H XMIll" Iau CandIdalloa' CawWttm Only)
SUB-TOTAL .. . .. : -
StWTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B : Expenditures tome (Attach Schedule B) (**also see debts end loans below) . . . .
Schedule F : Loan Repayments total (Attach Schedule F) . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . ... . . . . . . . . . . .. . . . . . . .

CASH ON HAND at toe end of Ihls reporting period (If final report batanoe must
be zero) (Attach DR-3) . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . .. . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . . .5 ~_
rwr:rr
'"UNPAID BILLS (From Schedule D - Atmch Schedule D)..... . . . . .. . .. . .... .. . .. . .. . ... . . . . .. . .. . ... . . . . .. ... . ...... . .. . . b '-
-IN KIND CONTRIBUTIOM (From Schedule E - Attach Schedule E) . .. . .. . .. . .. . . . . . . .. . . . . .. . .. . . .. . , . . . . . .. . . .. . 5
"OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . .. . . .. . . . . .. . . .. . . . . . . . . . . ... . . . . . . . ... . .. . . . . .. . .5 _.-,-

CONSULTANT BREAKDOWN (Schedule G Ahachad?) DYES (A NO

VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach SdMdute H)
 I:,JARREfJ Cl3 SHERIFF PAGE 03
05i'11 1'99'9 17 :39 515-951 - 1025

For Instructions, 8es Back of Form SCHEDULE

A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN
(Rev. 07103) I RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Stat9ment of Organlzetion AMENDING FORM

STATE CANDIDATES NOTE: IF A CONTRIBUTION 13 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 888.32A(B), 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 4 IF FOR
RECEIVED (if applicable) TO CANDIDATE - RECEIVED FUND-
(MMIDDIYR) AND PAC CHECK (If applicable) RAISER
NUMBER INCOME
ID# ~'~ ~u~~Ws '60
964 w -tea A uV_,
$
IQ-1 q-0 Qpts+~
CK#
daa,~la;
ID~
~p,l j S,~A
CK#a5-1 an I7 'tC4ytHl u d> r-,-
~ r
Ion

ID # "At IL41))
, ~ofwa~ 14

mnQ
CK#
C,RS X51%-
r G,pp~-1 t~ . .~,,
UAT La,k.~
1
~ 0-, 066
- =

-1

1-8-d CK9 Cjof 6,~ aiS c~ . ~c~t~, .l

ID#

CK#

ID*

CK#

ID#

CK#

I D#

CK#

C K#

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. Reletidnship 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
famlllal relationship, enter "not applicable" in the relationship column . (for Schedule AA
 515-951-1025 I;JAPPEN C0 SHERIFF PAGE 04
05r' l l .i 1999 17 :39

FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY
(Rev . Q7/03) 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 Sta(em t 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#
~2Cur~ {~t3~L l
o~~y CK# P ao_
J0A5

o0
CK# bbl W , 2

I D#
W rr -, Y1 s,
1r1P,ur. (~ , ~o
C K# N

ID# ~( tNO-non (hl,~s

14 4
JJ-g~o~ CK# w .2r-t
8 Bbl

C K#

ID*

C K#

I D#

C K#

SUB-TOTAL

TOTAL (!f 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 oleo 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 lowe Code 88A .402(3)(i),)

Page -----I__.. -f _J------

(for Schedule 0)
 515-951-1025 1.JARREN CO SHERIFF PAGE 05
05/11/1999 17 :39

FOR ANSTRUC77ONS, SEE BACK OF FORM SCHEDULE

E IN KIND
COMMITTEE NAME (WO be sums its on Statement of Organfza6on)

bl,r
(Rwv . 08/97)1 CONTRIBUTIONS

-- 01,~ 14-
HECK THIS BOX IF
AMENDING FORM

DATE RELATIONSHIP DESCRIPTION ESTIMATED -! IF FOR

RECEIVED NAME AND ADDRESS TO CANDIDATE OF IN KIND FAIR MARKET FUND-MISER
MMIDD/YR OF CO NTRIBUTOR ' if cable CONTRIBUTION VALUE CONTRIBUTION
1 Lit s
' pr M060(
A 50 i S s ~hes

~~ iS
Sa~-CDs 66
-----~-
O)7 5M c~ ~ .~~~ 5a
1,Ala~-j
' -20006 !A u
C~7n l?"1 G!7 r~l

=a.Aq .v ;..., . XAM-

SUB-TOTAL

TOTAL (Ir taut

page of this
sctwduln)

`DIeoIosure taw requires candt to disclow the reletlonshIp of ary reWive making an In kfnd eontdbution to the Page --I- of
committee . Relationship moot be shown to Ow third degree of eonsangulnlty (blood roletivas) and efinidy (relevf (for Schedule E)
by mwrlage). (Sec Page 2 of forms peoloet .) If suururme of coMriblAor Is the same as candkiate, bui there in no
fam(Nal telatfonehfp, enter "not appka In tM rofefonaNp column .