FOR INSTRUCTIONS, SEE BACK OF FORM FORM

Reset Fo
DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
(Rev. 07/2004) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization)
For Office Use Only
SILO Communication Comm . #
IMPORTANT : Indicate by # type of committee you are reporting for : Logged In -,
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party Scanned
(4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or Other
Political Subdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 10 )School Board or Other Political Computer
Subdivision PAC ( 11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES ONLY :
Candidate Name Political Party (if applicable)
Late reports are subject to
possible civil and criminal
Office Sought District (if Senate or House) penalties .

SIGNATURE OF PERSON FILING REPORT TELEPHONE DATE SIGNED

FINAL
I AM FILING A REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate by # 1-1
Local Committees, enter Date of Election
FlCHECK IF AMENDMENT TO REPORT DATED
2-15-2005

F] 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 .) Humboldt

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (Total of all funds held by the
committee . This amount MUST be the same as the cash on hand at the end
582.25
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) . . . . . . . . . . 65 .00
Schedule F : Loans Received total (Attach Schedule F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule H : Total Sales of Campaign Property (Attach Schedule H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
_(Schedule Happlies to Candidates' Committees Only)
SUB-TOTAL . . . . . $
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B : Expenditures total (Attach Schedule B) (**also see debts and loans below) . . . . 647 .25
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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

**UNPAID BILLS (From Schedule D -Attach Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

*IN KIND CONTRIBUTIONS (From Schedule E -Attach Schedule E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
**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) $
FPCM : PJ00ZTHPARk: FAM I L'T' DENT I STR`T' PC FAX HO . :5153323227 Apr . 04 2005 03 :05PM P1

FOR INSTRUCTIONS, SEE BACK OF FORM

DISCLOSURE SUMMARY PAGE
FORM
DR-2 DISCLOSURE
(Rev. 07/2004) REPORT

For Office Use Only

Comm tt ' 1"Z'7
b
Logged In
Scanned
Computer
Audited

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

S' lG y (Snol w k) ro-dyer, 6l7/X[A_A. , d ~eP _

~ .
IMPORTANT lndicato by # type of comrnlttee you are reporting for : 1I0 .,
( 1 )Stetawidell-eglslative/Judge Standing for Retention Candidate (2 )State PAC ( 3 )State Party
( 4 )County Central Committee ( 5 )County Candidate (6 )City Candidate ( 7 )School Board or Other Political
Subdivision Candidate (6 )County PAC (9 )City PAC ( 10 )School Board or Other Political Subdivision PAC (11)
Local Ballot Issue
CANDIDATE COMMITTEES ONLY :
Candidate Name Political Party (if applicable)

Office Sought District (if Senate or House)

Late reports are subject to possible civil and criminal penalties .

51f - 377- 373 0

SIGNATURE OF PERSON FILING REPORT TELEPHONE

DATE SIGNED

I AM FILING A
REPORT - FOR (1) ELECTION /(2)NON-
ELECTION YEAR .
(report date) Indicate by #
Local Committees, enter Date of Election
2, IT - os"
County & Local Committees, enter County in which Election Is held
A41a6-.A . b 0 rdf

CHECK IF AMENDMENT TO REPORT DATED

Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 .
(You must continue to file reports until a DR-3 Is filed .)

STATEMENT OF CASH ON HAND

 FRON : HOR ; HPARK FAf1 I LY DENTISTRY PC FAX PLO . :515.3323227 Apr . 04 2005 03 :05PM P2

the
CASH ON HAND at the beginning of the reporting period (Total of all funds held by
end
committee, This amount MUST be the same as the cash on hand at the
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)

(Schec_la&e H applies to Candidates' Committees Only)

SUB-TOTAL
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 OR-3)

"UNPAID BILLS (From Schedule D - Attach Schedule D) $

`IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) $

"""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) $

DISCLOSURE S UMMARY PAGE

Form DR-2
Revised 07/2004
STATEWIDE AND GENERAL ASSEMBLY CANDIDATES
STATE POLITICAL PARTIES &
OR JUDGE STANDING FOR RETENTION STATEWIDE PAC COUNTY
CENTRAL COMMITTEES
FI,FCTION YEAR 14FPOPTINC : UATCS
Raacn Duo
Oovarod Pn r{eN-Ineluvlyc
May 16 Jan, 1-Mny 14
July 14 May 16-Juiy 14
OU . 19 JL,u y 15-Oct. 14
,Ian . 19 Oct. IS-Doc . 31

NON-ELECTION YEAR REPORTINf+0ATES

H.AP_(j,Aufl Coverall narfcd-InC(ualve
July 19 Jan 1-July 14
Jan . 19 July 16-Dec 31
ELECTION YEAR PFPOrITINO GATES
For Instructions, See Back of Form SCHEDULE
Reset Fonn
CONTRIBUTIONS -- MONEY TAKEN IN
A MONETARY
(Rev . 07/03) RECEIPTS
(Including candidate's personal funds)

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

0 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 IF FOR
RECEIVED (if applicable) TO CANDIDATE* RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
I D#
3 ~^ rJ
. CK# yc ~uc~ti" 5 ~s -
i

ID#

CK#

1D#

CK#

I D#

CK#

1D#

CK#

1D#

CK#

I D#

CK#

I D#

CK#

1D#

CK#

I D#

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 contributor is the same as candidate, but there is no Page t of _~
familial relationship, enter "not applicable" in the relationship column . (for Schedule A)
 FOR INSTRUCTIONS, SEE BACK OF FORM Reset Form
SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B

(Rev. 07/03)
MONETARY
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)

CDw,Y,VV,~ C 0~,i 10" s

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# On,l 1°Rrvious
Hw :iboici~ - vti,oe- ~~~cvs a °r f ~r°V i~ C- PC P- T
I)')) CS' CK# )t!pl 51Z Su~0zr ~(oz-

ID#
tws c
CK# t 0. ~7 3
slw.6c ct f 'fit
ID#
f,svnJ
'~I d.1 j CL~ CK# iDd 3
.~
~Itlnvt~eiCi r ~~,~ ;-,clGv
/flctuSp~~L' A/ZWsIVCcjzre~ ccc~~e~ a~ l ~ . ZJ
5, 1 2. j w, .a n Pv s4 Jr_
L44Lh n ief ~
1D#
9. 0 -4
3/A'I/ 0 ' CK# lee~l ~yor3 Jtc~t . .~-> '?e,o OLI*

ID#

CK#

ID#

CK#

1D#

CK#

ID#

CK# ,ZA5 , 5
J.
L
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) .)

(for Schedule B)