RIIey No,6759 P,

JUI-19, ?005 11 :02AM Bradley &

FOR INSTRUCTIONS, SEE SACK OF FORM FORM

DISCLOSURE SUMMARY PAGE DR-2 I DISCLOSURE
(Rev . 0712004) REPORT
COMMITTEE NAME (Must be same as on Statement of Organization)
For Offlcs Use Onhr ~z/
Iowa Initiatives Committee Comm . fI

IMPORTANT: Indicate by 0 type of committee you are reporting for: Logged In VAL
(1 )Statewlds/Lsgielalive/Judgs Standing for Retention Candidate (2 )State PAC ( 3 )State Party Scanned
(4 )County Contra] Committee ( 6 )County Candidate ( 6 )City Candidate ( 7 )School Board or Other
Political Subdivision Candidate ( 6 )County PAC ( g )City PAC (10 )School Board or Other Political Computer
Subdivision PAC ( 11 ) Local Ba llot Issue Audited
CANDIDATE COMMITTEES
Candidate Name I F)I . 1 Party (if applicable)
44 Late reports are subject to
possible civil and criminal
Office Sought penaltles.

DATE SIGNED

July 19, 2005

I AM FILING A REPORT FOR (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate by # o"~,

Local Commltteea, enter Date of Election

[:]CHECK IF AMENDMENT TO REPORT DATED

E3 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 riled.)

STATEMENT OF CASH ON HAND

CASH ON HAND et the beginning of the reporting period . (Total of all funds held by the
committee. This amount MUST be the some as the cash on hand at the end 0
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-klnd below) ... .. .. ... 27,300
Schedule F: Loans Received total (Attach Schedule F) . .. ... .. .. ... .. ... ..... .. ... .. ......, .... ......... .. .. . 3,000
Schedule H : Total Sales of Campaign Property (Attach Schedule H) .. .. ... .. ..... .. .. .. .. ....... .... .
SSchadule H applies to Candidates' Committees Only)
SUB-TOTAL .. ... $ 30,300
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ("'also see debts and loans below) .. .. 26,0 15 .75
Schedule F: Loan Repayments total (Attach Schedule F) .. .. ... .. .. ... ... .. ..... ..... .. .. .. ..... ....... ... .. 3 .000
CASH ON HAND at the end of this reporting period (if final report balance must
be zero) (Attach OR-3) .. .. .... ..... . .. .. .. ..... .. ........ . ............. .. ... .. .. ... .. .. . .. ... .. ... .. ... .. .. .. .. .. .. ... .. ..... . . .$ 1 ,284 .25

"UNPAID BILLS (From Schedule D - Attach Schedule D) . ......... ..... .. ... .. ... .. ... ............ .... ..... .. .. ......... . $ Q
"IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) ... . .....,............. .......... .... .. .. .... .. $ 0
"OUTSTANDING LOANS (From Schedule F-Attach Schedule F) .. . .... ..... ... .. ... .. ..... .. ............ .. .. .... ..$ 0
CANDIDATE COMMITTEES ONLY:
CONSULTANT BREAKDOWN (Schedule G Attached?)
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
 & RIIey N0 -6153 P . 3
iUI-191 005 11 :02AM Bradley

For Instructions, See Back of Form SCHEDULE

A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same no on Statement of Organlzatlon) AMENDING FORM

Iowa Initiatives Committee

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 B8B.32A(8), Iowa Code, prohibits the use of Information copied from reports end statements for soliciting contributions or
for any commercial purpose by any person other than statutory polftlcal committees .

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD1YR) AND PAC CHECK (If applicable) RAISER
NUMBER INCOME
ID#
Tom Fold
01/28/05 $100
CK# 4404 Hickory Wind Lane
Marion, IA 52302
I D#
Harold Becker
02/07/05 ],000
CK# 230 Guaranty Bldg
Cedar Rapids, 1A 52401
I D#
Arvind Dandekar
1,000
02/12/05 CK# 2731 28th Avenue
Marion IA 52302
ID#
Robert F. Kazimour
02/07/05 1,000
CK# 5650 6th Street, SW
Cedar Rapids, IA 52406
ID#
Donald ery
02%15/05 100 Rosedaledale Road SE 100
CK#
Cedar Rapids, IA 52403
ID#
A, James Tinker
2304 Hillcrest Drive SE 100
02/12/05 CK#
Cedar Rapids, IA 52403
ID#
Emmett J. Schermann
02/08/05 702 Beaver Ridge Ct SE 100
CK#
Cedar Rapids, IA 52403
ID#
Bob Rush
03/02/05 P.O . Box 637 200
CK#
Cedar Raids, IA 52406
I D#
Paul Burns
Tower Place, One South Gilbert Street 100
03/18/05 CK#
Iowa City, IA 52240
ID#
Marcia Rogers
220] Ridgeway Drive SE 1,000
03118/05 CK#
Cedar Rapids, IA 52403
SUB-TOTAL

TOTAL ii last page of this schedule)

' Disclosure low requires candidate committees to disclose the relationship of any relative making e contribution to the
committee. Relationship must be shown to the third degree of consanguinity (blood releUves) and affinity (relatives by 1
mamage) , 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)
 No-6758 P- 4
JU1 .19, ?005 11 ;08AM Brad Ief & Rile!'

For Instructions, See Back of Form SCHEDULE

A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Iowa Initiatives Committee

STATE CANDIDATES NOTE: IF A CONTRIBUTION 18 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 I8 AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD,

CAUTION: Section 68B.32A(B), Iowa Code, prohibits the use of informatlon 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 J IF FOR
RECEIVED (If applicable) TO CANDIDATE' RECEIVED FUND-
(MMiDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
F. James Bradley
03/18/05 $1,000
CK# P.O. Box 2804
Cedar Rapids, IA 52406
ID#
Thomas J. Cilek
03/23/05 100
CK# 317 Magowan
Iowa City, IA 52240
ID#
Bob Bocken
03/17/05 Box 1313 1,000
CK#
Fort Dodge, IA 50501
ID#
Richard M. Quetach
03/24105 4320 Cottage Grove Pkwy SE 500
CK#
Cedar Raids IA 52403
ID#
Kathleen Halloran
03/30/05 825 17th Street SE 1,000
CK#
Cedar Rapids, JA 52403
ID#
Tom Feld
4404 Hickory Wind Ln 900
03/29/05 CK#
Manon, IA 52302
ID#
David and Stacey O'Brien
500
03/23/05 CK# 4726 Leprechaun Lane
Cedar Rapids, IA 52411
ID#
Laverne W. Flagel
03/23/05 3499 Stone Court 200
CK#
Marion, IA 52302
D#
Toby Shine
04/01/05 CK# 2312 Lakeside Avenue 1,000
Wah eton IA 51351
ID#
Tyler Olson
03/26/05 CK# P.O . Box 2804
Cedar Rapids, IA 52406 615 O
SUB-TOTAL

TOTAL (if last page of this schedule)

` Disclosure lawrequires candidate committees to diadose the relatlonshlp of any relative making a conirlbutlon to the
committee, Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by 2
marriage) . If aumame 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)
 Bradley & Riley No-6752 P . 5
Jul .19 . 2005 11 ;08AM

For Instructions, See Back of Form ~t,' ;,u !Nslty SCHEDULE

A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Iowa Initiatives Committee

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 18 AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN
DISCLOSURE BOARD,

CAUTION : Section 68B.32A(8), Iowa Code, prohibits the use of Information copied from reports end statements for sollcltlng contributions or
for any commercial purpose by any person other than statutory polltlcal committees .

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT q IF FOR
RECErVED (if applicable) TO CANDIDATE` RECEIVED FUND .
(MM/DD/YR) AND PAC CHECK (If applicable) RAISER
NUMBER INCOME
ID#
John Riccolo
04101/05 425 2nd Street SE $ 1,000
CK#
Cedar Rapids, IA 52401
ID#
Kelly Baier
03/26/05 P.O . Box 2804 250
CK#
Cedar Raids, TA 52406
ID#
Ron 8c Sue Olson
04101/05 722 5th Avenue SE 500
CK#
Cedar Raids LA 52403
ID#
Eldon Hemg
04/O1I05 3388 Kennedy Circle 500
CK#
Dubuque, IA 52002
I D#
Steve Hetrig
03127105 4001 Swift Road 2,000
CK#
Sarasota, FL 34231
ID#
Linda Bloodsworth
04/01/05 CK# 17048 215th Street 1,000
Davenport, IA 52804
ID#
Denise Dolan
04101105 2830 Oak Meadow Court 50
CK#
Dubuque, IA 52003
ID#
Jim Theisen
04101105 2900 Dodge 1,000
CK#
Dubuque, IA 52003
ID#
Gary Strait
500
04110105 CK# 3211 Cottage Grove Avenue SE
Cedar Raids IA 52403
ID#
Leslie H. Garner
800 First Street West 250
04/11105 CK#
Mt . Vernon, 1A 52314
SUB-TOTAL

TOTAL (if last page of this schedule)

Dlaclosurs law requires candidate committees fo disclose the relationship of any relative making a conirlbution to the
committee. Relationship must be shown to the third degree of consongulnlty (blood relatives) and affinity (reladws by 3
marriage) . If surname of contributor is the same as candidate, but there is no Pogo _ of
familial relationship, enter "not applicable" In the relationship column . (for Schedule A)
 Bradley & RIIey No,6750 P. 6
JuI .19 . 0005 11 :08AM

For Instructions, See Back of Form SCHEDULE

CONTRIBUTIONS -- MONEY TAKEN IN

A MONETARY
(Rev . 07/03) RECEIPTS
(Including candldale's personal funds)
0 CHECKTHIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Iowa Initiatives Committee

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 88B.32A(8), 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-
(MMIDD/YR) AND PAC CHECK (If applicable) RAISER
NUMBER INCOME
ID#
Thomas Parks
04/05/05 177 Ryscroft SE $500
CK#
Cedar Rapids, IA 52403
I D#
James Barta
04/02/05 1227 Blackhawk Drive 500
CK#
Dubuque, IA 52003
ID#
Cheryle Mitval®ky
04/04105 CK# 352 Park Terrace SE 500
Cedar Raids. IA 52403
I D#
Percy Harris
04/04105 3626 Bever Avenue SE 250
CK#
Cedar Raids. IA 52403
ID#
James Nernmers
04/05/05 2048 Sunland Drive SE 100
CK#
Cedar Rapids, IA 52403
ID#
Dennis Oldorf
04/01/05 P.O . Box 1883 1000
CK#
Cedar Rapids, IA 52406
ID#
John Ehrhart
04/05/05 425 2nd Street SE, Suite 1010 SO
CK#
Cedar Rapids, IA 52401
ID#
Sara Eide
03/25/05 329 43rd Street 100
CK#
Des Moines, IA 50312
I D#
Larry Murphy
04/15/05 531 6th Street NW 500
CK#
Oelwein IA 50662
I D#
Charles Berger
04/15/05 206 11th Avenue NW 250
CK#

I
Altoona, IA 50009
SUB-TOTAL $ 3,750

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 oonsangulnlty (blood relatives) and affinity (relatives by 4
marriage) . If surname of contrlbulor Is the same as candidate, but there Is no Page ___of
familial relationship, enter "not applicable" In the relationship column. (for Schedule A)
 Bradley & Riley No,6758 P, 7
Jul,19 . ?005 11 ;08AM

For Instructions, See Back of Form SCHEDULE

A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev, 07103) RECEIPTS
(Includlng candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organlzatlon) AMENDING FORM
Iowa Initiatives Committee

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 68B .32A(6), Iowa Code, prohibits the use of Information copied from reports and statements for soliciting contrlbutlons or
for any commerclel purpose by any person other than statutory polltlcel committees .

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT J IF FOR
RECEIVED (If applicable) TO CANDIDATE` RECEIVED FUND-
(MMIDDNR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
IN
Toby Shine
04118/05 P.O. Box 737 $1,000
CK#
Spencer, IA 51301
ID#
Charles Lang
04/21/05 8727 W. Bryn Mawr, #409 100
CK#
Chicago, IL 60631
ID#
Stove Jackson
04127/05 250
CK# P.O . Box 74198
Cedar Raids IA 52406
ID#
John Liale
05/11105 1,000
CK# P.O. Box 89
Clarinda Iowa 51632
I D#
Lowell Junkins 500
05111/05 CK# 818 Des Moines Street
Des Moines, IA 50309
10#
Al Chapman
1660 17th Avenue 300
05/11/05 CK#
Marion, IA 52302
ID#
Bill Swim 250
05/05105 CK# 6 Oak Park Lane NE
Iowa City, IA 52240
ID#
John Ruth 200
05/08105 CK# 641 Valleybrook Drive
Cedar Raids, IA 52403
ID#
Robert Merrick
1,000
05/28/05 CK# P.O. Box 370
Outtenb 1A 52052
I D#
Charles Lang
1820 400th Avenue 250
06/15/05 CK#
Brooklyn, IA 52211
SUB-TOTAL

TOTAL (If last page of this schedule)

Disclosure law requires candidate commlttess to disclose the relationship of any relative making a contrlbutlon to the
committee . Relatlonshlp must be shown to the thlrd degree of consanguinity (blood relatives) and afflnlty (relatives by 5
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)
 Nc,6759 P. 9
?005 11 :09AM Bradley & Riley
Jul .19 .

For Instructions, See Beck of Form SCHEDULE

I
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 07/03) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Iowa Initiatives Committee

STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THEETHICS
PAC IDENTIFICATION
AND CAMPAIGN
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA
DISCLOSURE BOARD,

CAUTION : Section 6813 .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 then statutory political committees .

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR
RECEIVED (If applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DDfYR) AND PAC CHECK (If applicable) RAISER
NUMBER INCOME
ID#
Carol Crossed $500
06116/05 CK# 1675 Clover Street
Rochester, NY 14618
ID#

CK#

I D#

CK#

ID#

CK#

10#

CK#

ID#

C K#

ID#

CK#

ID#

C K#

ID#

CK#

ID#

CK#

SUM-TOTAL S Soo

TOTAL (If last page of this schedule) S 27,300

Disclosure law requires candidate oommlttess 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 6 6
marriage) . If surname of oontrlbutor is the same as candidate, but there is no Page ------_ of _-~_
familial relationship, enter "not applicable" In the relationship column . (for Schedule A)
 & RIIey No,6752 P, 9
JuI,19 . ?005 11 ;09AM Bradley

.;ra
f
FOR INSTRUCTIONS, SEE HACK OF FORM :,a
' ;~t:,;.~., SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY

(Rev . 07/03) EXPENDITURES
STATE PAC COMMITTEES : NOTE ; FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE D CHECK THIS BOX IF

L
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)

Iawa Initiatives Committee

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (If applicable) (Disbursement) WAS MADE
(MMIDONR) AND PAC
CHECK
NUMBER
ID#
Wells Fargo Bank, NIA monthly service fee
02/22/05 666 Walnut Street $ 5.25
CK#N/A Des Moines, IA 50309

ID#
Wells Fargo Bank, N/A monthly service fee
03/21/05 66 Walnut Street 5.25
CK#N/A es Moines, IA 50309

ID#
airbank, Maslin polling
05/04/05 425 Colorado Avenue, Suite 180 26,000
CK#1001 ants Monica, CA 90404
ID#
Wells Fargo Bank, N/A monthly service fee
06/21/05 66 Walnut Street 5.25
CK#N/A es Moines, IA 50309
I D#

CK#

1D#

CK#

ID#

CK#

ID#

CK#

SUB-TOTAL $ 26,015 .75

TOTAL (if last page of this schedule) $ 26,015 .75

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Purchases of certain campaign property oosting 4500 or more must also be Inventoried on Schedule H . (Refer to Schedule H Instructions .)

Expenditures to personelentities 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 0 instructions and Iowa Code 88A .402(3)(i).)

(for Schedule B)
FOR INSTRUCTIONS, SEE SACK OF FOfMW SCHEDULE

CONMfrTEE NAVE(Must be same as on ShAemevd of Orgardzeffon)

F LOANS
(%v. 07103) RECEIVED
Iowa Initiatives Committee S REPAID

UCHECK THIS BOX IF

NOTE : This schedule reports money foaned to the aomrridee which is depasilled in the mmmitfee amount .
AMENDING FORM
TOTAL UNPAID LOANS FROM L.- T REPORTING PERIOD $ 0

PART I- MONETARY LOANS RECEIVED_ THIS REPORTING PERI(m PART II - MONETARY LOAN REPAYMENTS MADE THIS REPORTING PERIOD
(Original source of loan, &wh as a bank nmat be shwm d's third party is (L oens forgiven must be reported on Schedule E - &Imrd CovAributfons.)
inmfved . lrxude loans born carx"aPe's WsonW funds)
DATE NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT DATE PAID NAME AND ADDRESS OF LENDER RELATIONSHIP AL40UYT
RECEIVED (Induce Endorser's Name, ](Applicable) TO CANDIDATE OF LOAN (MMMIYR) Qnclude Endorser's Name, If Appbcabre) TO CANDIDATE' REPAID
MM2Dr1R It Applicable') If fcobte
S S
Tam Feld Tom Feld
4404 Hickory Wind Lane 4404 Hickory Wind Lane
OSI05I05 06110105 Marion, lA 52302 3,000
Marion, IA 52302 3,000

3,000
TOTAL (PART f) 3 3,000 TOTAL CASH REPAYMENTS (PARTH)
= 0
From Schedule E - TOTAL LOANS FORGIVEN
Z 0
TOTAL OUTSTAfIDING LOANS END OF REPORT PERIOD

'Disclosure law requires candidate commitlees to disclose the retalionsNp of any relative
maUV a contnbutfun to the committee Reie'.iarshiip must be shown to the third degree d
consanguinity (blood relatives) and atity (relatives by marriage) . It surname d corrtnbubr is
the some as candidate, but there is no familial relationship, erder'rrot appl'aable° in the 1
relarlionshfp column when R applies . of
(for Schedule F)