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FOR I NSTRUCTI ONS, SEE BACK OF FORMDI SCL OSURE SUMMARY PAGECOMMI TT EE NAME ( Mu s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n )

I MPORTANT : I n d i c a t e t y p e o f c o m m i t t e e y o u a r e r e p o r t i n g f o r :( 1 ) S t a t e w i d e / L e g i s l a t i v e C a n d i d a t e ( 2 ) S t a t e w i d e PAC ( 3 ) S t a t e P a r t y ( 4 ) C o u n t y / L o c a l C a n d i d a t e( 5 ) C o u n t y PAC ( 6 ) B a l l o t I s s u e / F r a n c h i s e C o mm i t t e e ( 7 ) C o u n t y / C i t y C e n t r a l C o m m i t t e eCANDI DATE COMMI TT EES ONL Y :C7a n d i mg P o l ' i c a l P a r t y

D i s t r i c t ( i f Se n a t e o r H o u s e )

SI GNATURE OF TREASURER ( o r p e r s o n f i l i n g t h i s r e p o r t )

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~ 1 Che c k i f t h i s i s f i n a l ( t e r m i n a t i o n ) r e p o r t an d a t t a c h N o t i c e o f D i s s o l u t i o n F or m DR- 3 .( Y ou mus t c o n t i n u e t o f i l e r e p o r t s u n t i l a N o t i c e o f D i s s o l u t i o n i s f i l e d . )

STATEMENT OF CASH ON HANDCASH ON HAND a t t h e b eg i n ni n g o f t h e r e p o r t i n g p e r i o d ( T h i s i s t h e t o t a l o f a l l mo n i e s h e l db y t h e c o mmi t t e e . T h i s amou n t MUST b e t h e s ame a s t h e c a s h o n h a n d a t t h e e n d

o f t h e l a s t r e p o r t i n g p e r i o d , o r mus t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ADD TOTAL MONEY TAKEN I N T HI S PERI ODSc h e d u l e A : Cash C o n t r i b u t i o n s t o t a l ( A t t a c h Sc h e d u l e A) ( " a l s o s e e i n - k i n d b e l o w) . . . . . . . . .Sc h e d u l e F : L o a n s Re c e i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d u l e H : T o t a l Sa l e s o f Camp a i g n P r o p e r t y ( A t t a c h Sc he du l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h ed u l e H a p p l i e s t o Ca n di d at e s ' Co mmi t t e e s On l y )SUB- TOTAL . . . . . $

SUBTRACT TOTAL MONEY SPENT T HI S PERI ODSc h e d u l e B : Ex p en di t u r e s t o t a l ( A t t a c h Sc h e d u l e B ) ( " a l s o s e e d e b t s an d l o a n s b e l o w) . . . .Sc h e d u l e F : L o a n Re p a yme n t s t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON HAND a t t h e e n d o f t h i s r e p o r t i n g p e r i o d ( i f f i n a l r e p o r t , b al a nc e mus tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

" UNP AI D BI L L S ( F r o m Sc h e d u l e D - A t t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $' I N KI ND CONTRI BUTI ONS ( F r o m Sc he du l e E - A t t a c h Sc h e d u l e E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $" " OUTSTANDI NG L OANS ( F r o m Sc h e d u l e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI T TE ES ONLY :CONSULT ANT BRE AK DOWN ( Sc h e du l e G At t a c he d ? )VALUE OF CAMPAI GN PROPERTY ( F r o m Sc h e d u l e H - A t t a c h Sc h e d u l e H) $

FORMD R - 2 DI SCLOSURE( Re v . 0 7 / 2 0 0 3)

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vDATE SI GNED

L a t e f i l e d r e p o r t s a r e s u b j e c t t o p o s s i b l e c i v i l an d c r i m i n a l p e n a l t i e sSEE I NSTRUCTI ONS ON BACK AND COMPLETE THE FOLL OWI NG SENTENCE : , fI AM F I L I NG A l e - 1 9 - D REPORT FOR AN/ A ( 1 ) ELECTI ON / ( 2 ) NON- E L ECT I ON YEAR .

L o c a l C o m m i t t e e s , e n t e r D a t e o f E l e c t i o n

Co u n t y & L o c a l C o m m i t t e e s , e n t e r C o u n t y i n, w h i c h E l e c t i o n i s h e l d

YES NO

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Fo r I n s t r u c t i on s , Se e Back o f Fo r mCONTRI BUTI ONS - MONEY TAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEENAME ( Mu s t be s ame a s o n St a t e me n t o f Or g a n i z a t i o n)

STATECANDI DATES NOTE : I F ACONTRI BUT I ON I S RECEI VED FROMASTATE PAC ( P OL I T I CA L ACT I ON COMMI TTEE) , L I S T THEPAC I DENT I F I CAT I ONNUMBERANDTHEPACCHECKNUMBER I N THE DESI GNATEDCOLUMN. A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CSAND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68B . 3 2 A ( 6 ) , I o wa Co d e, p r o h i b i t s t h e u s e o f i n f o r ma t i on c o p i e d f r o m r e p o r t s an d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r a n y c omme r c i a l p u r p o s e b y an y p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e es .

SUB- TOTAL

TOTAL ( i f l a s t page o f t h i s s c h e du l e )

D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c ommi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p mus t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) I f sumame o f c o n t r i b u t o r i s t h e s ame a s c a n di d a t e , b u t t h e r e i s n of a mi l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e " i n t h e r e l a t i o n s h i p c o l u mn .

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SCHEDULEA MONETARY( Re v . 0 7 / 0 3 ) RECEI PTSQ CHECK T HI S BOX I F

AMENDI NG FORM

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Fo r I n st r u c t i o n s, See Back o f Fo r mCONTRI BUTI ONS- MONEYTAKENI N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEENAME( Mu s t be same a s o n St a t e me n t o f Or g an i z a t i o n~ovy

SCHEDULEA I MONETARY( R ev . 0 7 / 0 3 ) RECEI PTS

CHECKT HI S BOX I FAMENDI NGFORM

STATECANDI DATES NOTE : I F ACONTRI BUT I ON I S RECE I VED FROMASTATE PAC ( POLMCAL ACTI ON COMMI TTEE) , L I S T THEPACI DENT I F I CATI ONNUMBERANDTHEPACCHECKNUMBER I N THE DESI GNATEDCOLUMN. A L I ST OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se c t i o n 6BB. 3 2 A ( 6 ) , I o wa Co d e, p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o p i e d f r o m r e p o r t s an d s t a t e me nt s f o r s o l i c i t i n g c on t r i b u t i o ns o rf o r an y c omme r c i a l p u r p o se b y an y p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

TOTAL ( i f l a s t page o f t h i s s c h e d ul e )

' D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e commi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f any r e l a t i v e mak i n g a c o n t r i b u t i o n t o t h ec ommi t t e e . R e l a t i o n s h i p mus t b e s h ow n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) an d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) . I f sumame o f c o n t r i b u t o r i s t h e s ame as c a n d i d a t e , b u t t h e r e i s n of a mi l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u mn .

SUB- TOTAL

Page eq~_ o f- ( f o r Sc h e d u l e A)

DATE PAC I D NUMBER NAME ANDADDRESSOF CONTRI BUTOR RELAT I ONSHI P AMOUNT v I F FRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE' RECEI VED FUND( MMl DD1YR) ANDPACCHECK ( i f a p p l i c a b l e ) RAI SNUMBER I NCO

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Fo r I n s t r u c t i o n s , Se e Ba c k o f F o r mCONTRI BUTI ONS - MONEY TAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TT EENAME( Mu s t b e s ame a s o n St a t e me n t o f Or g a ni z a t i o n)

, 0 7 ^ 10&Zdad.?t c2nt l _ C~zu i K - rSTATECANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I C AL ACT I ON COMMI TTEE) , L I S T THEPAC I DENT I F I CATI ONNUMBER AND THEPAC CHECK NUMBER I N THE DESI GNATED COLUMN . AL I ST OF I D NUMBERS I S AVA I L AB LE FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARDCAUTI ON : Se ct i o n 6 8B . 3 2 A ( 6 ) , I o wa Code , p r o h i b i t s t h e us e o f i nf o r ma t i o n c o pi e d f r o m r e p o r t s an d s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o rf o r any c omme r c i a l p u r p o s e b y an y p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

TOTAL ( i f l a s t page o f t h i s s c h e d ul e )

' D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c ommi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f any r e l a t i v e mak i ng a c o n t r i b u t i o n t o t h ec ommi t t e e . R e l a t i o n s h i p must b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) and a f f i n i t y ( r e l a t i v e s bym a r r i a g e ) , I f s umame o f c o n t r i b u t o r i s t h e same as c an di d a t e , b u t t h e r e i s nof a mi l i a l r e l a t i o n s h i p , e nt e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l umn .

SUB- TOTAL

P a g e o f- ( f o r Sc h e d u l e A)

SCHEDUL EA MONETARY

( Re v . 0 7 / 0 3 ) RECEI PTSQCHECK T HI S BOX I FAMENDI NG FORM

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( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t be s ame a s o n St a t eme n t o f O r g a n i z a t i o n )

STATECANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMASTATEPAC ( POL I T I CA L ACTI ON COMMI TTEE) , L I ST THEPAC I DENT I F I CAT I ONNUMBER ANDTHE P AC CHECK NUMBER I N THEDESI GNATED COLUMN . AL I S T OF I D NUMBERS I S A VA I L A BL E FROMTHE I OWA ETHI CS AND CAMPA I GNDI SCL OSURE BOARD.CAUTI ON : Se ct i o n 68B . 3 2 A ( 6 ) , I o wa Code , p r o h i b i t s t h e us e o f i n f o r ma t i o n c o pi e d f r o m r e p o r t s a nd s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o rf o r an y c omme r c i a l p u r p o s e by a ny p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e es .

TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e )

' D i s c l o s u r e l a w r e q u i r e s c a n d i d a t e c ommi t t e e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e mak i n g a c o n t r i b u t i o n t o t h ec o mmi t t e e . R e l a t i o n s h i p mus t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) I f s umame o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b ut t h e r e i s n of a mi l i a l r e l a t i o n s h i p , e n t e r ' n o t a p p l i c a b l e ' i n t h e r e l a t i o n s h i p c o l u mn .

SUB- TOTAL

P a g e o f( f o r Sc h e du l e A)

SCHEDULEA MONETARY

( Re v . 0 7 1 0 3 ) RECEI PTSCHECK T HI S BOX I FAMENDI NG FORM

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THI S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY :Pu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mus t a l s o b e i n v e n t o r i e d o n Sc h e d u l e H . ( R e f e r t o Sc h e d u l e H i n s t r u c t i o n s . )E x pe nd i t u r e s t o p e r s o n s / e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p o l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e mi z e d o nSc h e d u l e G b y t h e amo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p en d i t u r e mad e b y t h e p e r s o n / e n t i t y o n b e ha l f o f t h e c a n d i d a t e ' s c o mmi t t e e . ( R e f e r t oSc h e d u l e G i n s t r u c t i o n s a n d I o wa Cod e 6 8A . 4 0 2 ( 3 ) ( i ) . )

( f o r Sc h e d u l e 6 )

FOR I NSTRUCTI ONS, SEE BACK OF FORM R e s e t Fo t m SCHEDULEEXPENDI TURES B MONETARY- MONEY SPENT FROMCOMMI TTEE ACCOUNT ( Re v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DEOR LEGI SLATI V E CHECKTHI S BOXI F ICANDI DATES, L I ST THECANDI DATE I DENT I F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECKNUMBER FOREACH EXPENDI TURE . A L I ST OF I D NUMBERS I S AVA I L ABL E FROMTHE I OWA AMENDI NG FORMETHI CS & CAMPAI GN DI SCLOSURE BOARD.COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t eme n t o f O r g a n i z a t i o n )

CANDI DATE NAME AND ADDRESSTOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED

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T HI S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY :P ur c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 0 0 o r mo r e mu s t a l s o b e i n v e n t o r i e d o n S c he d u l e H. ( R e f e r t o S c he d u l e H i n s t r u c t i o n s . )E x pe nd i t u r e s t o p e r s o n s l e n t i t i e s p r o v i d i n g c o n s u l t i n g , a d v e r t i s i n g , f u n d - r a i s i n g , p a l l i n g , ma n a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e m i z e d o nSc h e d u l e G b y t h e amo u n t , p u r p o s e , a nd d at e o f e a c h t y p e o f e x pe nd i t u r e mad e b y t h e p e r s o n / e n t i t y o n b e h a l f o f t h e c a nd i d a t e ' s c o mmi t t e e . ( R e f e r t oSc h e d u l e G i n s t r u c t i o n s a nd I owa Cod e 68A. 4 0 2 ( 3 ) ( i ) . )

( f o r Sc h e d ul e B )

FOR I NSTRUCT I ONS , SEE BACK OF FORM I Re s e ' m I SCHEDULEEXPENDI TURES B MONETARY- MONEY SPENT FROMCOMMI TTEE ACCOUNT ( Re v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUT I ONSMADE T O STATEWI DEOR L EGI S L AT I V ECANDI DATES, L I ST THECANDI DATE I DE NT I F I CA TI ON NUMBER I N THE DES I GNATED COLUMN ANDTHE CHECKT HI S BOXI FPACCHECK NUMBER FOREACH EXPENDI TURE. A L I S T OF I D NUMBERS I S AVA I L ABL E FROMTHE I OWA AMENDI NG FORME T H I CS & CAMPAI GN DI SCLOSURE BOARD. iCOMMI TTEE NAME ( Mu s t b e s am e a s o n S t a t e me n t o f O r g a n i z a t i o n ) ~

r L . . ~ 1CANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDED

EXPENDED ( i f a p p l i c a b l e ) ( Di s b u r s e me n t ) WAS MADE( MMI DDI YR) AND PACCHECK

NUMBERI D# v M4VL e Gs k 2 N~ l e u 4 !CK# / O) VYI ~p l l 1 . L $1 D# w

PK-I1*t- ) 62CK# w )I D#C t 1 ,

1D# U. ~ k n0 n 1 l~~ ~ ' ~ sl a J l - ~ ~ Y q 9 0A00 vC K # t o l q

I D# v Yl C( rCK# s 2 9 r i s1D#CK#1 D#CK#I D#CK# `

SUB- TOTAL $TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) $ l J~

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FOR I N STRUC T I ON S, SE E BACK OF FORMCOMMI TT EE NAME ( M u s t beAame a s o n S t a t e me n t o f 0 a n h a t i o n )

O. / - v o

SUB- TOTAL

TOTAL ( i f l a s tp a g e o f t h i s

s c h e d u l e )

SCHEDULEE I N K I ND( R e v . 0 6 / 9 7 ) 1 CONTRI BUTI ONSQCHECK T HI S BOX I F

AMENDI NG FORM

a r e l a w r e q u i r e s c a n d i d a t e s t o d i s c l o s e t h e r e l a t i o n s h i p o f a n y r e l a t i v e ma k i n g a n I n k i n d c o n t r i b u t i o n t o t h ec o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o w n t o t h e t h i r d d e g r e e o f c o n s a n g u i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s ( f o r S c h e d u l e E )b y ma r r i a g e ) . ( S e e P a g e 2 o f f o r m s p a c k e t . ) I f s u r n a m e o f c o n t r i b u t o r i s t h e s am e a s c a n d i d a t e , b u t t h e r e I s n of a m i l i a l r e l a t i o n s h i p , e n t e r " n o t a p p l i c a b l e ' I n t h e r e l a t i o n s h i p c o l u m n .

DATERECEI VED( M M/ D DI Y R ) NAME AND ADDRESSOF CONTRI BUTORRELATI ONSHI PTO CANDI DATE' ( i f a p p l i c a b l e )

DESCRI PT I ONOF I N K I N DCONTRI BUTI ON

ESTI MATEDF A I R MARKETVALUE

4 I F FORFUND- RAI SERCONTRI BUTI ON

1 7 - C 3 - o v 1 - 3 F - 1E : 1E: 1F - 1F - 10aaaE- 1