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FOR I NSTRUCT I ONS, SEE BACK OF FORMDI SCLOSURE SUMMARY PAGECOMMI TT EE NAME( Mus t b e same 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 )

~1SV6 ~b c s f f r ~ l o v ) o _ ( NL Ln mw- ~ ,I MPORTANT : I n d i c a t e b y # t y p e o f c o mmi 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 i J u d g e S t a n d i n g f o r R e t e n t i o n C a n d i d a t e ( 2 ) S t a t e PAC ( 3 ) S t a t e P a r t y( 4 ) C o u n t y C e n t r a l C o mmi t t e e ( 5 ) C o u n t y C a n d i d a t e ( 6 ) C i t y C a n d i d a t e ( 7 ) S c h o o l B o a r d o r O t h e rP o l i t i c a l S u b d i v i s i o n C a n d i d a t e ( 8 ) C o u n t y PAC ( 9 ) C i t y PA C, k Sc h o o l B o a r d Or O t h e r P o l i t i c a lS u b d i v i s i o n PAC 1 1 1 ) L o c a l B a l l o t I s s u eCANDI DATE COMMI TT EES ONLY :

L a t e 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 lt h e c a n d i d a t e , f o r a c a n d i d a t e ' s c o mmi t t e ei n d i

1 AM F I L I N G AMAq, I ?& d - ,06W( r e p o r t dMe )

CHECK I F AMENDMENT T O REPORTWEO

i e s . P u r s u a n t t o I o w a Co de s e c t i o n 68 B . 3 2 A ( 7 )E h a i r p e r s o n , f o r a n y o t h e r t y p e o f c o mmi t t e e , i s t h er a t e r e p o r t s .

C h e c k i f t h i s i s f i n a l ( t e r mi n a t i o n ) r e p o r t a nd a l b c h N o t i c e o f D i s s o l u t i o n Fo r m DR- 3 .( Y o u mu s 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 DR- 3 i s t i l e d . )

REPORT FOR ( 1 ) ELECT I ON / ( 2 ) NON- ELECT I ON YEAR .I n d i c a t e b y #

STATEMENT OF CASH ON HANDCASH ON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d . ( T o t a l o f a l l f u n d s h e l d b y t h ec o mmi t t e e . T h i s am o u n t MUST b e t h e same 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 mu s 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 ODS c h e d u l e A : C a s h C o n t r i b u t i o n s t o t a l ( A t t a c h S c 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 ) . . . . . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n s R e c e i v e d t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e H : T o t a l S a l e s o f Camp a i g n P r o p e r t y ( A t t a c h S c h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( S c he d ul e H a p p l i e s t o Ca n d i d a t e s ' Co mmi t t e e s O n l y )SUB - TOTAL . . . . . . . . . . . . . . . . . . . . . . . $

SUBTRACT TOTAL MONEY SPENT T HI S PERI ODS c h e d u l e B : E x p e n d i t u r e s t o t a l ( A t t a c h S c h e d u l e B ) ( ' " ' a l s o s e e d e b t s a n d b a n s b e l o w ) . . . . . . . . . . . . . . .S c h e d u l e F : L o a n Re p a y me n t s t o t a l ( A t t a c h S c 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 a l a n c e mu s tb e z e r o ) ( A t t a c h D R- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - - - - - - - - . . . . . . $

F o r O f f i c e Us e On l yComm .L o g g e d l

F i l e w i t h :I o w a E t h i c s a n d Ca mp a i g nD i s c l o s u r e B o a r d5 1 0 E . 1 2 ' " , S t e . 1 ADe s Mo i n e s , I o w a 5 0 3 1 9F a x : 5 1 5 - 2 8 1 - 3 7 0 1

5 / 6 9 7 i f 1 t . 9 - 2 - 5 1, 6 1 6 )TELEPHONE DATE SI GNED

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

C o u n t y & L o c a l C o mmi t t e e s , e n t e r C o u n t y i nw h i c h E l e c t i o n i s h e l d

l e ? t , c ) O6l ' y l o 2 / Cp

" U NPAI D B I L LS ( F r o n t S c h e d u l e D - A t t a c h S c h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ - -* I N I 4 ND CONTRI BUT I ONS ( F r o m S c h e d u l e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $' " OU TS TANDI NG LOANS ( F r o m S c h e d u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

_ _- _ - _ _ ~- _ -

CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) YES- .CANDI DATE COMMI TT EES ONL YVALUE OF CAMPAI GN PROPERTY ( F r o m S c h e d u l e H - A t t a c h S c h e d u l e H ) $ - - - - - - - - - - -STATE COMMI TT EES : S u b mi t a r e c o n c i l e d c a mp a i g n a c c o u n t b a n k s t a t e m e n t i n J a n u a r y o f e a c h y e a r .

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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 - - MONEYTAKEN 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 TTEE NAME Mus t b e s ame a s on S t a t e me n t o f O r g a n i z a t i o n )

V

R e s e t Fo r m

STATECANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PAC ( P OL I T I CAL ACT I ON COMMI TTEE) , L I ST THEPAC I DENT I F I CATI ONNUMBERANDTHEPACCHECKNUMBER I N THEDESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .NOTE : ANY PERSON, OTHERTHANAN I NDI V I D UA L , THAT CONTRI BUTES MORETHAN $ 7 5 0 TOYOUR CAMPA I GN MAY HAVE F I L I NGRESPONSI BI L I T I ES AND SHOULD I MMEDI ATELY CONTACTTHEBOARD.CAUTI ON : S e c t i o n 6 8B . 3 2 A ( 6 ) , 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 a n 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 r f o r a n yc omme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n 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 .

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 )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 o mm i 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 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 wn 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 ym a r r i a g e ) I f s u r n ame 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 u t t h e r e i s n o P a g e o f

f 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 mn . ( f o r Sc h e d u l e A)

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECE I PTS

CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR RELAT I ONSHI P AMOUNT J I F FRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND( MM/ DD/ YR) ANDPACCHECK ( i f a p p l i c a b l e ) RAI SNUMBER I NCO

I D#O~ 0 ' CK# A941 1 ~ 5002

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0AI D#1Z31UP CK# 1O 1 f ' J ~ S ~ 2 1 ' w~ .

I D #CK# ' ~ L t - 1 1 7 k i yI D # 1 Y Cbr r ~~~"~ ~ ' \

~W CK#D# ~ q , ~ ( ~ ' 1 ~ 2 . t J ( Y 1 2 X

I D # R Vr q J t ~ , r ~ a Y ~ - sCK# aa ~ 1 cD# J f . s~, vW CK# D ' - - a

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F o 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 - - MONEYTAKEN 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 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 )

v

R e s e t Fo r m

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( POL I T ICAL ACTI ON COMMI TTEE) , L I S T THEPAC I DENTI F I CATI ONNUMBER ANDTHEPAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I LAB LE FROMTHE I OWA ETHI CS ANDCAMPAI GNDI SCL OSURE BOARD .NOTE : ANY PERSON, OTHER THAN AN I N D I V I D U A L , THAT CONTRI BUTESMORE THAN $ 7 5 0 TO YOUR CAMPAI GN MAY HAVE F I L I N GR ES P O N S I B I L I T I E S AND SHOUL D I MMEDI ATEL Y CONTACT THE BOARD .CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a n d s t a t e m e 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 r f o r a n yc o mm e r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mm i t t e e s .

SUB- TOTAL $ l l 0 1 - - )TOTAL ( i f l a s t p a g e o f t h i s s c h ed u 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 o mm i 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 m a k i n g a 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 b ym a r r i a g e ) . 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 ame a s c a n d i d a t e , b u t t h e r e i s n o P a g e l J of - 3f 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 mn . ( f o r S c h e d u l e A )

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECEI PTSCHECK T H I S BOX I FAMENDI NG FORM

DATE P AC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR REL ATI ONSHI P AMOUNT I FRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUN( MM/ D D / Y R ) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SNUMBER I NCI D# ~~~~\ l p ' d l Q CK#

hera C ! g x C a nU.~m-c ~ I t r ~ o 1 - q

CK# C _ eV~ ~ ~ o 2 - X2 5o f - ' 1 5 1I D# z \ 1CK# Y~C3. 0 1CK# ON - ~ ~ s a . sh~~ro \ o ~I D#

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Fo r I n s t r u c t i o n s , See Back o f Fo r mCONTRI BUTI ONS - - MONEYTAKEN 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 b e s ame 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 )

G t / - Po v&Mr i 1/ t ?r r y n h

R e s e t F or m

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM ASTATEPAC ( POL I T I CA L ACT I ON COMMI TTEE) , L I ST THEPAC I DENTI F I CAT I ONNUMBER ANDTHEPACCHECKNUMBER I N THE DESI GNATED COLUMN. A L I S T OF I D NUMBERS I S A VA I L A B L E F ROM THE I OWA ETHI CS ANDCAMPA I GND I SCLOSURE BOARDNOTE : ANY PERSON, OTHERTHANAN I NDI V I D UA L , THAT CONTRI BUTES MORETHAN $ 7 5 0 TOYOUR CAMPA I GN MAY HAVE F I L I NGRESPONS I BI L I T I ES AND SHOULD I MMEDI ATEL Y CONTACT THE BOARD .CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , p r o h i b i t s t h e u s e o f i n f o r m a t i o n c o p i e d f r o m r e p o r t s a nd s t a t e me nt 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 r f o r an yc omme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n 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 .

SUB- TOTALTOTAL ( I f l a s t p a g e o f t h i s s c h e d u l e )

P a g 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 o mm i 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 m a k i n g a c o n t r i b u t i o n t o t h ec o m m i t t e e . R e l a t i o n s h i p mu 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 b yma r r i a g e ) . I f s u r n ame 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 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 mn . ( f o r Sc h e d u l e A )

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECEI PTSCHECK THI S BOX I FAMENDI NGFORM

DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR RELA T I ONSHI P AMOUNT J I F FRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE* RECEI VED FUND( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RA I SNUMBER I NCO

I D#CK#I D# ~~ s 1 l e u JI ` b t pI D#

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T HI S BOX APPL I ES TO CANDI DATES ' COMMI TTEES ONLY :P u 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 m u s t a l s o b e i n v e n t o r i e d o n Sc h e d ul 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 p e n d i t u r e s t o p e r s o n s t 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 , m a n a g i n g , o r g a n i z i n g s e r v i c e s mu s 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 a m o 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 e n 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 h a l f o f t h e c a n d i d a t e ' s c o m m i 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 o wa Code 6 8 A . 4 0 2 ( 3 ) ( i ) . )

( f o r S c he d u l e B )

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

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUT I ONS MADE TO STATEWI DE OR LEG I SLAT I VE CHECK T HI S BOX I FCANDI DATES, L I S T THE CANDI DATE I DENT I F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA AMENDI NG FORMETHI CS & CAMPAI GN DI SCLOSURE BOARD .COMMI TTEE NAME ( M u s t b e s a m 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 )A " t wd1wh l l r i mb / ~" 1 ~' 7l tCANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCR I BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( MM/ DD/ YR) AND PACCHECKNUMBER 5 ~0. ~ I ZJi& / o CK# ~~~ S t $~ k e h - ~ ' 7~3 r

I D# l t i 4 , nCK# 1 55 ~

o a k - e5H, , O l 5n eI D# S < < s ~ t i ' ~~ r U P ~ s , s ~ - ~ ~ nr wy9v I s t S I `CK# n k e r \I D# St e d " R e , t mb0eS me I n ' t( . . ~ Q - + r d S nCK#I D# ( 3 ~~ . , p l e s ~ r 1 V c , 1 b ( ~ e - S O S+ a , 4 t o a , a . r ~ SCK#

k e r ' s t s z a o23 ~a,I D# f } ' ) o n r, k o n Tkof o ~r CA, ( y ) PGUCI r ) ' ~ ) h 0 +o 5CK# C ~ r c a ~ r ~ y

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T HI S BOX APPL I ES TO CANDI DATES' COMMI TTEES ONLY :P u 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 mu s 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 p e n d 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 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 mu s t a l s o b e d e t a i l i t e m i z e d o nS c h e d u l e G b y t h e a mo 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 e n d i t u r e ma d 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 n d i d a t e ' s c o mmi t t e e . ( R e f e r t oS c h e d u l e G i n s t r u c t i o n s a nd I o wa Code 6 8 A . 4 0 2 ( 3 ) ( i ) . )

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

FOR I NSTRUCTI ONS, SEE BACKOF FORM R e s e t F o r m SCHEDULEEXPENDI TURES B MONETARY- - MONEY SPENT FROM COMMI T TEE ACCOUNT ( Re v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TT EES : NOTE : F OR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI DATES, L I S T THE CANDI DATE I DENT I F I CAT I ON NUMBER I N THE DESI GNATED COLUMN AND THE CHECK T HI S BOX I FPAC CHECK NUMBER F OR EACH EXPENDI TURE A L I ST OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA AMENDI NGFORMETHI CS & CAMPAI GN DI SCLOSURE BOARDCOMMI TTEE NAME ( Mu s t b e s a m 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 )

a r 4 1 Q J a C- V" MW~CANDI DATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCR I 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( MM/ DD/ YR) AND PACCHECKNUMBERI D # A l l k e m yv ( , , CK# $ ' 7 ~~5aa a 1 ~ ~ 9 ~ ' Ov/ I D # Jc > d ~ . l ~ i ! a / S f c d t i ~ ~ m GU~ i C

l o C , CK# h 4 -I D # Q ( i f L e u OS ~ V_ ( Q CW, r J r s cn~ j .

~ ~a l a CK# a n y , i Loa ) O - r e S 1 ~ 1 1 . sU k e 1 T A 5oa . 3 - 7 7CK# 9 o b

5 c a Z

~3 l n C . aI D #CK# 9 1 ~

a ?~ v ' 7 I c y a i l 0 e 4 &p n k ~ 5 ' o LD# L ) 5 P. sCK# O, ~ANk A TAI D # 'U. s v s PA t V Cr5 1 3 1 ' 1 ) CK# f ) 5v v II D #

~ ~ 1 3lb CK# / -SUB- TOTAL $

TOTAL ( i f l a s t page o f t h i s s c h e du l e ) $ 111 .

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7/9

FOR I NSTRUCTI ONS, SEE BACK OF FORMI COMMI TT EE NAME ( Mu s t b e same 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 )NOTE : De b t s p r e v i o u s l y t o ne d t h a t r e ma i n u n p a i d must b e i n c l u d e d o n t h i sS c h e d u l e , a s w e l l a s a n y n e w o b l i g a t i o n s i n c u r r e d i n t h i s p e r i o d .

DEBTS I OBL I GAT I ONS REMA I NI NG T HI S REPORT I NG PER I OD( DO NOT I NCLUDE LOANS - - SHOWLOANS ON SCHEDULE F )

* I f a c t u a l f i g u r e i s un k n own , s h o w " e s t i ma t e d " b e s i d e t h e f i g u r e .

SCHEDULED I NCURRED( R e v . 0 8 / 9 8 ) 1 I NDEBTEDNESCHECK T HI S BOXI F AMENDI NGFORM

An " i n c u r r e d d e b t " i s a d e b t f o rg o o d s o r s e r v i c e s o r d e r e d o rr e c e i v e d , b u t n o t p a i d f o r b y t h ee n d o f t h e r e p o r t i n g p e r i o d . ,r e g a r d l e s s o f wh e t h e r a n i n v o i ch a s b e e n r e c e i v e d

Page o f( f o r Sc h ed u l e D)

CAND I DATE COMMI TTEES NOTE :* I n c u r r e d i n d e b t e d n e s s a l s o i n c l u d e s e a c h p e r s o n / e n t i t y w i t h wh om t h e c a n d i d a t e ' s c o mmi t t e e h a s e n t e r e d i n t o a c o n t r a c t d u r i n g t h e r e p o r t i n g p e r i o d f o r f u t u r eo r c o n t i n u i n g p e r f o r m a n c e . E n t e r t h e name o f t h e c o n s u l t a n t wh o p r o v i d e s o r p r o c u r e s s e r v i c e s f o r i t e m s s u c h a s 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 ro r g a n i z i n g s e r v i c e s R e p o r t o n S c h e d u l e G t h e n a t u r e o f p e r f o r m a n c e a n d t h e e s t i ma t e d p e r f o r m a n c e r e a s o n a b l y e x p e c t e d o f t h e c o n s u l t a n t .

DATEI NCURRED NAME AND ADDRESS OF PERSON DESCR I PT I ON OF GOODS ORSERVI CES PROVI DED OR BALANCE OWED ATCLOSE OF( MM/ DD/ YR) TOWHOM DEBT OR OBL I GAT I ON I S OWED PURCHASED REPORTI NGPERI OD*

e _ s ~ o T T ul

HU P 6 4 - I D AY~ J t , W w6 - 0 - ~ -

~ r ~ Ai c j L ( xa l ~ l v , ~ ,t q~ ~ a Sv s P s - po~Q~J O B ' ~ h l s f e j

V r ~ e Sr P- PUe_ I o ~~~1 J o c / c , r ~i s f 7 < 3 0 7

Ta N' ~ ~ - i r ~ ~ ~ e ; hp o l t . f ~Sf ~ Y c r t , Wb- r ~ ; c r s 02~. d ' D

SUB- TOTAL $JTOTAL DEBTS OWED BY COMMI TT EE AT T HE END OF T HI S REPORT I NG PERI OD $

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FOR I NSTRUCTI ONS, SEE BACK OF FORMCOMMI TT EE NAME ( M u s t b e same 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 )

t z l s ) " l " C 2r

' I f a c t u a l f i g u r e i s u n k n o w n , s h o w " e s t i m a t e d " b e s i d e t h e f i g u r e .

NOTE : De b t s p r e v i o u s l y r e p o r t e d t h a t r e ma i n u n p a i d must b e i n c l u d e d o n t h i sS c h e d u l e , a s w e l l a s an y n e w o b l i g a t i o n s i n c u r r e d i n t h i s p e r i o d .

DEBTS/ OBL I GAT I ONS REMA I N I NG T HI S REPORT I NG PER I OD( DO NOT I NCLUDE LOANS - - SHOWLOANS ON SCHEDULE F )

SCHEDUL ED I NCURRED( Re v . 0 8 / 9 8 ) 1 I NDEBTEDNESSCHECK T HI S BOXI F AMENDI NGFORM

An " i n c u r r e d d e b t " i s a d e b t f o rg o o d s o r s e r v i c e s o r d e r e d o rr e c e i v e d , b u t n o t p a i d f o r b y t h ee n d o f t h e r e p o r t i n g p e r i o d . ,r e g a r d l e s s o f wh e t h e r a n i n v o i c eh as b e e n r e c e i v e d .

1 7Page -( f o r Sc h e d u l e D )

CANDI DATE COMMI TT EES NOTE :' I n c u r r e d i n d e b t e d n e s s a l s o i n c l u d e s e a c h p e r s o n / e n t i t y w i t h wh om t h e c a n d i d a t e ' s c o m m i t t e e h a s e n t e r e d i n t o a c o n t r a c t d u r i n g t h e r e p o r t i n g p e r i o d f o r f u t u r eo r c o n t i n u i n g p e r f o r m a n c e E n t e r t h e name o f t h e c o n s u l t a n t wh o p r o v i d e s o r p r o c u r e s s e r v i c e s f o r i t e m s s u c h a s 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 , m a n a g i n g , o ro r g a n i z i n g s e r v i c e s . R e p o r t o n S c h e d u l e G t h e n a t u r e o f p e r f o r m a n c e a n d t h e e s t i m a t e d p e r f o r m a n c e r e a s o n a b l y e x p e c t e d o f t h e c o n s u l t a n t .

DATE DESCRI PT I ON OF GOODS OR BALANCE OWED ATI NCURRED NAME AND ADDRESS OF PERSON SERVI CES PROVI DED OR CLOSE OF( MM/ DD/ YR ) TOWHOM DEBT OR OBL I GAT I ON I S OWED PURCHASED REPORT I NGPERI OD'

L o

q / s ue

o a f k ~r ~~fJO~L~ ~r f l v l ~ l . ~> ~

J bdc . ~ ~ - ~ $ ! - . e r d Ct i ' T k , - , j j ~~ PaS~ 6POs t 6- y - a/ q~s . , at er n

S - I ~ ~ c ~

q e 4 - i Ue - wJ A N St d3 o ~ o w o ` ~ t i l ew y f u r s Os r ~ r

SUB- TOTAL $c

TOTAL DEBTS OWED BY COMMI T TEE AT T HE END OF T HI S REPORT I NG PER I OD $

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FOR I NSTRUCT I ONS, SEE BACK OF FORMCOMMI TT EE NAME ( M u s t b e same a s o n S t a t e me nt o f O r g a n i z a t i o n )

INOTE : De b t s p r e v i o u s l 4 r e p o r t e d t h a t r e ma i n u n p a i d mu s t b e i n c l u d e d o n t h i sS c h e d u l e , a s w e l l a s a n y n e w o b l i g a t i o n s i n c u r r e d i n t h i s p e r i o d .

DEBTS I OBL I GAT I ONS REMA I N I NG T HI S REPORT I NG PER I OD( DO NOT I NCLUDE L OANS - - SHOWLOANS ON SCHEDUL E F )

* I f a c t u a l f i g u r e i s u n k n o w n , s h o w " e s t i ma t e d " b e s i d e t h e f i g u r e

SCHEDUL ED I NCURRED( R e v . 0 8 1 9 8 ) 1 I NDEBTEDNESS

CHECK T HI S BOXI F AMENDI NGFORM

An " i n c u r r e d d e b t " i s a d e b t f o rg o o d s o r s e r v i c e s o r d e r e d o rr e c e i v e d , b u t n o t p a i d f o r b y t h ee n d o f t h e r e p o r t i n g p e r i o d . ,r e g a r d l e s s o f wh e t h e r a n i n v o i c eh a s b e e n r e c e i v e d .

Page &o f( f o r Sc h e d u l e D)

CAND I DATE COMMI TT EES NOTE :* I n c u r r e d i n d e b t e d n e s s a l s o i n c l u d e s e a c h p e r s o n / e n t i t y w i t h wh om t h e c a n d i d a t e ' s c o mmi t t e e h a s e n t e r e d i n t o a c o n t r a c t d u r i n g t h e r e p o r t i n g p e r i o d f o r f u t u r eo r c o n t i n u i n g p e r f o r m a n c e . E n t e r t h e name o f t h e c o n s u l t a n t wh o p r o v i d e s o r p r o c u r e s s e r v i c e s f o r i t e m s s u c h a s 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 ro r g a n i z i n g s e r v i c e s . R e p o r t o n S c h e d u l e G t h e n a t u r e o f p e r f o r m a n c e a n d t h e e s t i ma t e d p e r f o r m a n c e r e a s o n a b l y e x p e c t e d o f t h e c o n s u l t a n t .

DATEI NCURRED( MM/ DD/ YR) NAME AND ADDRESS OF PERSONT O WHOM DEBT OR OBL I GAT I ON I S OWEDDESCRI PT I ON OF GOODS ORSERVI CES PROVI DED OR

PURCHASEDBALANCE OWED AT

CLOSE OFREPORT I NGPERI OD*

CJd~~ ~. 1 s ~ ~ ~ eo ~ J o 4 4 1 5 7 4

~ / s u eN

r . CJ25 .

e . _ p Q i 9"

J Q c / q ~ l s f ~v s PS_

SUB- TOTAL $

TOTAL DEBTS OWED BY COMMI TT EE A T T HE END OF T HI S REPORT I NG PER I OD $