Midwest PAC__9748__scanned

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    FOR I NSTRUCT I ONS, SEE BACK OF FORMDI SCLOSURE SUMMARY PAGE

    COMMI TTEE NAME ( M u s t b e same a s o n S t a t e me n t o f Or g a n i z a t i o nMi d we s t Pa cI MPORTANT I n d i c a t e b y # t y p e o f c o mm i t t e e y o u a r e r e p o r t i n g f o r :( 1 2 11 ) S t a t e w i d e / L e g i s l a t i v e / 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 Co 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 y r AC ( 9 ) C i t y PAC ( 1 0 ) S c h o o l B o a r d o r 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 ICANDI DATE COMMI TT EES ONLY :C a n d i d a t e Name

    O f f i c e S o u g h t p FI LEn f 7w ) j D i s t r i c t ( i f Se n a t e o r H o u s e )

    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 l a n d c r i mi n a l p e n a l t i e s . P u r s u a n t t o I o wa Code s e c t i o n 6 8 B . 3 2 A ( 7 )t 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 e , an d t h e c 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 ei n d i v i d u a l r e s p o n s i b l e f o r f i l i n g t i me l y a n d a c c u r a t e r e p o r t s .

    SI GNATURE OF PERSON FI UWG REPORT

    I AMF I L I N G A Oc t o b e r 1 9 , 2 0 0 6( r e p o r t d a t e )

    OCHECK I F AMENDMENT TO REPORT DATEDChe 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 a n 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 Fo r m DR- 3( Y o u must 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 f 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 e

    c o mmi t t e e . T h i s amou n t MUST b e t h e same a s t h e c as h o n h a n d a t t h e e n do 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 must 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 he 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 an 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 S a l e s o f Campa i g n P r o p e r t y ( A t t a c h Sc h e d u l e H ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

    SUBTRACT TOTAL MONEY SPENT T HI S PERI ODS c he 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 Sc h e d u l e B ) ( * * a l s o s e e d e b t s a n 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 S c he d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

    CASHON 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 DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

    FORMDR- 2 DI SCLOSURE( R e v . 1 2 / 2 0 0 5 ) REPORTF o r O f f i c e Us e On l yComm . # WeeL o g g e d I nS c a n n e dCompu t e rA u d i t e d

    F i l e w i t h :I o wa E t h i c s a n d Campa i gnD i s c l o s u r e B oa r d5 1 0 E . 1 2 t h , S t e . 1 ADes Mo i n e s , I o w a 5 0 3 1 9Fa x : 5 1 5 - 2 8 1 - 3 7 0 1

    e :-; / - , $-~7G7STELEPHONE DATE SI GNED

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

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    2 , 1 7 5 . 0 00 . 0 00 . 0 0

    2 , 1 7 5 . 0 00 . 0 00 . 0 0

    ' " ` U N P A I D BI L L S ( F r o m S c h e d u l e D - A t t a c h S c he d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0- I N KI ND CONTRI BUT I ONS ( F r o m S c h e d u l e E - A t t a c h Sc h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0" * OUTSTANDI NG LOANS ( F r o m S c h e d u l e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0

    2 , 1 7 5 . 0 0

    CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) - YES J NOCANDI DATE COMMI TTEES ONLY :VALUE OF CAMPAI GN PROPERTY ( F r o m S c h e d u l e H - A t t a c h Sc h e d u l e H) $STATE COMMI TTEES : Su bmi t a r e c o n c i l e d c amp 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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    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 - - MONEY TAKEN I N

    ( I n c l u d i n g c a nd i d a t e ' s p e r s o na 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 Or g a n i z a t i o n )Mi d we s t Pa c

    SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECEI PTS0 CHECK T HI S BOX I FAMENDI NG FORM

    STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I CAL ACTI ON COMMI TTEE) , L I ST THE PAC I DENT I F I CAT I ONNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .NOTE : ANY PERSON, OTHER THAN AN I N DI V I D U AL , THAT CONTRI BUTES MORE THAN $ 7 5 0 TO YOUR CAMPAI GN MAY HAVE F I L I NGRESPONSI B I L I T I ES AND SHOULD I MMEDI ATELY 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 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 r f o r a n yc 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 a n s t a t u t o r y p o l i t i c a l c ommi t t e es .

    SUB- TOTALTOTAL ( 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 m m 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 y 2m 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 Page 1 o ff 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 eA)

    DATE PAC I D NUMBER NAME ANDADDRESS OF CONTR I BUTOR RELAT I ONSHI P AMOUNT J I F F ORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED F UND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# Ri c h ar d a n d Nanc y Degne r $ 5 0 0 . 0 09 / 1 / 2 0 0 6 CK# 5 0 1 1 2 7 9 0 NE 9 5 t h A v e n u eA n k e n y , I A 5 0 0 2 1I D# S . Ka y C h r i s t i a n 2 5 . 0 09 / 8 / 2 0 0 6 CK# 4 0 5 9 Pu r e br e d Du r o c Hogs1 3 9 1 3 3 4 t h RoadI D# L a r r y a n d Kar man Ni l g es 1 5 0 . 0 09 / 1 9 / 2 0 0 6 CK# 1 0 4 2 Us h e r A v e n u e4 0 0 8 Sumne r , I A 5 0 6 7 4I D# T ho ma s E . Wa l l 1 0 0 . 0 09 / 1 9 / 2 0 0 6 CK# 5 3 2 4 Mo r s e Road NE3 0 5 1 ' Town C i t y - 1 A 5 2 2 4 0I D# Ge r a l d J . Br e t e y 1 0 0 . 0 09 / 1 8 / 2 0 0 6 CK# 1 3 5 0 6 V i l l a g e Co u r t4 3 3 8 C l i v e , I A 5 0 3 2 5I D# De n n i s o r Su s an Ca r l s o n 1 0 0 . 0 08 / 2 9 / 2 00 6 CK# 1 90 2 2 30 t h S t r e e t7 0 5 1 Re d Oak, I A 5 1 5 6 6I D# J e f f an d Ke l l y Rehde r 1 0 0 . 0 09 / 1 1 / 2 0 0 6 CK# 6 0 9 3 3 8 3 9 Co o l i d ge A v e n u eHawa r den , I A 5 1 0 2 3I D#

    Ga l e n E . o r S h i r l e y Va n Beek 1 0 0 . 0 09 / 1 / 2 0 06 CK# 2 6 4 3 Ch er r y A v e n u e1 1 3 6 7 I n wo o d , I A 5 1 2 4 0I D# James o r Ma r g a r e t L e dge r 2 0 0 . 0 09 / 1 9 / 2 0 0 6 CK# 1 0 3 E a s t 1 5 t h S t r e e t

    4 9 5 7 Was h i n gt o n, I A 5 2 3 5 3I D# Do n a l d o r Sh a r o n S t r u t h e r s 2 0 0 . 0 09 / 1 8 / 2 0 0 6 CK# 3 0 2 3 2 7 10 t h A v e n u e8 6 7 3 C o l l i n s , I A 5 0 0 5 5

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

    ( I n c l u d i n g c a nd 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 S t a t e me n t o f O r g a n i z a t i o n )Mi d we s t Pa c

    STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A S TAT E PAC ( P OL I T I C A L ACTI ON COMMI T T E E ) , L I S T THE PA C I D EN T I F I C A T I ONNUMBER AND T HE PAC CHECK NUMBER 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 FROM THE I OWA E T H I C S AND CAMPAI GNDI SCLOSURE BOARD .NOTE : ANY PERSON, OTHER T H AN A N I ND I V I DU AL , THAT CONTR I BUTES MORE THAN $ 7 5 0 TO YOUR CAMPA I GN MAY HAVE F I L I NGRESPONS I BI L I T I E S AND SHOULD I MMEDI ATELY CONTACT THE BOARDCAUT 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 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 r f o r an yc 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 a n s t a t u t o r y p o l i t i c a l c ommi t t e e s .

    SUB- TOTAL

    TOTAL Of l a s t p a g e of 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 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 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 y 2 2ma 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 Page o ff 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 he d u l eA)

    SCHEDULEA MONETARY( Re v . 0 7 / 0 3 ) RECE I PTSCHECK T HI S BOX I FAMENDI NG FORM

    DATE PAC I D NUMBER NAME AND ADDRESS OF CONTR I BUTOR RELAT I ONSHI P AMOUNT J I F FORRECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECE I VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) R AI S ERNUMBER I NCOMEI D# Mi c h a e l o r R e b e c c a Se x t o n $ 1 0 0 . 0 01 0 / 2 / 2 0 0 6 CK# 3 4 3 4 2 2 0 2 Ogd en A v e n u eRo c k we l l C i t y , I A 5 0 5 7 9I D#

    Max o r Ge o r g i a Sc h mi d t 5 0 0 . 0 01 0 / 2 / 2 0 0 6 CK# 7 7 7 7 1 6 2 5 9 F i r A v e n u eEl ma I A 5 0 6 2 8I D#CK#I D#CK#I D#CK#I D#CK#I D#CK#I D#CK#I D#CK#I D#CK#