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HAPPY J OES

Fo r I n s t r u c t i o n s , Se e Back o f Fo r m

CONTRI 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 )

E6 2 242 7050

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 )

1 1 / 0 8 10 6 02 : 2 9pm P . 002

SCHEDULE

A MONETARY( R e v . 0 7 / 0 3 )

I

RECEI PTS

QCHECK T HI S BOX I FAMENDI NGFORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECE I V ED FROM A S T A T E PAC ( P O L I T I C AL A C T I O N C OMMI T T EE ) , L I S T THE PA C I D EN T I F I C AT I O NNUMBER AND T HE P AC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I OWA E T HI C S AND CAMPAI GNDI SCLOSURE BOARD .

NOTE : ANY PERSON, OTHER THANAN I N DI V I D U A L , THAT CONTRI BUTES MORE THAN $ 7 5 0 TO YOUR CAMPAI GN MAY HAVE F I L I N GRESPONSI BI LI TI ES AND SHOULD I MMEDI ATELY 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 mmi t t e e s .

DATE PAC I D NUMBER NAME ANDADDRESSOFCONTRI BUTOR RELATI ONSHI P AMOUNT I F FOR

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE` RECEI VED FUND-( MM/ DDI YR) AND PAC CHECK ( I f a p p l i c a b l e ) RAI SER

NUMBER I NCOMEI D# 1 / c 4A - . 5; V7 e e. o S

CK# E - 0 - 3

0 5

I D#

CK# r '

I D#

6- - . 7 75I D#

1 0 - 1 7 -4CK# I f Al , Y6 " 7 1, 1

L y ~. r FL. , 3 , 3 fI D#

, 7 - i C c ~A' " t ~ , p

, l oCK# 9 I sI D#

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HAPPY JOESS63 242 ?030

Fo r I n s t r u c t i o n s , Se e Back o f Fo r m

CONTRI 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 TTEE 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 l z a t i d n )

5WAe - Z - / J . 5 - r - - Z

< < ~ , ( 5 ~ e -A- , f uA. / - : ~

-

1 1 10 3 / 0 6 09 : 3 9p m P . 003

SCHEDULE

A MONETARY( Re v . 0 7 / 0 3 )

RECEI PTS

QCHECK T HI S BOX I F

AMENDI NG FORM

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A ST AT E PAC ( P O L I T I C A L ACT I ON COMMI TTEE) . L I S T THE PAC I D EN T I F I C A T I O NNUMBER AND T HE P AC CHECK NUMBER I N T HE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S A V A 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 THAN AN I N D I V I D UA L , THAT CONTRI BUTES MORE THAN $ 7 5 0 TO YOUR CAMPAI GN MAY HAVE F I L I N GRESPONSI BI L I T I ES AND SHOUL D I MMEDI ATELY CONTACT THE BOARD.

CAUT I ON : S e c t i o n 6 6 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 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 o m m 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 mmi t t e e s .

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT

,I F FOR

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MMI DDI YR) ANDPAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBERI NCOME

ok 2 11 v 1 - 3A5I D#

7 3

1 4 r w ' 4 1 `

1 % ~ - f 1 6CK #

7 / 1 - 3P - A.

r"i - M S o d ' f 7 ~. C ~ t i "

I D#

CK#

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HAPPY J O ESSE3 242 70301 1, 1 ' 0 3/ 0 60 3 : 33pmP . 004

FOR I NSTRUCTI ONS, SEEBACKOF FORM f a t i t l } : $ SCHEDULE

EXPENDI TURESB MONETA RY

- - MONEY SPENT FROM COMMI TTEE ACCOUNT ( R e v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUT I ONSMADE TO STATEWI DE OR L E GI S L AT I V ECHECK T H I S BOX I FCANDI DATES, L I S T THE CANDI DATE I D E NT I F I C A T I ON NUMBER I N T HE DESI GNATED COL UMN AND T HE

PAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM T HE I OWA AMENDI NG FORMETHI CS 8 CAMPAI GN DI SCLOSURE BOARD .

COMMI T T EE NAME ( M u 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 )

CANDI DATE NAME AND ADDRESS T O WHOM PURPOSE AMOUNT

DATE I D NUMBER EXPENDI TURE ( DESCR I BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( Di s b ur s e me n t ) WAS MADE

( MM/ DD/ YR) AND PACCHECK

NUMBER

. a ~

C c . , ~ - r w . - ~ , f i r !S7

CK# / s u es : =

/ er , / 7 7 ~ i l k

I D #

D#

CK# l o a - 3

I D #

CK#

I D #

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HAPPY J OESS6 8 2 4 2 1 0 8 01 1 / 0 8 / 0 6 0 8 : 8 9 p m P . OOS

FOR I NSTRUCT I ONS , SEE BACK OF FORM

COMMI TT EE NAME ( M u 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 )

SCHEDULE

E I N - K I N Dt Re v . 0 6 1 9 7 ) CONTRI BUT I ONS

0CHECK T HI S BOX I F

AMENDI NG FORM

DATE

RECE I VED( MMI DD/ YR)

NAME AND ADDRESSOF CONTRI BUTOR

RELAT I ONSHI P

T O CANDI DATE* ( i f a p p l i c a b l e )

DESCRI PT I ONOF I N K I ND

CONTRI BUT I ON

EST I MATEDFA I R MARKET

VALUE

I F FOR

FUND- RA I SERCONTRI BUT I ON

E ` T 7 u r 3 L i C. ; 9 . ~ 1 P , ~ - w 7 y e ~F T %LC

9 r r f-

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