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

COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t eme n t of Or g an i z a t i o n)

0 6 1 1 cKned ' ; ~ ; 7_yf & U n d e r i - e a l S ~ A C 0 i sI MPORTANT: I n d i c a t e by # t y p e o f c o mmi t t e e y o u ar e r e p o r t i n g f o r :( 1 ) S t a t e wi d e / L e g i s l a t i v e / J u d ge St a nd i n g f o r Re t e nt i o n Ca nd i d a t e ( 2 ) S t a t e PAC ( 3 ) S t a t e P a r t y( 4 ) Co un t y Cen t r a l Commi t t e e ( 5 ) Co un t y Ca nd i d a t e ( 6 ) C i t y Ca nd i d a t e ( 7 ) Sc h o o l B oa r d o r Ot h e rP o l i t i c a l Su bd i v i s i o n Ca nd i d a t e ( 8 ) Co u nt y PAC ( 9 ( 1 0 ) S c h oo l B oa r d o r Ot h e r P o l i t i c a lSu bd i v i s i on PAC ( 1 1 ) L o c a l B a l l o t I s s ue aMG

P o l i t i c a l Par t y ( i f a p p l i c a b l e )

D i s t r i c t ( i f Se n at e o r Hou se )

L at e r e p o r t s ar e s u bj e c t t o p os s i b v i and c r i m i 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 Co d e s ec t i on 68B . 3 2 A( 7 )t h e c a nd i d a t , f o r a c and i d at e ' s c o mmi t t e e, and t h e c h ai r p er s on , f o r an y ot h e r t y p e o f c ommi t t e e , i s t h ei n d i v i d u a l ~ s p ns i b ! p f or f i l i n g "l yan d a c c ur a t e r e por t s .

SI GNATURE OF PERSONF I L I NG

1 AMF I L I NG A Ll 4` t E D d ( , 1( r e p o r t d a t e )

CHECKFMAENDNENT TOREPORT DATED

VCheck 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 and a t t a c h No t i c e o f D i s s o l u t i o n F or m DR- 3 .( Yo u mus t c o nt i n ue 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 . )

STATEMENT OF CASH ON HAND

0REPORT FOR ( 1 ) ELECTI ON / ( 2 ) NON- EL E CT I ON YEAR .

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CASHONHAND 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 o t a l o f a l l f u nd s h el l b y t h ec o mmi t t e e. Th i s amount MUST b e t h e s ame as t h e c a s h o n h a nd a t t h e endo f t h e l a s t r e p o r t i n g p er i od o r mus t be 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

FORMDR- 2 DI SCLOSURE( Re v . 1 2 / 2 0 0 5 ) REPORTFo r Of f i c e Us e OnNComm #L o g g e d I nScannedComp u t e rAu d i t ed

F i l e w i t hI o wa Et h i c s an d Camp a i g nDi s c l os ur e B oa r d5 1 0 E. 1 2 ` x , St e . 1 ADes Mo i n e s , I o wa 5 0 3 1 9Fax : 5 1 5 - 2 8 1 - 3 7 0 1

12&&- dd5 -V ' 6 1 ~&,TELEP } ZONE DATE

Lo ca l Commi t t e e s , e n t e r at e o f E l e c t i o n

Coun t y & L I Commi t t e e s , e nt e r Co u n t y i nwh i c h 6 l o c t i o o i s h e l dwat t r r m ) l

ADD TOTAL MONEYTAKEN I N T HI S PERI ODSc h e d ul e A : Cas h Con t r i bu t i on s t o t a l ( A t t ac h Sc h e d u l e A ) ( ' a l s o s ee i n - k i n d b e l o w) . . . . . . . . . . . . . . . . . . . . . . . . . I ~ " VSc h e d ul e F: L o a n s Re c ei v e d t o t a l ( A t t a c h Sc h e d ul e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d ul e H: T o t a l Sa l e s o f Camp a i g n Pr op er t y ( A t t a c h Sc h e d ul e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h ed ul eHap p l i e s t o Ca nd i d a t e s ' Commi t t ees On l y )SLOB - TOTA L . . .

SUBTRACT TOTAL MONEYSPENT T HI S PERI ODSc h e d u l e B: Ex p e nd 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 see d e bt s and l o an s b el o w) . . . . . . . . . . . . . . . . . . ~PSc h e d ul e F : L o a n Rep a y me n t s t o t a l ( A t t ac h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ( '

CASHONHAND a t t h e end 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 tbe z e r o ) ( A t t ac h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

" " UNP AI D BI L L S ( F r om Sc h e d ul e D - A t t ac h Sc h e d ul e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $" I N KI ND CONTRI BUTI ONS ( F r omSc h e d ul e E - A t t a c h Sc h e d ul e E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $' OUTSTANDI NG LOANS ( F r omSc h e d u l e F - At t ac h Sc h e d ul e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CONSULTANT BREAKDOWN( S c h ed u l eGA t t a c h ed ? )CANDI DATE COMMI TTEES ONLY :VALUEOF CAMPAI GNPROPERTY ( F r om Sc h e d ul e H - A t t ac h Sc h ed u l e H) $STATE COMMI TTEES : Su bmi t a r e c o nc i l e d c a mp a i g n a c c o u n t bank s t a t emen t i n J a n u ar y o f e a c h yea r .

-YES L , 1 0 ' NO

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F o r I n s t r u c t i o n s , Se e B a c k 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 b e same 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 )

STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI T T E E ) , UST THE PAC I D E NT I F I C A T I O NNUMBER AND THE 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 HI C S AND CAMPAI GNDI SCLOSURE BOARD .NOTE : ANY PERSON, OTHER THAN AN I ND I V I DU AL , THAT CONTRI BUTES MORE THAN $ 7 5 0 TO YOUR CAMPAI GN MAY HAVE F I L I NGRESPONS I B I L I T I 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 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- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c he 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 mmi 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 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 a me o f c o n t r i b u t o r i s t h e same a s c a n d i d a t e , b u t t h e r e i s n o Pa~_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 Sc h e du l e A)

SCHEDULEA MONETARY( Re v 0 7 / 0 3 ) RECE I PTSQCHECK THI S BOX I F

AMENDI NGFORM

DATERECE I VED PAC I D NUMBER( i f a p p l i c a b l e ) NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FOR( MM/ DD/ YR) AND PAC CHECK TOCANDI DATE`( i f a p p l i c a b l e ) RECE I VED FUND-RA I S ERNUMBER I NCOMEI D# Bb Ol d Al a nCY pS6CK# 5 - , ? ! - f wy Av e

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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 S c 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 / 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 nSc 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 r d 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 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 w a Code 6 8 A . 4 0 2 ( 3 ) ( i ) . )

Page / o f

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

FOR I NSTRUCTI ONS, SEE BACK OF FORM I Re " ~ FOrm SCHEDULEEXPENDI TURES - - MONEY SPENT FROM COMMI T TEE ACCOUNT B MONETARY( Re v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DEOR 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 COLUMNAND THE CHECK T HI S BOX I FPAC 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 ( 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 )

d ~ r 0 C 4 i Z0 6 7 0 0 1 ' Unde r wd d i ' r OOCANDI DATE NAME AND ADDRESS TO WHOM 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 ) ( Di s b u r s e me n t ) WASMADE( MM/ DD/ YR) AND PACCHECKNUMBER0 5 - o 1 04 I D#Pa f e 6 r i l e d CK# 1 a 6 I t ? t I a G e t Uf l e , Ad v e r l f s ! $ 6 y ~l r

I D# p TNeo l a ~~~ 1~~ . 5 . ~9-cbo GPr e , , , , e u S ^ y y e s- ~ i r n a- f e dCK# Oh I QSf r e - p o r f G5

05/ 3 ,D/ 0 0 I a cud ~/ o s ~ Sh e i ~ c l r e d C r S ~ n0 0 S h a , 5 $ 9 q . 7 d i e wo o d ~ r p 4 Sc ~ r ~ rCK# out u h r l e r wo o d S. 4 . 5 1 5 7 Ot t 16P 5UPl r " e 5 ; '.I D#CK#I D#CK#

I D#CK#I D#CK#I D#CK#

SUB- TOTAL $ ( G20, , 9 ' UTOTAL ( I f l a s t page o f t h i s s c h e du l e ) $