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COMMI TT EE NAME ( Mu s t be s ame a s o n S t a t eme n t o f Or g a ni z a t i o n)

I MPORTANT n d i c a t e b y # t y p e mmi t t e e y o u a r 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 / J u d g e l 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 m m i 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 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 P AC- - ( 1 1 ) L o c a l B a l l o t I s s u eCANDI DATE COMMI TT EES ONL Y:C a n d i d a a me P o l i t i c a l P a r t y ( i f a p p l i c a b l e )

O f f i c e S o u g h t / 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 m i n d (- 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 ommi t t e e a nd 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 mm i t t e e , i s t h ei n d i v WUM r e w a o s i b l e f o r l y , a c u r a t e r e p o r t s .

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CHECK I F AMENDMENT TO REPORT DATEDChec 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( 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 . )

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 mm i t t e e . T h i s amount 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 . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ADDTOTAL MONEY TAKEN I N T HI S PERI ODS c h e d u l e A: Cas 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 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 ) . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e F : Loans R e 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h e du l e H a p p l i e s t o Ca n d i d a t e s ' Commi t t e es On l y )SUB- TOTAL . . . . . . . . . . . . . . . . . . . . . . .$

SUBTRACT TOTAL MONEY SPENT T HI S PERI ODSc 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 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 ) . . . . . . . . . . . . . . . .S c h e d u l e F : L o a n Repay men 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 DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

FORMDR- 2( Re v . 1 2 1 2 0 0 5 )F o r O f f i c e Us e On l yComm . #Lo g g e d I n _ _ 5S c a n ne dComput e r -A u d i t e d

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I 1 NI PAI D B I L LS ( F r o m S c h e d u l e D - A t t a c h Sc h e d u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $" I N KI NDCONTRI BUI TOI NS ( 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $" * OUTSTANDI NG LOANS ( F r o m S c h e d u l e F - A t t a c h S c he 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 - NOCANDI DATE COMMI TT EES ONL Y:VALUE OF CAMPA I 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 TT EES : Su bmi 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 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 )I COMMI TT EE 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 )

SCHEDULEA MONETARY( R e v . 0 7 1 0 3 ) RECEI PTSCHECK T H I S BOX I FAMENDI NG FORM

STATE C AN D1 b A T E S N OT E : CONTRI BUTI O I S RECEI VED FROM A STATE PAC ( P OL I T I C A L ACTI ON COMMI TTEE) . L I S T THE PAC I DENTI F I CATI ONNUMBER AND THE PAC CHECK NUMBER I N THE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .NOTE : ANY PERSON, OTHER THAN AN I N DI V I D U A L , THAT CONTRI BUTES MORE THAN $ 7 5 0 TOYOUR CAMPAI GNMAYHAVE F I L I N GR E S PO NS I B I L I T I E S AND SHOULD I MMEDI ATELYCONTACT 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 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 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 mme 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 d 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 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 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 a m e 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 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 e A )

DATE PA I v NUMBER v e ~ _ l l _. ~ l a l ( . . , : L I . A T I ~ N S HRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MWDDYR) AND PACCHECK ( f f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# / , ' aCK# C G~ce - ~ t ~' f~Uc ~i z - t

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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 ( M u s t b e s ame a s o n a t eme n t o f O r g a n i z a t i o n )_ . ,

R ES P O NS I B I L I T I E S AND SHOULD I MMEDI ATELY CONTACT THE BOARD .

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 )

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

STATE CA I DATES NOTE' 1 A CONTRI BUTI ON DECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I ST THEPAC I DENT I F I CATI ONNUMBER AND THE PAC CHE CNUMBER I N THE DESI GNATED COL UMN. A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD.NOTE : ANY PERSON, OTHER THAN AN I N DI V I D UA L , THAT CONTRI BUTES MORE THAN $ 7 5 0 TO YOUR CAMPAI GN MAY HAVE F I L I N GCAUTI 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 .

" 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 m m 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 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 am e 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 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 m n . ( f o r S c h e d u l e A )

DATE PAC I V NUMBER DW s = a a a - R EL A T I ON SH I P AMOUNT - 4 I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-( MM/ D D / Y R ) AND PAC CHECK ( i f a p p l i c a b l e ) R AI S ERNUMBER I NCOMEI D# / y ; a -4

f . ~ 7 v Z S. S $CK# ` Sd. J ' pe .~3 v ~

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T HI S BOX APPL I E S 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 S c h e d u l e H . ( R e f e r t o S c 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 er 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 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 mm i 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 n d I o w a Code 6 8 A . 4 0 2 ( 3 ) ( i ) . )

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

FOR I NSTRUCTI ONS, SEE BACK OF FORM ( SCHEDULEEXPENDI TURES B MONETARY- - MONEY SPENT FROM COMMI TT EE ACCOUNT ( R e v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L E GI S L AT I V ECANDI DATES, L I S T THE CANDI DATE I DE NT I F I C AT I ON NUMBER I N T HE DESI GNATED COLUMN AND THE D 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 FROM THE 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 t a t e me n t o f O r g a n i z a t i o n )

CANDI PA3 : E NAME SI D ADDRESS T O 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 ) ( D i s b u r s e me n t ) WAS MADE( MMI DD/ YR) AND PACCHECKNUMBER

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T HI S BOX APPL I 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 h e d u l e H. ( R e f e r t o S c 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 f 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 made 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 n d I o w a Code 6 8 A . 4 0 2 ( 3 ) ( i ) . )

Pa g e o Z O f( f o r S c h e d u l e B )

FOR I NSTRUCT I ONS, SEE BACK OF FORM ~ SCHEDULEEXPENDI TURES B MONETARY- - MONEY SPENT FROM COMMI TTEE ACCOUNT ( R e v . 0 7 1 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI DATES, L I S T THE CANDI DATE I D ENT I F I CA T I O N NUMBER I N THE DESI GNATEDCOLUMN AND THE CHECKT HI S BOXI FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE 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 St a t e me n t o f O r g a n i z a t i o n )

CANDI D, ' ~ V E NAMKI - 3NDADDRESSTOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADE( MMI DD/ YR) ANDPACCHECKNUMBER

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FOR I NSTRUCT I ONS, SEE BACK OF FORMCOMMI TT EE NAME ( M u s t b e s ame a s o n S t a t e m e n t o f O r g a n i z a t i o n ,l 2 t t o

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* 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 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 e P a g e ~ I o f 1c 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 ( 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 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 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 .

DATERECEI VED( MM/ DD/ YR) NAME AND ADDRESSOF CONT RI B UT ORRELAT I ONSHI PTO CANDI DATE* ( i f a p p l i c a b l e )

DESCRI PT I ONOF I N KI NDCONTRI B UT I ON

ESTI MATEDF AI R MARKETVALUEI F FORFUND- RAI SERCONTRI BUT I ON

~ ~ ~ / ~ P h R o k ) ( - l Yc iA i r s4 ~ ro1 . o~4 a6 l o r r 5 SC , . OS$

7 / 7 5 ,F - 1F - 1F - 1F - 11- 1F - 1F - 1F - 1F - 1