Verizon Iowa State Good Government Club6038Scanned

8/7/2019 Verizon Iowa State Good Government Club__6038__Scanned

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FOR I NSTRUCT I ONS , SEF BACK OF FORM

COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g

VERI ZON I OWA STATE GOOD GOVERNMENT CLUB

I MPORTANT : I n d i c a t e 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 ) S t a t e w i d e / L e g i s l a t i v e Ca n di d a t e ( 2 ) S t a t e w i d e PAC ( 3 ) S t a t e P a r t y ( 4 ) Co u n t y / L o c a l Ca n d i d a t e

( 5 ) Co u n t y PAC ( 6 ) B a l l o t I s s u e / F r a n c h i s e C o mmi t t e e ( 7 ) Co u nt y / C i t y C e n t r a l C ommi t t e e( 8 ) S u pp o f t S l a t e o f Ca n di d a t e s

J~Z~ w

SI GNATUP47M TREASURER ( o r p e r s o n f i l i n g t h i s r e p o r t ) TELEPHONE DATE S I GNED

Ro u t i n e Pe n a l t i e s Du e F o r L a t e F i l e d Re po r t s R a n g e f r o m $ 2 0 t o $800

SEE I NSTRUCTI ONS ON BACK AND COMPLETE THE FOLLOWI NGSENTENCE :

I AM F I L I N G A OCT 1 9 , 2 0 0 4 REPOR T FOR AN / A ( 1 ) ELECT I ON / ( 2 ) NON - E LEC T I ON YEAR .

CI A I F AMENDMENT TO REPORT DATED

DISCLOSURESUMMARYPAGE

( r e p o r t d a t e ) I n d i c a t e o n e

OCT 1 9 , 2004

h e 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 F o 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 N o t i c e o f D i s s o l u t i o n i s f i l e d . )

STATEMENT OF CASH ON HAND

eL 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 iw h i c h e l e c t i o n i s h e l d

CASH 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 h i s i s t h e t o t a lo f a l l mo n i e s h e l d b y t h e c o mmi t t e e . T h i s amoun t MUST b e t h es ame 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 mus t b e z e r o i f t h i s i s t h e f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5 , 8 51 . 4 1

ADDTOTAL MONEY TAKEN I N T HI S PERI OD

Sc h e du 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 Sc h e d u l e A ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 , 6 9 2 . 6 8

Sc h e du l e F : L o a n 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 0 0

Sc h e du l e H : T o t a l S a l e s o f C amp a 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 0 0

( S c h e d u l e H a p p l i e s t o C a n d i d a t e s ' Co mmi t t e e s o n l y )SUB- TO TAL . . . . . . . . $ 3 , 6 92 . 6 8

SUBTRACT TOTAL MONEY SPENT T HI S PERI OD

Sc h e du 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 , 5 5 0 . 0 0

Sc h e du 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 Sc h e du l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 0 0

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 mus tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 5 , 9 9 4 . 0 9

UNPAI D BI L LS ( F r o m Sc h e du l e D - A t t a c h Sc h e du l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0

I N KI ND CON T RI BU T I ON S ( F r o m Sc h e d u l e E - A t t a c h Sc h e du l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0

OUTSTANDI NG LOANS ( F r o m Sc h e du l e F - A t t a c h Sc h e du l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0

CANDI DATE COMMI TTEES ONLY :

CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? ) YE S NO

VALUE OF CAMPAI GN PROPERTY ( F r o m Sc h ed u l e H - A t t a c h Sc h e du l e H ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0



F o r I n s t r u c t i o n s , Se e Bac k o f Fo r m

CONTRI BU T I 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 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 )

VERI ZON I OWA S TA TE GOOD GOVERNMENT CLUB

STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMM I T T E E ) , L I ST T HE PAC I DE NT I F I C AT I ONNUMBER ANDTHE PAC CHECK NUMBER

I N THHE DES I GNATED COLUMN.A L I ST OF I D NUMBERS I S AVA I LABLE FROM T HE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 on t r i b u t i o ns o rf o r a ny c 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 I $ 26 . 00

TOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e ) 1 $

* D i s c l o s u r e l a w r e q u i r e s c a n di 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 must 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .

Page 1 o f 44

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

SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

.~X CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 1 I F FORRECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a b l e ) R AI S E RNUMBER I NCOME

0 7 / 23 / 04 I D# Uh i t e mi z e d Re c e i p t 1 . 00

CK#

08 / 06 / 04 I n# Uh i t e mi z e d Re c e i p t 1 . 00

CK#

0 8 / 2 0/ 0 4 I D# Uh i t e mi z e d Re c e i p t 1 . 00

CK#

09 / 0 3 / 0 4 I D# Uh i t e mi z e d Re c e i p t 1 . 00

CK#

0 9 / 1 7 / 0 4 I D# Uh i t e mi z e d Re c e i p t 1 . 00

CK#

1 0 / 0 1 / 0 4 I D# Uh i t e mi z e d Re c e i p t 1 . 00

CK#

0 7 / 2 3 / 0 4 I D# Rodney D. Ande r s o n 5 . 001 6 5 4 F i s h e r Av e

CK# New S h ar o n , I a 5 0 2 0 7

0 8 / 06 / 04 I D# Rodney D. Ande r s o n 5 . 001 6 5 4 Fi s h er Av e

CK# New S h ar o n , I a 5 0 20 7

0 8 / 20 / 04 I D# Ander s o n1 6 5 4 F i s h er

5 . 00

CK#Av

New S h ar o n , l a 5 0 20 7

0 9 / 0 3 / 0 4 I D#R

D . An d e r s o n 5 . 001 6 5 4 F i s h e r Av e

CK# New S h ar o n , I a 5 0 2 0 7



Fo r I n s t r u c t i o n s , See Ba c k o f F o r m

CONTRI 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 ds )

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 )


STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMMI T T E E ) , L I S T T HE PAC I DE NT I F I C AT I ONNUMBER AND THE PAC CHECK NUMBER I N THHE DE S I GNAT ED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA' ETHI C S AND CAMPAI GN

DI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 op 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 ut i o ns o rf o r a n y c o mme r c i a l p u r p o s e b y a ny p e r s o n o t h e r t h an 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 .

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 di 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 mus 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .

Page 2 o f 44

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

SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

MX CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f ap p l i c ab l e ) TO CANDI DATE* RECEI VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) R AI S E R

NUMBER I NCOME

0 9 / 1 7 / 0 4 I D# Rod n e yD . An d e r s o n 5 . 001 6 5 4 F i s h e r Av e

CK# New S h ar o n , I a 5 0 20 7

1 0 / 0 1 / 0 4 I D# Rodney D . An d e r s o n 5 . 001 6 5 4 F i s h e r Av e

CK# New S h ar o n , I a 5 0 20 7

0 7 / 2 3 / 0 4 m# Mi c h e l l e R . Bar man 2 . 5 01 5 1 5 Re ed S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# Mi c h e l l e R . Ba r n t mm 2 . 5 01 5 1 5 Re ed S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 20 / 04 I D# Mi c h e l l e R . Bar man 2 . 5 01 5 1 5 Re ed S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 03 / 04 I D# Mi c h e l l e R . Ba r n t mr < 2 . 5 0

1 5 1 5 R e e d StCK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7 / 0 4 I D# Mi c h e l l e R . Bar man 2 . 5 01 5 1 5 Reed St

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Mi c h e l l e R . Ba r n um 2 . 5 01 5 1 5 Reed S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7 / 23 / 04 I D# Ro n a l d D . Br own 2 . 5 0PO Bo x 2 2 6

CK# New S h ar o n , l a 5 0 20 7


I

CK#

INew S h ar o n , I a 5 0 20 7

I I I I



Fo r I n s t r u c t i o n s , S e e B a c k o f F o r m


( 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 same a s o n S t a t e me n t o f Or g an i z at i o n )


STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMMI T T E E ) , L I S T T HE PAC I DE NT I F I C AT I ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN.A L I S T OF I D NUMBERS I S AVA I LABLE FROM T HE I OWA ETHI C S ANDCAMPAI GNDI SCLOSURE BOARD.

CAUT I ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 ut i o ns o rf o r an y c o mme r c i a l p u r p o s e b y a ny p e r s o n o t h e r t h an 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 .

TOTAL ( i f l a s t page 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 di 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 mus 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .

Pa g e 3 o f 44

( f o r S c h e du l e A)

SCHEDULE

A MONETARY

( Re v . b 6 / 9 7 ) RECEI PTS

F CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FOR

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) R AI S E RNUMBER I NCOME


CK# New S h ar o n , l a 5 0 20 7

0 9 / 0 3 / 0 4 I D# Ro n a l d D . Br own 2 . 5 0PO Bo x 2 2 6

CK# New S h ar o n , l a 5 0 20 7

0 9 / 1 7 / 04 I D# Ro n a l d D . Br own 2 . 5 0PO Bo x 2 2 6

CK# New S h ar o n , I a 5 0 20 7

1 0 / 01 / 04 I D# Ro n a l d D . Br awn 2 . 5 0PO Bo x 2 2 6

CK# New S h ar o n , I a 5 0 20 7

0 7 / 23 / 04 I D# Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#

0 8 / 2 0/ 0 4 I D# Un i t e aa i z ed Re c e i p t 1 . 00

CK#

0 9 / 0 3 / 0 4 I D# Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#


CK#



F o r I n s t r u c t i o n s , S e e Bac k o f Fo r m

CON TR I BU T I ON S - - MONEY TAKEN I N


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 )

VER I ZON I OWA S T A T E GOOD GOVERNMENT CLUB

S TA TE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBER ANDTHE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN. A

L I S T OF I D NUMBERS I S AVA I LABLEFROM THE

I OWA ETHI C S AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 ut i o ns o r

f o r an y c o mme r c i a l p u r p o s e b y a ny p e r s o n o t h e r t h an 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 .

TOTAL ( i f l a s t p ag 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 nd i d at 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 must 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 ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .

Page 4 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI P T S

RX CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CON T RI BU T OR RELAT I ON SHI P AMOUNT f I F FORRECE I VED ( i f a p p l i c a b l e ) T O CANDI DAT E * RECE I VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI S ER

NUMBER I N COME

0 7 / 23 / 04 I D# Ch e r y l A . Ch r i s t i n s o n 2 . 5 01 4 2 8 Reed S t r e e t

CK# Gr i n ne l l , I a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# Ch e r y l A . Ch r i s t i n so n 2 . 5 01 4 2 8 Reed S t r e e t

CK# Gr i n ne l l , l a 5 0 1 1 2

0 8 / 2 0/ 0 4 m# Ch e r y l A . Ch r i s t i n s o n 2 . 5 01 4 2 8 Reed S t r e e t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# Ch e r y l A . Ch r i s t i n s o n 2 . 5 01 42 8 Re e d S t r e e t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7 / 0 4 I D# Ch e r y l A . Ch r i s t i n s o n 2 . 5 01 42 8 Re e d St r e et

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Ch e r y l A. Ch r i s t i n s o n 2 . 5 01 4 2 8 R e e d St r e et

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7 / 23 / 04 I D# C y n t h i a S . Cl o y e d 5 . 001 2 2 1 Pr i n c e S t r e e t

CK# Gr i n n e l l , I a 5 0 1 1 2

08 / 06 / 04 I D# C y n t h i a S . Cl o y e d 5 . 0 01 1 2 1 Pr i n c e S t r e e t

CK# Gr i n n e l l , I a 5 0 1 1 2

08 / 2 0 / 0 4 I D# C y n t h i a S . Cl o y e d 5 . 0 01 1 2 1 Pr i n c e S t r e e t

CK# Gr i n n e l l , l a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# C y n t h i a S . Cl o y e d 5 . 0 01 2 2 1 Pr i n c e S t r e e t

CK# Gr i n n e l l , I a 5 0 1 1 2



F o r I n s t r u c t i o n s , Se e Ba c k o f Fo r m





STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER ANDTHE PAC CHECK NUMBER I N THHE DE S I GNAT ED COLUMN . A L I S T

OF I D NUMBERS I S AVA I LABLEFROM THE

I OWA ETHI C S AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 and s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o rf o r a n y c 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 an 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 1 $ 3 0 . 00

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 ) J $

" 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 mus t b e s h o w n t o t h e t h i r d d e gr e e o f c o n s an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms 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 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 .

Page 5 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

~X CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ Y R) ANDPAC CHECK ( i f a pp l i c a b l e ) R AI S E RNUMBER

I NCOME

09 / 1 7 / 04 I D# Cy n t h i a S . Cl o y e d 5 . 0 01 21 Pr i n c e S t r e e t

CK# Gr i n n e l l , I a 5 01 1 2

1 0/ 01 / 04 I D# Cy n t h i a S . Cl o y e d 5 . 0 01 1 -21 Pr i n c e S t r e e t

CK# Gr i n n e l l , I a 5 0 1 1 2

07 / 23 / 04 I D# Un i t e a i z e d Re c e i p t 2 . 5 0

CK#

0 8/ 0 6/ 0 4 I D# Un i t e mi z e d Re c e i p t 2 . 5 0

CK#


CK#

09 / 03 / 04 I D# Un i t e n i z e d Re c e i p t 2 . 5 0

CK#

09 / 1 7 / 04 I D# Un i t e mi z e d Re c e i p t 2 . 5 0

CK#

1 0/ 01 / 04 I D# Un i t a mi z e d Re c e i p t 2 . 5 0

CK#

07 / 23 / 04 m# J a y M. Ct n i n gs 2 . 5 0140 8 Ol d 6 Rd .

CK# Ma l c o m, I a 5 0 1 5 7

08 / 06 / 0 4 I D# J a y M. C3m~n i ngs

1 4 0 8 Ol d 6d2 . 5 0

CK# Ma l c o m, l a 5 0 1 5 7







VER I ZON I OWA S T A T E GOODGOVERNMENT CLUB

S T AT E C ANDI DAT E S N OT E : I F A CON T RI BU T I ON I S RECE I VED FROM A S T A T E PAC ( POL I T I C AL ACT I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE

I OWAETHI C S AND

CAMPAI GNDI SCLOSURE BOARD

CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 and s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o rf o r a ny c 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 an 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 I S 1 9 . 0 0


* 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 must b e shown t o t h e t h i r d d e g r e e o f c o n s an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) 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 .

Page 6 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI P T S

M CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTR I BUTOR RELAT I ON SHI P AMOUNT J I F FORRECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I N COME

0 8 / 2 0 / 0 4 I D# J a y M . ~mmi ns 2 . 5 01 4 0 8 Ol d 6 Rd -.

CK# Ma l c o m, I a 5 0 1 5 7

0 9 / 03 / 0 4 I D# J a y M . Cu ma i n g s 2 . 5 01 4 0 8 Ol d 6 Rd .

CK# Ma l c o m, l a 5 0 1 5 7

0 9 / 1 7 / 0 4 I D# J a y M . CL ; mmr i nrgs 2 . 5 01 4 0 8 Ol d 6 Rd .

CK# Ma l c o m, I a 5 0 1 5 7

1 0 / 01 / 0 4 I D# J a y M . Cummngs 2 . 5 01 4 0 8 Ol d 6 Rd .

CK# Ma l c o m, I a 5 0 1 5 7

0 7 / 2 3 / 0 4 I D# Un i t e mi z e d Re c e i p t 1 . 5 0

CK#

0 8 / 06 / 04 I D# Un i t e mi z e d Re c e i p t 1 . 5 0

CK#


CK#


CK#

09 / 1 7 / 0 4 I D# Un i t e mi z e d Re c e i p t 1 . 5 0

CK#


CK#








S TATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A S T A T E PAC ( POL I T I C AL AC T I ON C OMMI T T EE ) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER AND T HE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T

OF I DNUMBERS I S

AVA I LABLEFROM

T HE I OWA ETHI CSAND

CAMPAI GNDI SCLOSURE BOARD.CAUT I ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 on t r i b u t i o ns o rf o r a ny c o mme 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 o mmi t t e e s .

SUB- TO TAL I $ 1 6 . 8 0

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 ) 1 $

* 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 mus 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c ke t ) . 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 .

Page 7 o f 4 4

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

SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

0 CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT / I F FORRECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a b l e ) RAI SERNUMBER I NCOME

0 7 / 23 / 0 4 I D# Ana l De v i l d e r 2 . 3 61 4 1 4 3 50 t h Av e

C R C # Br o o k l y n , I a 5 2 2 1 1

0 8/ 0 6 / 0 4 I D# An n a De v i l d er 2 . 3 61 4 1 4 3 50 t h Av e

CK# Br o o k l y n , I a 5 2 2 1 1

0 8 / 2 0/ 0 4 I D# An n a De v i l d e r 2 . 3 61 4 1 4 3 50 t h Av e

CK# Br o o k l y n , I a 5 2 2 1 1

0 9 / 0 3 / 0 4 I D# An n a De v i l d e r 2 . 3 61 4 1 4 3 50 t h Av e

CK# Br o o k l y n , I a 5 2 2 1 1

0 9 / 1 7 / 0 4 I D# A n n a De v i l d e r 2 . 3 61 4 1 4 3 50 t h Av e

CK# Br o o k l y n , I a 5 2 2 1 1


CK#

08 / 0 6/ 0 4 I D# Un i t e mi z e d Re c e i p t 1 . 00

CK#

08 / 20 / 04 I D# Un i t e mi z e d Re c e i p t 1 . 00

CK#

09 / 0 3 / 0 4 m# Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#








S TA TE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL AC T I ON COMMI T T E E ) , L I S T T HE PAC I DE NT I F I C AT I ONNUMBER AND THE PAC CHECK NUMBER I N THHE DE S I GNAT ED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM T HE I OWA ETHI C S ANDCAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68 B . 3 2A( 6 ) , I o wa Co d e , 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 nd s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o rf o r a n y c 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 an 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 1 $ 4 0 . 00


* D i s c l o s u r e l a w r e q u i r e s c a n di 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 mus 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 ng u i n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y I r e l a t i v e s b ym a r r i a g e ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .

Pa ge 8 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI P T S

~ X CHECK T HI S BOX IAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTR I BUTOR RELAT I ON SHI P AMOUNT A/ I F FORRECE I VED ( i f a p p l i c a b l e ) T O CANDI DATE* RECEI VED FUND-

( MM/ DDI YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I N COME

1 0/ 01 / 04 I D# Un i t e mi z e d Re c e i p t 1 . 0 0

CK#

07 / 23 / 04 I D# S u s a n M. Ed e l e n 4 . 0 03 6 3 0 9 0 t h S t

CK# Gr i n n e l l , l a 5 0 1 1 2

08 / 06 / 0 4 I D# S u s a n M. Ed e l e n 4 . 0 03 6 3 0 9 0 t h S t

CK# Gr i n n e l l , I a 5 0 1 1 2

08 / 20 / 0 4 I D# S u s a n M. Ed e l e n 4 . 0 03 6 3 0 9 0t h S t

CK# Gr i n n e l l , I a 5 0 1 1 2

09 / 03 / 04 I D# S u s a n M. Ed e l e n 4 . 0 03 6 3 0 9 0t h S t

CK# Gr i n n e l l , I a 5 0 1 1 2

09 / 1 7 / 04 I D# S u s a n M. Ed e l e n 4 . 0 03 6 3 0 9 0t h S tCK# Gr i n n e l l , I a 5 0 1 1 2

1 0/ 01 / 04 I D# S u s a n M. Ed e l e n 4 . 003 6 3 0 9 0t h S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7 / 2 3 / 0 4 I D# Roma i n e K . F e n n e r 5 . 0 0423 4 20 t h s t r e e t

C S C # Gr i n n e l l , l a 5 0 1 1 2

0 8/ 0 6/ 0 4 I D# Rr ma i n o K , Fe n n e r 5 . 0 0423 4 20 t h S t r e e t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8/ 2 0/ 0 4 I D# Roma i n e K. F e n n e r 5 . 0 042 3 4 20 t h S t r e e t

CK# Gr i n n e l l , I a 5 01 1 2






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 Or g a n i z a t i o n /

VER I ZON I OWA S TA TE GOOD GOVERNMENT CLUB

S T AT E C ANDI DAT E S NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL AC T I ON COMMI T T E E ) , L I S T T HE PAC I DE NT I F I C AT I ONNUMBER AND THE PAC CHECK NUMBER I N T HHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM T HE

I OWA ETHI C S ANDCAMPAI GNDI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 op 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 on t r i b u t i o ns o rf o r a ny c o mme 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 o mmi t t e e s .

SUB- TOTAL I S 3 3 . 50



Page 9 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI P T S

n X CHECK T HI S BOX IAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CON T RI BU T OR RELAT I ON SHI P AMOUNT J I F FORRECE I VED ( i f a p p l i c a b l e ) T O CANDI DAT E * RECE I VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I N COME

0 9 / 0 3 / 0 4 I D# Rr mw i n p K . Fenne r 5 . 0 04 2 3 4 2 0t h St r e et

CK# Gr i n ne l l , I s . 5 0 1 1 2

0 9 / 1 7 / 0 4 I D# Rcma n e K . Fenne r 5 . 0 04 2 3 4 2 0 t h s t r ee t

C 3 C # Gr i n ne l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Rc a i n e K . Fa r mer 5 . 004 2 3 4 2 0t h s t r ee t

CK# Gr i n ne l l , l a 5 0 1 1 2


C S C #


CK#

0 8/ 2 0/ 0 4 I D# Un i t e mi z e d Re c e i p t 1 . 00

CK#


C 3 C #

0 9 / 1 7 / 04 I D# Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#

07 / 23 / 04 I D# J o h n S . F l a n n e r y 1 2 . 5 01 0 2 4 2 1 s t

CK# W. Des Mo i n e s , l a 5 0 2 6 5







VERI ZON I OWA S T A T E GOODGOVERNMENT CLUB

S TA TE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I C AL ACT I ON COMM I T T E E ) , L I ST THE PAC I DE NT I F I C AT I ON

NUMBER ANDTHE PAC CHECK NUMBERI N THHE DES I GNATED COLUMN

. AL I S T

OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI C S ANDCAMPAI GN

DI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68B . 3 2A( 6 ) , I o wa Co d e , 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 op 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 on t r i b u t i o ns o r

f o r a ny c 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 .

* D i s c l o s u r e l a w r e q u i r e s c a n di 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 mus 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 sa n gu i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .


Pa ge 1 0 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECE I P T S

R CHECK T HI S BOXAMENDI NG FORM

DAT E PAC I D NUMBER NAME AND ADDRESS OF CON T RI BU T OR RELAT I ON SHI P AMOUNT J I F FOR

RECE I VED ( i f a p p l i c a b l e ) T O CANDI DAT E * RECE I VED FUND-

( MM/ DD/ YR ) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I N COME

08 / 06 / 04 I D# J o h n S . F l a n n e r y 1 2 . 5 01 0 2 4 2 1 s t

C 3 C # W. De s Mo i n e s , I a 5 0 2 6 5

08 / 2 0 / 0 4 I D# J o h n S . F l a nn e r y 1 2 . 5 01 0 2 4 21s t

C S C # W. De s Mo i n e s , I a 5 0 2 6 5

0 9 / 0 3 / 0 4 I D# J o h n S . F l a n n e r y 1 2 . 5 01 0 2 4 21s t

CK# W. De s Moues , I s 5 0 2 6 5

0 9 / 1 7 / 0 4 I D# J o h n S . F l a n n e r y 1 2 . 5 01 0 2 4 2 1 s t

CK# W. Des Mo i n e s , I a 5 0 26 5

1 0 / 0 1 / 0 4 I D# J o h n S . F l a n n e r y 1 2 . 5 01 0 2 4 2 1 s t

CK# W. Des Mo i n e s , I s . 5 0 2 6 5

0 7 / 2 3 / 0 4 m# Pa t r i c i a A . Go s s el i n k 2 . 5 0

1 5 3 4 6 S 8 4 t h Av e ECK# Gr i n n e l l , I s . 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# Pa t r i c i a A . Go s s el i n k 2 . 5 01 5 3 4 6 S 8 4 t h Av e E

CK# Gr i n n e l l , l a 5 0 1 1 2

0 8 / 20 / 04 I D# Pa t r i c i a A . Go s s el i n k 2 . 5 01 5 3 4 6 S 8 4 t h Av e E

CK# Gr i n ne l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# Pa t r i c i a A . Go s s e l i n k 2 . 5 01 5 3 4 6 S 8 4 t h Av e E

CK# Gr i n ne l l , l a 5 0 1 1 2

0 9 / 1 7 / 0 4 I D# Pa t r i c i a A. Go s s e l i n k 2 . 5 01 5 3 4 6 S 8 4 t h Av e E

CK# Gr i n ne l l , I a 5 0 1 1 2






COMMI TTEENAME ( Mu s t be 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 )


STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( P OL I T I C AL ACTI ON COMMI TTEE) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUT I ON : S e c t i o n 68B . 3 2A( 6 ) , I o wa Co d e, p r oh i b i t s t h e us e o f i n f o r ma t i o n c o p i e d f r om r e p or t s a n d 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 ns o r

f o r an y c omme r c i a l p ur p o s e by a ny p er 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 .


* Di s c l o s u r e l a w r e q ui r e s c an 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 any r e l a t i v e ma k i n g a c on t r i b ut i o n t o t h e

c o mmi t t e e . Re l a t i o ns h i p mu s t b e shown t o t h e t h i r d d e g r e e o f c o ns an g u i n i t y ( b l o od r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S ee P a g e 2 o f f o r ms p ac k e t ) . I f s u r n a me o f c o nt r i b u t o r i s t h e sa me a s c an d i d at 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 pp l i c a bl e ' i n t h e r e l a t i o ns h i p c o l u mn .

Page . 1 1 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

F X CHECK T HI S BOX

AMENDI NGFORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT , / I F FOR

RECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a pp l i c a b l e ) R AI S E R

NUMBER I NCOME

1 0/ 01 / 04 I D# Pa t r i c i a A . Go s s e l i n k 2 . 5 01 5 3 4 6 S 8 4t h Av e E

CK# Gr i n n el l , l a 5 0 1 1 2

07 / 23 / 04 I D# El l e n T . Gr a f f 4 . 0 07 00 Ga r f i e l d S t

CK# Tama, I a 5 2 3 3 9

08 / 06 / 0 4 I D# El l e n T . Gr a f f 4 . 0 07 00 Ga r f i e l d S t

CK# Tama, I a 5 2 3 3 9

08 / 20 / 0 4 I D# El l e n T . Gr a f f 4 . 0 07 00 Ga r f i e l d S t

CK# Tama, I a 5 2 3 3 9

09 / 03 / 04 I D# El l e n T . Gr a f f 4 . 0 07 00 Ga r f i e l d S t

CK# Tama, l a 5 23 3 9

09 / 1 7 / 04 I D# El l e n T . Gr a f f 4 . 0 0

7 00 Ga r f i e l d S tCK# Tama, I a 5 2 3 3 9

1 0/ 01 / 04 I D# El l e n T . Gr a f f 4 . 007 00 Ga r f i e l d S t

CK# Tama, l a 5 2 3 3 9

07 / 23 / 04 I D# An d r e w J . Gr o s e n b a c h 5 . 001 1 1 6 Re e d S t Ap t 1 01

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8/ 0 6/ 0 4 I D# An d r e w J . Gr o s e n b a c h 5 . 0 01 1 1 6 Re e d S t Ap t 1 01

CK# Gr i n n e l l , I a 5 01 1 2

0 8/ 2 0/ 0 4 I D# An d r e w J . Gr o s e n b a c h 5 . 0 01 1 1 6 Re e d S t Ap t 1 01

CK# Gr i n n e l l , I a 5 01 1 2






COMMI TTEENAME ( Mu 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 at i o n )


STATE CANDI DATES NOTE : i F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMMI T T E E ) , L I S T T HE PAC I DE NT I F I C AT I ON


L I S T OF I D NUMBERS I S AVA I LABLEFROM T HE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) . I o wa C o d e , 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 ut i o ns o r




Page_ 1 2 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK T HI S BOXAMENDI NG FORM

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

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE" RECEI VED FUND-

( MM/ DD/ Y R) ANDPAC CHECK ( i f a p p l i c a b l e ) R AI S E R

NUMBER I NCOME

0 9 / 0 3 / 0 4 I D# And r ew J . Gr o s e n b a c h 5 . 001 1 1 6 Re e d S t Ap t 1 0 1

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7 / 0 4 I D# And r ew J . Gr o s e n b a c h 5 . 001 1 1 6 Re e d S t Ap t 1 0 1

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0 / 01 / 04 I D# And r ew J . Gr ose nbach 5 . 0 01 1 1 6 Reed St Ap t 1 0 1

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7 / 2 3 / 0 4 m# J e n n i f e r Gu n d e r s o n 2 . 5 040 9 Cl a y S t

CK# Ma l c o m, l a 5 0 1 5 7

08 / 0 6 / 0 4 I D# J e n n i f e r Gu n d e r s o n 2 . 5 04 0 9 Cl a y S t

CK# Ma l c om, I a 5 0 1 5 7

0 8 / 2 0/ 0 4 I D# J e n n i f e r Gu n d e r s o n 2 . 5 0

4 0 9 Cl a y S tCK# Ma l c o m, I a 5 0 1 5 7

0 9 / 0 3 / 0 4 I D# J e n n i f e r Gu n d e r s o n 2 . 5 04 0 9 Cl a y S t

CK# Ma l e = , I a 5 0 1 5 7

0 9 / 1 7 / 0 4 I D# J e n n i f e r Gu n d e r s o n 2 . 5 040 9 Cl a y S t

CK# Ma l c o m, I a 5 0 1 5 7

1 0 / 0 1 / 0 4 m# J e n n i f e r Gu n d e r s o n 2 . 5 0409 Cl a y S t

CK# Ma l c o m, I a 5 0 1 5 7

0 7 / 2 3 / 0 4 I D# T r a c i A . Gu t h r i e 8 . 001 2 1 Ad a i r S t

CK# Ke l l o g g , I a 5 0 1 3 5










STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL AC T I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA

ETHI C S ANDCAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 nd s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o rf o r a n y c o mme r c i a l p u r p o s e b y a ny p e r s o n o t h e r t h an 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 .



' D i s c l o s u r e l a w r e q u i r e s c a nd i d at 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 must 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Pag e 2 o f f o r ms 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 s ame a s c a n d i d a t e , b ut 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 .

P a g e 1 4 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

~ X CHECK T HI S BOX IAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT ( I F FORRECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE* RECEI VED FUND-



C3C#

0 7 / 23 / 04 I D# Ann M . Ra n s s e n 6 . 00PO Bo x 2 4 6

CK# Ke l l o g g , I a 5 0 1 3 5

0 8 / 0 6 / 0 4 I D# Ann M . H a n s s e n 6 . 0 0PO Bo x 2 46

CK# Ke l l o g g , I a 5 0 1 3 5

0 8 / 2 0/ 0 4 I D# Ana M . H a n s s e n 6 . 00PO Bo x 2 46

CK# Ke l l o g g , I a 5 0 1 3 5

0 9 / 0 3 / 0 4 I D# Ana M. H a n s s e n 6 . 00PO Bo x 2 4 6

CK# Ke l l o g g , l a 5 0 1 3 5

0 9 / 1 7 / 04 I D# Ann M . H a n s s e n 6 . 00

PO Bo x 2 4 6C2C# Ke l l o g g , l a 5 0 1 3 5

1 0 / 0 1 / 0 4 I D# Ana M . H a n s s e n 6 . 0 0PO Bo x 2 4 6

CK# Ke l l o g g , I a 5 0 1 3 5


CK#

0 8/ 0 6 / 0 4 I D# Un i t e mi z e d Re c e i p t 2 . 5 0

C 2 C #


CK#








STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I C AL AC T I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER AND THE PAC CHECK NUMBER I N T HHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM T HE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 on t r i b u t i o ns o rf o r a ny c o mme 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 o mmi 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 nd i d at 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 must 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .

P a g e 1 5 o f 44

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

SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

. 0 CHECK T HI S BOXAMENDI NG FORM

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


( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a b l e ) RAI SER

NUMBER I NCOME

0 9 / 03 / 0 4 I D# Un i t e mi z e d Re c e i p t 2 . 5 0

CK#


CK#


CC#


CK#


CK#


CK#


CC#


CC#


CC#


I

CK#

I I I I






COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a n i z at i o n )


STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I C AL ACT I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBER ANDTHE PAC CHECK NUMBER I N THHE DE S I GNAT ED COLUMN. A

L I S T OF I D NUMBERS I SAVA I LABLE FROM T HE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.CAUT I ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 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 ut i o ns o r

f o r an y c o mme 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 an 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- TO TAL

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 nd i d at 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 e

c o mmi t t e e . R e l a t i o n s h i p must 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 an g u i n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s b y

m a r r i a g e ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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

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 .Page 1 6 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

MX CHECK T HI S BOX I

AMENDI NG FORM



( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a b l e ) R AI S E R

NUMBER I NCOME


CK#


CK#

09 / 0 3 / 0 4 I D# Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#

1 0 / 01 / 0 4 I D# Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#


CK#


CK#


CK#


CK#

! I I j ~






COMMI TTEENAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a n i z a t i o n )


STATE CANDI DATES NOTE : I F A CON T RI B UT I ON I S RECE I VED FROM A S T A T E PAC ( P OL I T I C AL ACT I ON COMM I T T E E ) , L I ST T HE PAC I DE NT I F I C AT I ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN. A

L I S T OF I D NUMBERS I SAVA I LABLE FROM THE I OWA ETHI C S ANDCAMPAI GN

DI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 on t r i b u t i o ns o r

f o r a ny c o mme r c i a l p u r p o s e b y a ny 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


" D i s c l o s u r e l a w r e q u i r e s c a n di 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 e

c o mmi t t e e . R e l a t i o n s h i p mus 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 sa n gu i n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s b y


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 .Pa ge 1 7 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK T HI S BOX I

AMENDI NG FORM



( MM/ DD/ Y R) ANDPAC CHECK ( i f ap pl i c ab l e ) R AI S E R

NUMBERI NCOME


CK#

0 7 / 2 3 / 0 4 I D# Peggy A . J a n t z e n 2 . 5 0

5 22 9 t h Avenue

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8/ 0 6 / 0 4 I D# Peggy A . J a n t z e n 2 . 5 0

5 2 2 9 1 1 3 Avenue

CK# Gr i n ne l l , l a 5 0 1 1 2

0 8 / 20 / 04 I D# Peggy A. J a n t z e n 2 . 5 0

5 22 9 t h Avenue

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 03 / 04 I D# Peggy A . J a n t z e n 2 . 5 0

5 22 9 t h Avenue

CK# Gr i n n e l l , l a 5 0 1 1 2


5 2 2 9 t h Avenue

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0 / 01 / 04 I D# Peggy A . J a n t z e n 2 . 5 0

5 2 2 9 t h Avenue

CK# Gr i n n e l l , l a 5 0 1 1 2

0 7 / 23 / 04 I D# Di a n e J . Ke e n a n 2 . 5 0

1 2 2 8 Wes t S tCK# Gr i n ne l l , I a 5 0 1 1 2

0 8 / 06 / 04 I D# Di ane J . Keenan 2 . 5 0

1 2 2 8 Wes t S tCK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 2 0/ 0 4 I D# Di ane J . Keenan 2 . 5 0

1 2 2 8 Wes t S tCK# Gr i n ne l l , I a 5 0 1 1 2








STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I C AL ACT I ON COMM I T T E E ) , L I ST THE PAC I DE NT I F I C AT I ON

NUMBERAND

THE PAC CHECKNUMBER I N THHE DES I GNATED COLUMN

. A

L I S T OFI D NUMBERS

I SAVA I LABLE FROM THE I OWA ETHI C S ANDCAMPAI GN

DI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa Co d e , 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 on t r i b u t i o ns o r

f o r a n y c 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 an 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 .

* 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 mus 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 ) 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 ) ( S e e Page 2 o f f o r ms p a c k et ) . 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

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 .

TOTAL ( i f l a s t p ag e o f t h i s s c h ed u l e )

Page 1 8 o f 44

( f o r Sc h e d ul e A)

SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

. ~CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P ' AMOUNT ( I F FOR

RECEI VED ( i f a pp l i c ab l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a pp l i c a b l e ) R AI S E R

NUMBER I NCOME

0 9 / 03 / 04 I D# Di ane J . Keenan 2 . 5 01 2 2 8 Wes t St

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7 / 04 I D# Di ane J . Keenan 2 . 5 01 2 2 8 Wes t St

CK# Gr i n n e l l , l a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Di ane J . Keenan 2 . 5 01 2 2 8 We s t S t

CK# Gr i n n e l l , l a 5 0 1 1 2

0 7 / 23 / 04 I D# Pame l a L . Ke s s l e r 5 . 002 5 5 42 0t h Av e

CK# Gr i n ne l l , I a 5 0 1 1 2

08 / 06 / 04 I D# Pame l a L . Ke s s l e r 5 . 002 5 5 42 0t h Av e

CK# Gr i n ne l l , l a 5 0 1 1 2

0 8 / 2 0/ 0 4 I D# Pmne l a L . Ke s s l e r 5 . 00

2 5 5 42 0t h Av eCK# Gr i n ne l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# Pame l a L . Ke s s l e r 5 . 002 5 5 4 20 t h Av e

CK# Gr i n ne l l , I s 5 0 1 1 2

0 9 / 1 7 / 0 4 I D# Pame l a L . Ke s s l e r 5 . 002 5 5 4 20 t h Av e

CK# Gr i n ne l l , l a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Pame l a L . Ke s s l e r 5 . 0 02 5 5 42 0 t h Av e

CK# Gr i n ne l l , I a 5 0 1 1 2


CK#








S T A T E CANDI DA T E S NOTE : I F A CON T RI B UT I ON I S RECE I VED FROM A S T A T E PAC ( P OL I T I C AL AC T I ON C OMMI T T EE ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBER AND T HE PAC CHECK NUMBER I N T HHE DES I GNATED COLUMN A L I S T OF I DNUMBERS I S AVA I LABLE FROM THE I OWA ETHI C S AND CAMPAI GN

DI SCLOSURE BOARD .CAU T I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o wa C o d e , 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 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 a n y c 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 .


* D i s c l o s u r e l a w r e q u i r e s c a nd i d at 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 e

c o mmi t t e e . R e l a t i o n s h i p must 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 an g u i n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s b y

m a r r i a g e ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 ut t h e r e i s n o

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 .Pa g e 1 9 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) REC EI P T S

r X CHECK T HI S BOX IAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CON T RI BU T OR RELAT I ON SHI P AMOUNT / I F FOR

RECE I VED ( i f a p p l i c a b l e ) T O CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I N COME


CK#


CK#


CK#

0 9 / 1 7 / 0 4 I D# U n i t e mmi z e d Re c e i p t 1 . 00

CK#


C 3 C #

0 7 / 2 3 / 04 I D# Ki mb e r l y K . Kr i e g e l 2 . 5 0

6 1 6 Ma i n S tCK# Br o o k l y n , l a 5 2 2 1 1

0 8 / 06 / 04 I D# Ki mb e r l y K . Kr i e g e l 2 . 5 0

6 1 6 Ma i n S tCK# Br o o k l y n , l a . 5 2 2 1 1

0 8 / 20 / 04 I D# Ki mbe r l y K . Kr i e g e l 2 . 5 06 1 6 Ma i n S t

CK# Br o o k l y n , l a 5 2 2 1 1

0 9 / 0 3 / 0 4 I D# Ki mb e r l y K . Kr i e g e l 2 . 5 06 1 6 Ma i n S t

CK# Br o o k l y n , I a 5 2 2 1 1

0 9 / 1 7 / 04 I D# Ki mb e r l y K . Kr i e g e l 2 . 5 06 1 6 Ma i n S t

CK# Br o o k l y n , I a 5 2 2 1 1






COMMI TTEENAME ( Mu s t b e s a m e 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 )


STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A S T A T E PAC ( POL I T I C AL ACT I ON COMM I T T E E ) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER

ANDTHE PAC CHECK

NUMBER I N THHE DES I GNATED COLUMN.A L I S T OF I D NUMBERS

I SAVA I LABLE

FROM THEI OWA ETHI C S

ANDCAMPAI GNDI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 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 ut i o ns o r



" D i s c l o s u r e l a w r e q u i r e s c a nd i d at 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 must 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .

Pa g e 2 0 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

MX CHECK T HI S BOXAMENDI NGFORM


RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE " RECEI VED FUND-

( MM/ DD/ Y R) ANDPAC CHECK ( i f ap p l i c ab l e ) R AI S E R

NUMBER I NCOME

1 0 / 0 1 / 0 4 I D# Ki mb e r l y K . Kr i e g e l 2 . 5 06 1 6 Ma i n S t

CK# Br o o k l y n , I a 5 2 2 1 1


CK#

08 / 0 6/ 0 4 m# Un i t e mi z e d Re c e i p t 1 . 0 0

CK#

08 / 20 / 04 I D# Un i t e mi z e d Re c e i p t 1 . 0 0

CK#


CK#


CK#

1 0 / 01 / 04 I D# u hi t e mi z e d Re c e i p t 1 . 00

CK#

0 7 / 23 / 04 I D# Sha r o n L . Kr t mm 2 . 5 01 5 4 1 5 N 7 5 t h Av e E

CK# Gr i n ne l l , I a 5 0 1 1 2

08 / 06 / 04 I D# Sha r o n L . Kx l amn 2 . 5 01 5 4 1 5 N 7 5 t h Av e E

CK# Gr i n ne l l , I a 5 0 1 1 2

0 8 / 2 0/ 0 4 m# Sha r o n L . Kr t mm 2 . 5 01 5 4 1 5 N 7 5 t h Av e E

CK# Gr i n ne l l , l a 5 0 1 1 2








STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL AC T I ON COMMI T T E E ) , L I S T T HE PAC I DE NT I F I C AT I ON


L I ST OF I DNUMBERS I S AVA I LABLE FROM T HE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.CAUT I ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 and s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o r

f o r a ny c o mme 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 o mmi 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 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 e

c o mmi t t e e . R e l a t i o n s h i p mus 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 ) a n d a f f i n i t y ( r e l a t i v e s b y

m a r r i a g e ) ( S e e Page 2 o f f o r ms p a c ke t ) . 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

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 .Page 21 o f 44

( f o r Sc h e du l e A )

SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

n X CHECK T HI S BOX I FAMENDI NG FORM

DAT E PAC I D NUMBER NAME AND ADDRESS OF CONTR I BUTOR RELAT I ON SHI P AMOUNT J I F FOR

RECE I VED ( i f a pp l i c a b l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ Y R) ANDPAC CHECK ( i f a p p l i c a b l e ) R AI S E R

NUMBER I NCOME

0 9 / 0 3 / 0 4 I D# Sha r o n L . Kr man 2 . 5 01 5 4 1 5 N 7 5t h Av e E

CK# Gr i n ne l l , l a 5 0 1 1 2

0 9 / 1 7 / 04 I D# S h a r o n L . Kx1af 2 . 5 0

1 5 4 1 5 N 7 5 t h Av e E

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Sha r o n L . Kr t n n n 2 . 5 0

1 5 4 1 5 N 7 5t h Av e Ec K# Gr i n n e l l , I a 5 0 1 1 2


CK#


CK#

0 8 / 2 0/ 0 4 I D# Un i t e mi z e d Re c e i p t 1 . 0 0

CK#


CK#


CK#


CK#

0 7 / 23 / 04 I D# Debr a E . Lewi s 5 . 00

1 2 0 2 El m S t r e e tCK# Gr i n n e l l , l a 5 0 1 1 2




C ON T RI BU T I ON S - - MONEY TAKEN I N




S TA TE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I C AL ACT I ON COMM I T T E E ) , L I ST T HE PAC I DE NT I F I C AT I ON


L I ST OF I D NUMBERS I S AVA I LABLE FROMTHE

I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa Co d e , 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 op 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 on t r i b u t i o ns o rf o r a ny c 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 .



Page 2 2 o f 4 4


SCHEDULE

A MONETARY

( R e v . 0 6/ 9 7 ) RE CE I P T S

EX CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CON T RI BU T OR RELAT I ON SHI P AMOUNT J I F FORRECE I VED ( i f a p p l i c a b l e ) T O CANDI DAT E * RECEI VED FUND-

( MM/ DD/ YR ) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I N COME

08 / 0 6/ 0 4 m# Debr a E . L e wi s 5 . 0 01 2 0 2 El m St r e et

CK# Gr i n n e l l , I a 5 0 1 1 2

08 / 20 / 04 I D# Debr a E . Le wi s 5 . 0 01 2 0 2 El m St r e et

CK# Gr i n n e l l , l a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# Debr a E . Le wi s 5 . 001 2 0 2 El m St r e et

CK# Gr i m 1 1 , I a 5 0 1 1 2

0 9 / 1 7 / 04 I D# Debr a E . Le wi s 5 . 001 2 0 2 El m S t r e e t

CK# Gr i n n e l l , l a 5 0 1 1 2

1 0 / 01 / 04 I D# Debr a E . L e w i s 5 . 001 2 0 2 El m S t r e e t

CK# Gr i n n e l l , I s 5 0 1 1 2


CK#

Y0 9 / 1 7 / 04 I D# Un i t e mi z e d Re c e i p t 2 . 5 0

CK#

1 0 / 0 1 / 0 4 I D# Un i t e: a i z e d Re c e i p t 2 . 5 0

CK#

07 / 2 3 / 0 4 I D# S u s a n J . Mc Ca i n 2 . 5 0

CK#4 3 7 0Ma l c o m, g Ih a 5 01 5 ' 7

6 3 Bo x8

08 / 0 6 / 0 4 I D# S u s a n J . Mc Ca i n 2 . 5 04 3 7 0 6 3 Bo x

8CK# Ma l c o m, I s 5 01 5 ' 7



Fo r I n s t r u c t i o n s , S e e Ba c k o f F o r m





STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER ANDTHE PAC CHECK NUMBER I N THHE DES I GNATED

COLUMN. A L I S T

OFI D NUMBERS

I SAVA I LABLE FROM T HE

I OWAETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 ut i o ns o rf o r an y c o mme r c i a l p u r p o s e b y a ny p e r s o n o t h e r t h an 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 .



Page 2 3 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

n CHECK T HI S BOXAMENDI NG FORM



( MM/ DD/ YR) ANDPAC CHECK ( i f a p p l i c a b l e ) R AI S E RNUMBER I NCOME

0 8 / 2 0 / 0 4 I D# S u s a n J . Mc Ca i n 2 . 5 04 3 7 0 Hi g h w ay 6 3 , Ha a s 8

CK# Ma l c c m, l a 5 0 1 5 7

0 9 / 03 / 04 I D# S u s a n J . Mc Ca i n 2 . 5 04 3 7 0 Hi g h wa y 6 3 , Bo x 8

CK# Ma l c am, I a 5 0 1 5 7

0 9 / 1 7 / 0 4 I D# Susan J . Mc Ca i n 2 . 5 04 3 7 0 Hi g h wa y 6 3 , Bo x 8

CK# Ma l c am, l a 5 0 1 5 7

1 0 / 0 1 / 0 4 m# Susan J . Mc r a i n 2 . 5 04 3 7 0 Hi ghway 6 3 , Bo x 8

CK# Ma l c am, I a 5 0 1 5 7

0 7 / 2 3 / 0 4 m# Un i t e o i z e d Re c e i p t 1 . 00

CK#

0 8 / 0 6 / 0 4 I D# Un i t e a i z e d Re c e i p t 1 . 00

CK#

0 8 / 2 0/ 0 4 I D# Un i t e o i z e d Re c e i p t 1 . 00

CK#

09 / 0 3 / 0 4 I D# Un i t e a i z e d Re c e i p t 1 . 00

CK#


CK#


CK#








STATE CANDI DATES NOTE : I F A CON TR I BUT I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBER AND T HE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM T HE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 ut i o ns o r

f o r an y c o mme r c i a l p u r p o s e b y a ny p e r s o n o t h e r t h an 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


* D i s c l o s u r e l a w r e q u i r e s c a nd i d at 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 mus t b e s h o w n t o t h e t h i r d d e gr e e o f c o n s an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .

Pa g e 2 4 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS






CK#


CK#

0 7 / 2 3 / 0 4 m# Un i t e mi z e d Re c e i p t 2 . 5 0

CK#


CK#


CK#


CK#


CK#


C 3 C #

0 7 / 2 3 / 0 4 I D# Rhonda R . Mayes 5 . 003 02 2 nd Av e

C 3 C # Gr i n n e l l , l a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# Rhonda R . Mayes 5 . 003 02 2 nd Av e

CK# Gr i n n e l l , I a 5 0 1 1 2






COMMI TTEENAME ( Mu 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 n )


* 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 mus t b e shown t o t h e t h i r d d e g r e e o f c o n s an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Pa g e 2 o f f o r ms p a c k e t ) . 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 .

STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A S T A T E PAC ( POL I T I C AL AC T I ON C OMMI T T EE ) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER ANDTHE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM T HE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 on t r i b u t i o ns o rf o r a ny c o mme 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 o mmi t t e e s .


Page 25 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

I CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT % f I F FORRECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE* RECEI VED FUND-


NUMBER I NCOME

0 8 / 2 0 / 0 4 I D# Rho n d a R . May es 5 . 0 03 0 2 2n d Av e

CK # Gr i m 1 1 , I a 5 0 1 1 2


CK# Gr i n n e l l , I a 5 0 1 1 2


CK# Gr i n n e l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Rho n d a R . Moy es 5 . 0 03 0 2 2n d Av e

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7 / 2 3 / 0 4 I D# Un i t e mi z ed Re c e i p t 2 . 5 0

CK #


CK #

0 8 / 2 0 / 0 4 I D# Un i t a a i z e d Re c e i p t 2 . 5 0

CK #


CK #

0 9 / 1 7 / 0 4 m# Un i t e mi z ed Re c e i p t 2 . 5 0

CK #


CK #








STATE CANDI DATES NOTE : I F A CON TR I BUT I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMM I T T E E ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBER AND T HE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM T HE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 ut i o ns o rf o r an y c o mme r c i a l p u r p o s e b y a ny p e r s o n o t h e r t h an 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 .

TOTAL ( i f l a s t p ag 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 nd i d at 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 must 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 ut 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 .

Pa g e 26 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

. ~ CHECK T HI S BOXAMENDI NG FORM



( MM/ DD/ Y R) ANDPAC CHECK ( i f a p p l i c a b l e ) R AI S E RNUMBER I NCOME

0 7 / 2 3 / 0 4 I D# R e b e c c a L . No r t h c u t t 2 . 5 07 0 5 E F l o od S t Bo x 8 1 9

CK# Mo n t e z u ma , I a 5 0 1 7 1

0 8 / 0 6 / 0 4 I D# R e b e c c a L . No r t h c u t t 2 . 5 07 0 5 E Wood S t Bo x 8 1 9

CK# Mo n t e z u ma , I a 5 0 1 7 1

0 8 / 2 0/ 0 4 I D# Re b e c c a L . No r t h c u t t 2 . 5 07 0 5 E Wood S t Bo x 8 1 9

CK# Mo n t e z u ma , l a 5 0 1 7 1

09 / 0 3 / 0 4 I D# R e b e c c a L . No r t h c u t t 2 . 5 07 0 5 E Wood S t Bo x 8 1 9

CK# Mo n t e z u ma , l a 5 0 1 7 1

0 9 / 1 7 / 04 I D# R e b e c c a L . No r t h c u t t 2 . 5 07 0 5 E Wood S t Bo x 8 1 9

CK# Mo n t e z u ma , I a 5 0 1 7 1

1 0 / 01 / 04 I D# R e b e c c a L . No r t h c u t t 2 . 5 0

7 0 5 E Wood St Bo x 8 1 9CK# Mo n t e z u ma , l a 5 0 1 7 1


CK#

08 / 06 / 04 I D# Un i t ea i z ed Re c e i p t 1 . 0 0

CK#

08 / 20 / 04 I D# Un i t e t L i z ed Re c e i p t 1 . 0 0

CK#

09 / 0 3 / 0 4 I D# Un i t ea i z ed Re c e i p t 1 . 0 0

CK#






COMMI TTEENAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g an i z at i o n )


STATE CANDI DATES NOTE : I F A CON T RI B UT I ON I S RECE I VED FROM A S T A T E PAC ( P OL I T I C AL ACT I ON COMM I T T E E ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBER AND THE PAC CHECK NUMBER I N T HHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI C S ANDCAMPAI GN

DI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa Co d e , 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 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 on t r i b ut i o ns o rf o r a n y c 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 an 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 .


* 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 mus 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k et ) . 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

P a g e 2 7 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

CHECK T HI S BOX I

AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT , / I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ Y R) AND PAC CHECK ( i f a pp l i c a b l e ) R AI S E RNUMBER I NCOME

0 9 / 1 7 / 04 I D# Un i t e mi z e d Re c e i p t 1 . 0 0

CK#


CK#


CK#

08 / 06 / 04 I D# Un i t e t t i z e d Re c e i p t 2 . 5 0

CK#


CK#


CK#


CK#

1 0 / 01 / 04 I D# Un i t ea i z ed Re c e i p t 2 . 5 0

CK#

07 / 2 3 / 0 4 I D# Mi c h a e l D. Pa wl o ws k i 5 . 009 0 2 H a n o v e r Dr i v e

CK# So u t h L a k e , T x 7 60 9 2

08 / 0 6/ 0 4 I D# Mi c h a e l D. Pa wl o ws k i 5 . 009 02 Ha n o v e r Dr i v e

CK# So u t h L a k e , T S c 7 6 0 9 2



F o r I n s t r u c t i o n s . S e e Bac k o f Fo r m





STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A S T A T E PAC ( POL I T I C AL ACT I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBERAND


. AL I S T OF I D NUMBERS I S AVA I LABLE

FROM THE I OWAETHI C S AND

CAMPAI GN

DI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa Co d e , 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 and 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 ut i o ns o r


` 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 must b e s h o w n t o t h e t h i r d d eg 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 ) a n d a f f i n i t y I r e l a t i v e s b ym a r r i a g e ) ( S e e Page 2 o f f o r ms p a c k e t ) 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 .


Page 28 o f 4 4


SCHEDULE

A MONETARY

( Re v . ' 06 / 9 7 ) RECEI PTS

EX CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT - I I F FORRECEI VED ( i f ap p l i c ab l e ) TO CANDI DATE" RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) R AI S E R

NUMBER I NCOME

0 8 / 2 0 / 0 4 I D# Mi c h a e l D . Pa wl o w s k i 5 . 009 02 H a n o v e r Dr i v e

CC# So u t h L a k e , T S c 7 6 0 9 2

0 9 / 0 3 / 0 4 I D# Mi c h a e l D . Pa w l o w s k i 5 . 009 02 H a n o v e r Dr i v e

CK# S o u t h L a k e , T x 7 60 9 2

0 9 / 1 7 / 0 4 I D# Mi c h a e l D . Pa wl o ws k i 5 . 009 02 H a n o v e r Dr i v e

CK# So u t h L a k e , T x 7 6 0 9 2

1 0 / 01 / 04 I D# Mi c h a e l D. Pa wl o ws k i 5 . 009 02 H a n o v e r Dr i v e

CK# So u t h L a k e , T x 7 60 9 2

0 7 / 2 3 / 0 4 I D# Li n da M . P e a c e 5 . 001 1 0 8 S u mme r S t

C E C # Gr i n n e l l , l a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# Li n da M . P e a s e 5 . 00

1 1 0 8 S u mme r S tCK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 2 0/ 0 4 I D# Li n da M . P e a s e 5 . 001 1 0 8 s u mme r S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# Li n da M . Pease 5 . 001 1 0 8 S u mme r S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7 / 0 4 I D# Li n da M. Pease 5 . 0 01 1 0 8 S u mme r S t

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0 / 01 / 04 I D# Li n da M. Peace 5 . 0 01 1 0 8 S u mme r S t

CK# Gr i n n e l l , I a 5 0 1 1 2








S TATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A S T A T E PAC ( POL I T I C AL ACT I ON COMM I T T E E ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBERAND


. A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI C S AND CAMPAI GN

DI SCLOSURE BOARD.CAUT I ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 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 ut i o ns o rf o r a n y c 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 an 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 .


" 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 mus 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k et ) . 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 .

Pa g e 2 9 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

~ X CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 41 I F FOR

RECEI VED ( i f a p p l i c a b l e ) T O CANDI DATE" RECEI VED FUND-


NUMBER I NCOME

0 7 / 2 3 / 0 4 I D# J ame s R . Ph e l p s 2 . 5 01 6 0 2 1 0 t h Avenue Pl a c e

C t # Gr i m 1 1 , I a 5 0 1 1 2

08 / 0 6/ 0 4 I D# J ame s R . Ph e l p s 2 . 5 01 6 0 2 1 0 t h Avenue Pl a c e

CK# Gr i n n e l l , I a 5 0 1 1 2

08 / 20 / 04 I D# James R . Ph e l p s 2 . 5 01 6 0 2 1 0 t h Avenue Pl a c e

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 03 / 04 I D# James R . Ph e l p s 2 . 5 01 6 0 2 1 0t h Avenue Pl a c e

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7 / 0 4 I D# J a me s R . Ph e l p s 2 . 5 01 6 0 2 1 0t h Avenue Pl a c e

CK# Gr i n n e l l , l a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# J mn e s R . Ph e l p s 2 . 5 0

1 6 0 2 1 0t h Avenue Pl a c eCK# Gr i n ne l l , I a 5 0 1 1 2

0 7 / 2 3 / 0 4 I D# J a n K . P o p e 5 . 006 0 3 Va n Ho r n e C i r

CK# Gr i n ne l l , I a 5 0 1 1 2

08 / 0 6 / 0 4 I D# J a n K . P o p e 5 . 006 0 3 Va n Bo r n e C i r

CK# Gr i n ne l l , I a 5 0 1 1 2

0 8 / 2 0/ 0 4 I D# J a n K . P o p e 5 . 006 0 3 Va n Home Ci r

CK# Gr i n ne l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# J a n K . P o p e 5 . 006 0 3 Va n Ho r n e Ci r

CK# Gr i m 1 1 , l a 5 0 1 1 2




CON TRI BU T I ON S - - MONEY TAKEN I N






STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A S TATE PAC ( POL I T I C AL AC T I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI C S ANDCAMPAI GN

DI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 nd s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o r

f o r a ny c 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 .

Page 3 0 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

M CHECK T HI S BOX I

AMENDI NG FORM

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



0 9 / 1 7 / 0 4 I D# J a n K . Gape 5 . 006 0 3 Va n Home Ci r

CK# Gr i n n e l l , l a . 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# J a n K . Pope 5 . 006 0 3 Va n Ho r n e C i r

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7 / 23 / 0 4 I D# Un i t mi z e d Re c e i p t 1 . 00

CK#

0 8/ 0 6 / 0 4 I D# Un i t e mi z e d Re c e i p t 1 . 00

CK#

0 8 / 2 0/ 0 4 I D# Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#

0 9 / 1 7 / 0 4 I n # Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#


CK#


CK#






COMMI TTEE NAME ( Mu 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 n )


STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMM I T T E E ) , L I ST THE PAC I DE NT I F I C AT I ONNUMBER ANDTHE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD.CAUT I ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa Co d e , 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 op i e d f r o m r e p o r t s a nd s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o rf o r a n y c 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 I $ 1 0 . 0 0

TOTAL ( i f l a s t page o f t h i s s c h e d u l e ) 1 $

* 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 mus 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 an g u i n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y I r e l a t i v e s b ym a r r i a g e ) ( S e e Page 2 o f f o r ms p a c k et ) . 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

Pa g e 3 1 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS


DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT ( I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ Y R) ANDPAC CHECK ( i f ap p l i c ab l e ) R AI S E RNUMBER I NCOME


CK#


CK#


CK#


CK#


CK#


CK#


CK#

0 9 / 0 3 / 0 4 m# Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#


CK#



F o r I n s t r u c t i o n s , S e e Bac k o f F o r m




VER I ZON I OWA S TA TE GOODGOVERNMENT CLUB


NUMBERAND

THE PAC CHECKNUMBER I N THHE

DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA . ETHI C S ANDCAMPAI GN

DI SCLOSURE BOARD .CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa Co d e , 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 and 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 ut i o ns o r



* D i s c l o s u r e l a w r e q u i r e s c a nd i d at 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 must 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms 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 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 .

Page - 3 2 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

RX CHECK T HI S BOX I F

AMENDI NG FORM


RECEI VED ( i f ap p l i c ab l e ) TO CANDI DATE* RECEI VED FUND-


NUMBER I NCOME

0 7 / 2 3 / 0 4 I D# Ba r b a r a J . S c h u l t z 2 . 5 0

5 1 0 Pe a r l S tCK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# Ba r b a r a J . S c h u l t z 2 . 5 0

5 1 0 Pe a r l S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 2 0/ 0 4 m# Ba r b a r a J . S c h u l t z 2 . 5 0

5 1 0 Pe a r l S tCK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# Ba r b a r a J . S c h u l t z 2 . 5 05 1 0 Pe a r l S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7 / 04 I D# Ba r b a r a J . S c h u l t z 2 . 5 05 1 0 Pe a r l S t

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0 / 01 / 04 I D# Ba r b a r a J . S c h u l t z 2 . 5 0

5 1 0 Pe a r l S tCK# Gr i n n e l l , l a 5 0 1 1 2


CK#


CK#


CK#


CK#






COMMI TTEE NAME ( Mu 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 n )


* 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 e

c o mmi t t e e . R e l a t i o n s h i p mus 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 an g u i n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s b y

m a r r i a g e ) ( S e e Page 2 o f f o r ms p a c k et ) . 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 .


STATE CANDI DATES NOTE : I F A CON T RI B UT I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMM I T T E E ) , L I ST T HE PAC I DE NT I F I C AT I ON

NUMBERANDTHE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.CAUT I ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 nd s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o r

f o r a ny c o mme r c i a l p u r p o s e b y a ny 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 .

Page 3 3 o f 4 4

( f o r Sc h e du l e A)

SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

M CHECK T HI S BOX IAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT , ' I F FOR


( MM/ DD/ Y R) ANDPAC CHECK ( i f ap pl i c ab l e ) R AI S E R

NUMBER I NCOME

0 9 / 1 7 / 0 4 m# U n i t e m i z e d R e c e i p t 1 . 0 0

C K #


C K #


C K #

0 8 / 0 6 / 0 4 m# U n i t e mi z e d R e c e i p t 2 . 5 0

C K #


CK#


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C K #


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C K #


C K #






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


STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL AC T I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBER AND T HE PAC CHECK NUMBER I N T HHE DES I GNATED COLUMN. A

L I S T OF I D NUMBERSI S AVA I LABLE FROM T HE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.CAUT I ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 and s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o r

f o r a ny c o mme 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 o mmi 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 di 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 e

c o mmi t t e e . R e l a t i o n s h i p mus t b e shown 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 ) a n d a f f i n i t y ( r e l a t i v e s b y

m a r r i a g e ) ( S e e Pa g e 2 o f f o r ms p a c k e t ) . 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 3 4 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

M CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT - I I F FOR



NUMBER I NCOME

0 8 / 2 0/ 0 4 I D# Un i t e a i z e d Re c e i p t 1 . 2 5

CK#

0 9 / 0 3 / 0 4 I D# Un i t e oi z ed Re c e i p t 1 . 25

CK#

0 9 / 1 7 / 0 4 I D# Un i t e ai z ed Re c e i p t 1 . 25

CK#

1 0 / 01 / 04 I D# Un i t ea i z ed Re c e i p t 1 . 2 5

CK#

07 / 23 / 04 I D# Mi c h e l e L . S i s s o n 3 . 00

1 4 2 1 4 t h Av e

CK# Gr i - e l l , I a 5 0 1 1 2

08 / 06 / 04 I D# Mi c h e l e L . S i s s o n 3 . 00

1 4 2 1 4 t h Av eCK# Gr i n ne l l , l a 5 0 1 1 2

0 8 / 2 0/ 0 4 I n # Mi c he l e L . S i s s o n 3 . 0 01 4 2 1 4 t h Av e

CK# Gr i n ne l l , I a 5 0 1 1 2

0 9 / 03 / 0 4 I D# Mi c h e l e L . S i s s o n 3 . 00

1 4 2 1 4 t h Av eCK# Gr i n n e l l , I a 5 0 1 1 2

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I I I I I ~









NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN.A L I S T OF I D NUMBERS I S AVA I LABLE

FROM THE I OWAETHI C S

AND CAMPAI GN

DI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 and s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o r

f o r a n y c 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 an 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 . '


* 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 must 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .

Page 3 5 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

~ X CHECK T HI S BOXAMENDI NG FORM




NUMBER I NCOME

0 7 / 2 3 / 0 4 I D # U n i t e m i z e d R e c e i p t 2 . 5 0

C K #


C K #


C K #


C K #

0 9 / 1 7 / 0 4 I D # U n i t e mi z e d R e c e i p t 2 . 5 0

C K #


CK#

0 7 / 2 3 / 0 4 I D # K a t h y V . S t a n e k 2 . 5 0PO B o o t 9 2 6

C K # Gr i m 1 1 , I a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D # K a t h y V . S t a n e k 2 . 5 0P O B o x 9 2 6

CK# G r i n n e l l , I a 5 0 1 1 2

0 8 / 2 0 / 0 4 I D # K a t h y V . S t a n e k 2 . 5 0P O Bo x 9 2 6

C K # G r i n n e l l , l a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D # K a t h y V . S t a n e k 2 . 5 0P O Bo x 9 2 6

C K # G r i n n e l l , I a 5 0 1 1 2









* D i s c l o s u r e l a w r e q u i r e s c a n di 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 e

c o mmi t t e e . R e l a t i o n s h i p mus 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 sa n gu i n i t y I b l o o d r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s b y



STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL AC T I ON COMMI T T E E ) , L I S T T HE PAC I DE NT I F I C AT I ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN. A

L I S T OF I DNUMBERS I S AVA I LABLE FROM T HE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 on t r i b u t i o ns o r

f o r a ny c o mme 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 o mmi t t e e s .

Page 3 6 o f 44


SCHEDULE

A MONETARY

( Re v 0 6/ 9 7 ) RECEI PTS

F CHECK T HI S BOX IAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT v1 I F FOR



NUMBER I NCOME

0 9 / 1 7 / 0 4 I D# Ka t h y V . St a n e k 2 . 5 0

PO Bo x 9 2 6CK# Gr i me 1 1 , I a 5 0 1 1 2

1 0 / 01 / 04 I D# Ka t h y V . St a n e k 2 . 5 0

PO B o a t 9 26

CK# Gr i n n e l l , I a 5 0 1 1 2


CK#


CZ#

0 8 / 2 0/ 0 4 m# Un i t e a i z e d Re c e i p t 1 . 0 0

CK#


CK#

09 / 1 7 / 0 4 I D# Un i t en i z ed Re c e i p t 1 . 00

CK#


C a t #


Ca t #


CZ#








STATE CANDI DATES NOTE : I F A CON TR I BUT I ON I S RECE I VED FROM A STATE PAC ( POL I T I C AL ACT I ON COMM I T T E E ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBER ANDTHE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA' ETHI C S AND CAMPAI GN

DI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 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 ut i o ns o r




Pa g e 3 7 o f 44

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

SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

FX CHECK T HI S BOX

AMENDI NG FORM




NUMBER I NCOME


CK#

09 / 0 3 / 0 4 I D# Un i t ea i z ed Re c e i p t 2 . 5 0

CK#

09 / 1 7 / 0 4 I D# Un i t emd z e d Re c e i p t 2 . 5 0

CK#

1 0 / 0 1 / 0 4 I D# Un i t ea i z ed Re c e i p t 2 . 5 0

CK#

07 / 2 3 / 0 4 I D# Ma r c i a T a r v i n 2 . 5 05 0 2 7 Hwy 6 3

CC# Mo n t e m- , i s 5 0 1 7 1

0 8/ 06 / 0 4 I D# Ma r c i a Ta r v i n 2 . 5 0

5 0 2 7 Hwy 6 3CK# Mo l n t e z t a n a , I a 5 0 1 7 1 .

0 8 / 2 0/ 0 4 I D# Ma r c i a Ta r v i n 2 . 5 05 02 7 Hwy 6 3

CC# Mo n t e z t ml a , I a 5 0 1 7 1

0 9 / 0 3 / 0 4 I D# Ma r c i a Ta r v i n 2 . 5 05 02 7 Hwy 6 3

CK# Mon t e z uma , I a 5 0 1 7 1

0 9 / 1 7 / 0 4 I D# Ma r c i a Ta n n i n 2 . 5 05 02 7 Hwy 6 3

CC# Mo n t e z t mi a , I a 5 0 1 7 1

1 0 / 0 1 / 0 4 I D# Ma r c i a Ta r v i n 2 . 5 05 0 2 7 Hwy 6 3

1

CC# Mo n t e z t ml a , I a 5 0 1 7 1

I I I



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 m






NUMBER ANDTHE PAC CHECK NUMBER I N THHE DE S I GN ATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI C S AND CAMPAI GN

DI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 and s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o r




Page _ 3 8 - o f 44


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

F RI CHECK T HI S BOXAMENDI NG FORM




NUMBER I NCOME

0 7 / 2 3 / 0 4 I D# Ka r en Va n So e l e n 2 . 5 01 2 6 9 5 S 92nd Av e E

CK# S u l l y , I a 5 0 25 1

0 8 / 06 / 04 I D# Ka r en Va n So e l e n 2 . 5 0

1 2 6 9 5 S 92nd Av e ECK# S u l l y , I a 5 0 2 5 1

0 8 / 20 / 04 I D# Ka r en Va n So e l e n 2 . 5 01 2 6 9 5 S 9 2 n d Av e E

CK# S u l l y , I a 5 0 2 5 1

0 9 / 03 / 04 I D# Ka r e n Va n So e l e n 2 . 5 01 2 6 9 5 S 9 2 n d Av e E

CK# S u l l y , l a 5 0 2 5 1

0 9 / 1 7 / 04 I D# Ka r e n Va n S o e l e n 2 . 5 01 2 6 9 5 S 9 2 n d Av e E

CK# S u l l y , I a 5 0 2 5 1

1 0 / 0 1 / 0 4 I D# Ka r e n Va n So e l e n 2 . 5 0

1 2 6 9 5 S 92n d Av e ECK# S u l l y , I a 5 0 2 5 1


CK# .


CK#

0 8/ 2 0/ 0 4 m# Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#








STATE CANDI DATES NOTE : I F A CON TR I BUT I ON I S RECE I VED FROM A STATE PAC ( POL I T I CAL AC T I ON C OMMI T T EE ) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER AND T HE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM T HE I OWA ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 ut i o ns o rf o r an y c o mme r c i a l p u r p o s e b y a ny p e r s o n o t h e r t h an 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 .


* D i s c l o s u r e l a w r e q u i r e s c a n di 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 mus 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .

Page 3 9 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


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-( MM/ DD/ YR) ANDPAC CHECK ( i f a p p l i c a b l e ) R AI S E R

NUMBER I NCOME


CK#


CK#

0 7 / 2 3 / 0 4 I D# Mar l i s R . Va n Za n t e 2 . 5 01 4 0 1 7 Hwy F - 6 2 E

CK# L y n n v i l l e , l a 5 0 1 5 3

0 8 / 0 6 / 0 4 m# Mar l i s R . Va n Za n t e 2 . 5 01 4 0 1 7 Hwy F - 6 2 E

CK# L y n n v i l l e , I a 5 0 1 5 3

0 8 / 20 / 04 I D# Mar l i s R . Va n Za n t e 2 . 5 0E 1 4 0 1 7 Hwy F - 6 2 E

CK# L y n n v i l l e , I a 5 0 1 5 3

t 0 9 / 03 / 04 I D# Mar l i s R . Va n Za n t e 2 . 5 0

1 4 0 1 7 Ewy F - 6 2 ECK# L y n n v i l l e , l a 5 0 1 5 3

0 9 / 1 7 / 0 4 m# Mar l i s R . Va n Za n t e 2 . 5 01 4 0 1 7 Hwy F - 6 2 E

CK# L y n n v i l l e , I a 5 0 1 5 3

1 0 / 01 / 04 I D# Mar l i s R . Va n Za n t e 2 . 5 01 4 0 1 7 Hwy F - 6 2 E

CK# L y n n v i l l e , I a 5 0 1 5 3

0 7 / 23 / 04 I D# Ka r l a L . Va n d e r l e e s t 2 . 001 5 2 7 0 N 75t h Av e E

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# Ka r l a L . Va n d e r l e e s t 2 . 001 5 2 7 0 N 75t h Av e E

CK# Gr i n ne l l , I a 5 0 1 1 2



4 k






STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I C AL ACT I ON COMM I T T E E ) , L I ST THE PAC I DE NT I F I C AT I ONNUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI C S AND

CAMPAI GNDI SCLOSURE BOARD.CAUT I ON : Se c t i o n 68 B . 3 2 A( 6 ) . I o wa C o d e , 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 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 ut i o ns o rf o r a n y c 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 an 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- TO TAL I S . 2 , 5 2 7 . 9 2

TOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e ) J $

* D i s c l o s u r e l a w r e q u i r e s c a nd i d at 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 must 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Pa g e 2 o f f o r ms 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 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 .

Page 4 0 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

~X CHECK T HI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-



CK# Gr i n n e l l , I a 5 0 1 1 2


CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7 / 04 I D# Ka r l a L . Va n d e r l e e s t 2 . 001 5 2 7 0 N 75t h Av e E

CK# Gr i n ne l l , I s . 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Ka r l a L . Va n de r l e es t 2 . 0 01 5 2 7 0 N 7 5t h Av e E

CK# Gr i n ne l l , l a 5 0 1 1 2

0 7 / 2 7 / 04 I D# Ve r i z o n Good Go v e r n me n t C l u b - T S [ 1 , 2 5 0 . 008 1 6 Co n g r e s s Av e . , S u i t e 1 5 0 0

CK# Au s t i n , T 5 c 7 8 7 0 1

1 0 / 1 2 / 0 4 I D# Ve r i z o n Good Go v e r n me n t C l u b - T X 1 , 2 50 . 00

C 3 C # 8 1 6x 7 8 7 0 1

S u i t e 1 5 0 0Au s t i n

0 7 / 2 3 / 0 4 I D# Debor ah D. Wal ke r 4 . 9 82 3 8 Ho r s e s h o e Dr

CK# Mo n t e z u ma , I a 5 0 1 7 1

0 8/ 0 6 / 0 4 I D# Debor ah D . Wal ke r 4 . 9 823 8 Ho r s e s h o e Dr

C 3 C # Mo n t e z u ma , I a 5 0 1 7 1

0 8 / 20 / 04 I D# De b o r a h D . Wal ke r 4 . 9 82 3 8 Ho r s e s h o e Dr

CK# Mo n t e z u ma , I a 5 0 1 7 1

0 9 / 0 3 / 0 4 I D# De b o r a h D . Wal ke r 4 . 9 82 3 8 Ho r s e s h o e Dr

IC 3 C #

IMo n t e z u ma , l a 5 0 1 7 1

I I 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 Or g an i z at i o n )



NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI C S AND CAMPAI GN

DI SCLOSURE BOARD.CAUTI ON: Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 nd s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o r



` D i s c l o s u r e l a w r e q u i r e s c a n di 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 mus 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 ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t ) . 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 .

Pa g e 4 1 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK T HI S BOX I

AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT - / I F FOR

RECEI VED ( i f ap pl i c ab l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ Y R) ANDPAC CHECK ( i f a pp l i c a b l e ) R AI S E R

NUMBER I NCOME

0 9 / 1 7 / 0 4 I D# De b o r a h D . Wal ke r 4 . 9 82 3 8 Ho r s e s h o e Dr

CK# Mo n t e z u ma , I a 5 0 1 7 1

1 0 / 01 / 0 4 I D# De b o r a h D . Wal ke r 4 . 9 8

2 3 8 Ho r s e s h o e Dr

CK# Mo n t e z u ma , I a 5 0 1 7 1

0 7 / 23 / 0 4 I D# Dav i d L . Wea v er 2 . 5 0

1 7 9 Wal nu t Ro a dCK# Gr i n n e l l , I s . 5 0 1 1 2

0 8 / 06 / 04 I D# Dav i d L . Wea v er 2 . 5 01 7 9 Wal nu t Ro a d

CK# Gr i n n e l l , I s 5 0 1 1 2

0 8 / 20 / 04 I D# Dav i d L . Wea v er 2 . 5 01 7 9 Wal nut Ro a d

CK# Gr i n ne l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# Dav i d L . Wea v er 2 . 5 0

1 7 9 Wal nut RoadCK# Gr i n ne l l , I a 5 0 1 1 2

0 9 / 1 7 / 0 4 I D# Dav i d L . Wea v er 2 . 5 01 7 9 Wal nut Road

CK# Gr i n ne l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Dav i d L . Wea v er 2 . 5 01 7 9 Wal nut Road

CK# Gr i n ne l l , I a 5 0 1 1 2

0 7 / 23 / 04 I D# J o a n n L . We l l s 5 . 0 025 6 Newbu r g Ro a d

CK# Gr i n ne l l , I s , 5 0 1 1 2

0 8 / 06 / 04 I D# J o a n n L . We l l s 5 . 0025 6 Newbu r g Ro a d

1

CK# Gr i n ne l l , I s . 5 0 1 1 2








STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A STATE PAC ( POL I T I C AL ACT I ON COMMI T T E E ) , L I S T THE PAC I DE NT I F I C AT I ONNUMBER AND THE PAC CHECK NUMBER I N THHE DE S I GNAT ED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI C S AND CAMPAI GN

DI SCLOSURE BOARD.CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 and 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 ut i o ns o rf o r a n y c 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 an 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 .

TOTAL ( i f l a s t page 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 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 mus t b e shown t o t h e t h i r d d e g r e e o f c o n s an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( Se e P a g e 2 o f f o r ms 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 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 .

Pa g e 4 2 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT % I I F FORRECEI VED ( i f ap p l i c ab l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ Y R) ANDPAC CHECK ( i f ap p l i c ab l e ) R AI S E RNUMBER I NCOME

0 8 / 2 0/ 0 4 I D# J o a n n L . We l l s 5 . 0025 6 Ne wb u r g Road

CK# Gr i n ne l l , l a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# J o a n n L . We l l s 5 . 0025 6 Ne wb u r g Road

CK# Gr i n ne l l , l a 5 0 1 1 2


CK# Gr i n ne l l , l a , 5 0 1 1 2


CK# Gr i n ne l l , I a 5 0 1 1 2


CK#


CK#


CK#


CK#


CK#


CK#



F o r I n s t r u c t i o n s , S e e Bac k o f F o r m





" 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 e

c o mmi t t e e . R e l a t i o n s h i p mus 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 an g u i n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s b y

m a r r i a g e ) ( S e e Page 2 o f f o r ms p a c ke t ) . 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



STATE CANDI DATES NOTE : I F A CON T RI BU T I ON I S RECE I VED FROM A S T A T E PAC ( POL I T I C AL AC T I ON C OMMI T T EE ) , L I S T THE PAC I DE NT I F I C AT I ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM T HE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD

CAUTI ON : Se c t i o n 68 B . 3 2A( 6 ) , I o wa C o d e , 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 and s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o r


Pa g e 4 3 o f 44

( f o r S c h ed u l e A)

SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

EX CHECK T HI S BOX IAMENDI NG FORM




NUMBER I NCOME

0 7 / 23 / 04 I D# Li n da J . Wi n c h e l l 2 . 5 0

3 1 5 2n d Avenue

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# Li n da J . Wi n c h e l l 2 . 5 0

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0 9 / 0 3 / 0 4 I D# L i n d a J . Wi n c h e l l 2 . 5 0

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0 9 / 1 7 / 04 I D# L i n d a J . Wi n c h e l l 2 . 5 0

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NUMBERAND

THE PAC CHECKNUMBER

I N THHE DES I GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI C S ANDCAMPAI GN

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

SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

0 CHECK T HI S BOX I

AMENDI NG FORM

DATERECEI VED

( MM/ DD/ YR)

PAC I D NUMBER( i f a pp l i c a b l e )ANDPAC CHECK

NUMBER

NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P

TO CANDI DATE*( i f a pp l i c a b l e )

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FOR I N ST RU CT I ON S, SEE BACK OF FORM

EXPENDI TURES - - MONEY SPENT FROM COMMI TT EE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CON T R I B UT I ON S MADE T O STATEWI DE OR LEGI S LAT I V E

CANDI DATES , L I S T THE CANDI DATE I DE NT I F I C AT I ON NUMBER I N THE DES I GNATED COLUMN ANDTHE

PAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA

ETHI C S & CAMPAI GN DI SCLOSURE BOARD .

COMMI TTEENAME ( Mus t b e s ame a s o n St a t eme n t o f Or g an i z at i o n )


a 0 #0 0 1 2 4

r h y d ' a , AE 6 8 5 0 8 P o l i t i c a l . Omi t r i b u t i m


SUB- TOTAL 1 $ 1 , 5 00 . 0

THI S BOXAPPL I ES TOCANDI DATES' COMMI TT EES ONLY :

Pu 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 $500 o r mo r e must a l s o b e i n v e n t o r i e d o n S c he d u l e H . ( R e f e r t o S c he 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 mus t a l s o b e d e t a i l i t e m i z e d o n

S c he d u l e G b y t h e amo 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 en 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 o

S c he d u l e G i n s t r u c t i o n s a n d I o wa Co de 5 6 . 6 1 3 ) ( i ) . )

Page 1 o f 4

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

SCHEDULE

B MONETARY

( Re v . 0 9 / 9 7 ) EXPENDI TURE

0CHECK T HI S BOX I F

AMENDI NG FORM

DATE

EXPENDED

( MM/ DD/ YR)

CANDI DATE

I D NUMBER

( i f a p p l i c a b l e )

ANDPAC

CHECK

NUMBER

NAME ANDADDRESS TOWHOM

EXPENDI TURE

( Di s b u r s e me n t ) WASMADE

PURPOSE

( DESCRI BE TRANSACTI ON)

AMOUNT

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0 9 / 1 4 / 0 4 1 D I #

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Bc V l e Pt i a l i c S e r v i c e 0a u d s s i m 5 0 0 . 0 0

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0 0 1 2 5( O u t s ,

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a 0 #

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0 0 1 2 8 ll , L a 5 0 1 1 2

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2 + I q r I c D e t v i t t G l a l e r a l 2 0 0 4 / i d 7 4

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0 0 1 2 3 I I e r t i a m d a , i s 5 0 1 2 5

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3 1 1 3 Ki MWA a l = > l e ame r a l 2 0 0 4 / i aQ0 De s M o i n e s , La 5 0 3 0 9 w i ; t i aa l . 03 3 b i b r i m

0 0 1 . 2 6

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a 0 # Rt . 1 Pd L t i c a l O > r i t r i b u t i m

0 0 1 3 4 F t . M3 d i sm, I a 5 2 6 2 1

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P O H o s c 2 2 0 G a l e t r a l 2 0 0 4 / i aC# Ro d , I a 5 0 6 7 0 PbU t L a i l 0 3 3 t r i b l _ = a l t

0 0 1 3 7S h e 1 1

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1 2 0 0 Nx t h S t r e e t coal 2 00 4 / m



FOR I N S T RU CT I ON S , SEE BACK OF FORM


STATE PAC COMMI T T E E S : NOTE : FOR CON T R I B UT I ON S MADE T O STATEWI DE OR LEGI S LAT I V E

CANDI DATES , L I S T THE CANDI DATE I DE NT I F I C AT I ON NUMBER I N THE DES I GNATED COLUMN ANDTHE

PAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA

ETHI C S & CAMPAI GN DI SCLOSURE BOARD .

COMMI TTEE NAME ( Mu s t b e s ame 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 )


CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE

TOTAL ( i f l a s t page o f t h i s s c h ed u l e ) 1 $

AMOUNT

SUB- TOTAL 1 $ 1 , 0 50 . 0 0

T HI S BOX APPL I E S TO CANDI DATES' COMMI TTEES ONLY :

Pu 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 $500 o r mo r e must a l s o b e i n v e n t o r i e d o n S c he d u l e H . ( R e f e r t o S c h ed u l e H i n s t r u c t i o n s . )


S c h ed u l e G b y t h e amo 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 en 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 o

S c h ed u l e G i n s t r u c t i o n s a n d I o wa Co d e 5 6 . 6 ( 3 ) ( i ) . )

Pa g e 2 o f 4

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

SCHEDULE

B MONETARY

( Re v . 0 9/ 9 7 ) EXPENDI T URE

El CHECK T HI S BOX I F

AMENDI NG FORM

DATE

EXPENDED( MM/ DD/ YR)

I D NUMBER( i f a p p l i c a b l e )AND PACCHECKNUMBER

EXPENDI TURE( D i s b u r s e m e n t ) WAS MADE

( DESCRI BE TRANSACT I ON ) EXPENDED

09 / 1 4 / 04 I I # L h i b md z e d bme 5 0 0 . 0 0 -

Qd 1

09 / 1 7 / 0 4 l D l l Gi p p f r r a t i v e Wmat t ee St a t e 1 3 o us e / l e g i s l a t t a q / x e p 200 . 0 0

5 8 6 I C 3 j c k Gi p p Gaul 2004/ ~ a 0 3 1Po1 i t i Ml 03 3 t r i b , r i m

00 1 33 P e a c i i w h , I a 52101

09 / 1 7 / 0 4 Ci t i z e ns £ c c Gk =B t a St a t e 200 . 0 0

Gr c n s t a l Ge ne r a l 2004/ i a -

220 H e a 3 1 e t t A9 e Ad i t y c a l Ct n t x i b at i r n

0 0 1 3 2 Oo i x mi l Shams, I a 5 1 90 3

08 / 26 / 04 3 D# Hs er f x r S t a t e Ae p r e e s t a t i v e S t a t e Ha ; I S Q / l r e c p s l a t u a ' e / x v 5 0 . 0 0

Ge r i Pl y Gwe c a l 20 04 / i i

r 3 K 1 ~ 2 1 3 7 t h s t r e e t N4 C b r Ax i b i t i r n

00121 I A l t o o a a , I a 50009

1 0 / 0 4/ 0 4 l a wn Dwmxa t i c Pe t t y S t a t e Po l i t a r wl Pa t t y 5 00 . 0 0

9 0 9 8 3 4 5 V i d t Me r P o s y Gaul 2 00 4/ i a

Qd k DEB M3 d n e s , I a 5 0 3 1 0 P a l i t d r c a l r tmt x i b , t i m

00 1 38

0 9/ 1 7 / 0 4 l D* I NVr e m f o r S t a t e S e na t e 200 . 0 0S t e we x t l v e r s m G~ a ~ ~ u ~ ~ l ~ , 2 ~ 0 0 4 / i a 0 0 5

3020 Dow- L V i l l i s r e n I t a d Po l i t i c al s t i r 00 1 30 Don s , I a 500 7 1

1 0 / ] . 1 / 0 4 1 1 3 ~ J a r ~ 2 ' ~ s Ommi t t e e S t a t e x e p 20 0 . 0 0

1 8 0 8 5 8t h S t r e e t Ga i e c a l 2004/ i aWe s t De s M o d n e s , l a 5 2 3 3 9 Pa l i t i c al a 2 i t r i b , t i m

00 1 39

09 / 1 7 / 0 4 K d b b d e f i c r r Sa t e S t a t e S e na t e 20 0 . 0 0

P O Hc x 1 9 0 Gex a l 2 0 0 4 / s r p 1 4

PJ ml e t d a g , I a 50 5 36 P o l i t i c a l Or t x i b u t i m

00129



FOR I N ST RU CT I ON S, SEEBACKOF FORM


STATE PAC COMMI T T E E S : NOTE : FOR CON T RI BU T I ON S MADE T O STATEWI DE OR LEGI S LAT I V E

CANDI DATES , L I S T THE CANDI DATE I DE NT I F I C AT I ON NUMBER I N T HE DES I GNATED COLUMN AND THE


ETHI CS &CAMPAI GN DI SCLOSURE BOARD.


VERI ZON I OWA S T A T E GOOD GOVERNMENT CLUB

NAME AND ADDRESS T OWHOMCANDI DATE PURPOSE


AMOUNT

SUB- TOTAL I S 1 , 1 0 0 . 0 0

T HI S BOX A PP L I E S T O CANDI DATES' COMMI T T EES ONLY :

Pu 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 $500 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 he d u l e H . ( R e f e r t o S c h ed u l e H i n s t r u c t i o n s . )


S c h ed u l e G b y t h e amo 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 o

S c h ed u l e G i n s t r u c t i o n s a n d I o wa C o d e 5 6 . 6 ( 3 ) ( i ) . )

P a g e 3 o f 4

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

SCHEDULE

B MONETARY

( R e v . 0 9 / 9 7 ) EXPENDI TURE

0 CHECK T H I S BOX I FAMENDI NG FORM

0 7 / 2 7 / 0 4 1

0 9 / 1 7 / 0 4

1 1 I #

C I O /0 0 ] 1 8

M l a p t y f i c c S t a r v e R P. I r e s s u t a t i v eP a t r i c k MmTW1 5 3 N Gr o a d v i e t y A v e .u u e , 7 a 5 2 0 0 1

P e l u e z f o r S t a t e P e P r e s e o d a t i v e

S t a t e H n u a a i t l a J x f l - A n r e l / zWG w e a a l 2004/ i i =C l o n t r i b k i m

1 0 0 . 0 0

5 0 . 0 01 1 4 F i r s t Am. E Gau l 2 0 0 4 / i iC d c a L o o s a , l a 5 0 6 3 5 P t a 1 i t i o d l 0 3 3 L x i i b u t i m

0 0 1 3 6

0 7 / z 7 / o 4 3 1 * P a u l B e l l f o r S t a t e R4: 1 r e e a l i t a t i v e S t a t e T 3 L 7 1 / l e g+ ' a l a t ,m. ~ZW 1 0 0 . 0 0

6 1 1 E . 1 7 t h S t . N . Ge n e r a l 2 0 0 4 / i aQ0 Ne w t = l a 5 0 2 0 8 C t a 3 t r i b t i m

0 0 1 1 9

0 9 / 1 7 / 0 4 P u t n e y f o r S e r r a t e S t a t e 1 0 0 . 0 0J d a z P u b i e y G e u e a a l 2 0 0 4 / s d 2 0

QK I 1 3 6 5 1 7 0 t h S t r e e t Po l i t i c a l a3 2 -- r b u t i m0 0 1 3 5 GI z d a o d c , I a 5 0 6 3 5

0 9 / 1 7 / 0 4 1 D # , l i e u . , P a t t y o f l o m s t a t e P o l i t i c a l P a r t y 5 0 0 . 0 05 2 1 E . l o c u s t s t r e e t Ga u l 2 0 0 4 / i a

Qc # D e s N b d n e s , I a 5 0 3 0 9 P o l i t i c a l Omr i k u t i m0 0 1 3 1

0 9 / 1 4 / 0 4 I I * A n d J o h n s o n P u b l i c S e r v i c e C b md e s i a n 1 0 0 . 0 01 2 0 0 N o r t h S t r e e t Ge c r a l 200; / / e

C 1 0 k Ca h e , N B 6 8 5 0 8 P o l i t i c a l C o r i t r b u t i m0 0 1 2 7

DATEEXPENDED

( M M / D D / Y R )

I D NUMBER( i f a p p l i c a b l e )AND PACCHECKNUMBER

E X P EN D I T U R E( D i s b u r s e m e n t ) WAS MADE

( D ES CR I B E TRANSACT I ON) EXPENDED

0 8 / 2 6 / 0 4 1 1 * I r a d v &r h u l a S e ~ + t e S t a t e S s c a t e 5 0 . 0 0G a r r a l 2 0 0 4 / i a

P O B o x 5 6 3 f } 0 l 3 t r i b u t r n

0 0 1 2 2 I A 5 2 3 0 2

0 8 / 1 8 / 0 4 Go d t t e e t o E l e c t N 3 t t M o [ b y S t a t e 9 e o a t e 1 0 0 . 0 0

M 3 t t b e w M o O p y Gwaa l 2 0 0 4 / s M l4 7 2 0 P b o d i a n d A v e . P o l i t i c a l C fo n t r i b u t i m

0 0 1 2 0 D e s M o d n e s , I a 5 0 3 2 0



FOR I N ST RU CT I ON S, S EE BACK OF FORM


STATE PAC COMMI T T E E S : NOTE : FOR CON T R I B UT I ON S MADE T O ST ATEWI DE OR LEGI S LAT I V E

CANDI DATES , L I S T THE CANDI DATE I DE NT I F I C AT I ON NUMBER I N THE DES I GNATED COLUMN AND T HE


ETHI CS &CAMPAI GN DI SCLOSURE BOARD.



CANDI DATE

I D NUMBER

( i f a p p l i c a b l e )AND PAC

CHECK

NUMBER

NAME ANDADDRESS TOWHOM

EXPENDI TURE

( Di s b u r s e me n t ) WASMADE


THI S BOXAPPL I ES TOCANDI DATES' COMMI TTEES ONLY :

Pu 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 $500 o r mo r e mus t a l s o b e i n v e n t o r i e d o n S c h ed u l e H . ( R e f e r t o S c h ed u l e H i n s t r u c t i o n s . )

Ex p e nd 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 , man 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 n

S c h ed u l e G b y t h e amo u n t , p u r p o s e , a n d d a t e o f e ac 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 o

S c h ed u l e G i n s t r u c t i o n s a n d I o wa Co d e 5 6 . 6 ( 3 ) ( 1 ) . )

Page 4 o f


SCHEDULE

B MONETARY


DCHECK T HI S BOX I F

AMENDI NG FORM



FOR I N S T RU CT I ON S , SEE BACK OF FORM

I AM F I L I NG A

CASH

DI SCLOSURE SUMMARY PAGE


VERI ZON I OWA STATE GOODGOVERNMENT CLUB

I MPORTANT : I n d i c a t e 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 C a n d i d a t e ( 2 ) S t a t e w i d e PAC ( 3 ) S t a t e P a r t y ( 4 ) C o u n t y / L o c a l C a n d i d a t e( 5 ) C o u n t y PAC ( 6 ) B a l l o t I s s u e / F r a n c h i s e Co mmi t t e e ( 7 ) C o u n t y / C i t y C e n t r a l C o mm i t t e e( 8 ) S u p p o r t S l a t e o f C a n d i d a t e s

SI GNATURE TREASURER ( o r p e r s o n f i l i n g t h i s r e p o r t ) TELEPHONE

Ro u t i n e Pe na l t i e s Du e F o r La t e F i l e d Re po r t s R a n g e f r o m $ 2 0 t o $800

SEE I NSTRUCTI ONS ONBACKANDCOMPLETE THE FOLL OWI NG SENTENCE :

OCT 1 9 , 2 0 0 4 - REPORT FOR AN/ A ( 1 ) ELECTI ON / ( 2 ) NON- ELECTI ON YEAR .

( r e p o r t d a t e )

CHECK I F AMENDMENT TO REPORT DATED

C h e 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 No t i c e o f Di s s o l u t i o n F o r m DR - 3 .( Yo u mus t c o n t i n ue t o f i l e r e p o r t s u n t i l a No t i c e o f D i s s o l u t i o n i s f i l e d . )

STATEMENT OF CASH ON HAND

I n d i c a t e o n e e

ON HAND a t t h e b eg i n n i n g o f t h e r e po r t i n g p e r i o d . ( T h i s i s t h e t o t a l -o f a l l mo n i e s h e l d b y t h e c o mmi t t e e . T h i s amount MUST b e t h es ame a s t h e c as 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 t h e f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

FORM

DR - 2 DI SCLOSURE

( R e v . 0 1 / 9 8 ) REPORT

Comm . #

I n d ex ed

Au d i t e d

C o mp u t e r

i D - / ? - D 4 /DATE SI GNED

L o c a l Commi t t e e s , e n t e r Da t e o f E l e c t i o n

Co u n t y & L o c a l C ommi t t e e s , e n t e r Co u n t y i nwh i c h e l e c t i o n i s h e l d

5 , 8 5 1 . 4 1

ADD TOTAL MONEY TAKEN I N T HI S PERI OD

S c h ed u l e A : C a s h Co nt r i b u t i o ns t o t a l ( At t a c h S c h ed u l e A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 , 4 42 . 6 8

S c h ed u l e F : L o a n 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 0 0

S c h ed u l e H : T o t a l S al e s o f C amp a i g n Pr o pe r t y ( At t a c h Sc h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 0 0

( S c h e d u l e H a pp 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 . . . . . . . . $ 2 , 4 42 . 6 8

SUBTRACT TOTAL MONEY SPENT T HI S PERI OD

S c h ed u l e B : Ex p en 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 , 6 5 0 . 0 0

S c h ed u l e F : L o a n Re p a y me n t s t o t a l ( At t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 0 0

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 al a nc e mu s t

b e z e r o ) ( A t t a c h DR - 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3 , 6 44 . 0 9

UNPAI D BI L L S ( F r o m Sc h e d u l e D - At t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0

I N KI ND CONTRI BUTI ONS ( F r o m S c h ed u l e E - At t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0

OUTSTANDI NG LOANS ( F r o m S c he d u l e F - At t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0

CANDI DATE COMMI TTEES ONLY :

CONSULT ANT BREAKDOWN ( S c h ed u l e G At t a c h ed ? ) YES NO

VALUE OF CAMPAI GN PROPERTY ( F r o m S c he d u l e H - At t a c h S c h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0






COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a ni z a t i o n)


STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ONNUMBER AND THE PACCHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 6 8 8 . 3 2 A ( 6 ) , I o wa Cod e , 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 and s t a t e me n t s f o r s o l i c i t i n g c o nt r i bu t i o ns o rf o r a ny c omme r c i a l p u r p o se by any 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 .

* D i s c l o s u r e l a w r e q u i r e s c a nd 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 ny 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 mus 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 ns a ng ui ni t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms 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 s am e a s c a n d i d a t e , b u t t h e r e i s nof 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

TOTAL ( i f l a s t page o f t h i s s c h ed ul e )

Page 1 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6/ 9 7 ) RECEI PTS

CHECK THI S BOX I F

AMENDI NG FORM

- DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT % I I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a p pl i c a bl e ) RA I SERNUMBER I NCOME

0 7 / 2 3 / 0 4 I D# Un i t e mi z ed Re ce i pt 1 . 0 0

CK#


CK#

s

0 8 / 2 0 / 0 4 I D# - Un i t ea i z ed Rec ei pt 1 . 0 0

CK#


CK#


CK# -

1 0 / 0 1 / 0 4 m# Un i t e mi z e d Rece i p t 1 . 0 0

CK#

0 7 / 2 3 / 0 4 m# Rodney D . An d e r s o n 5 . 0 01 6 5 4 F i s h e r Av e

CK# New S h a r o n , l a 5 0 2 0 7

0 8 / 0 6 / 0 4 I D# Rodney D . An d e r s o n 5 . 0 01 6 5 4 Fi s h er Av e

CK# New S h a r o n , I a 5 0 2 0 7

0 8 / 2 0 / 0 4 I D# Rodney D . An d e r s o n 5 . 0 01 6 5 4 Fi s h er Av e

CK# New S h a r o n , l a 5 0 2 0 7

0 9 / 0 3 / 0 4 m# Rodney D . An d e r s o n 5 . 0 01 6 5 4 Fi s h er Av e

CK# New S h a r o n , l a 5 0 2 0 7



F o r I n s t r u c t i o n s , Se e B a c k o f F o r m



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 )


STATE CANDI DATES NOTE : . I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68 B . 3 2 A( 6 ) , I o wa Cod e , 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 or t s and s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o r

f o r a n y c o mme r c i a l p u r p o s e b y any p e r s o n o t h e r t h an 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 .

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 di d at 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 e

c 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 eg r e e o f c on s a ng u i n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e Page 2 o f f o r ms 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 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 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 .

SUB- TOTAL

Page 2 o f 4 4

( f o r Sch edu l e A)

SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7) RECEI PTS

CHECK THI S BOX I F

AMENDI NG FORM

` r AT E - "- - PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT d I F FOR

RECEI VED ( i f a pp l i c a bl e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a b l e ) RA I SER

NUMBER I NCOME

0 9/ 1 7/ 0 4 I D# -RodneyD. An d e r s o n 5 . 0 01 6 5 4 F i s h e r Av e

CK# New Sh a r o n , I a 5 0 207

1 0 / 01 / 04 I D# RodneyD . An d e r s o n 5 . 0 01 6 5 4 F i s h e r Av e

CK# Ne w Sh a r o n , I a 5 0 207

a

0 7/ 2 3 / 0 4 I D# - Mi c h e l l e R . B r n u m 2 . 501 51 5 Re e d St

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8/ 0 6 / 0 4 I D# Mi c h e l l e R. Ba r n t mi 2 . 5 01 5 1 5 Reed St

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8/ 2 0 / 0 4 I D# Mi c h e l l e R. ' Ba r n u r m 2 . 5 01 5 1 5 Reed St

CK# Gr i n n e l l , I a 501 1 2 -

09 / 0 3 / 04 I D# Mi c h e l l e R. Ba r n t mt 2 . 501 5 1 5 Reed St

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9/ 1 7 / 0 4 I D# Mi c h e l l e R . Ba r n t mt 2 . 5 01 5 1 5 Reed St

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0/ 0 1/ 0 4 I D# Mi c h e l l e R . Ba r nu m 2 . 5 01 5 1 5 Reed St

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7/ 2 3 / 0 4 I D# Ro n a l d D . B r o wn 2 . 50PO Bo x 2 2 6

CK# Ne w Sh a r o n , I a 5 0 207

0 8/ 0 6/ 0 4 I D# Ro n a l d D.B r a wn 2 . 5 0PO Bo x 2 2 6

C a t # Ne w Sh a r o n , I a 5 0 207



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 m



COMMI TTEENAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or 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 ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ON

NUMBER AND THE PACCHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON: Se c t i o n 68 B . 3 2 A( 6 ) , I o wa Cod e , 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 and s t a t e me n t s f o r s o l i c i t i n g c on t r i bu t i o ns o r

f o r an y c o mme 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 o mmi t t e e s



c o mmi t t e e . R e l a t i o n s h i p must 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 ns a ng ui n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e P a g e 2 o f f o r ms p a c k e t ) 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 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 .

Page 3 o f 4 4

( f o r Schedu l e A)

SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK T HI S BOX I F

AMENDI NG FORM

. _



( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c abl e ) RA I SER

NUMBER I NCOME

0 8 / 2 0 / 04 I D# Rona l d D . Br o o m 2 . 5 0

PO B o o t 2 2 6CK# New Sh a r o n , I a 5 0 2 0 7

0 9 / 0 3 / 0 4 I D# Rona l d D . Br o o m 2 . 5 0

PO B o o t 2 2 6

CK#New

Sh a r o n , I a 5 0 2 0 7 a

0 9/ 1 7/ 0 4 I D# Rona l d D . B r o wn 2 . 5 0

PO Bo x 2 2 6CK# New Sh a r o n , l a 5 0 2 0 7

1 0 / 0 1 / 04 I D# Rona l d D . B r o wn 2 . 5 0

PO Bo x 2 2 6CK# New Sh a r o n , I a 5 0 2 0 7

0 7/ 2 3 / 0 4 I D# Un i t emi z e d Re c e i p t 1 . 0 0

CK#


CK#

0 8/ 2 0 / 0 4 I D# Un i t e l a i z e d Re c e i p t 1 . 0 0

CK#


CK#

0 9/ 1 7 / 0 4 I D# Un i t en i z ed Re c e i p t 1 . 0 0

CK#

1 0/ 0 1/ 0 4 I D# Un i t e ai z ed Re c e i p t 1 . 0 0

CK#






COMMI TTEENAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a ni z a t i o n)


STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I C AL ACT I ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ON

NUMBER AND THE PAC CHECK NUMBER I N THHE 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 ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , p r o h i b i t s t h e us e o f i n f o r ma t i o n c o pi e d f r o m r e p o r t s an d s t a t e me nt s f o r s o l i c i t i n g c o nt r i bu t i o ns o r

f o r any c o mme r c i a l p ur p o s e by 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 o mmi t t e e s . .

TOTAL ( i f f 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 nd 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 ny 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 e

c o mmi t t e e . R e l a t i o n s h i p must b e s h own 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 ) a nd 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 ) ( S e e P a g e 2 o f f o r ms 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 .

P a g e 4 o f - 4 4


SCHEDULE

A MONET ARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT d I F FOR


( MM/ DD/ YR) AND PAC CHECK ( i f a pp l i c a bl e ) RA I S ER

NUMBER I NCOME

07 / 2 3 / 04 I D# Ch e r y l A . Ch r i s t i ns on 2 . 5 01 4 2 8 Reed St r e et

CK# Gr i n n e l l , I a 5 0 1 1 2

08 / 0 6/ 04 I D# Ch e r y l A . Ch r i s t i ns om 2 . 5 01 4 2 8 Reed St r e e t

CK # Gr i m 1 1 ,I a 5 0 1 1 2

s

0 8 / 2 0 / 0 4 I D# Ch e r y l A . Ch r i s t i n e + 2 . 5 01 4 2 8 Reed St r e e t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9/ 03 / 04 I D# Ch e r y l A . Ch r i s t i ns on 2 " 5 01 4 2 8 Reed S t r e e t

CK # Gr i m 1 1 , I a 5 0 1 1 2

0 9 / 1 7 / 0 4 I D # Ch e r y l A . C h r i s t " n n 2 . 5 01 4 2 8 Reed St r e et _

CK # Gr i n n e l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D # Ch e r y l A . Ch r i s t i ns on 2 . 5 0

1 4 2 8 Reed St r e etCK # Gr i n n e l l , I a 5 0 1 1 2

07/ 2 3 / 0 4 I D # Cy nt h i a S . Cl o y e d 5 . 0 01 1 2 1 Pr i nc e St r e et

CK # Gr i n a e l l , l a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# Cy nt h i a S . Cl o y e d 5 . 0 01 2 2 1 Pr i nc e St mt

C K # Gr i n n e l l , I a 5 0 1 1 2

0 8 / 2 0 / 0 4 I D # Cy nt h i a S . Cl o y e d 5 . 0 01 2 2 1 Pr i nc e St r e et

CK # Gr i n a e l l , I a 5 0 1 1 2

09 / 0 3 / 04 I D # Cy nt h i a S . Cl o y e d 5 . 0 01 2 2 1 Pr i nc e S t r e e t

C K # Gr i n n e l l , l a 5 0 1 1 2






COMMI TTEE NAME / Mu s t b e s ame a s o n S t a t e me n t o f Or g a n i z a t i o n/




DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , p r o h i b i t s t h e u se 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 and s t a t e me nt s f o r s o l i c i t i n g c o nt r i b ut i o ns o rf o r a ny c o mme r c i a l p ur p o s e b y any 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 .

TOTAL ( i f l a s t p a g e o f t h i s s c h e d ul e )

* D i s c l o s u r e l a w r e q u i r e s c a nd 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 ny 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 must b e s h own t o t h e t h i r d d eg r e e o f c on s a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms 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 .

Page 5 o f 44


SCHEDULE

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( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

0 9 / 1 7 / 0 4 I D# Cy n t h i a S . Cl o y ed 5 . 0 01 2 2 1 Pr i n c e St r e et

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Cy n t h i a S . Cl o y ed 5 . 0 01 2 2 1 Pr i n ce St r e et

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7 / 2 3 / 0 4 I D# Un i t e t i i z e d Re c e i p t 2 . 5 0

CK#

0 8 / 0 6 / 0 4 I D# Un i t eai z ed Rece i p t 2 . 5 0

CK#

0 8 / 2 0 / 0 4 I D# Un i t eai z ed . Re ce i p t 2 . 5 0

CK#

0 9 / 0 3 / 0 4 I D# Un i t emi z e d Re c e i p t 2 . 5 0

CK#

0 9 / 1 7 / 0 4 I D# Un i t en i z ed Re c e i p t 2 . 5 0

CK#

1 0 / 0 1 / 0 4 I D# Un i t eai z ed Re c e i p t 2 . 5 0

CK#

0 7 / 2 3 / 0 4 I D# J ay M. Ct mmi n g s 2 . 5 01 4 0 8 Ol d 6 Rd .

CC# Ma l c o m, I a 5 0 1 5 7

0 8 / 0 6 / 0 4 I D# J ay M. Comi ngs 2 . 5 01 4 0 8 Ol d 6 Rd .

CK# Ma l c o m, l a 5 0 1 5 7






COMMI TTEENAME ( Mu s t be s ame a s o n St a t e me n t o f Or 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 ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON : Se c t i o n 68B . 3 2 A( 6 ) , I o wa Code , 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 and s t a t e me nt s f o r s o l i c i t i n g c on t r i bu t i o ns o r

f o r a n y c o mme r c i a l p u r p o s e by 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 es . -

' D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e es 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 ny 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 must 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 ns a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms 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 nof 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 .


Page 6 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

FI CHECK THI S BOX I F

AMENDI NG FORM

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

RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE` RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c abl e ) RAI SER

NUMBER I NCOME

0 8/ 2 0 / 0 4 I D# J oy M. s emi n g s 2 . 5 01 4 0 8 Ol d 6 Rd .

CK# Ma l c o m, I a 5 0 1 5 7

0 9 / 0 3 / 0 4 I D# J oy M. i n r n a 2 . 5 0

1 4 0 8 Ol d 6 Rd .

CK# Ma l c o m, I a 5 0 1 5 7

0 9 / 17 / 04 I D# J ay M. i n gs 2 . 5 01 4 0 8 Ol d 6 Rd .

C : K# Ma l c o m, I a 5 0 1 5 7

1 0 / 01 / 04 I D# J oy M. i n g s 2 . 5 01 4 0 8 Ol d 6 Rd .

CK# Ma l c o m, I a 5 0 1 5 7


C a t #


Cs t #


CK#

0 9 / 0 3 / 0 4 I D# Un i t e mi z e d Re c e i p t - 1 . 5 0

CK#


C a t #

1 0 / 01 / 0 4 I D# Un i t e mi z e d Re c e i p tx

1 . 5 0

CK#




CONTRI BUTI ONS - -MONEY TAKEN I N


COMMI TTEENAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or 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 ( POL I T I CA L ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ON

NUMBER ANDTHE PAC CHECK NUMBER I N THHE 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 ETHI CS ANDCAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2A ( 6 ) . I o wa Cod e , 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 nd s t a t e me nt s f o r s o l i c i t i n g c o nt r i b ut i o ns o r

f o r an y c o mme r c i a l p ur p o se b y any 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 . .


* D i s c l o s u r e l a w r e q u i r e s c a nd 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 must b e s h own t o t h e t h i r d d e g r e e o f c o ns a n gu i n i t y Wood r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms p a c ke 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 .

Page 7 o f - - 4 4

( f o r Schedul e A )

SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

FI CHECK T HI S BOX I F

AMENDI NG FORM



( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a bl e ) RAI SER

NUMBER I NCOME

0 7/ 2 3 / 0 4 I D# An na Dev i l der 2 . 3 6

1 4 1 4 3 50 t h Av eCK# B r o o k l y n , I a 5 2 2 1 1

0 8/ 0 6 / 0 4 I D# Anna De v i l d er 2 . 3 6

1 4 1 4 3 50 t h Av e

CK# B r o o k l y n , I a 5 2 2 1 1 z

0 8/ 2 0 / 0 4 I D# Anna De v i l d er 2 . 3 61 4 1 4 3 50 t h A v e

CK# B r o o k l y n , I a 5 2 2 1 1

0 9/ 0 3 / 0 4 I D# Anna De v i l d er 2 . 3 61 4 1 4 3 50 t h Av e

CK# B r o o k l y n , I a 5 2 2 1 1

0 9/ 1 7/ 0 4 I D# An n a Dev i l de r 2 . 3 61 4 1 4 3 50 t h Av e -

CK# B r o o k l y n , I a 5 2 2 1 1

0 7/ 2 3 / 0 4 I D# Un i t emi z e d Recei pt 1 . 00

CK#

0 8 / 0 6 / 0 4 I D# Un i t emi z ed Rec ei p t 1 . 00

CK#

0 8/ 2 0 / 0 4 I D# Un i t emi z e d Re c e i p t 1 . 00

CK#


CK#

0 9 / 1 7/ 0 4 I D# Un i t emi z e d Re c e i p t 1 . 0 0

CK#






COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or 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 ( POL I T I CAL ACT I ON COMMI TTEE ) , L I S T THE PAC I DENT I F I CATI ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I L A B L E FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , 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 pi e d f r o m r e p o r t s and s t a t e me n t s f o r s o l i c i t i n g c o nt r i bu t i o ns o rf o r an y c o mme r c i a l p ur p o se b y any 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 .


" D i s c l o s u r e l a w r e q u i r e s c a nd 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 mus 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 ns a n gu i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms 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 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 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 .

Page 8 o f 4 4


SCHEDUL E

A MONETARY

( Re v . 0 6 / 9 7) RECEI PTS


AMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE" RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a bl e ) RAI SERNUMBER I NCOME

1 0/ 0 1/ 0 4 m# Un i t e mi z e d Re c e i p t 1 . 00

CK#

07 / 2 3 / 0 4 I D# Susan M. Ed e l e n 4 . 003 6 3 0 9 0t h S t

CK# Gr i n ne l l , I a 5 0 1 1 2

08 / 0 6 / 0 4 I D# Susan M. Ede l e n 4 . 003 6 3 0 90 t h S t

C a t # Gr i n ne l l , I a 5 0 1 1 2

08 / 2 0 / 0 4 I D# Susan M. Ede l e n 4 . 003 6 3 0 90 t h S t

CK# Gr i n ne l l , I a 5 0 1 1 2

09 / 0 3 / 0 4 I D# S u s a n M. Ede l e n 4 . 003 6 3 0 90 t h S t -

CK# Gr i n ne l l , I a 5 0 1 1 2

0 9 / 17 / 04 I D# Susan M. Ede l e n 4 . 00

3 6 3 0 90 t h S tCK# Gr i n ne l l , I a 5 0 1 1 2

1 0 / 01 / 04 I D# Susan M. Ede l e n 4 . 003 6 3 0 90 t h S t

CK# Gr i n ne l l , I a 5 0 1 1 2

0 7 / 2 3 / 04 I D# Rr . ~ RB i n p K . Fenne r, . 5 . 00

4 2 3 4 2 0 t h s t r ee tCK# Gr i m 11 , I a 5 0 1 1 2

0 8 / 06 / 04 I D# Rr ma i n e K . Fenne r 5 . 004 2 3 4 2 0t h St r e et

CK# Gr i n ne l l , I a 5 0 1 1 2

0 8 / 2 0 / 04 I D# Rcma i n s a K . Fenne r 5 . 004 23 4 2 0 t h s t r ee t

C a t # Gr i n ne l l , I a 5 0 1 1 2








STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ONNUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , 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 op i e d f r o m r e p or 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 on t r i b ut i o ns o rf o r any c 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 an 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 1 $ 3 3 . 5 0

TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) 1 $' 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k et ) . 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 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 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 .

Page 9 o f 4 4


SCHEDULEA MONETARY

( Re v . 0 6 / 9 7) RECEI PTS

CHECK THI S BOX I F

AMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT / I F FORRECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE" RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

0 9 / 0 3 / 0 4 I D# Ro ma i n e K . F e n n e r 5 . 0 04 2 3 4 20 t h St r eet

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7/ 0 4 I D# Rc ma i n p K . F enne r 5 . 0 04 2 3 4 2 0t h s t r e e t

C( # Gr i n n e l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Rc ma i n p K . F e n n e r 5 . 0 04 2 3 4 2 0t h s t r e e t

CK# Gr i n a e l l , I a 5 0 1 1 2

0 7 / 2 3 / 0 4 I D# Un i t mi z ed Re c e i p t 1 . 0 0

CK#

0 8 / 0 6 / 0 4 I D# Un i t ml i z ed Re c e i p t 1 . 0 0

CC#


C( #


CK#

0 9 / 1 7 / 0 4 I n # Un i t emi z e d Re c e i p t 1 . 0 0

CK#


C( #

0 7 / 2 3 / 0 4 I D# J o h n S . F l a n n e r y 12 . 5 01 0 2 4 2 1 s t

CK# W. De s Mo i n e s , I a 5 0 2 6 5





COMMI TTEENAME ( 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 )




DI SCLOSURE BOARD .

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , 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 or t s a nd s t a t e me n t s f o r s o l i c i t i n g c o nt r i b ut i o ns o r

f o r an y c 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 . ,



* D i s c l o s u r e l a w r e q u i r e s c a nd 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 must b e s h ow n t o t h e t h i r d d e g r e e o f c o ns a n gu i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms p a c k e t l . 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 er 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 .

Page 1 0 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK THI S BOX I F

AMENDI NG FORM




NUMBER I NCOME

0 8/ 0 6 / 0 4 I D# John S . F l a n n e r y 1 2 . 5 01 0 2 4 2 1 s t

CK# W. De s Mo i n e s , I a 5 0 2 6 5

0 8 / 2 0 / 0 4 I D# John S . F l a n n e r y 1 2 . 5 0

1 0 2 4 2 1 s t

CK# W. Des Mo i n e s , I a 5 0 2 6 5

0 9/ 0 3 / 0 4 I D# John S . Fl a n n ex y 1 2 . 5 0

1 0 2 4 21 s tCK# W. Des Mo i n e s , I a 5 0 2 6 5

0 9/ 1 7 / 0 4 I D# J o h n S . F l a n n e r y 1 2 . 5 01 0 2 4 2 1s t

CK# W. De s Mo i n e s , I a 5 0 2 6 5

1 0 / 0 1 / 0 4 I D# John S . F l a n n e r y 1 2 . 5 01 0 2 4 2 1s t -

CK# W . Des Mo i n e s , I a 5 0 2 6 5

0 7 / 2 3 / 0 4 I D# P a t r i c i a A . Go s s el i n k 2 . 5 0

1 5 3 4 6 S 8 4 t h Av e ECK# Gr i m 1 1 , I a 5 0 1 1 2

0 8/ 0 6 / 0 4 I D# Pa t r i c i a A . Go s s e l i n k 2 . 5 01 5 3 4 6 S 8 4 t h Av e E

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8/ 2 0 / 0 4 I D# Pa t r i c i a A . Go s s e l i n k 2 . 5 01 5 3 4 6 S 8 4 t h Av e E

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9/ 0 3 / 0 4 I D# Pa t r i c i a A. Go s s el i n k 2 . 5 0

1 5 3 4 6 S 84 t h Av e ECK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 17 / 04 I D# P a t r i c i a A . Go s s el i n k 2 . 5 01 5 3 4 6 S 84 t h Av e E

CK# Gr i m 1 1 , I a 5 0 1 1 2








STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I ST THE PAC I DENT I F I CATI ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I L A B LE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Code , 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 op i e d f r om r e po 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 on t r i b u t i o n s o r

f o r any c o mme r c i a l p u r p os 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 o mmi 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 nd i d a t e c ommi 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 mus t b e s h ow n t o t h e t h i r d d eg r e e o f c on s a ng u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms 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 s ame a s c a n d i d a t e , b u t t h er 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 .

TOTAL ( i f l a s t page o f t h i s s c h ed u l e)

Page 1 1 o f 4 4

( f o r Sc he du l e A)

SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

a CHECK T HI S BOX I F

AMENDI NG FORM


RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

1 0 / 0 1 / 04 I D# Pa t r i c i a A . Go s s el i n k 2 . 5 015346 S 84 t h Av e E

CK# Gr n n e l l , l a 5 0 1 1 2

0 7/ 2 3 / 0 4 I D# El l en T . Gr a f f 4 . 0 0700 Ga r f i el d S t

CK# Ta n a , I a 5 2 3 3 9 a

0 8/ 0 6 / 0 4 I D# El l en T . Gr a f f 4 . 0 0

7 0 0 Ga r f i el d S tCK# Ta ma , l a 5 2 3 3 9

0 8/ 2 0 / 0 4 I D# El l en T . Gr a f f 4 . 0 0

7 0 0 Ga r f i el d S tCK# Tama , I a 5 2 3 3 9

0 9/ 0 3 / 0 4 I D# El l en T . Gr a f f 4 . 0 0

7 0 0 Ga r f i el d StCK# Tama , I a 5 2 3 3 9

0 9/ 1 7/ 0 4 m# El l en T . Gr a f f 4 . 0 0

7 0 0 Ga r f i el d StCK# Tama , I a 5 2 3 3 9

1 0/ 0 1/ 0 4 I D# El l en T . Gr a f f 4 . 0 07 0 0 Ga r f i el d St

CK# Ta ma , l a 5 2 3 3 9

0 7/ 2 3 / 0 4 I D# And r ew J . Gr osenbac h 5 . 0 01 1 1 6 Reed St Ap t 101

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# And r ew J . Gr osenbac h 5 . 0 011 1 6 Re e d St Apt 101

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8/ 2 0 / 0 4 I D# And r ew J . Gr osenbac h 5 . 0 011 1 6 Re e d St Ap t 101

CK# Gr i n n e l l , l a 5 a 1 1 2









NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATEDCOLUMN .

A L I S T OF I DNUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68 8 . 3 2 A( 6 ) , I o wa Cod e , p r o h i b i t s t h e us e o f i n f o r ma t i o n c o pi e d f r o m r e p or t s and s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o r

f o r a ny c o mme r c i a l p u r p o s e b y any p e r s o n o t h e r t h an 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 .


' D i s c l o s u r e l a w r e q u i r e s c a nd 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 e

c o mmi t t e e . R e l a t i o n s h i p mus t b e s h o w n t o t h e t h i r d d e gr e e o f c o ns a ng ui n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e Page 2 o f f o r ms p a c ke 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 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 .

Page 1 2 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7) RECEI PTS


AMENDI NG FORM


RECEI VED ( i f a pp l i c ab l e ) TO CANDI DATE" RECEI VED FUND-


NUMBER I NCOME

0 9 / 0 3 / 0 4 I D# An d r ew J . Gr os enba c h 5 . 00

1 1 1 6 ReedS t

t 1 0 1

CK# Gr i n n e l l , I a N1 12

0 9/ 1 7/ 0 4 I D# An d r e w J . Gr os enba c h 5 . 00

1 1 1 6 Reed

S t

Ap t 1 0 1

CK# Gr i n n e l l , l a 5 K1 1 2 x

1 0 / 0 1 / 04 I D# An d r ew J . Gr os enba c h 5 . 00

1 1 1 6 Reed

S tAp t 101

CK# Gr i n n e l l , I a 5112

0 7/ 2 3 / 0 4 I D# J e n n i f e r Gu n de r s o n 2 . 50

4 0 9 Cl a y S tCK# Ma l c om, I a 5 01 5 7

0 8/ 0 6 / 0 4 I D# Je nn i f e r Gunde r s o n 2 . 50

4 0 9 Cl a y S t "CK# Ma l c o m, I a 50157

0 8/ 2 0 / 0 4 I D#Je nn i f e r Gu nd er s on 2 . 50

40 9 Cl a y StCK# Ma l c o m, I a 5 0 1 5 7

0 9/ 0 3 / 0 4 I D# J e n n i f e r Gunde r s o n 2 . 50

40 9 Cl a y St

CK# Ma l c o m, I a 5 0 1 5 7

0 9/ 1 7/ 0 4 I D# Je nn i f e r Gu n d e r s o n - 2 . 50

40 9 Cl a y S tCK# Ma l c o m, I a 50157

1 0/ 0 1/ 0 4 I D# J e n n i f e r Gunde r s o n 2 . 5 0409 Cl a y S t

CK# Ma l c o m, I a 5 0 1 57

0 7 / 2 3 / 04 I D# T r a c i A. Gu t h r i e 8 . 00

1 2 1 Ad ai r S tCK# Ke l l o gg , I a 5 0 1 3 5








STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T ICAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ON

NUMBER AND THE PACCHECK NUMBER I N THHE DESI GNATED COLUMN.A L I S T OF I D

NUMBERS I SAVA I LABLE

FROM THEI OWA

ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON : Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , 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 nd s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o n s o r

f o r a n y c o mme r c i a l p u r p o s e b y any p e r s o n o t h e r t h an 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 .


' D i s c l o s u r e l a w r e q u i r e s c a n di 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 e

c 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 ns a ng u i n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e Page 2 o f f o r ms 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 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

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 pp 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 .Page 1 3 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NG FORM


RECEI VED ( i f a pp l i c a bl e ) TO CANDI DATE' RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c ab l e ) RA I SER

NUMBER I NCOME

0 8 / 0 6 / 0 4 I D# Tr a c i A. Gu t h r i e 8 . 0 0

1 2 1 Ad ai r S t

CK# Kel l o g g , I a 5 0 1 3 5

0 8/ 2 0 / 0 4 I D# Tr a c i A . Gu t h r i e 8 . 00

1 2 1 Ad ai r St

CK# Ke l l o gg , I a 5 0 1 3 5 s

0 9 / 0 3 / 0 4 I D# T r a c i A . Gut h r i e 8 . 00

1 2 1 Ad a i r S tCK# Ke l l o g g , I a 5 0 1 3 5

0 9 / 1 7/ 0 4 I D# Tr a c i A . Gu t h r i e 8 . 0 0

1 2 1 Ad a i r S tCK# Ke l l o gg , I a 5 0 1 3 5

1 0 / 01 / 04 I D# Tr a c i A . Gu t h r i e 8 . 0 0

1 2 1 Ad a i r S t -

CK# Ke l l o gg , I a 5 0 1 3 5

0 7/ 2 3 / 0 4 I D# Un i t e mi z e d Re c e i p t1 . 0 0

CK#


CK#

0 8/ 2 0 / 0 4 I D# Un i t emi z ed Rec ei p t 1 . 0 0

CK#


CK#


CK#






COMMI TTEENAME ( Mu s t b e s am 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 )


STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I ST THE PAC I DENT I F I CATI ON

NUMBERAND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI L A B LE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68 B . 3 2 A( 6 ) , I o wa Cod e , p r oh i b i t s t h e u s e o f i n f o r ma t i o n c op i e d f r o m r e p or 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 on t r i b u t i o ns o r

f o r a ny c o mme r c i a l p u r p o s e b y any 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 .


c o mmi t t e e . R e l a t i o n s h i p mus 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 ns a ng u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms 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 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 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


P a g e 1 4 o f 44


SCHEDUL E

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR . RELATI ONSHI P AMOUNT ; I F FOR



NUMBER I NCOME


CK#

0 7 / 2 3 / 0 4 I D# An n M. Ran s s e n 6 . 00

PO Bo x 2 4 6

CK# Ke l l o g g , I a 5 0 1 3 5 a

0 8 / 0 6 / 04 I D# An n M. R a n s s e n 6 . 0 0

PO B o a t 2 4 6CK# Ke l l o g g , I a 50135

0 8/ 2 0 / 0 4 m# An a M . Ra n s s e n 6 . 0 0PO B c a c 2 4 6

CK# Ke l l o g g , I a 5 0 1 3 5

0 9/ 0 3 / 0 4 I D# An n M. Ran s s e n 6 . 0 0

PO Bo x 2 4 6CK# Ke l l o g g , l a 5 0 1 3 5

0 9 / 17 / 04 I D# An n M. Man s s e n 6 . 0 0

PO Bc x 2 4 6CK# Ke l l o g g , I a 5 0 1 3 5

1 0/ 0 1/ 0 4 I D# An n M. H a n s s e n 6 . 0 0PO Bo x 2 4 6

CK# Ke l l o g g , I a 5 0 1 3 5


CK#

0 8 / 06 / 0 4 I D# Ua i t e mi z e d Re c e i p t 2 . 50

CK#


CK#








STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ON

NUMBER ANDTHE PAC CHECK

NUMBER I N THHEDESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , p r o h i b i t s t h e u s e o f i nf o r ma t i o n c o p i e d f r o m r e p o r t s and s t a t e me nt s f o r s o l i c i t i n g c o nt r i b ut i o ns o r

f o r an y c o mme r c i a l p u r p o s e b y a ny 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 .


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 ) 1 $ -


c o mmi t t e e . R e l a t i o n s h i p must b e shown t o t h e t h i r d d e g r e e o f c o ns a ng u i n i t y ( b l o o d r e l a t i v e ) a nd a f f i n i t y ( r e l a t i v e s b y

ma r r i a g e ) ( S e e P a g e 2 o f f o r ms p a c k e t ) . 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 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 .

Page 1 5 o f 4 4


SCHEDULEA MONETARY

( Re v . 0 6 / 9 7) RECEI PTS


AMENDI NG FORM


RECEI VED ( i f a pp l i c a bl e ) TO CANDI DATE" RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a pp l i c a bl e ) RAI SER

NUMBER I NCOME

0 9 / 0 3 / 0 4 m# Un i t en i z ed Re c e i p t 2 . 5 0

CK#

0 9 / 1 7 / 0 4 m# Un i t emi z e d Re c e i p t 2 . 5 0

CK#


CK#


CK#


CK#


CK#

0 9/ 0 3 / 0 4 m# Un i t emi z e d Re c e i p t 2 . 5 0

CK#

0 9 / 1 7/ 0 4 m# Un i t emi z e d Re c e i p t - 2 . 5 0

CK#


CK#


CK#









NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , p r o h i b i t s t h e u se 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 nd s t a t e me n t s f o r s o l i c i t i n g c o nt r i b ut i o ns o rf o r a n y c o mme r c i a l p u r p o s e b y any 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 . ,

TOTAL ( i f l a st page o f t h i s s c h e d ul e )

' D i s c l o s u r e l a w r e q u i r e s c a nd 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 ny 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 must b e s h o w n t o t h e t h i r d d e gr e e o f c o ns a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms p a c ke t l . 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 s ame a s c a n d i d a t e , b u t t h e r e i s nof 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 .

Page 1 6 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7) RECEI PTS


AMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 1 1 F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) AND PACCHECK ( i f a pp l i c ab l e ) RAI SERNUMBER I NCOME


C K #

0 8 / 2 0 / 0 4 m# U n i t e a i z e d R e c e i p t 1 . 0 0

C K #


C K #


C K #


C K #


C K #


C K #


C K #


C K #


C K #






COMMI TTEENAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a ni z a t i o n)


STATE CANDI DATES NOTE: I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ON


DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , 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 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 nt r i but i o ns o r

f o r a n y c o mme r c i a l p ur 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 o mmi t t e e s . ,

SUB- TOTAL $ 2 3 . 5 0 1TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) 1 $

' 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 e

c o mmi t t e e . R e l a t i o n s h i p must 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 an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms 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 .

P a g e 1 7 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7) RECEI PTS


AMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT % f I F FOR


( MM/ DD/ YR) ANDPAC CHECK ( i f a p p l i c a b l e ) RA I SER

NUMBER I NCOME

1 0 / 0 1 / 0 4 I D# I I n i t e mi z e d Re c e i p t 1 . 0 0

CK#


5 2 2 9 t h Avenue

CK#Gr i n ne l l ,

I a 5 0 1 1 2a

0 8 / 0 6 / 0 4 I D# Peggy A. J a nt z e n 2 . 5 0

5 2 2 9 t h Avenue

CK# Gr i m 11 , I a 5 0 1 1 2

0 8/ 2 0 / 0 4 I D# Peggy A . J a n t z e n 2 . 5 0

5 2 2 9 t h Avenue

CK# Gr i n n e l l , l a . 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# P e g g y r A . J a n t z e n 2 . 5 0

5 2 2 9 t h Avenue

C 3 C # Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7 / 0 4 I D# Peggy A . J a nt z e n 2 . 5 0

5 2 2 9 t h AvenueCK# Gr i n a e l l , I a 5 0 1 1 2


5 2 2 9 t h Avenue

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7 / 2 3 / 0 4 I D# Di a ne J . Keenan , 2 . 5 01 2 2 8 Wes t St

C 3 C # Gr i n n e l l , I a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# Di a n e J . Ke e ^ a n 2 . 5 0

1 2 2 8 Wes t St

CK# Gr i n ne l l , I a 5 0 1 1 2

0 8 / 2 0 / 0 4 I D# Di a n e J . Keenan 2 . 5 0

1 2 2 8 Wes t S tCK# Gr i m 11 , I a 5 0 1 1 2






COMMI TTEE NAME ( Mu s t b e s am 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 )



NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON : Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , p r oh 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 po 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 on t r i b u t i o ns o rf o r a n y c o mme r c i a l p u r p o s e b y a ny 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 . ,

' D i s c l o s u r e l a w r e q u i r e s c a nd 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 mus t b e shown t o t h e t h i r d d e g r e e o f c o ns a n gu i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms 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 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 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 .


Page 1 8 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK THI S BOX I F

AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

0 9 / 0 3 / 0 4 I D# Di a n e J . Keenan 2 . 5 01 2 2 8 Wes t S t

CK# Gr i n ne l l , I a 5 0 1 1 2


CK# Gr i n ne l l , I a 5 0 1 1 2


CK# Gr i n ne l l , I a 5 0 1 1 2


CK# Gr i n - e l l , I s 5 0 1 1 2


CK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 2 0 / 0 4 I D# Pame l a L . Ke s s l e r 5 . 0 0

2 5 5 4 20 t h Av eCK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 m# Pame l a L . Ke s s l e r 5 . 0 02 5 5 4 20 t h Av e

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 17 / 0 4 I D# Pame l a L . Ke s s l e r 5 . 0 02 5 5 4 20 t h Av e

CK# Gr i n n e l l , I a 5 0 1 1 2


CK# Gr i n n e l l , l a 5 0 1 1 2

0 7 / 2 3 / 0 4 I D# Un i t e s a i z e d Re c e i p t 1 . 0 0

CK#






COMMI TTEENAME ( 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 )


STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ONNUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , p r oh 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 ns o rf o r an y c o mme r c i a l p u r p o s e b y any 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 .

' D i s c l o s u r e l a w r e q u i r e s c a nd 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 ns a n gu i n i t y ( b l o o d r e l a t i v e ) 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 ) ( Se e Pa g e 2 o f f o r ms 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 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 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 .


Page 1 9 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a p pl i c a b l e ) TO CANDI DATE" RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a b l e ) RA I SERNUMBER I NCOME


CK#

08 / 2 0/ 04 I D# Un i t e a i z ed Re c e i p t 1 . 0 0

CK#


CK#


CK#

1 0/ 0 1/ 0 4 I D# Un i t e t t i z ed Re c e i p t 1 . 0 0

CK#

07 / 2 3 / 04 I D# Ki mb e r l y K . Kr i e g e l 2 . 5 06 16 Ma i n St

CK# B r o o k l y n , I a 5 2 2 1 1

08 / 06 / 04 I D# Ki mb e r l y K . Kr i e g e l 2 . 5 06 16 Ma i n St

CK# B r o o k l y n , I a 5 2 2 1 1

08 / 2 0/ 04 I D# Ki mb e r l y K . Kr i e g e l 2 . 5 06 16 Ma i n St

CK# B r o o k l y n , I a 5 2 2 1 1

0 9/ 0 3 / 0 4 I D# Ki mb e r l y K . Kr i e g e l 2 . 5 06 16 Ma i n St

CK# B r o o k l y n , I a 5 2 2 1 1

0 9/ 1 7/ 0 4 I D# Ki mb e r l y K . Kr i e g e l 2 . 5 06 1 6 Ma i n St

CK# B r o o k l y n , I a 5 2 2 1 1









NUMBER AND THE PACCHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , 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 op i e d f r o m r e p o r t s and s t a t e me n t s f o r s o l i c i t i n g c o nt r i b ut i o ns o r

f o r an y c o mme r c i a l p ur p os e b y any p e r s o n o t h er 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 .

' D i s c l o s u r e l a w r e q u i r e s c a n di 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 ny 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 must b e s h own t o t h e t h i r d d e g r e e o f c o ns a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms p a c k e t ) . 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 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 .


Page 2 0 o f 4 4

( f o r Schedu l e A )

SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7) RECEI PTS


AMENDI NG FORM




NUMBER I NCOME

1 0 / 0 1 / 0 4 I D # K i mb e r l y K . K r i e g e l 2 . 5 06 1 6 Ma i n S t

C K # B r o o k l y n , I a 5 2 2 1 1


C K # z


C K #


C K #

0 9 / 0 3 / 0 4 I D # U n i t e n i z e d R e c e i p t 1 . 0 0

C K #

0 9 / 1 7 / 0 4 I D # U n i t e n i z e d R e c e i p t 1 . 0 0

C K #


C K #

0 7 / 2 3 / 0 4 I D # S h a r o n L . K r t mm 2 . 5 01 5 4 1 5 N 7 5 t h 'Av e E

C K # G r i n n e l l , I a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D # S h a r o n L . K r t mm 2 . 5 01 5 4 1 5 N 7 5 t h Av e E

C K # G r i n n e l l , I a 5 0 1 1 2

0 8 / 2 0 / 0 4 I D # S h a r o n L . K r u m m 2 . 5 01 5 4 1 5 N 7 5 t h Av e E

C K # G r i n n e l l , I a 5 0 1 1 2






COMMI TTEENAME ( Mu s t be sa me a s o n S t a t e me n t o f Or 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 ( POL I T ICAL ACTI ON COMMI TTEE) , L I ST THE PAC I DENT I F I CATI ON

NUMBER ANDTHE PACCHECK

NUMBER I NTHHE

DESI GNATEDCOLUMN .

A L I ST OF I DNUMBERS

I S AVA I LABLEFROMTHE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON: Se c t i o n 68B . 3 2A( 6 ) , I o wa Cod e , 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 pi 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 nt r i bu t i o ns o r

f o r a ny c o mme r c i a l p ur p o se by a ny 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 . .

TOTAL ( i f l a s t page 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 nd 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 must b e s h own t o t h e t h i r d d e g r e e o f c o ns a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms 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 er 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 .

Page 2 1 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NG FORM



( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SER

NUMBER I NCOME

0 9/ 0 3 / 0 4 I D# Sha r o n L . Kx l a r m 2 . 5 01 5 4 1 5 N 7 5t h Av e E

CK# Gr i mm 11, I a 5 0 1 1 2

0 9/ 1 7/ 0 4 I D# Sha r on L . Kr u m 2 . 5 01 5 4 1 5 N 7 5t h Av e E

CK# Gr i n n e l l , I a 5 0 1 1 2 x

10 / 01 / 04 I D# Sha r on L . Kr t mm 2 . 5 01 5 4 1 5 N 7 5t h Av e E

CK# Gr i n n e l l , I a 5 0 1 1 2

07 / 2 3 / 0 4 I D# Un i t emi z e d Re c e i p t 1 . 00

CK#

08 / 06 / 04 I D# Un i t emi z e d Re c e i p t 1 . 00

CK#

0 8/ 2 0 / 0 4

m#Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#


CK#

1 0/ 0 1/ 0 4 I D# Ua i t en i z ed Re c e i p t 1 . 00

CK#

07 / 2 3 / 0 4 I D# Deb r a E . L e wi s 5 . 001 2 0 2 El m St r e et

CK# Gr i n n e l l , I a 5 0 1 1 2






COMMI TTEENAME ( Mu s t b e s am 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 )


STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ONNUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Co de , 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 or t s a nd s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o n s o r

f o r an y c o mme r c i a l p u r p os e b y a n y p e r s o n o t h e r t h an 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 .

TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) 1 $

` D i s c l o s u r e l a w r e q u i r e s c a nd 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 mus t b e s h o w n t o t h e t h i r d d e gr e e o f c o n s an g u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms 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 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 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 .

SUB- TOTAL I $ 3 7 . 5 0

Page 2 2 o f 4 4


SCHEDULEA MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NG FORM


RECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE" RECEI VED FUND-


NUMBER I NCOME

0 8 / 0 6 / 0 4 I D# Debr a E . L e wi s 5 . 0 0

1 2 0 2 El m St r e et

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 2 0 / 0 4 I D# Debr a E . L ewi s 5 . 0 0

1 2 0 2 El m S t r e e tCK# Gr i n n e l l , I s 5 0 1 1 2

s

0 9 / 0 3 / 0 4 I D# Debr a E . L e wi s 5 . 0 0

1202 El m St r e et

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9/ 1 7 / 0 4 I D# Debr a E . L e wi s 5 . 0 0

1 2 0 2 El m St r e et

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Debr a E . L ewi s 5 . 0 0

1 2 0 2 El m St r e et _CK# Gr i n ne l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# Ua i t e mi z e d Re c e i p t 2 . 5 0

CK#


CK#


CK#

0 7 / 2 3 / 0 4 I D# Susan J . Mc Ca i n 2 . 5 04370 Hi ghwa y 6 3 , Bo x 8

CK# Ma l c o m, I a 5 0 1 5 7

0 8 / 0 6 / 0 4 I D# Susan J . Mc Ca i n 2 . 5 04 3 7 0 Hi ghwa y 6 3 , Bo x 8

CK# Ma l c o m, I a 5 0 1 5 7



F o r I n s t r u c t i o n s , See B a c k o f Fo r m



COMMI TTEENAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g a ni z a t i o n)


STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL 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 THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE PROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68B . 3 2 A( 6 ) , I o wa Code , p r oh i b i t s t h e u s e o f i n f o r ma t i o n c op i e d f r o m r e p o r t s an d s t a t e me nt s f o r s o l i c i t i n g c o nt r i b ut i o ns o r

f o r an y c o mme 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 o mmi t t e es .

TOTAL ( i f l a s t page 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 nd i d a t e c o mmi t t e es 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 must b e s h own t o t h e t h i r d d e g r e e o f c o ns a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms 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 nof 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 .

Page 2 3 o f 4 4

( f o r Sc he d u l e A)

SCHEDUL E

A MONETARY

( Re v . 0 6 / 9 7) RECEI PTS

CHECK THI S BOX I F

AMENDI NG FORM



( MM/ DD/ YR) ANDPAC CHECK ( i f a p pl i c a b l e) RAI SER

NUMBER I NCOME

0 8 / 2 0 / 0 4 I D# Susan J . Mc Ca i n 2 . 5 04 3 7 0 Hi g h w a y 6 3 , Bo x 8

CK# Ma l c om, I a 5 0 1 5 7

0 9 / 0 3 / 0 4 I D# Susan J . Mc Ca i n 2 . 5 0

4 3 7 0 Hi ghway 6 3 , Bo o t 8CK# Ma l c om, l a . 5 0 1 5 7

s

0 9/ 1 7/ 0 4 -I D# Susan J . Mc Cai n 2 . 5 0

4 3 7 0 Hi ghway 6 3 , Bo x 8CK# Ma l c om, I a 5 01 5 7

1 0/ 0 1/ 0 4 I D# Susan J . Mc Ca i n 2 . 5 0

4370 Hi ghway 6 3 , Bo x 8CK# Ma l c om, I a 5 0 1 5 7

0 7/ 2 3 / 0 4 m# Un i t e mi z e d Re c e i p t 1 . 00

CK#

08 / 06 / 04 I D# Un i t en i z ed Re c e i p t 1 . 00

CK#

08 / 20 / 04 I D# Un i t eai z ed Re c e i p t 1 . 00

CK#


CK#

09 / 17 / 04 I D# Un i t eai z ed Re c e i p t 1 . 00

CK#


CK#





( 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 ds )



STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ONNUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD

CAUTI ON: Se c t i o n 68B . 3 2A( 6 ) , I o wa Cod e , p r oh 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 or t s and s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o rf o r a ny c 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 .


` D i s c l o s u r e l a w r e q u i r e s c a nd 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 mus t b e s h o w n t o t h e t h i r d d e gr e e o f c o ns a ng ui n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms 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 .

Page 2 4 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NG FORM

DATE PAC I D NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 1 I F FOR



NUMBER I NCOME

0 7/ 2 3 / 0 4 I D# # Un i t e mi z e d Re c e i p t 2 . 5 0

CK#


CK#

0 7/ 2 3 / 0 4 I D# Un i t emi z ed Re ce i p t 2 . 5 0

CK#

0 8/ 0 6 / 0 4 I D# Un i t emi z ed Re ce i p t 2 . 5 0

CK#


CK#


CK#


CK#


CK#

0 7/ 2 3 / 0 4 I D# Rhonda R . Mv y es 5 . 0 03 0 2 2nd Av e

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8/ 0 6 / 0 4 m# Rhonda R . Moy es 5 . 0 03 0 2 2n d Av e

CK# Gr i n n e l l , I a 5 0 1 1 2






COMMI TTEENAME ( Mu s t b e s am 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 )


STATE CANDI DATES NOTE: I F

A CONTRI BUTI ONI S

RECEI VEDFROM

ASTATE PAC

( POL I T I CAL ACTI ON COMMI TTEE) , L I S TTHE PAC

I DENT I F I CATI ONNUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I L A B LE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , 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 op i e d f r o m r e p or 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 on t r i b ut i o ns o rf o r an y c o mme r c i a l p u r p o s e b y a ny 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 . . -


' D i s c l o s u r e l a w r e q u i r e s c a nd 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 mus 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 ng u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms 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 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 .

Page 25 o f 4 4


SCHEDUL E

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK THI S BOX I F

AMENDI NG FORM


RECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c ab l e ) RAI SER

NUMBER I NCOME

0 8 / 2 0 / 0 4 I D# Rhonda R . May es 5 . 0 03 0 2 2 n d Av e

C 3 C # Gr i n ne l l , l a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# Rhonda R . May es 5 . 0 0

3 0 2 2 n d Av eCK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 17 / 04 I D# Rhonda R . May es 5 . 0 03 0 2 2 nd Av e

C 3 C # Gr i n n e l l , I a 5 0 1 1 2

1 0 / 01 / 04 I D# Rhonda R . May es 5 . 0 03 0 2 2 nd Av e

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7 / 2 3 / 0 4 I D# Un i t e mi z ed Re c e i p t 2 . 50

CK#

0 8/ 0 6 / 0 4 I D# Un i t e mi z ed Re c e i p t 2 . 50

CK#

0 8/ 2 0 / 0 4 I D# Un i t e mi z ed Re c e i p t 2 . 50

CK#

0 9 / 0 3 / 0 4 I D# Un i t e mi z ed Re c e i p t 2 . 50

CK#

0 9/ 1 7/ 0 4 m# Un i t e mi z ed Re c e i p t 2 . 50

CK#

1 0/ 0 1/ 0 4 I D# Un i t e mi z ed Re c e i p t 2 . 50

CK#






COMMI TTEENAME ( Mu s t be sa me 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 FROMA STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I ST THE PAC I DENT I F I CATI ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I L A B LE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2A( 6 ) , I o wa Code , 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 an d s t a t e me nt s f o r s o l i c i t i n g c o nt r i bu t i o ns o r

f o r an y c o mmer c i a l p ur p o s e by a n y p er s o n o t h er 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 es .

* D i s c l o s u r e l a w r e q u i r e s c a nd i d a t e c o mmi t t e es 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 must 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 ng u i n i t y ( b l o o d r e l a t i v e ) a n d a f f i n i t y ( r e l a t i v es b yma r r i a g e ) ( S e e P a g e 2 o f f o r ms 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 .


Page 2 6 o f - - 4 4


SCHEDUL E

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NG FORM




NUMBER I NCOME

0 7/ 2 3 / 0 4 I D# Re b e c c a L . No r t h cu t t 2 . 5 07 0 5 E F l o o d St Bo x 8 1 9

CK# Mo n t e z uma , I a 5 0 1 7 1

0 8/ 0 6 / 0 4 I D# Rebecca L . No r t h cu t t 2 . 5 0

7 0 5 EF l o o d

StBo x

8 1 9CK# Mo n t e z uma , I a 5 0 1 7 1 z

0 8/ 2 0 / 0 4 I D# Rebecca L . No r t h c ut t 2 . 5 07 0 5 E F l o o d St Bo x 81 9

CK# Mo n t e z t mi a , l a 5 0 1 7 1

0 9/ 0 3 / 0 4 I D# Rebecca L . No r t h c ut t 2 . 5 07 0 5 E Wood St Bo x 81 9

CK# Mo n t e z u ma , I a 5 0 1 7 1

0 9/ 1 7/ 0 4 I D# Rebecca L . No r t h c ut t 2 . 5 0

70 5 E F l o o d St Bo x 81 9CK# Mo n t e zt mr l a , I a 5 0 1 7 1

1 0 / 01 / 04 I D# Rebecca L . No r t h c ut t 2 . 5 07 0 5 E Wood St Bo x 8 1 9

CK# Mo n t e z u ma , I a 5 0 1 7 1

0 7 / 2 3 / 0 4 I D# Ua i t e mi z e d Re c e i p t 1 . 0 0

CK#


CK#

0 8 / 2 0 / 0 4 I D# Un i t e ai z ed Re c e i p t 1 . 0 0

CK#


CK#









NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN. A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .

CAUTI ON : Se c t i o n 68B . 3 2 A( 6 ) , I o wa Code , p r oh 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 on t r i b u t i o ns o r

f o r a n y c o mme 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 o mmi 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 nd 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 mus 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 ns a ng u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms 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 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


Page 27 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

FI CHECK THI S BOX

AMENDI NG FORM



( MM/ DD/ YR) ANDPAC CHECK ( i f a p pl i c a b l e ) RA I SER

NUMBER I NCOME

0 9/ 1 7/ 0 4 I D# LMi t ea i z ed Re c e i p t 1 . 00

CK#


CK#

0 7/ 2 3 / 0 4 I D# Un i t e mi z e x l Re c e i p t 2 . 5 0

( 3 #


CK#

0 8/ 2 0 / 0 4 m# Uh i t ea i z ed Re c e i p t 2 . 5 0

CK#

0 9/ 0 3 / 0 4 I D# Ua i t e mi z e d Re c e i p t 2 . 5 0

CK#

0 9 / 1 7/ 0 4 I D# Un i t ea i z ed Re c e i p t 2 . 5 0

CK#

1 0 / 0 1 / 0 4 I D# Un i t e a a i z e d Re c e i p t 2 . 5 0

CK#

0 7/ 2 3 / 0 4 I D# Mi chae l D . P a wl o ws k i 5 . 009 0 2 Hanover Dr i v e

CK# Sou t h L a k e , Tx 76092

0 8/ 0 6 / 0 4 m# ' Mi chae l D . P a wl o ws k i 5 . 009 0 2 Hknove r Dr i v e

CK# Sou t h L a k e , Tx 7 6 0 9 2






COMMI TTEENAME / Mu s t b e s ame a s o n S t a t e me n t o f Or g a ni z a t i o n/


STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CALACTI ON COMMI TTEE) ,

L I S T THEPAC I DENT I F I CAT I ONNUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON: Se c t i o n 68B . 3 2A( 6 ) , I o wa Cod e , p r o h i b i t s t h e us e o f i n f o r ma t i o n c o pi e d f r o m r e p o r t s an d s t a t e me nt s f o r s o l i c i t i n g c o nt r i b ut i o ns o rf o r any c o mme r c i a l p ur p o s e b y a ny p e r s o n o t h e r t h an 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 .

* D i s c l o s u r e l a w r e q u i r e s c a nd i d at 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 ny 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 must b e s h own t o t h e t h i r d d eg r e e o f c o n s a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms p a c ke t ) . 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 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 .

SUB- TOTAL 1 $ 5 0 . 0 0

TOTAL ( i f l a s t p a g e o f t h i s s c h e d ul e ) I 5

Page 2 8 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT ( I F FORRECEI VED ( i f a pp l i c a bl e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a p p l i c a b l e ) RA I SERNUMBER I NCOME

0 8 / 2 0 / 0 4 I D # M i c h a e l D . P a wl o ws k i 5 . 0 09 0 2 H a n o v e r D r i v e

C K # S o u t h L a k e , T x 7 6 0 9 2

0 9 / 0 3 / 0 4 I D # M i c h a e l D . P a wl o ws k i 5 . 0 0

9 0 2 H a n o v e r Dr i v eC K # S o u t h L a k e , T S c 7 6 0 9 2a

0 9 / 1 7 / 0 4 I D # M i c h a e l D . P a wl o ws k i 5 . 0 09 0 2 H a n o v e r Dr i v e

C K # S o u t h L a k e , T S c 7 6 0 9 2

1 0 / 0 1 / 0 4 I D # M i c h a e l D . P a wl o ws k i 5 . 0 09 0 2 H a n o v e r D r i v e

C K # S o u t h L a k e , T x 7 6 0 9 2

0 7 / 2 3 / 0 4 I D # L i n d a M . P e a s e 5 . 0 01 1 0 8 St e e r S t

C K # G r i n n e l l , l a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D # L i n d a M . P e a s e 5 . 0 01 1 0 8 St e e r S t

C K # G r i n n e l l , I a 5 0 1 1 2

0 8 / 2 0 / 0 4 I D # L i n d a M. P e a s e 5 . 0 01 1 0 8 S u m m e r S t

CK # G r i n n e l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D # L i n d a M. P e a s e 5 . 0 01 1 0 8 Summer S t

CK # G r i n n e l l , I a 5 0 1 1 2


C K # G r i n n e l l , I a 5 0 1 1 2


C K # G r i n n e l l , I a 5 0 1 1 2






COMMI TTEENAME / Mu s t b e s ame a s o n S t a t e me n t o f Or 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( POL I T I CAL ACTI ON COMMI TTEE) , L I ST

THE PACI DENT I F I CAT I ONNUMBER AND THE PACCHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON: Se c t i o n 688 . 3 2A( 6 ) , I o wa Cod e , p r oh 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 an d s t a t e me nt s f o r s o l i c i t i n g c ont r i b ut i o ns o rf o r any c o mme r c i a l p ur 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 .


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 ) 1 $ _

' D i s c l o s u r e l a w r e q u i r e s c a nd i d at 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 must b e s h own t o t h e t h i r d d e g r e e o f c o ns a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms p a c k e t ) . 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 same a s c a n d i d a t e , b u t t h e r e i s nof 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 .

P a g e 2 9 o f 4 4

( f o r Sche du l e A)

SCHEDULEA MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS


AMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT / I F FORRECEI VED ( i f a pp l i c ab l e ) TO CANDI DATE` RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a bl e ) RA I SERNUMBER I NCOME

0 7/ 2 3 / 0 4 I D# J am e s R . Ph e l p s 2 . 5 01 6 0 2 1 0t h Avenue P l a c e

CK# Gr i nne l l , I a 5 0 1 1 2

0 8/ 0 6/ 0 4 I D# J am e s R . Ph e l p s 2 . 5 0

1 6 0 2 1 0t h Avenue P l a c eCK# Gr i nne l l , I a 5 0 1 1 2a

0 8/ 2 0/ 0 4 I D# J am e s R . Ph e l p s 2 . 5 01 6 0 2 1 0t h Avenue P l a c e

CK# Gr i nne l l , I a 5 0 1 1 2

0 9/ 0 3 / 0 4 I D# J am e s R . Ph e l p s 2 . 5 01 6 0 2 1 0t h Av e nu e P l a c e

CK# Gr i nne l l , I a 5 01 1 2

0 9/ 1 7/ 0 4 m# J ames R . Ph e l p s 2 . 5 01 6 0 2 1 0t h Av e nu e P l a c e

CK# Gr i nne l l , I a 5 0 1 1 2

1 0 / 01 / 04 I D# James R . Ph e l p s 2 . 5 01 6 0 2 1 0t h Av e nu e P l a c e

CK# Gr i n ne l l , I a 5 0 1 1 2

0 7/ 2 3 / 0 4 I D# J a n K . P o p e 5 . 0 06 0 3 Va n Ho r n e Ci r

CK# Gr i nne l l , l a 5 0 1 1 2

0 8/ 0 6/ 0 4 I D# J a n K . P o p e 5 . 0 06 0 3 Va n Ho r n e Ci r

CK# Gr i nne l l , I a 5 0 1 1 2

08 / 2 0/ 04 I D# J a n K . P o p e 5 . 0 06 03 Va n Ho r n e Ci r

CK# Gr i n ne l l , I a 5 0 1 1 2

0 9/ 0 3 / 0 4 m# J a n K . P o p e 5 . 0 06 03 Va n Ho r s e Ci r

CK# Gr i n ne l l , l a 5 0 1 1 2









NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , p r oh i b i t s t h e u s e o f i n f o r ma t i o n c op i e d f r o m r e p o r t s and s t a t e me n t s f o r s o l i c i t i n g c o nt r i bu t i o ns o rf o r an y c o mme r c i a l p u r p o s e by a ny 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 .


* D i s c l o s u r e l a w r e q u i r e s c a nd 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 ny 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 must b e s h own t o t h e t h i r d d e g r e e o f c o ns a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e ( s a g e 2 o f f o r ms 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 .

Page 3 0 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK T HI S BOX I

AMENDI NG FORM

_ _

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT v ' I F FOR


( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a bl e ) RA I SERNUMBER I NCOME

0 9 / 17 / 04 I D# J an K . P o p e 5 . 0 06 0 3 Van Ho r n e Ci r

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0/ 0 1/ 0 4 I D# J an K . Pope 5 . 0 06 0 3 v an Ho r ne Ci r

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7/ 2 3 / 0 4 I D# - Un i t emi z e d Re c e i p t 1 . 0 0

CK#


CK#

0 8/ 2 0 / 0 4 I D# Ua i t emi z e d Re c e i p t 1 . 0 0

CK#


CK#

0 9/ 1 7/ 0 4 I D# Un i t emi z e d Re c e i p t 1 . 0 0

CK#

1 0/ 0 1/ 0 4 I D# Un i t eai z ed Re c e i p t 1 . 0 0

CK#

0 7 / 2 3 / 0 4 I D# Un i t e l ; t i z e d Re c e i p t 1 . 0 0

CK#


CK#






COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a n i z a t i o n)



NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI L A B LE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 688 . 3 2 A( 6 ) , I o wa Cod e , 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 and s t a t e me nt s f o r s o l i c i t i n g c o nt r i b ut i o ns o rf o r a ny c o mme r c i a l p ur p o s e b y any 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 .


' D i s c l o s u r e l a w r e q u i r e s c a nd 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 ny 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 must b e s h own t o t h e t h i r d d e g r e e o f c o ns a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms 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 mi 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 .

P a g e - 3 1 - o f - 4 4


SCHEDUL E

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK THI S BOX I

AMENDI NG FORM


RECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE" RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a bl e ) RA I SER

NUMBER I NCOME


CK#

0 9/ 0 3 / 0 4 m# Un i t en i z ed Re c e i p t 1 . 0 0

CK#s

0 9/ 1 7/ 0 4 m# Un i t emi z e d Re c e i p t 1 . 0 0

CK#

1 0/ 0 1/ 0 4 m# Uh i t emi z e d Re c e i p t 1 . 0 0

CK#

0 7/ 2 3 / 0 4 m# Ua i t emi z e d Re c e i p t 1 . 0 0

CK#

0 8/ 0 6 / 0 4 m# Un i t emi z e d Rece i p t 1 . 0 0

C 3 C #

0 8/ 2 0 / 0 4 m# Uh i t e t i l i z ed Re c e i p t 1 . 0 0

CK#


CK#

0 9/ 1 7/ 0 4 m# Un i t emi z e d Re c e i p t 1 . 0 0

C S C #

1 0/ 0 1/ 0 4 m# Un i t emi z e d Rece i p t 1 . 0 0

CK#






COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a ni z a t i o n)


STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I ST THE PAC I DENT I F I CAT I ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 688 . 3 2 A( 6 ) , I o wa Cod e , p r oh i b i t s t h e u se 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 an d s t a t e me nt s f o r s o l i c i t i n g c ont r i bu t i o ns o r

f o r an y c o mme 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 o mmi 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 nd 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 ny 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 must b e s h o w n t o t h e t h i r d d eg r e e o f c o ns a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms p a c k e t ) . 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 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 mi 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 .


Page 3 2 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK THI S BOXAMENDI NG FORM


RECEI VED ( i f a p p l i c a b l e l TO CANDI DATE` RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a pp l i c a bl e ) RA I SER

NUMBER I NCOME

0 7/ 2 3 / 0 4 I D# Ba r b ar a J . Sa bu l t z 2 . 5 0

5 1 0 Pea r l StCK# Gr i n n e l l , I a 5 0 1 1 2

0 8/ 0 6 / 0 4 I D# Ba r b ar a J . Sc h u l t z 2 . 5 0

5 1 0 Pea r l S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 2 0 / 0 4 I D# Ba r b a r a J . Sc h u l t z 2 . 5 05 1 0 P e a r l S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9/ 0 3 / 0 4 I D# Ba r b a r a J . Sc h u l t z 2 . 5 05 1 0 P ea r l S t

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7/ 0 4 I D# Ba r b a r a J . Sc b u l t z 2 . 5 05 1 0 Pea r l S t -

CK# Gr i n a e l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Ba r b a r a J . Sc h u l t z 2 . 5 05 1 0 P e a r l S tCK# Gr i n n e l l , I a 5 0 1 1 2

0 7 / 2 3 / 0 4 I D# Un i t e mu . z e d Re c e i p t 1 . 0 0

CK#

0 8 / 0 6 / 0 4 I D# Un i t emi z e d Re c e i p t _ 1 . 0 0

CK#


CK#

0 9/ 0 3 / 0 4 I D# Uh i t e mi z e d Re c e i p t 1 . 0 0

CK#




CONTR I BUT I ONS - - MONEY TAKEN I N


COMMI TTEENAME ( 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 )

VER I ZON I OWA STATE GOOD GOVERNMENT CLUB

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACT I ON COMMI TTEE ) , L I ST THE PAC I DENTI F I CAT I ON

NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLETROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 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 on t r i b ut i o ns o rf o r an y c 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 an 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 .

TOTAL ( i f l a s t p ag 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 nd 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 ns an g ui n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms p a c ke 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 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 .

Page 3 3 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK T HI S BOX I

AMENDI NG FORM

" -DATE - - PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT I I F FOR



NUMBER I NCOME

0 9 / 1 7 / 04 I D# Ua i t e mi z e d Re c e i p t 1 . 0 0

CK#


CK#

0 7/ 2 3 / 0 4 I D# - Un i t e mi z e d Re c e i p t 2 . 5 0

CK#

0 8/ 0 6 / 0 4 XD# Un i t e mi z e d Re c e i p t 2 . 5 0

CK#

0 8/ 2 0 / 0 4 I D# Un i t e ai z e d Re c e i p t 2 . 5 0

CK# -


CK#

0 9 / 1 7/ 0 4 I D# Ua i t e mi z e d Re c e i p t 2 . 5 0

CK#


CK#


CK#


CK#






COMMI TTEENAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a n i z a t i o n!



NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , 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 nd s t a t e me n t s f o r s o l i c i t i n g c o nt r i b ut i o ns o rf o r an y c o mme r c i a l p ur p o s e b y a ny 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 .


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

' D i s c l o s u r e l a w r e q u i r e s c a n di 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 must b e s h own t o t h e t h i r d d eg r e e o f c o ns a ng ui n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms 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 .

Page 3 4 o f 4 4


SCHEDULE

A MONET ARY

( Re v . 0 6 / 9 7) RECEI PTS

CHECK THI S BOX IAMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORRECEI VED ( i f a pp l i c a b l e ) TO CANDI DATE" ' RECEI VED FUND-

( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c a b l e ) RAI SERNUMBER I NCOME


CK#

0 9 / 0 3 / 0 4 I D# Un i t emi z e d Rece i p t 1 . 2 5

CK#a

0 9 / 1 7 / 0 4 I D#- Un i t emi z ed Rec ei pt 1 . 2 5

CK#

1 0 / 0 1 / 0 4 I D# Un i t emi z e d Rece i p t 1 . 2 5

CK#

0 7 / 2 3 / 0 4 I D# Mi c h e l e L . Si s s o n 3 . 0 01 4 2 1 4 t h Av e

CK# Gr i n n e l l , l a 5 0 1 1 2

0 8 / 0 6 / 0 4 I D# Mi c h e l e L . Si s s o n 3 . 0 01 4 2 1 4 t h Av eCK# Gr i n n e l l , I a 5 0 1 1 2

0 8 / 2 0 / 0 4 I D# Mi c h e l e L . Si s sam 3 . 0 01 4 2 1 4 t h Av e

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 I D# Mi c h e l e L . Si s s m 3 . 0 01421 4 t h Av e

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 1 7 / 0 4 I D# Mi c h el e L . Si s s om 3 . 0 01 4 2 1 4 t h Av e

CK# Gr i nn e l l , I a 5 0 1 1 2

1 0 / 0 1 / 0 4 I D# Mi c h el e L . Si s s m 3 . 0 01 4 2 1 4 t h Av e

CK# Gr n n e l l , I a 5 0 1 1 2




CONTR I BUT I ONS - - MONEY TAKEN I N


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 )

VER I ZON I OWA STATE GOOD GOVERNMENT CLUB

* D i s c l o s u r e l a w r e q u i r e s c a nd 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 mus t b e s h o w n t o t h e t h i r d d eg r e e o f c on s a ng u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms 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 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 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 .

STATE CANDI 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 T TEE) , L I S T THE PAC I DENT I F I CAT I ON

NUMBER AND THE PACCHECK NUMBER I N THHE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I LABLE . F R OM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68B . 3 2A( 6 ) , I o wa C o d e , 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 and s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o rf o r any c o mme r c i a l p ur p o s e b y an y p e r s o n o t h er t h an 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 .


Page 3 5 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7) RECEI PTS

a CHECK T HI S BOX I

AMENDI NG FORM

DATEy PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FOR



NUMBER I NCOME


CK#


CK#s


CK#


CK#

0 9/ 1 7/ 0 4 m# Un i t e mi z e d Re c e i p t 2 . 5 0

CK# -

1 0/ 0 1/ 0 4 m# Un i t e mi z e d Re c e i p t 2 . 5 0

CK#

0 7/ 2 3 / 0 4 I D# Ka t h y V . St a ne k 2 . 5 0PO Bo x 92 6

C S C # Gr i n n e l l , I a 5 0 1 1 2

0 8/ 0 6 / 0 4 I D# Ka t h y V . St a ne k 2 . 5 0PO Box 92 6

C Z C # Gr i n n e l l , I a 5 0 1 1 2

0 8/ 2 0 / 0 4 I D# Ka t h y V . St a ne k 2 . 5 0PO Bc x 92 6

CK# Gr i n n e l l , I a 5 0 1 1 2

0 9/ 0 3 / 0 4 I D# Ka t h y V . St a ne k 2 . 5 0PO Bc x 92 6

CK# Gr i n n e l l , I a 5 0 1 1 2






COMMI TTEE NAME ( Mus t b e s ame a s o n S t a t e me n t o f Or g a n i z a t i o n)



NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD .

CAUTI ON: Se c t i o n 688 . 3 2A( 6 ) , I o wa Cod e , 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 op 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 nt r i bu t i o ns o r

f o r any c o mme r c i a l p u r p o s e by an y p e r s o n o t h e r t h an 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 .


' D i s c l o s u r e l a w r e q u i r e s c a nd 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 ny 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 must 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 ns a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms 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 s ame a s c a n d i d a t e , b u t t h e r e i s nof 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 .

Page 3 6 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7) RECEI PTS

CHECK THI S BOX I

AMENDI NG FORM

' DA TE` PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT ( I F FOR



NUMBER I NCOME

0 9/ 1 7/ 0 4 I D# Ka t h y V . St anek 2 . 5 0

PO B o o t 92 6CK# Gr i n n e l l , I a 5 0 1 1 2

1 0/ 0 1/ 0 4 I D# Ka t h y V . St anek 2 . 5 0PO Box 9 2 6

CK# Gr i a ne l l , I a 5 0 1 1 2


CK#

0 8 / 0 6 / 0 4 I D# Un i t emi z e d Re c e i p t 1 . 00

CK#


C S C # -


CK#

09 / 1 7 / 04 I D# Un i t emi z e d Re c e i p t 1 . 00

CK#

1 0/ 0 1/ 0 4 I D# Un i t emi z e d Re c e i p t 1 . 00

CK#


CK#


CK#






COMMI TTEENAME ( 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 )



NUMBER ANDTHE PAC CHECK

NUMBER I N THHE DESI GNATED COLUMN. A L I ST

OFI D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 688 . 3 2 A( 6 ) , I o wa Cod e , p r oh 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 or 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 on t r i b u t i o ns o r


TOTAL ( i f l a s t p ag 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 di d at 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 mus 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 ns a ng u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms 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 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 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 .

Page 3 7 o f --44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7) RECEI PTS

CHECK THI S BOX I

AMENDI NG FORM

DATE ~ ' PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT [ I F FOR


( MM/ DD/ YR) ANDPAC CHECK ( i f a p pl i c a bl e ) RA I SER

NUMBER I NCOME


CK#

09 / 0 3 / 0 4 I D# Un i t e mi z e d Re ce i p t 2 . 5 0

CK#

0 9/ 1 7/ 0 4 I D# - Un i t e mi z e d Re c e i p t 2 . 5 0

CK#


CK#

07 / 2 3 / 04 I D# Ma r c i a Ta r v i n 2 . 5 05 0 2 7 Hwy 6 3

CK# Mont ez uma , I a 5 0 1 7 1

0 8 / 0 6 / 04 I D# Ma r c i a Ta r v i n 2 . 5 05 0 2 7 Hwy 6 3

CK# Mo n t e z t mi a , l a 5 0 1 7 1

0 8 / 2 0 / 04 I D# Ma r c i a Ta r v i n 2 . 5 05 0 2 7 Hwy 6 3

CK# Mc n t e mmi a , I a 5 0 1 7 1

0 9/ 0 3 / 0 4 I D# Ma r c i a Ta r v i n 2 . 5 05 0 2 7 Hwy 6 3 -

CK# Mo n t e z t mi a , I a 5 0 1 7 1

0 9/ 1 7/ 0 4 I D# Ma r c i a Ta r v i n 2 . 5 05 0 2 7 Hwy 6 3

CK# Mo n t e z t mi a , I a 5 0 17 1

1 0/ 0 1/ 0 4 I D# Ma r c i a Ta r v i n 2 . 5 05 0 2 7 Hwy 6 3

CK# Mont ez u ma , I a 5 0 1 7 1









NUMBER AND THE PAC CHECK NUMBER I N THHE DES I GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , p r oh 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 and s t a t e me nt s f o r s o l i c i t i n g c o nt r i bu t i o ns o r

f o r an y c o mme r c i a l p u r p o se by any 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 .


' D i s c l o s u r e l a w r e q u i r e s c a n di 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 must b e s h own 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 ) a nd a f f i n i t y ( r e l a t i v e s byma r r i a g e ) ( S e e P a g e 2 o f f o r ms p a c k e t ) . 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 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 .

Page 38 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

0 CHECK THI S BOX I

AMENDI NG FORM

DATE PAC I D NUMBER NAMEANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT - / I F FOR


( MM/ DD/ YR) ANDPAC CHECK ( i f a pp l i c ab l e ) RA I SERNUMBER I NCOME

07 / 2 3 / 04 I D# Ka r e n Va n So e l e n 2 . 5 01 2 6 9 5 S 9 2 n d Av e E

CK# Su l l y , l a 5 0 2 5 1

08 / 06 / 04 I D# Ka r e n Van So e l e n 2 . 5 01 2 6 9 5 S 9 2 n d Av e E

CK# Su l l y , I a 5 0 2 5 1a

08 / 2 0/ 04 I D# - Ka r e n Va n So e l e n 2 . 5 01 2 6 9 5 S 9 2nd Av e E

CK# Su l l y , I a 5 0 2 5 1

0 9/ 0 3 / 0 4 I D# Ka r e n Van So e l e n 2 . 5 01 2 6 9 5 S 9 2nd Av e E

CK# Su l l y , I a 5 0 2 5 1

0 9/ 1 7/ 0 4 I n# Ka r e n Va n So e l e n 2 . 5 01 2 6 9 5 S 9 2nd Av e E

CK# Su l l y , I a 5 0 2 5 1

1 0/ 01 / 04

m# Ka r e n Van So e l e n 2 . 5 01 2 6 9 5 S 9 2 n d Av e ECK# Su l l y , I a 5 0 2 5 1

07 / 2 3 / 04 I D# Un i t e mi z e d Re c e i p t 1 . 00

CK#


CK#


CK#


CK#






COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f Or g a n i z a t i o n)




DI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 688 . 3 2 A( 6 ) , I o wa Cod e , p r o h i b i t s t h e us e o f i n f o r ma t i o n c op i e d f r o m r e p o r t s and s t a t e me nt s f o r s o l i c i t i n g c o nt r i bu t i o ns o r

f o r an y c o mme r c i a l p ur p os e by a ny p e r s on o t h er t h an s t a t ut o r y p o l i t i c a l c o mmi t t e e s .

TOTAL ( i f l a s t pa ge of t h i s s c h ed ul e )

' D i s c l o s u r e l a w r e q u i r e s c a nd 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 ny 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 must b e shown t o t h e t h i r d d e g r e e o f c on s a ng u i n i t y ( b l o o d r e l a t i v e ) a nd 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 ) ( S e e P a g e 2 o f f o r ms p a c k e t ) . 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 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 .

Page 3 9 o f 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK T HI S BOX I

AMENDI NG FORM

- - DATE - - PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT v ' I F FOR


( MM/ DD/ Y R) ANDPAC CHECK ( i f a pp l i c a bl e ) RAI SER

NUMBER I NCOME

0 9 / 17 / 04 I D# Un i t e mi z e d Rece i p t 1 . 0 0

CK#

1 0/ 0 1/ 0 4 I D# Un i t e mi z e d Rece i p t 1 . 0 0

CK#s

0 7/ 2 3 / 0 4 I D# _ Mar l i s R . Van Z an t e 2 . 5 0

1 4 0 1 7 Ewy F - 62 ECK# L y nn v i l l e , I a 5 0 1 5 3

0 8/ 0 6 / 0 4 I D# Mar l i s R . Van Z an t e 2 . 5 0

1 4 0 1 7 Ewy F - 62 ECK# L y n n v i l l e , I a 5 0 1 5 3

0 8/ 2 0 / 0 4 I D# Mar l i s R . Van Z an t e 2 . 5 01 4 0 1 7 Hwy F - 6 2 E

CK# L y n n v i l l e , I a 5 0 1 5 3

0 9/ 0 3 / 0 4 I D# Mar l i s R . Van Z an t e 2 . 5 0

1 4 0 1 7 Ewy F - 6 2 ECK# L y nn v i l l e , I a 5 0 1 5 3

0 9/ 1 7 / 0 4 I D# Mar l i s R . Van Z an t e 2 . 5 01 4 0 1 7 Hwy F - 6 2 E

CK# L y n n v i l l e , I a 5 0 1 5 3

1 0/ 0 1/ 0 4 I D# Mar l i s R . Van Z an t e 2 . 5 01 4 0 1 7 Ewy F- 6 2 E

CK# L y n n v i l l e , l a 5 0 1 5 3

0 7/ 2 3 / 0 4 I D# Ka r l a L . Va n d er l e es t 2 . 0 01 5 2 7 0 N 7 5t h Av e E

CK# Gr i n - 11 , I a 5 0 1 1 2

0 8/ 0 6 / 0 4 I D# Ka r l a L . Va n de r l e es t 2 . 0 01 5 2 7 0 N 7 5t h Av e E

CK# Gr i n n e l l , l a 5 0 1 1 2









NUMBER AND THE PACCHECK NUMBER I N THHE DESI GNATED COLUMN.

A L I S T OF I D NUMBERS I S AVAI LABLE ' FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , 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 pi e d f r o m r e p or t s a nd s t a t e me n t s f o r s o l i c i t i n g c on t r i b ut i o ns o r

f o r a ny c o mme r c i a l p u r p o se b y a ny p e r s o n o t h e r t h an 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


' D i s c l o s u r e l a w r e q u i r e s c a nd 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 mus t b e s h ow n t o t h e t h i r d d e g r e e o f c o ns a n gu i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms 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 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 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 .

Page 4 0 o f -- 4 4


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

1 - 0 1 CHECK THI S BOXAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT / I F FORRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE" RECEI VED FUND-

( MM/ DD/ YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOME

0 8 / 2 0 / 0 4 I D# Ka r l a L . Va n de r l e es t 2 . 0 0

1 5 2 7 0 N 75 t h Av e ECK# Gr i n n e l l , I a 5 0 1 1 2

0 9 / 0 3 / 0 4 M# Ka r l a L . Va n de r l e es t 2 . 0 01 5 2 7 0 N 7 5t h Av e $

CK# Gr i n n e l l , I s 5 0 1 1 2


1 5 2 7 0 N 7 5t h Av e ECK# Gr i n n e l l , I a 5 0 1 1 2


1 5 2 7 0 N 7 5t h Av e ECK# Gr i n n e l l , l a 5 0 1 1 2

0 7 / 2 7 / 0 4 I D# Ve r i z o n Good Go v e r n l I n e n t Cl u b - Tx 1 , 2 5 0 . 0 08 1 6 Co n g r e s s Av e . , Su i t e 1 5 0 0 _

CK# Au s t i n , Tx 7 8 7 0 1

0 7 / 2 3 / 0 4 I D# Debo r ah D . Wa l ke r 4 . 9 82 3 8 Ho r s e s hoe DrCK# Mo n t e z u u t l a , l a 50171

0 8 / 0 6 / 04 I D# Debo r ah D . Wa l ke r 4 . 9 82 3 8 Ho r s e s hoe Dr

CK# Mo n t e z u ma , I a 5 0 1 7 1

0 8 / 2 0 / 0 4 I n # De b o r a h D . Wa l ke r 4 . 9 82 3 8 Ho r s e s hoe Dr

CK# Mo n t e z u ma , l a 5 0 1 7 1

0 9 / 0 3 / 0 4 I D# Debo r ah D . Wa l ke r 4 . 9 82 3 8 Ho r s e s hoe Dr

CK# Mo n t e z u ma , I a 5 0 1 7 1

0 9 / 1 7 / 0 4 m# Debo r ah D . Wa l ke r 4 . 9 82 3 8 Ho r s e s hoe Dr

CK# Mo n t e z t mi a , I a 5 0 1 7 1











NUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVAI LABLETROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.

CAUTI ON: Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , p r o h i b i t s t h e us e o f i n f o r ma t i o n c op i e d f r o m r e p o r t s and s t a t e me n t s f o r s o l i c i t i n g c o nt r i bu t i o ns o r

f o r an y c o mme r c i a l p ur p o s e by a ny 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 .


" D i s c l o s u r e l a w r e q u i r e s c a nd 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 ny 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 must b e s h own t o t h e t h i r d d e gr e e o f c o ns a ng u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms p a c k e t ) . 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 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 .

P a g e 4 2 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7) RECEI PTS

CHECK THI S BOX I

AMENDI NG FORM




NUMBER I NCOME

0 9/ 0 3 / 0 4 I D# J o a n a L . We l l s 5 . 00256 Newbur g Road

CK# Gr i mm 11 , I a 5 0 1 1 2

09 / 1 7 / 0 4 I D# JoamL . We l l s 5 . 00

2 5 6 Newbur g RoadCK# Gr i n n e l l , I a 5 0 1 1 2

x

1 0/ 0 1 / 0 4 I D# " Joann L . We l l s 5 . 002 5 6 Newbur g Road

CK# Gr i n n e l l , I a 5 0 1 1 2

07 / 2 3 / 0 4 m# Un i t emi z e d Re c e i p t 1 . 00

CK#


CK#


( 3 C #


CK#


CK#


CK#

0 7/ 2 3 / 0 4 I D# Li n da J . Wi n c h e l l 2 . 503 1 5 2nd Avenue

CK# Gr i n n e l l , I a 5 0 1 1 2






COMMI TTEE NAME ( Mu s t b e s am 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 )


STATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A STATE PAC ( POL I T I CAL ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CAT I ONNUMBER AND THE PAC CHECK NUMBER I N THHE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS AND CAMPAI GN

DI SCLOSURE BOARD.

CAUTI ON : Se c t i o n 68B . 3 2 A( 6 ) , I o wa Cod e , 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 or t s a nd s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o rf o r a n y c o mme r c i a l p u r p o s e b y a ny 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 . - - -


* D i s c l o s u r e l a w r e q u i r e s c a nd 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 mus t b e shown t o t h e t h i r d d e g r e e o f c o n sa n gu i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e Page 2 o f f o r ms 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 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 .

Page 4 3 o f 44


SCHEDULE

A MONETARY

( Re v . 0 6 / 9 7 ) RECEI PTS

CHECK T HI S BOX I

AMENDI NG FORM

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT ( I F FORRECEI VED ( i f a pp l i c a bl e ) TO CANDI DATE* RECEI VED FUND-

( MM/ DD/ YR) AND PACCHECK ( i f a pp l i c a bl e ) RA I SERNUMBER I NCOME

0 8/ 0 6 / 0 4 I D# L i n da J . Wi n c h e l l 2 . 5 03 1 5 2 n d Avenue

CK# Gr i n ne l l , I a 5 0 1 1 2


CK# Gr i n ne l l , I a 5 0 1 1 2 ,


CK# Gr i n ne l l , I a 5 0 1 1 2

0 9/ 1 7/ 0 4 I D# L i n da J . Wi n c h e l l 2 . 5 03 1 5 2 n d Avenue

CK# Gr i n n e l l , I a 5 0 1 1 2

1 0/ 0 1/ 0 4 I D# L i n da J . Wi n c h e l l 2 . 5 03 1 5 2 n d Avenue -

CK# Gr i n n e l l , I a 5 0 1 1 2

0 7/ 2 3 / 0 4 I D# Un i t e mi z ed Re c e i p t 1 . 0 0

CK#

0 8/ 0 6 / 0 4 I D# Un i t e mi z ed Re c e i p t 1 . 0 0

CK#

0 8/ 2 0 / 0 4 I D# Un i t e mi z e d Re c e i p t - 1 . 0 0

CK#


CK#


CK#






COMMI TT EE NAME ( Mu s t b e s am 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 )


STATE CANDI DATES NOTE: I F

A CONTRI BUTI ON I S RECEI VEDFROM

ASTATE PAC

( POL I T I CAL ACTI ONCOMMI TTEE) , L I ST T HE P AC I DENT I F I CAT I ON


DI SCLOSURE BOARD .

CAUTI ON: Se c t i o n 6 8 B . 3 2 A( 6 ) , I o wa Cod e , p r oh i b i t s t h e u s e o f i n f o r ma t i o n c op 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 on t r i b u t i o ns o r

f o r a n y c 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 . . , .


` D i s c l o s u r e l a w r e q u i r e s c a nd 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 mus 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 ns a ng u i n i t y ( b l o o d r e l a t i v e ) 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 ) ( S e e P a g e 2 o f f o r ms 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 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 .

P a g e 4 4 o f 4 4


SCHEDULE

A MONET ARY

( R e v . 0 6 / 9 7 ) RECEI PTS

CHECK THI S BOX I

AMENDI NG FORM

DATERECEI VED

( MM/ DD/ YR)

PAC I D NUMBER( i f a p p l i c a b l e )

AND PAC CHECKNUMBER

NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI PTO CANDI DATE'

( i f a p p l i c a b l e )

AMOUNTRECEI VED

( I F FORFUND-

RAI SERI NCOME

1 0 / 0 1 / 0 4 I D#

CK#

Un i t e a i z e d Re c e i p t 1 . 0 0

z



FORI NSTRUCT I ONS, SEE BACK OF FORM

EXPENDI TURES - - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATEPAC COMMI TTEES : NOTE : FOR CONTRI BUT I ONS MADE TO STATEWI DE OR LEGI S LA TI V ECANDI 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 ST OF I D NUMBERS I S AVAI LAB LE FROMTHE I OWAETHI CS & CAMPAI GN DI SCLOSURE BOARD .

COMMI TT EE 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 )


TOTAL f i f l a s t p a g e o f t h i s s c h ed u l e ) 1 $

SUB- TOTAL I $ 2 , 2 0 0 . 0 0

T HI S BOX APP L I E S TO CANDI DATES' COMMI TTEES ONLY :

Pu 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 . )

Ex p en 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 , manag 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 nSc h e d u l e G b y t h e amo 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 pe nd 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 an 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 wa Co de 5 6 . 6 ( 3 ) ( 1 ) . )

Pag e 1 o f 3

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

SCHEDULE

B MONETARY


2 CHECK T HI S BOX I F

AMENDI NG FORM

DATE

_EXPENDED( MM/ DD/ YR)

CANDI DATE

I D NUMBER( i f a p p l i c a b l e )

AND PACCHECK

NUMBER

NAME AND ADDRESS TOWHOMEXPENDI TURE

/ D i s b u r s e me n t / WAS MADE

PURPOSE- ( DESCRI BE TRANSACTI ON)

AMOUNT

EXPENDED

0 9 / 1 4 / 0 4 Bo y l e P t t a l i c Se r v i c e Q' mi ds i m 5 0 0 . 0 04 2 0 S . 1 1 t h St r e e t Gma i 2 0 0 4 / mami n , NE 6 8 5 0 8 Ra 7 . i t i c a l C l o 3 t r i b u t i c u

0 0 1 2 5

0 9 / 1 7 / 0 4 Th 0 1 1 OomnL t b e e s t a bs ~~4eq~, I l a t u r /np 2 0 0 . 0 0DmVQnx a u Gmec a l . 2 00 4 / i a

a l t 2 4 4 4 0 0 w , , ; t ; , t a l a l o 3 t r i b ut i m

0 0 1 1 2 8 Gd r r , p , r a 5 0 1 1 2

0 8 / 2 6/ 0 4 s t a t e a o u mn , a - - i s ,a t ur e / x e p 5 0 . 0 0ma n i c L h v i . t t Ge n e r a l 2004/ 46 1 1 wAd f f i x x i

0 0 1 2 3 T n i i f i A o l a , J I L 5 0 1 2 5

0 9 / 1 4 / 0 4 De n r r 3 e n f o r St a b s C t mm i t t e e s l a t e Sew 5 0 . 0 03 ] 1 3 K i n e%r Ave ma Geoe z a l 2 00 4 / i aDe s M: d ~ l s , l e . 5 0 3 0 9 P u l i t L C a

0 0 1 2 6

0 9 / 1 7 / 0 4 f t a i f Cr S e r i a t e s t a t e 2 00 . 0 06 0 3 8 laFr a i m coa l 2004/ aM

Rt . 1 i a l i t i ml ( l o o t r b u t i r n0 0 1 3 4 F. . MK b s c n , l a 5 2 6 2 7

0 9 / 1 7 0 4 s t a t e Vn NM/ j e r j l j e ]; 1h1EWr EP 5 00 . 0 0

P O B o o t 2 2 0 C o ~ ~ ' a l 2 00 4 / i aa s 9 h e 7 . 1 p 4C )C , I a 5 0 6 7 0 P i o l i t l c a l C l o m t ! d b u t i0 0 1 3 7

0 9 / 1 4 / 0 4 3 1 * Ge r a l d Vap - p J bUc S e v i c e P t t a l i c Se r v i c e Co mn d s s i m 5 00 . 0 01 2 0 0 l a t h St r e e t Ge c e c a l 2 0 0 4 / n e

a l l Ca s t s , NE 6 8 5 0 8 A ' 1 1 7 t L c al C b r i t i l i b u t i0 0 1 2 4

0 9 / 1 7 / 0 4 Qpp f l o g Pe pr e amt a t i v e a o un i t t e e $ t 3 t e Eb m e l / l sg; a l a t * , . Wnp 2 0 0 . 0 05 8 6 a l a l c k Gi r p G, e ~ n ~ e ~ r ~ a l ~ 2 ~ 0 ( 4 / i a 0 3 1

CI A 2 1 2 Hi g h P a " " ' . . a L Cbat 1 b u tm0 0 1 3 3 D a o l o r a h , I a 5 2 1 0 1



FOR I NSTRUCTI ONS, SEE BACK OF FORM

EXPENDI TURES - - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR L EGI SL ATI VE

CANDI DATES, L I ST THE CANDI DATE I DENT I F I CATI ON NUMBER I N THE DESI GNATED COLUMN AND THE

PAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S A VA I L A BL E FROMTHE I OWA

ETHI CS & CAMPAI GN DI SCLOSURE BOARD .

COMMI TTEENAME ( Mu s t b e s ame a s o n St a t e me n t o f Or g a n i z a t i o n )


TOTAL ( i f l a s t page o f t h i s s c h e du l e ) 1 $

SUB- TOTAL / $ 1 , 5 0 0 . 00

T HI S BOXAPPLI ES TOCANDI DATES' COMMI TTEESONLY:

Pu 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 must 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 / 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 mus 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 amo un t , p u r p o s e , a nd da 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 on 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 o

Sc h e d u l e G i n s t r u c t i o n s a nd I o wa Co de 5 6 . 6 ( 3 ) ( 1 ) . )

Page 2 o f 3


SCHEDULE

B MONETARY

( Re v . 0 9 / 9 7) EXPENDI TURE

01 CHECK T HI S BOX I F

AMENDI NG FORM

DATE

EXPENDED

( MI G1/ DD%YR)

CANDI DATE

I D NUMBER

( i f a pp l i c ab l e )

ANDPAC

CHECK

NUMBER

NAMEANDADDRESS TOWHOM

EXPENDI TURE

/ D i s b u r s e me n t ) WASMADE

PURPOSE

. , ( DE SCRI BE TRANSACTI ON)

AMOUNT

EXPENDED

0 9 / 1 7 / 0 4 3 1 * a t i 7 1 19 0 11 1 5 i w G r c w t e l s l y s e w 2 0 0 . 0 0Ga e l u a i 2 0 0 4 /

2 2 0 B e C Ee t t t o P o l i t i c a l O c n t r i b u t i m0 0 1 3 2 Cb r i c i l BI &Es, M! L 5 1 5 0 3

0 8 / 2 6 / 0 4 P o s e r f i a t S t a t e A e F c e s e c i t a t i w s t a t e 1133Wn, - T ' ; h =e /ny 50 . 0 0

Ga i S t e e r G 9 3 e a 3 2 0 0 4 / i a

C K # 2 3. 3 7 t h S t r e e t W C t l a t r i b u t i m0 0 1 2 1 A l t o a a , T h 5 0 0 0 9

1 0 / 0 4 / 0 4 Z a w n 1 C p a mt y S t a t e P h t i t i t a t EwLt y 5 00 . 0 0

9 0 9 8 1 3 4 5 l i l b i b o a r P e r i a l a y Ga e a t 2 0Wi aC0 ' D e s M b d n e s , T a 5 0 3 1 0 P c l i t i c a l O o n t r i b t i m

0 0 1 3 8

0 9 / 1 7 0 4 1 9 1 1 9 1 : 1 3M f i c r s t a t e s~ 2 0 0 . 0 0S t e w a r t 1 y e r s a z G e n e r a l 2 0 0 4 / i a 0 0 5

C E O 3 0 2 0 D o t e s - Wi l ; , . na H o e d w, 7 ; t i c s l C t n t r Am& ;m

0 0 1 3 0 n a g s , I a 5 0 0 7 1

1 0 / 1 1 / 0 4 m# J n o C i 7 s Q = I r L t t e e S t a t e Rs+-MhT, * Q / gy p 2 0 0 . 0 08 0 8 5 8 t h s t r e e t G e n e r a l 2 0 0 4 / i i

0 0 R e s t D e s M o t i v e s , 1 a 5 2 3 3 9 P t l i t i c a l Ot l o t r i b u t i m0 0 1 3 9

0 9 / 1 7 / 0 4 K i b b d e b o r S e n a t e S t a t e S e n a t e 2 0 0 . 0 0P0BI 3C190 Ge a l a a l 2 0 0 4 / s d D 4

C i d # Hmmt dmaV, I a 5 0 5 3 6 P a t i c a l O t i n t . i b u t i m0 0 1 2 9

0 8 / 2 6 / 0 4 3 1 * i o n S e n a t e S t a t e s a ~ a t e 5 0 . 0 0I i a b y _ f c cGaul 2 0 0 4 / i a

C K k T O B I C K 5 6 3 O~ i b u t i m0 0 1 2 2 N a r i m , 7 a 5 2 3 0 2

0 8 / 3. 9 / 0 4 Omm i t t e e t o Meat M9 t t . W( by S t a t e S e f l a t e 1 0 0 . 0 0Gaul 2 0 0 4 / k E l l

C [ # 4 7 2 0madp a l e . Mi t i a a l c r n r a , t r i m0 0 1 2 0 D e s Mo i n e s , l a 5 0 3 2 0



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