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FORI NSTRUCTI ONS, SEEBACK OF FORMDISCLOSURESUMMARYPAGE

COMMI TTEE NAME ( Mu s t b e s ame as o n St a t emen t o f Or g a n i z a t i o n )I OWA 5 T I I D I ST , DEMOCRATI C STATE CENTRAL COMMI TTEE

I MPORTANT I n d i c a t e b y # t y p e o f c ommi t t e e y o u a r e r e p o r t i n g f o r . 1 2 1( 1 ) S t a t e w i d e / L e g i s l a t i v e / J u d g e St a n d i n g f o r R e t e n t i o n Ca n d i d a t e ( 2 ) S t a t e PAC ( 3 ) S t a l e P a r t y{ 4 ) Co u nt y C e n t r a l Commi t t e e ( 5 ) Co u n t y Ca n d i d a t e ( 6 ) C i t y Ca n d i d a t e ( 7 ) S c ho o l B o ar d o r Ot h e rP o l i t i c a l S u b d i v i s i o n Ca n d i d a t e ( 8 ) Co u nt y PAC ( 9 ) C i t y PAC ( 1 0 ) S c h o o l B o ar d o r Ot he r P o l i t i c a lS u b d i v i s i o n PAC 1 1 L o c a l B a l l o t I

O f f i c e S o u g h t

Rese t .Fo r m

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

D i s t r i c t ( i f Se n a t e o r H o u s e )

L a t e r e p o r t s a r e s u b j e c t t op os s i b l e c i v i l an d c r i m i n a l p e n a l t i e s . P u r s u a n t t o I o wa Co d e s e c t i o n 68B. 3 2 A( 7 )t h e c a n d i d a t e , f o r a c a n d i d a t e ' s c ommi t t e e, an d t h e c h a i r p e r s o n , f o r an y o t h er t y p e o f c ommi t t e e, i s t h ei n d i v i d y ~ Y r e s p o n s i b l o r f i n g t i m e en d ac c u r a t e r e p o r t s .

SI GNATUREOF ERSON F I L I N G REPORT

I AM F I L I NG A DECEMBER 3 1 , 2 0 0 6( r e p o r t d a t e ) I n d i c a t e b y #

CHECK I F AMENDMENT TO REPORT DATED

[ ] Ch 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 an d a t t a c h No t i c e o f D i s s o l u t i o n F or m D R- 3 .( Y o u mus t c o n t i n u e t o f i l e r e p o r t s u n t i l a DR- 3 i s f i l e d . )

SUBTRACT TOTAL MONEY SPENT THI S PERI OD

REPORT FOR ( 1 ) ELECTI ON / ( 2 ) NON- E LECT I ON YEAR .

STATEMENT OF CASH ON HANDCASHON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d . ( T o t a l o f a l l f u n ds h e l d b y t h e

c o mmi t t e e . T h i s amou nt MUST b e t h e s ame a s t h e c a s h o n h a n d a t t h e en do f t h e l a s t r e p o r t i n g p e r i o d o r mus t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . $ADDTOTAL MONEY TAKEN I N THI S PERI ODSc h e d u l e A : Cas h C o n t r i b u t i o n s t o t a l ( A t t a c h Sc h e d u l e A) ( * a l s o s ee i n - k i n d b el o w) . . . . . . . . . . . . . . . . . . . .Sc h e d 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 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . .Sc h e d u l e H : T o t a l Sa l e s o f Campa i g n P r o p e r t y ( A t t a c h Sc h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h ed u l e H ap pl i e s t o Ca n d i d a t e s ' Commi t t e e s On l y )SUB- TOTAL . . . . . . . . . . . . . . . . . . . $ 0 . 0 0

Sc h e d 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 Sc h e d u l e B ) ( * * a l s o s ee d e bt s an d l o an s b e l o w) . . . . . . . . . . . . . . . . .Sc h e d u l e F: L oan Rep a yme n t s t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON HAND a t t h e en 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 mus tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

FORMDR-2 DI SCLOSURE

( Re v . 1 2 / 2 0 0 5 ) REPORTFo r O f f i c e Us e On l yComm. # _AL o g g e d I nSc a n ne dCompu t e rA ud i t ed

F i l e w i t h :I o wa E t h i c s a n d Camp a i g nD i s c l o s u r e B o ar d5 1 0 E . 1 2 ' , St e . 1 ADes Mo i n e s , I o wa 5 0 3 1 9Fa x : 5 1 5 - 2 8 1 - 3 7 0 1

- 7 i , a - 2 C( - I w&3 1 - 11 5 - 6 7TELEPHONE 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 8 L o c a l Commi 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

1 , 6 7 9 . 8 0

3 , 5 0 0 . 0 00 . 0 00 . 0 0

2 , 4 5 0 . 0 00 . 0 02 , 7 2 9 . 8 0

J NO

* * UNP AI D B I L L S ( F r o n t Sc h e d u l e D - A t t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0* I N K I ND CONTRI BUTI ONS ( Fr o mSc h e d u l e E - A t t a c h Sc h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0* * OUTSTAND I NG LOANS ( F r o mSc h e d u l e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 0 . 0 0CONSULTANT BREAKDOWN( Sc h e du l e G A t t a c he d ?) YESCANDI DATE COMMI TTEES ONLY :

0 . 0 0VALUEOF CAMPAI GN PROPERTY( Fr omSc h e d u l e H - A t t a c h Sc h e d u l e H) $STATE COMMI TTEES : Submi t a r e c o n c i l e d c amp a i g n a c c o u n t b a nk s t a t e me n t i n J a n u ar y o f e a c h y ea r .

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Fo r I n s t r u c t i o ns , See Back o f Fo r mCONTRI BUTI ONS - - MONEYTAKENI N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )COMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t eme n t o f O r g a n i z a t i o n )I OWA 5TH DI ST DEMOCRATI CSTAT1 CF NTRALCOMMI T TE 1 . 1 1

STATE CANDI DATES NOTE : I F ACONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( P OL I T I C AL ACTI ON COMMI TTEE) , L I S T THE PAC I D ENT I F I C AT I ONNUMBER AND THE PAC CHECK NUMBER I N THE 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 .NOTE : ANY PERSON, OTHERTHANAN I N DI V I DUA L, THATCONTRI BUTESMORE THAN $ 7 5 0 TOYOUR CAMPAI GNMAY HAVE F I L I NGRESPONS I B I L I T I E S AND SHOULD I MMEDI ATELY CONTACT THE BOARD .CAUTI ON: S e c t i o n 6 8B. 3 2 A ( 6 ) , p r o h i b i t s t h e u s e o f i n f o r ma t i o n c o pi e d f r o m r e p o r t s a n d s t a t e me n t s f o r s o l i c i t i n g c o n t r i b u t i o n s o r f o r an yc omme r c i a l p u r p o s e b y a n y p e r s o n o t h e r t h a n s t a t u t o r y p o l i t i c a l c o mmi t t e e s .

SUB- TOTAL

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 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 an 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 s ) an d a f f i n i t y ( r e l a t i v e s b yma r r i a g e ) I f s u r n ame o f c o n t r i b u t o r i s t h e s ame as c a n d i d a t e , b u t t h e r e i s n o Page l o f If 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 umn . ( f o r S c he d u l eA)

SCHEDULEA MONETARY( Re v . 0 7 / 0 3 ) RECEI PTS0 CHECKTHI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESSOF CONTRI BUTOR RELAT I ONSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) TOCANDI DATE` RECEI VED FUND-( MM/ DDNR) ANDPACCHECK ( i f a p p l i c a b l e ) RAI S ERNUMBER I NCOME

I D# PO' I " CAWATTAMI ? COUNTYDEMOCRATI C $2500 . 0 01 0- 2 5 - 0 6 CK# CENTRAL, COMMI TTEE, HELENE . 13AUMELTREASURER6 0 5 N1 5 t h , Co u n c i l Bl u f f s l a 5 1 5 0 1

I D#f . ? J o y c e Sc hu l t e f o r Co n g r e s s Co mmi l t e $1000 . 0 01 0- 2 5 - 0 6 CK# Ro b e r t Ne l s o n , Ex i r a T r e a s u r e r

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

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FORI NSTRUCTI ONS, SEEBACK OFFORMEXPENDI TURES - - MONEY SPENT FROM COMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DEOR LEGI SLAT I VECANDI DATES, L I ST THE CANDI DATE I DENT I F I CAT I 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 LABLE FROMTHE I OWAETHI CS 8 CAMPAI GN DI SCLOSURE BOARD .COMMI TT EENAME ( Mu s t b e same a s o n St a t eme n t o f O r g a n i z a t i o n )I OWA 5 ` r i I DI STRI CT STATECENTRALCOMMI TTEE

SCHEDULEB MONETARY

( Re v . 0 7 / 0 3 ) ' EXPENDI TURESD CHECK THI S BOXI FAMENDI NG FORM

SUB- TOTAL 1 $ 2 45 0 , 0 0TOTAL ( i f l a s t page o f t h i s s c h e du l e ) l $ 2 4 5 0 . 0 0

THI S BOX APPLI ES TO CANDI DATES' COMMI TTEES ONLY :Pu r c h a s e s o f c e r t a i n c amp 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 Sch e d u l e H . ( R e f e r t o Sch e d u l e H i n s t r u c t i o n s . )E x 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 , man a g i n g , o r g a n i z i n g s e r v i c e s must a l s o b e d e t a i l i t e mi z e d o nSch e d u l e Gb y t h e amou n t , p u r p o s e , an d d a t e o f e a c h t y p e o f e x pe 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 ommi t t e e . ( R e f e r t oSch e d u l e G i n s t r u c t i o n s an d I o wa Code 6 8A . 4 0 2 ( 3 ) ( 1 ) . )

( f o r Sch e d u l e B )

CANDI DATE NAMEANDADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( Di s b u r s e me n t ) WAS MADE( MM/ DD/ YR) ANDPACCHECKNUMBER

I D# G u r t 1 u - i e Co u n t y Ce n t r a l Commi t t e e Co nt r i b ut i o n1 1 - 3 - 0 6 CK# Sus a n Cr a me r " t r e as u r e r , , Bo x $ 1 0 0 0 . 0 01 94 , Gu t h r i e Ce n t e , l a 50115

I D# Cr awl ' o r d Co u n t y Ce n t r a l Co mmi t t e e , Co nt r i b ut i o n1 1 - 3 - 0 6 CK# Amy Os b o r n e , Tr e as u r e r , 2 7 2 5 . 3 7 0 t h 95 0 . 0 0S t r e e t , Ma n n i n g , l a 51455

I D# Audubo n Co u n t y Demo c r a t Ce t n r al Co n t r i b u t i on1 1 - 3 - 0 6 Co mmi t t e e , Peggy Sma l l e y T r e s u r e r e r , 50 0 . 0 0CK# 612 E a s t Di v i s i o n , Audubo n l a 50025

I D#

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