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F , - - ) P 1KSTRUCi I ONS , SEE BACK OF FORM. DI SCLOSURESU,4ARYRAGECOMMI TTEE NAME ( Mu s t b e s ame a s on t a t e me nt o f . o r g a n i z a t i o n )

C! ~ / , ~

l ~

0 1 /

cr t c t - f - eI 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 C o 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 mmi 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 sCANDI DATE COMMI TTEES ONLY :Ca nd i d a t e Name

P o l i t i c a l P a r t ySTEU~

O f f i c e Sou g h t

D i s t r i c t ( i f Se na t e o r Hou s e )

Rou t i ne P e n a l t i e s Due Fo r L a t e F i l e d Rep or t s R a n g e f r o m $ 2 0 t o $ 8 0 0SEE I NSTRUCTI ONS ON BACK AND COMPL ETE THE FOL L OWI NG SENTENCE :I AM FI L I NG AF t ~ t . ' 1 2

9 O

E l Che 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 Fo r m DR- 3 .( Y ou 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 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

Z

I n d i c a t e one

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 l o f a l l mon i e s h e l dby t h e c o mmi t t e e . T h i s amoun t MUST be t h e s a m e a s t h e c a s h on h a nd a t t h e endo f t h e l a s t r e p o r t i n g p e r i o d , o r mu s t be z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

FORMD R - 2( Re v . 0 1 / 2 0 0 1 )F o r O f f i c e Us e O n l y

1-7,Comm . #

I n d e x e d

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A u d i t e dC o mp u t e r

DATE S1GED

DI SCL OSUREREPORT

- I ` 7 - 0 1

REPORT FOR A N/ A ( 1 ) E L ECT I ON / ( 2 ) NON- EL E CT I ON YEAR .

( r e p o r t d a t e )

CHECK I F AMENDMENT TO REPORT DATED L 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 i nw h i c h E l e c t i o n i s h e l d

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F o r I n s t r u c t i o n s , Se e B a c k o f Fo r mCONTRI BUTI ONS - - MONEY TAKEN I N

( I n c l u d i n g c a n d i d a t e ' s p e r s o n a l f u n d s )I COMMI TTEE NAME ( 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 ( P OL I T I C A L ACTI ON COMMI TTEE) , L I S T THE PAC I DE NT I F I CA T I O NNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATED COLUMN . A L I ST OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD .

SCHEDULEA

( Rev . 0 6 / 9 MONETARYRECEI PTS[ , CHECK THI S BOX I FAMENDI NG FORM

CAUTI ON : S e c t i o n 6 8 B . 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 m a 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 eme 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 rf o r a ny c omme 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"U t c a l c o mmi t t e e s .

DATE PAC I D NUMBER NAME A ADDRESS' OF CONTRI BUTOR RELATI ONSHI P AMOUNT q I F FORRECEI VED ( i f a p p l i c a b l e ) ( D TOCANDI 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- 4 9

CK# - ~o j ,t e . ~Ca. S Wi n t . ' 4 Tr e f , t J $ C0 . , ' IiQY - 5 - 0 , 7 - 3

CK# ' W ; r i ~ e 1 . 5 e " , ~ Z4 56 27 Y 0 - v eI D #c K# Qv ' a ~ , ~ r e i n 4[I D # 330` v - t Q

2 CK#1 , 1

(10canr n 46 3 -110

t l e e e i e~ j l~a Y~ r t t S ~ J 0 b4 - e e -1 D # 6 0 3 A/ rU) 4ad s t ' 6 , o

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) 40R. I NSTRUCTI ONS, SEE BACK OF FORM, ' EXPENDI TURES , . - MONEY SPENT FROMCOMMI TTEE ACCOUNT

STATE PAC COMMI TTEES : NOTE : , FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VE -CANDI DATES, L I S , 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 S T OF I D NUMBERS I S AVAI LABLC FROMTHE I OWAETHI CS & CAMPA! GN DI SCL OSURE BOARD .COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n )

CANDI DATEDATE

I L I NUMBER; s EXPENDED

( i f a p p l i c a b l e )(MNJDD/ YR) : ' .

AND PACCHECKNUMBER . .

I D#1 CK#

rCK#, I D #

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CK#

NAME ANQf ADDRESSWHOMRE( D i s b u r s e m e n t ) WAS MADE

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NCMWFO? CON- MUTI ONS I MADE TO S 7 A - r E W 1 ' - - ) ' ! : 0 ? , LEO! I L AT I V ECAT Y0 . - N 7 7 S , L ! ! ; T T Y , ` - - ' CANDMAI MENMRCAPMN` j MS ER I N T ' - I = _ OES i GNAT 7 2 C COLUVMANDTHF-PACCM- NUMERAWEACH EAPEN09USE A WS7 OF I II N - L Y V 3 E I Q S i S AVA : ! - ' T - c r - - ; C' A THE I n : V A0w- A UAMwN9 N DI MAMRE BOARD .

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