FOR INSTRUCTIONS, SEE BACK OF FORM FORM

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DISCLOSURE SUMMARY PAGE DR-2 DISCLOSURE
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev. 07/2004) 1 REPORT

L
For Office Use Only
er r &Apf r \~ or Comm. #
IMPORTANT: Indicate by # type of committee you are repo ing for: Logged In a)(
( 1 )Statewide/Legislative/Judge Standing for Retention Candidate ( 2 )State PAC ( 3 )State Party Scanned
(4 )County Central Committee ( 5 )County Candidate ( 6 )City Candidate ( 7 )School Board or Other
Political Subdivision Candidate ( 8 )County PAC ( 9 )City PAC ( 10 )School Board or Other Political Computer x'1112
Subdivision PAC ( 11 ) Local Ballot Issue Audited
CANDIDATE COMMITTEES ONLY:
Candidate Name Political Party (if applicable)
Late reports are subject to
0C,r.,e I,() . 11A "t b Z. uer , - possible civil and criminal
Office Sought District (if Senate or House) penalties .
wpe-y~Sor
"?la -(a5 _? - ~g 3,F- I-/- l.) -os-
SI NATU E F FILING RESRT TELEPHONE DATE SIGNED

t, r
I AM FILING A . r f NI't 6~ ~RT FOR (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate by #

Local Committees, enter Date of Election

OCHECK IF AMENDMENT TO REPORT DATED
11'12 "6
Check if this is final (termination) report and attach Notice of Dissolution Form DR-3. County & Local Committees, enter County in
(You must continue to file reports until a DR-3 is filed.) which Election is held

STATEMENT OF CASH ON HAND

CASH ON HAND at the beginning of the reporting period . (Total of all funds held by the
committee . This amount MUST be the same as the cash on hand at the end
of the last reporting period or must be zero if this is first report filed.) . .. ... ... .. . .. ... . .. .. . ... .. ... .. . $ /51 .3S-
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) (*also see in-kind below) .. ... .. . .. ~D -
Schedule F: Loans Received total (Attach Schedule F) . . . .. . .. . .. ... .. . .. ... ... .. . .. ... . .. .. . .. . .. ... ... .. . ..
Schedule H: Total Sales of Campaign Property (Attach Schedule H) . .. . .. ... ... .. . .. . .. . .. ... .. . .. ...
(Schedule H applies to Candidates' Committees Only)
SUB-TOTAL .....$ ( CQ t . 3S_
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) (**also see debts and loans below).. ..
Schedule F: Loan Repayments total (Attach Schedule F) . . . . .. .. . .. ... .. . .. ... .. . . . . .. . .. . .. ... .. . .. . .. ... ..
CASH ON HAND at the end of this reporting period (if final report balance must
be zero) (Attach DR-3) .. ... ... .. ... . . ... . .. . . . .. . .. ... ... .. . .. .. . .. . .. . .. . . . . . . .. . . . . .. .. . .. . .. .. . . . . .. .. . . . . .. . .. . . . ... .. . .. . .. $

**UNPAID BILLS (From Schedule D - Attach Schedule D).. .. . .. ... ... .. . .. . .. . .. ... .. . .. . .. ... .. . .. . .. . .. ... .. . .. . .. ... .. $
*IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) . ... .. ... ... .. . . . ... . .. . . . ... ... .. . .. .. . .. ... .. $
**OUTSTANDING LOANS (From Schedule F -Attach Schedule F) . . ... ... .. ... ... .. . .. ... . . . .. . ... .. . .. .. . .. . .. ... .. $
CANDIDATE COMMITTEES ONLY:
CONSULTANT BREAKDOWN (Schedule G Attached?) YES NO
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN-KIND
COMMITTEE NAME (Must be sam as on St tement of Organization) (Rev. 06/97)1 CONTRIBUTIONS

O CHECK THIS BOX IF

AMENDING FORM

DATE RELATIONSHIP DESCRIPTION ESTIMATED J IF FOR

RECEIVED NAME AND ADDRESS TO CANDIDATE OF IN KIND FAIR MARKET FUND-RAISER
(MM/DD/YR) OF CONTRIBUTOR ' (if applicable) CONTRIBUTION VALUE CONTRIBUTION
ay W~Qn~ ~-

71
F-1
71
F-1
F-1
71
F-1
TOTAL (if last
page of this
schedule)

'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page of
committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule E)
by marriage) . (See Page 2 of forms packet .) If surname of contributor is the same as candidate, but there is no
familial relationship, enter "not applicable" in the relationship column .
FOR 1NSTRUCT7ONS, SEE BACK OF FORM
SCHEDULE

F
, c 4-;Pr 5llo,,oru fso-r
COMTTEE NAME(Must be same as on Statement of Organization) LOANS
(Rev. 071W) RECEIVED
tlk~ .~ l iw,Vie - a REPAID
NOTE : This schedule reports money loaned to the committee which Is deposited In gtis committee account. CHECK THIS BOX IF
TOTAL UNPAID LOANS FROM ICI REPORTING PERIOD $ ;:2 ?d a "O AMENDING FORM

nanY afinueranw o naue VAea~anr _ an Tuae 6COAOT1wn Dig-,-NS s"nT N- Ynwariwv r nam orm"Yupwn Y"nR Twm. RGRnpTINa PFRrnn
(0rly(nei source of loan, such as bank, rrwst be shown if a rhWparty is (Loans forgiven must be reported on Schedule E- In-kind Contributions)
involved. fnclude bans fbm candialete's personal funds.)
DATE NAME AND ADDRESS OF LENDER RELATNDJVSHIP AMOUNT DATE PAID NAME AND ADDRESSOF LENDER RELATIONSHIP AMOUNT
RECEIVED (Include Endorser's Name, If Applicable) TO CANDIDATE OF LOAN (MANDDIYR) (Include Endorser's Name, If Applicable) TO CANDIDATE' REPAID
MMIDD1YR if A icable' If A Ifcable
s s
!a 3 '331 (a a~.
hV%A I6ke, , T"AtI4

TOTAL (PART f) S TOTAL CASH REPAYMENTS (PART10

From Schedule E - TOTAL LOANS FORGIVEN s---, _

TOTAL OUTSTANDING LOANS END OF REPORT PERIOD $

'Disclosure low requires candidate committees to dfadose the relationship of any relative
makIng a contribution to the committee. Relationship must be shown to the third degree of
consanguinity(blood relatives) and afanfty (relatives by marriage). If surnarna orwwbubor 15
the same es candidate. but thewe is no famiYal relationship . entsr'not applfoabla'in the
relationship column when it applies. Page of
(for Schedule F)
 Notice of Dissolution FORM
DR-3
6 (Rev . 07/03)

NOTICE OF
Mail to : DISSOLUTION
IECDI3
510 East 122 Suite IA For Office Use Only
Des Moines, Iowa 50319
Comm . #
Indexed
Audited '
Computer ,ckrL
Certified Date of Dissolution

COMMITTEE NAME

s
M L .h b~Uo- , r -e r S,xE u, b,,
Official Name of Committee

33 i 43? a 44, 5-ke&~

Street

`'Yl0~-V%0 Lk S LA
City, State, Zip Code

RID,) &S-3 -2g3R-

Area Telephone
Code

WHEN TO FILE :
The Notice of Dissolution must be filed within thirty (30) days of completion of all the following:

1. All debts, loans and obligations have been paid or transferred ;

2. All campaign funds have been spent;
3. All campaign property sold or transferred (candidates only); and
4. A final report disclosing all transactions closing the committee .

For state candidates and state PACs, a final bank statement must be filed with the Notice of Dissolution or as soon as
possible if the bank statement is not available at the time the Notice of Dissolution is filed.

x ,/~)' " ~-
Signs e of Candidati _ _ _ . . ..___ _, _ . _ . ._ .. _. . . _....... ...

X - 2 -- o .
Date Signed

FOR INSTRUCTIONS, SEE BACK OF FORM

This form is not applicable to statutory political committees .