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DR-2 DISCLOSURE
DISCLOSURE SU1, AARY PAGE (Rev . 01/98) REPORT

For Office Use I


COMMITTEE NAM (Must be same as on atem nt of O aniz Lion Comm . K
Indexed
~) L
Audited C j -G '2 ~~. . .
IMPORTANT: Indicate type of committee you are reporting for D Computer
( )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( s )County/Local Candidate
I
( )County PAC (f)
5 Issue/Franchise Committee ( 7 )County/City Central Committee
(8t)Support S ,of es

`SIGN URE OF TR ' URER (or person filing this report) TELEPHONE - DATE SIGNED

Routine Penalties Due For Late Filed Reports Range from $20 t $866 ,
JAN 1 1 2002
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE : f _

l1

I AM FILING A I ~ ?CEO REPORT FOR AN/A (1) ELECTION /(2)N


(report date) Indicate one

E]CHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election

Check if this is final (termination) report and attach Notice of Dissolution Form DR-3. County & Local Committees, enter County in
which Election is held
(You must continue to file reports until a Notice of Dissolution is filed.)

STATEMENT OF CASH ON HAND


CASH ON HAND at the beginning of the reporting period . (This is the total
of all monies 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 Ned.) ........................... . .... . ... .. . .....................................$
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) ................................................ .
Schedule F: Loans Received total (Attach Schedule F) ................ ...................................... .
Schedule H: Total Sales of Campaign Property (Attach Schedule H) ................................. .
(Schedule H ap-Olies to Candidates' Committees OnIV)

,1 SUB-TOTAL......$ ; 15- S0
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) .......... .... .. .. .. ................. .................. .. .. 14 (4 Ot) G
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) . .. ..... .. ....... .. .. ............... ..... ....... ....... .. ..... . .. ................. ................ ........$ I T) S l 0 I

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) .. .. .... .. .... ..... ..... ..... .. ..... ..... .... .. ......$ Q
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

CONTRIBUTIONS - MONEY TAICEN IN- SCHEDULE MONETARY


(Including candidates versonal funds) A IuECEItvTS
(Rev. ot"n
COMMITTEE NAME (Must be the same as on Shbamsnt of Organization)
CHECK THIS BOX
AMENDING FORM
Lansing for House District #45
STATE CANDIDATES NOTE: IF A CONTRIBUION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMrrTEE) LIST THE
PAC IDENTIFICATION NUMBER AND THE PAC CHECKNUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBER IS
AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION : Section 68B.32A(6), Iowa Code, prohibits the use ofinformation copied from reports and statements for
soliciting contributions or for any commercial purpose by any person other than statutory political committees.

DATE ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSWP AMOUNT IF FOR


RECEIVED appicaUs) TO CANDIDATE' RECEIVED "FUND-
(NIINDDVYR) PAC CHE (if appicable) RAISER
PI UMBER INCOME
ID# Larry T. Wilson
8/24/01 Ck# 6100 308 Koser Iowa City, IA 52246 $ 50 .00 X
ID # David C. Bakius
8/24/01 CK# 598 34 N 7th Iowa Ci IA 52245 $ 50 .00 X
ID # Harry R. Wolf
42 N. High Cr. NE
8/24/01 CK# 809 Iowa City, IA 52240 $ 50.00 X
ID # David L. Rust
915 E. Bloomington St.
8/24/01 CK# 7269 Iowa Ci IA 52245 $ 100.00 X
ID # Michael R. Huber
8/24/01 CK# 1126 Box 5301 Coralville IA 52241 $ 100.00 X
ID # Nancy Williams
8/24/01 CK# 2450 1929 Hafor Iowa Ci IA 52246 $ 100.00 X
ID # Patricia Vunderink
1152 Hunters Run
8/24101 CK# 60 Iowa City, IA 52246 $ 100.00 X
ID # R .E. Myers
9 Woodland Heights
8/24/01 CK# 3147 Iowa City, IA 52240 $ 100.00 X
ID # Mary Neu
8/24/01 CK# 3629 212 Ferson Iowa City,IA 52246 $ 35 .00 X
ID # Margaret P. Winegarden
26 Kensington Ct.
8/24/01 CK# 9376 Iowa City, IA 52245 $ 40.00 X
ID #
CK#
SUB TOTAL $ 725.00
TOTAL (if last page of this schedule)

*Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution tothe
committee. Relationship my be show to the third dWroe ofconsanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 offorms packet.) IfSurname ofcontri'lxrtor is the same as candidate, but there is no familial
relationship, enter `Shot applicable" in the relationship eohnun.
Page -__ or ~ ..
(for Scneduis A)
FOR INSTRUCTIONS, SEE .BACK OF FORM

SCHEDULE
CONTRIBUTIONS - MONEY TAIMN IN MONETARY
(Including candidate's personal funds) A RFCE:PrS
(Rev. 06/97)
COMMITTEE NAME (Mua be the two as an Stdemt of Orpadzation)
CHECK THIS BOX IF
AMENDING FORM
Lensing for House District #45
STATE CANDIDATES NOTE : IF A CONTRIBUION IS RBCENED FROM A STATE PAC (POLITTCAL ACTION COMMITTEE) LIST THE
PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBER IS
AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION: Section 68B .32Af Iowa Code, prohibits the use of information copied from reports and statements for
soliciting contributions or for any commercial purpose by any person other than statutory political committees.

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MMIDD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME

ID # Michael J. Lensing
411 E. Fairchild
8/24/01 CK# 5754 Iowa City, IA 52245 Ex-husband $ 50.00 X
ID # Carrie Z. Norton
920 Ginter
8/24/01 CK# 6301 Iowa C' IA 52240 $ 50 .00 X
ID # Thomas A. Jepson
1003 9th
8/24/01 CK# 8081 Kalona IA 52247 $ 50 .00 X
ID # John A. Gross
4 Brickwood Knoll
8/24/01 CK# 2562 Iowa City, IA 52240 $ 50.00 X
Edwin J. Zastrow
ID #
9 S. Mt. Vernon Drive
8/24/01 CK# 4284 Iowa City, IA 52245 $ 50.00 X
ID # Robert E. Dvorsky
412 6th Street
8/24/01 CK# 2200 Coralville IA 52241 $ 25.00 X
ID # A. Ross Wilbum
1917 Taylor Drive
8/24/01 CK# 3495 Iowa City, IA 52240 $ 25.00 X
Thomas H. Baldridge
ID#
915 Oakcrest St No. 16
8/24/01 CK# 4893 Iowa City, IA 52246 $ 25.00 X
ID # Victoria L. Thiede
958 Westside Drive
8/24/01 CK# 3567 Iowa City, IA 52246 $ 25.00 X
ID # Veme Kelley
376 KoserAvenue
8/24/01 CK# 4151 Iowa City, IA 52246 $ 25.00 X
ID # Mary Masher
40 Gryn Court
8/24/01 CK# 9988 Iowa City, IA 52246 $ 25.00 X
SUB TOTALI $ 400.00 I -
TOTAL (if last page of this schedule)

*Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to the
committee. Relationship my be show to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 offorms packet .) If Surname ofcontributor is the same as candidate, but there is no familial
relationship, enter "not applicable" in the relationship eolmun. Page -3-of A_
(for Schedule A)
FOR INSTRUCTIONS, SEE.BACK OF FORM

CONTRIBUITONS -MONEY TAI{EN IN- SCHEDULE


MONETARY
(Including candidate's personal funds) A
(RAV. 0M
COMMITTEE NAME (Must be the same as on Statement of 5Ftizatbn)
CHECK THIS BOX IF
AMENDING FORM
Lensing for House District #46

STATE CANDIDATES NOTE: IF ACONTRIBUTON IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE) LIST THE
PAC IDENTIFICATION NUMBER AND THE PAC CHECKNUMBER IN THEDESIGNATED COLUMN. A LIST OF ID NUMBER
IS
AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION: Section 68&32A(6~ Iowa Code, prohibits the use of information copied from reports and statements for
soliciting contributions or for any commercial purpose by any person other than statutory political committees.

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MNIDDIYR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME

ID # Joseph L. Bolkcom
728 2nd Avenue
8/24/01 CK# 2599 Iowa C IA 52245 $ 25.00 X
ID # Harry L. Seelman
2451 IWV Rd. SW
8/24/01 CK# 9832 Oxford IA 52322 $ 10.00 X
ID # Dorothy M. Paul
608 Larch Lane
8/24/01 CK# 8532 Iowa City, IA 52245 $ 15.00 X
ID # Deborah Gill
808 - 8th Avenue
8124/01 CK# 11399 Coralville IA 52241 $ 20.00 X
ID # David P. Redlawsk
26 Gallup Place
8/24/01 CK# 9732 Iowa City, IA 52246 $ 20.00 X
ID # Joan Huntley
1501 Westview
8/24/01 CK# 6821 Coralville IA 52241 $ 20.00 X
ID # Sally Stutsman
3714 - 500th St SW
8/24/01 CK# 15745 Riverside IA 52327 $ 25 .00 X
ID # P.A. Cancilla
2257 Sugar Bottom Road NE
8/24/01 CK# 6691 Solon IA 52333 $ 25 .00 X
ID # Rod Sullivan
2326 E. Court Street
8/24/01 CK# cash Iowa City, IA 52245 $ 40.00 X
ID # Mike Partridge
1220 Village Road, Apt 9
8/24/01 CK# cash Iowa City, IA 52240 $ 20.00 X
ID # Jo McCarty
536 S Summit Street
8/24/01 CK# cash Iowa City, IA 52240 $ 20.00 X

TOTAL (if last page of this schedule)

'Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the
oammittee. Relationship my be show to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 offorms packet.) IfSurname ofcontributor is the same as candidate, but there is no familial )
relationship, enter "not applicable" in the relationship colmun.
Page 3- 41_.._ of
(for SCheduf" A)
FOR INSTRUCTIONS, SEE-BACK OF FORM

SCHEDULE
CONTRIBUTIONS - MONEY TAIM IN MONETARY
(Including candidate's personal funds) A RECEIPTS
(t-. os"
COMMITTEE NAME (Must be the same as on Statement a Orgatcadon)
CHECK THIS BOX IF
AMENDING FORM
Lensing for House District #45

STATE CANDIDATES NOTE : IF A CONTRIBUTON IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE) LIST THE
PAC IDENTIFICATION NUMBER AND THE PAC CHECKNUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBER IS
AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION: Section 68B.32A(6), Iowa Code, prolubits the use ofinformation copied from reports and statements for
soliciting contributions or for any commercial purpose by any person other than statutory political committees.

DATE PAC ID NUMBER NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT IF FOR
(if ~~) TO CANDIDATE' RECEIVED FUND-
RECEIVED
(if applicable) RAISER
(MMIDDIYR) AND PAC CHECK
INCOME
NUMBER

Charlie Earlham
ID # 1152 E. Court
8/24/01 CK# cash Iowa City, IA 52240 $ 20.00 X
ID #
8124/01 CK# cash Various - less than $25.00 each $ 145.00 X
David R. Ulrick
ID # 514 Terrace Road
9/14/01 CK# 1016 Iowa City, IA 52245 $ 40.00
Charles A. Skaugstad
ID # 524 W. Park Road
9/14/01 CK# 8043 Iowa City, IA 52246 $ 100.00
Iowa Committee of Automotive Retailers
ID # 6059 1111 Office Park Road
10/24/01 CK# 2160 West Des Moines IA 50265 $ 100.00
Ted Townsend
ID # 2425 Hubbell
1217/01 CK# 7098 Des Moines IA 50317 $ 100.00

D#
8/01,10/01 I
11/01,12/01 CK# Interest $ 2.70

ID#
CK#
ID #
CK#
ID#
CK#
SUBTOTAL $ 507.70
TOTAL (if last page of this schedule) ?7e'00

'Disclosure law requires candidate committees to disclose the relationship ofany relative making a contribution to the
committee. Relationship my be show to the third degree of consanguinity (blood relatives) and affinity (relatives by
marriage) (See Page 2 of forms padcet.) IfSurname of conthitor is the same as candidate, but there is no familial
relationship, enter "not applicable' in the relationship colmun.
Page 14 of z4_ . .
(for Schedule A)
FOR INSTRUCTIONS, SEE BACK OF r 'M SCHEDULE

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT B


(Rev . 09/97)
MONETARY
EXPENDITURES
STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES . LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE O CHECK THIS BOX IF
PAC CHECK NUMBER FOR EACH EXPENDITURE. A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD

COMMITTEE NAME (Must be same as on Statement of Organization)

ke'AS 1 ~ 4-t c (~e N14' I c f " ,-


CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER

e.`
I D#

CK# $ 06
C)Sy et v-~~
ID# ,
c7
yo
II ~C 1
CK#G
S,~0 L~wa Cr 1 Zz o

I ~C°t f
ID#
s
, 9
r
CK# 1) U5 ; S
1 p ~~
I D#

IFYr `~50~
5~ 3

I D#

~z 7I~ CK#0

ID#

CK# _ _
IZ7/6 ASS _
a_ 1
ID#

CK#

ID#

CK#

SUB-TOTAL $ 4 11 . y`

TOTAL (if last page of this schedule) $ 11~

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)

Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's committee. (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(1) .)

(for Schedule B)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN KIND
COMMITTEE NAM (Mustbe same as on Sta t of Org"rabon)~ Rev. A6/9 7 CONTRIBUTIONS

~e rn -
El 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

311 0 )

SUB-TOTAL

TOTAL (if lost

page of this

schedule)

'Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page ' I
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 .

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