Printed at the Iowa Ethics & Campaign Disclosure Board, 05/31/2005 12:54 :04

DR-2
FORM Dr2 : Disclosure Summary Page Statutory Due Date 01/19/2002
Adjusted Due Date //
Received Date 12/28/2001
Postmark Date 12/27/2001
ID #: 785 Amended ll
committee : Citizens For Mundie
Comm Type: General Assembly Candidate
Date Due :01/19/2002
Report Year: 1998
Treasurer: Patrick Q. Palmer (515) 456-4268
Chair : Faye Mundie (515) 972-4283
County:

Election Date: 11/03/1998

Statement of Cash On Hand Cash On Hand at Start of Period $1,474.53

Schedule A: Cash Contributions Total $0.00
Schedule F: Loans Received Total $0.00
Schedule H: Campaign Property Sales $0 .00
SUB-TOTAL $1,474.53

Schedule B : Expenditures Total $100.00

Schedule F : Cash Loan Repayments $1,374.53
Cash on Hand At End of Period $0.00

Loans in Place at Start of Period $3,200.00

Additional Assets and Liabilities
Schedule D: UnPaid Bills $0.00
Schedule E : In-Kind Contributions $1,825.47
Schedule F: Forgiven Loans $1,825.47
Schedule F: Outstanding Loans $1,825 .47
Schdule G: Consultant Breakdown? No
Schedule H : Campaign Property Value $0 .00

Note : [~] "Flag" symbolizes information entered by IECDB Auditor.

FORM DR-2: Citizens For Mundie
Printed at the Iowa Ethics & Campaign Disclosure Board, 05/31/2005 12:54 :05
SCHEDULE B : Expenditures -- Money Spent From Committee Account
Sch-B
Committee Name Committee ID : 785 Statutory Due DateT1/19/2002

Citizens For Mundie Adjusted Due Date ~ / I

Received DateJ12/2 8/2001
Postmark Date 12/27/2001
Status :Original Commmittee Type : General Assembly Candidate Amended

Date Committee . ID Name and Address To Whom Expenditure (Disbursement) Was Made Amount
Received Check # Purpose : Description of Transaction Expended

11/27/2001 Palmer, Patrick Q .

Chk : 884 114 3rd Avenue NE
$100 .00
- Hampton, IA 50441
PURPOSE : Other Expenditure : Paid Treasurer
[#378]

Sub-Total
Report Total $100 .00

Note : P1 ] "Flag" symbolizes information entered by IECDB Auditor.

SCHEDULE B : Citizens For Mundie Page 1 of 1
Printed at the Iowa Ethics & Campaign Disclosure Board, 05/31/2005 12 :54:08 (for schedule B)
SCHEDULE E: In Kind Contributions
Committee Name 785 Statutory Due Date ~ 01/19/2002
Sch-E
Committee ID :
Citizens For Mundie Adjusted Due D atel / /
Received Date 1 12 /28/2001
Postmark Date 12/27/2001
Status :Original Commmittee Type :General Assembly Candidate Amen de6fj //

Date Contributor Information Description of In Kind Contribution Amount

12/16/2001 RELATION : Self : Debt Forgiven by Norman Mundie
$1,825 .47
Mundie, Norman
2270 235th Street
[#381 ] Fort Dodge, IA 50501

Fundraiser Regular Total

Sub-Total $0 .00 $1, 825 .47 $1,825 .47
Report Total $0 .00 $1,825 .47 $1,825 .47

SCHEDULE E : Citizens For Mundie Page 1 of 1

Printed at the Iowa Ethics & Campaign Disclosure Board, 05/31/2005 12 :54:12 (Schedule E)
 SCHEDULE F : Loans Received & Repaid Sch-F
Committee Name Committee ID : 785 Statutory Due Date 0111912002
Citizens For Mundie Adjusted Due Date I l
Received Date 1 1212812001
Postmark Date 1212712001
Status :Original Commmittee Type :General Assembly Candidate Amende d 11

Total UnPaid Loans, Last Period : $3,200 .00

PART II - MONETARY LOAN REPAYMENTS MADE THIS REPORTING PERIOD

Date Name and Address of Lendaer Relationship To Amount

Paid (Include Endorser's Name, If Applicable) Candidate Repaid

11/27/2001 Mundie, Norman Self $1,374 .53

2270 235th . Street ENDORSER : Norman Mundie
[#379] Fort Dodge, IA 50501

12/16/2001 Mundie, Norman Self $1,825 .47

2270 235th Street ENDORSER : Norman Mundie
(Forgiven'
[#380] Fort Dodge, IA 50501

Total Loans RePaid (Part II) : $3,200 .00

From Schedule E - TOTAL LOANS FORGIVEN : $1,825 .47

TOTAL OUTSTAND I NG LOANS END OF REPORT PERIOD : $0 .00

SCHEDULE F : Citizens For Mundie Page 1 of 1

Printed at the Iowa Ethics & Campaign Disclosure Board, 0513112005 12:54:16 (for schedule F)