rielly thomas1516scanned

8/7/2019 Rielly Thomas__1516__scanned

1/13

FOR I NSTRUCTI ONS, SEE BACKOF FORMDI SCLOSURE SUMMARYPAGECOMMI TTEE NAME ( M u s t b e s ame a s o n S t a t e m e n t o f O r g a n i z a t i o n )R i e l l y f o r S e n a t eI MPORTANT : I n d i c a t e b y # t y p e o f c o m m i 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 t a t i v e / J u d g e S t a n d i n g f o r R e t e n t i o n C a n d i d a t e ( 2 ) S t a t e PAC ( 3 ) S t a t e P a r t y( 4 ) C o u n t y C e n t r a l C o mm i t t e e ( 5 ) C o u n t y C a n d i d a t e ( 6 ) C i t y C a n d i d a t e ( ? ) S c h o o l B o a r d o r O t h e rP o l i t i c a l S u b d i v i s i o n C a n d i d a t e ( 8 ) C o u n t y PAC ( 9 ) C i t y PAC ( 1 0 ) Sc h o o l B oa r d o r O t h e r P o l i t i c a lS u b d i v i s i o n PACE 1 1 ) L o r d B a l l o t I s s u eCANDI DATE COMMI TTEES ONLYC a n d i d a t e Name 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 )Thomas R i e l l y D e m o c r a t

O f f i c e S o u g h t D i s t r i c t ( i f S e n a t e o r H o u s e )S t a t e S e n a t e D i s t r i c t 3 8

( o g I - ( 0 7 3 - ( 0 7g?SI GNAVURE OF PERSON FI L I NGi REPORTAMF I L I N G A O c t o b e r 2 9 , 2 0 0 4

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

OCHECK I F AMENDMENT TO REPORT DATED

, - . t , _REPORT FOR ( 1 ) 1 1I T- , tOCT 29 2004i n q

C h 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 a n d a t t a o u t o n o r m D R- 3 .( Y o u m u s 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 D R - 3 i s f i l e d . )

R i t t " a r ~ i

STATEMENT OF CASH ON HAND

y #

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 o t a l o f a l l f u n d s h e l d b y t h ec o mm i t t e e T h i s a m o u n t MUST b e t h e s a m e a s t h e c a s h o n h a n d a t t h e e n 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 m u s 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 . ) . . . . . . . . . . . . . . . . . . . . . . . $ADD TOTAL MONEY TAKEN I N T HI S PERI ODS c h e d u l e A C a s 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 S c h e d u l e A ) ( ` a l s o s e e i n - k i n d b e l o w ) . . . . . . .S c h e d u l e F : L o a n s R e c e i v e d t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e H T o t a l S a l e s o f C a mp a i g n P r o p e r t y ( A t t a c h S c h e d u l e H ) . . . . . . . . . . . . . . . . . . . .

( S c h e d u l e H a p p l i e s t o C a n d i d a t e s ` C o mm i t t e e s O n l y )SUB- TOTAL . . . . $

SUBTRACT TOTAL MONEY SPENT T H I S PERI ODS c h e d u l e B E x p e n d i t u r e s t o t a l ( A t t a c h S c h e d u l e B ) ( " a l s o s e e d e b t s a n d l o a n s b e l o w ) . . . .S c h e d u l e F L o a n R e p a y m e n t s t o t a l ( A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CASH ON HAND a t t h e e n 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 a l a n c e m u s tb e z e r o ) ( A t t a c h DR - 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* * U N P A I D B I L L S ( F r o m S c h e d u l e D - A t t a c h S c h e d u l e D ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $' I N K I ND CONTRI BUTI ONS ( F r o m S c h e d u l e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $- OUTSTANDI NG LOANS ( F r o m S c h e d u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI TTEES ONLYCONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? )VALUE OF CAMPAI GN PROPERTY ( F r o m S c h e d u l e H - A t t a c h S c h e d u l e H ) $

2 ' d B9T T- ZL9 - Tt , 9 F ,, I s j n a T 1 TC

FORMDR- 2 DI SCLOSURE( R e v 0 7 1 2 0 0 4 ) REPORT

c omm 4L o g g e d I nS c a n n e dC o mp u t e rA u d i t e dL a t e r e p o r t s a r e s u b j e c t t op o s s i b l e c i v i l a n d c r i m i n a lp e n a l t i e s .

10- 09 - 6DATE SI GNEDON 1 ( 2 ) N O N - E L E C T I O N YEAR

L o c a l C o m m i t t e e s , e n t e r Da t e o f E l e c t i o nC o u n t y S L o c a l C o m m i 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

9 , 8 5 6 . 1 1

1 1 2 , 7 9 2.00 0

1 2 2 , 6 4 8 . 1 11 0 7 , 8 5 0 - 1 4

1 4 , 7 9 7 . 9 7

3 2 - 5 9 2 . 1 1

YE S 1 7 6 / NO

c l T t , : ZO ~ 0 Be 4


2/13

Fo r I n s t r u c t i o n s , Se e Back o f For mCONTRI BUTI ONS - MONEYTAKEN 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 )COMMI TTEENAME ( Mu s t b e s ame a s on S t a t e me n t o f O r g a n i z a t i o n )Ri e l l y f o r S en a t e

STATE CANDI DATES NOTE_ I F A CONTRI BUT I ON I S RECEI VED FROMASTATE PAC( P OL I T I CA L ACTI ON COMMI TTEE) , L I ST THE PACI DENT I F I CATI ONNUMBERANDTHEPACCHECKNUMBER I N THE DESI GNATED COLUMN. A L I S T OF 1 0 NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUT I ON : Se c t i o n 6 8 B _ 3 2 A ( 6 ) , I o wa Cod e , p r o h i b i t s t h e us e o f i n f o r ma t i on c o p i e d f r o m r e p or t s and s t a t e me n t s f o r s o l i c i t i n g c on t r i b u t i o ns o rf o r a n y c o mme r c i a l p u r p o s e b y an y p e r s o n o t h e r t h an 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- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h e du l 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 a n y r e l a t i v e ma k i n g a o on l n b u f m t o t h ec o mmi t t e e . R e l a t i o n s h i p mu s 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 d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s b y 1 - 7ma r r i a g e ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s a m e a s c a n d i d a t e , b u t t h er e i s n o Pag e- __f a m i 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 u mn . ( f o r Sc h e du l e A)

6 - o f 69I I - ZL9- I - I F 9 R , >( s j n a I I TC d I ~ ' : ZO t > ' 0 6Z 4

SCHEDULEA MONETARY( R ev , 0 7 10 3 ) RECEI PTSQCHECKT HI S BOX I FAMENDI NGFORM

DATE PACI DNUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MM/ DD/ Y R) AND PACCHECK ( i f a p p l i c a b l e ) RAI SENUMBER I NCOMI D# I o wa De mo c r a t i c P a r t y - Se n a t e Tr uman Fund1 0 / 1 8 / 0 4 CK# 5 6 6 1 F l e u r Dr 6 3 , 0 0 0 . 0 06 4 4 1 De s Mo i n e s , l i t 5 0 3 2 1I D # 6 0 4 6 J u s t i c e f o r A l l1 0 / 1 8 / 0 4 CK# 2 1 8 6 t h Av e Su i t e 5 2 6 ` , 0 0 0 ' 0 0 1 =3 9 0 9 De s Mo i n e s , I A 5 0 3 0 9 - 4 0 9 1I D# 6 0 7 0 I o wa L a w PAC1 0 / 1 8 / 0 4 CK# 5 2 1 E a s t L o c u s t S t . FL 3 r d 5 0 0 . 0 03 1 1 7 De s Moi nes I A 5 0 3 0 9 - 1 9 3 9I D# He a t h e r Bombe i1 0 / 1 8 / 0 4 CK# 1 8 8 2 4 Z e p h y r Av e 1 0 0 . 0 0

De l t a , I A 5 2 5 5 0t 0 # J a n e n e Chan Power s1 0 / 1 8 / 0 4 CK# 1 4 5 6WBy r o n St 5 0 , 0 0C h i c a g o , I L 6 06 1 3 - 2 8 2 8I D # Un i t e mi z e d Con t r i b u t i o n s1 0 / 1 8 / 0 4 CK# 1 8 5 . 0 0I D# J u l i e Gr ot ewol d

1 0 / 1 8 / 0 4 CK# 8 0 7 H i g 1 T Ave E 1 0 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7I D# Do n a l dKCa mp b e l l1 0 / 1 8 / 0 4 CK# 1 60 9 S Pa r kAve 3 5 . 0 0

Os k a l o os a , I A 5 2 5 7 7I D# Ne a t Hadden1 0 / 1 8 / 0 4 CK# 8 07 Woodl and Rd 5 0 . 0 0Os k a l o o 1 A 5 2 5 7 7I D# 6 2 9 4 I o wa Ci t y Ca r p e n t e r s PAC1 0 / 2 0 / 0 4 CK# 7 05 S C l i n t o n S t 2 00 . 0 01 1 7 3 I o wa C i t y , 1 A 5 2 2 4 0


3/13

F o r I n s t r u c t i o n s , Se e Ba c k o f F o 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 )COMMI T TEENAME ( Mu s t b e s ame as o n St a t emen t o f O r g a n i z a t i o n )R i e l l y f o r S e n a t e

STATECANDI DATES NOTE : I F A CONTRI BUTI ON I S RECE I VED FROMA STATE PAC ( P OL I T I C A L ACT I ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ONNUMBER AND THEPAC CHECK NUMBER I N THE DESI GNATEDCOLUMN . A L I S T OF I D NUMBERS I S AVAI LABLEFROMTHE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON : Se ct i o n 68B. 3 2 A ( 6 ) , I o wa Code , p r o h i b i t s t h e us e o f i n f o r ma t i o n c op i e d f r o m r e p o r t s and s t a t e me 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 ns o rf o r an y c omme r c i a l p u r p o s e b y a ny p er s o n o t h er t h an 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- TOTALTOTAL ( i f l a s t p a g e o f T h i s s c h e du l 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 ommi 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 a n y r e l a t i v e mak 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 gr 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 ) a n d a f f i n i t y ( r e l a t i v e s b y 2ma r r i a g e ) . I f s umame o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h er e i s n o Page ---o f -f a m i 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 o o l u mn . ( f o r Sc h e d u l e A)

~ , ' o l B9TT - ZL9 - 1 ~ 1 9 R ,> ( s j nU 1 1 i C d T i , : z 0 - 1 , 0 GZ 4

SCHEDULEA MONETARY( Re v . 0 7 1 0 3 ) RECEI PTS

CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT 4 I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-(M"I ") AND PAC CHECK C t f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# 6 0 4 6 J u s t i c e f o r A l l PAC $1 0 / 2 0 / 0 4 CK# 2 1 8 6 t h Av e S t e 5 2 6 2 , 5 0 0 . 0 03 9 2 3 De s Mo i n e s , I A 5 0 3 0 9I D # Wap el l o Co u n t y D e mo c r a t i c C e n t r a l Commi t t e e1 0 / 2 0 1 0 4 CK# 2 0 0 ' 0 00 8 8 7 Ot t umwa , I A 5 2 5 0 1I D#

S a n d r a DS a n d e r s1 0 / 2 0 / 0 4 CK# 2 3 8 2 P l y mo u t h Av e 5 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7I D# Ma r i e War e1 0 / 2 0 / 0 4 CK# 2 1 6 T e r r a c e Dr 5 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7l D# Da v i d F o u b e r t1 0 / 2 0 / 0 4 CK# 2 1 5 0 3 1 0 t h S t 1 0 0 . 0 0N o r t h E n g l i s h , I A 5 2 3 1 6I D # I o wa D e mo c r a t i c P a r t y - S t a t e Ac c o u n t1 0 / 2 1 1 0 4 CK# 5 6 6 1 F l e u r Dr 2 8 , 5 0 0 . 0 01 7 8 4 , 9 De s . Mo i n e s , I A 5 0 3 2 1I D # H a r o l d H e s l i n g a

1 0 / 2 1 / 0 4 CK# 5 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7I D # L a r r y An d er s o n1 0 / 2 1 / 0 4 CK# 2 1 4 C a l d w e l l P l a c e 5 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7I D # Mi k e Vo r e1 0 1 2 1 / 0 4 CK# 2 4 1 1 Mc Mu l l i n Dr 3 0 0 . 0 0Os k a l o o s i A 5 2 5 7 7I D # P a t B u r k e1 0 / 2 1 / 0 4 CK# 1 3 0 1 Edmunds- o n Dr 1 0 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7


4/13

Fo r I n s t r u c t i o n s , Se e Ba c k o f F o r mCONTRI BUTI ONS - - MONEYTAKEN 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 )COMMI TTEE NAME ( Mu s t h e s ame a s o n St a t eme n t o f Or g an i z a t i o n )

R i e l l y f o r Se n a t e

SCHEDULEA MONETARY( Re v . 0 7 / 0 3 ) RECEI PTSa CHECK T HI S BOX I FAMENDI NGFORMSTATECANDI DATES NOTE: I F ACONTRI BUT I ON I S RECEI VED FROMA STATE PAC ( P OL I T I CA L ACT I ON COMMI T TEE ) , L I S T THEPAC I DENT I F I CAT I ONNUMBER ANDTHEPACCHECKNUMBER I N THEDESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CS ANDCAMPAI GNDI SCLOSURE BOARD.CAUT I 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 o p i e d f r o m r e p o r t s an d s t a t e m e 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 rf o r an y c o mme r c i a l p u r p o s e b y an 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 ommi t t e es .

' 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 m m i 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 a n y r e l a t i v e m a k i n g a c o n t r i b u t i o n t o t h ec o m m i t t e e . R e l a t i o n s h i p m u s 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 ) a n d a f f i n i t y ( r e l a t i v e s b y 3 " 1m a r r i a g e ) . I f s uma r n e o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o Page _ o f __f a m i l i a l r e l a t i o n s h i p , e n t e r " n o t e p p t 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 u mn ( f o r S c h e d u l e A )

S' d 69TI - aL9- Ti s9

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e )

RAsi na T T i C l i t ' =ZO ~ 1 0 62 4

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE` RECEI VED FUND-( MM/ DDf YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI S ERNUMBER I NCOMI D# Wi l l i am V a nD e v e n d e r $1 0 / 2 1 / 0 4 CK# 1 0 0 6 May wood Dr 3 5 . 0 0Os k a l o o s a , I A 5 2 5 7 7I D# Da r a Di c k ey1 0 / 2 1 1 0 4 CK# 3 0 2 N. 9 t h 1 0 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7I D#

T e d Ov e r b e r g e n1 0 / 2 1 / 0 4 CK# 4 0 . 0 0Os k a l o o s a , TA 5 2 5 7 7I D# Ma t t h ew Moor e1 0 / 2 1 / 0 4 CK# 1 1 8 No r t h Ma r k e t S t 1 0 0 . 0 0Os k a l o o s k , I A 5 2 5 7 7I D# Ma r y E R i e l l y1 0 1 21 / 0 4 CK# 2 00 8 So u t h I i t h St Mo t h e r 1 0 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7I D# Ro b e r t L y n n

I O/ 2 I J 0 4 CK# 1 1 0 6 Fo x Ru n Dr 5 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7I D# Ga r y Wa l k e r1 0 / 2 1 l 0 4 CK# 1 2 8 2 C Av e E 1 0 0 . 0 0Os k al o os a , I A 5 25 77I Q# Max S h i e l d s1 0 1 21 / 0 4 CK# 1 8 0 6 S I I t h St 4 0 . 0 0Os k a l o o s a , l A 5 2 5 7 7I D# J o h n Po t h o v e n1 0 / 2 1 / 0 4 CK# 3 Pa r k P l a c e 2 5 0 . 0 0O s k a l o o s a 1 A 5 2 5 7 7I D# N a n c y Sp r y1 0 1 21 / 0 4 CK# 4081s t AveE 5 0 . 0 0Os k a l o o s a , l A 5 2 5 7 7


5/13

Fo r I n s t r u c t i o n s , Se e Bac k o f F o 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 ( u n d s )COMMI TT EENAME ( Mu s t b e s ame a s o n S t a t e m e n t o f O r g a n i z a t i o n )

R i e l l y f o r Se n a t e

SCHEDULEA MONETARY( R e v . 0 7 1 0 3 ) RECEI PTS0 CHECK T HI S BOX I FAMENDI NG FORMSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROMA STATE PAC ( POL I T I CA L ACTI ON COMMI TTEE) , L I S T THE PAC I DENT I F I CA TI ONNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATEDCOLUMN . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA ETHI CSAND CAMPAI GNDI SCLOSURE BOARD.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 o p i e d f r o m r e p o r t s an d s t a t e m e 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 rf o r an y commer c i a l p u r p o s e b y an 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 ommi t t e es .

SUB- TOTALTOTAL ( i f l a s t p a g e o f t h i s s c h ed u l 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 a n 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 m u s t b e s h o wn 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 ) a n d a f f i n i t y ( r e l a t i v e s b y e 4 ' 7m a r r i a g e ) . I f s u ma r n e o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o Page _ o f _f a m i 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 u mn . ( f o r S c h e d u l e A )

9- d 6911- ZL9 - T119 R , , I s j na TTTC d Tt ' : ZO t ' O 62 4

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE` RECEI VED FUND}( MM/ DDI YR) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# Da v i d Ahmad $1 0 / 2 1 / 0 4 CK# POB o x 6 5 1 0 0 . 0 0

Os ka l o o s a , I A 5 2 5 7 7I D# Un i t e mi z e d Co n t r i b u t i o n s1 0 / 2 1 / 0 4 CK# 3 3 0 . 0 0I D# T h e r e s a Gr ahek1 0 / 2 1 1 0 4 CK# 1 6 0 5 AAv e E 5 0 . 0 0Os k a l o o I A 5 2 5 7 7I D# L o r i Oaks1 0 / 2 1 / 0 4 CK# 1 9 0 9 Edmu n d s o n Dr 5 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7I D# L i n d a Y at e s1 0 / 2 1 / 0 4 CK# 2 0 3 NWes t St 2 0 0 . 0 0S i g o t n T l e y , I A 5 2 5 9 1I DN Br an d on St o ne1 0 / 2 1 / 0 4 CK# 1 1 3 I / 2 Hi g b Av eW 4 0 . 0 0O s k a l o o s a , I A 5 2 5 7 7l p # D a n i e l l e Rouw1 0 / 2 1 / 0 4 CK# 3 1 0 So u t b 9 t h S t 1 0 0 . 0 0O s k a l o o s a , I A 5 2 5 7 7I D# James Z i mmer man1 0 / 2 1 / 0 4 _ CK# 1 1 0 Hi g h Av eWS u i t e 3 A 1 0 0 . 0 0O s k a l o o s a , I A 5 2 5 7 7I D# Un i t e mi z e d Co n t r i b u t i o n s1 0 / 2 2 / 0 4 CK# 1 6 2 . 0 0

aI D# A r l e n e Wi ed man n

1 0 / 2 2 / 0 4 CK# 3 1 2 Keomah V i l l a g e 4 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7


6/13

Fo r I n s t r u c t i on s , Se e Back o f Fo r mCONTRI BUTI ONS - MONEYTAKEN 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 )COMMI TTEENAME ( Mu s t be same 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 )Ri e l l y f o r Se n a t e

STATE CANDI DATES NOTE : I F ACONTRI BUTI ON I S RECEI VED FROM ASTATEPAC ( P OL I T I CA L ACTI ON COMMI TTEE) , L I ST THE PAC I DE NT I F I CA TI ONNUMBER ANDTHEPAC CHECKNUMBER I N THE DESI GNATEDCOLUMN. A L I ST OF I D NUMBERS I S AVAI LABLEFROMTHE I OWA ETHI CSAND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se 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 se o f i n f o r ma t i on c o p i e d f r o m r e p or t s an 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 rf o r a n y c o mme r c i a l p u r p o s e b y an y p e r s o n o t h e r t h an s t a t u t o r y p o l i t i c a l c o mmi t t e es .

' 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 es 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 a n 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 mu s 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 ) a n d a f f i n i t y ( r e l a t i v e s b y 5ma r r i a g e ) - t f sumamo f c o n t r i b u t o r I s t h e s a m e a s c a n d i d a t e , b u t t h e r e i s n o P a g e-T- o ff a m i 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 pp l i c ab l e i n t h e r e l a t i o n s h i p c o l u mn . ( f o r Sc h e d u l e A)

1 , - d G9TT - ZL9- T t 19


SCHEDULEA I MONETARY( R ev . 0 7 1 0 3 ) RECEI PTS

C~ CHECK T HI S BOX I FAMENDI NGFORM

1 , 1 3 5 . 0 0

R, > ( s j n a 1I TC d l ~' : Z0 * ' 0 Gz 4

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT J I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DAT I E ` RECEI VED FUND-( MWDDI YR) ANDPACCHECK ( i f a p p l i c a b l e ) RA I SERNUMBER I NCO

I D# Wi l l i a m Y B e n s o n , J r $1 0 / 2 2 / 0 4 CK# 2 6 8 5 J e w e l / Av e 5 0 , 0 0O s k a l o o s a , 1 A 5 2 5 7 71 0 / 2 2 1 0 4

I D#CK#

Mi c h el l e Pi e r s o n2 2 9 5 i n d ep e n d en c e Ave 5 0 . 0 0 ElO s k a l o o s a , I A 5 2 5 7 7I D#Mah a s k a Co u n t y Democr at s1 0 1 2 2 1 0 4 CK# 3 0 0 . 0 01 9 3 Os k a l o os a , I A 5 2 5 7 7

I D# Tom Fi t z g er a l d1 0 1 2 2 / 4 4 CK# 6 5 8 4 5 t h St 1 7 5 . 0 0Des Mo i n e s , I A 5 0 3 1 2I D# Un i t e mi z e d Co n t r i b u t i o n s1 0 / 2 2 / 0 4 CK# 1 3 5 . 0 0I D# Mar y Ru f f r i d g e1 0 / 2 2 / 0 4 CK# 2 0 4 1 5 t h Av e E 1 0 0 . 0 0O s k a l o o s a , T A 5 2 5 7 7I D i t Un i t e mi z e d Co nt r i b u t i o ns1 0 / 2 6 / 0 4 CK# 1 5 0 . 0 0I D# J o s e p h Rya n1 0 / 2 6 / 0 4 CK# 3 0 1 4 t h Av e E 5 0 ' 0 0Os k a l o o s a , 1 A 5 2 5 7 7I D# Mar yAPa t t e r s o n1 0 / 2 6 / 0 4 CK# 1 0 4WGl e n da l e Rd 7 5 . 0 0Os k a l o o s l A 5 2 5 7 71 D# Ri c h a r d LBamar d

1 0 / 2 6 / 0 4 CK# 1 1 0 1 N 1 s t St . 5 0 . 0 0Os k a l o o s a , l A 5 2 5 7 7


7/13

Fo r I n s t r u c t i on s , Se e Back o f Fo r tCONTRI BUTI ONS - - MONEYTAKEN 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 )COMMI TTEE NAME ( Mu s t b e s ame a s on S t a t e me n t o f O r g a n i z a t i o n )R i e l l y f o r S e n a t e

STATE CANDI DATES NOTE : I F ACONTRI BUTI ON I S RECEI VED FROMASTATE PAC ( P OL I T I C A L ACT I ON COMMI TTEE) , L I S T THE PACI DENT I F I CATI ONNUMBERANDTHEPACCHECK NUMBER I N THE DESI GNATED COLUMN. A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GNDI SCLOSURE BOARD.CAUTI ON: Se c t i on 68B . 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 ma t i o n c o pl e d f r o m r e p or t s and 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 ns o rf o r an y c omme r c i a l p u r p o s e b y any p e r s o n o t h e r t h an 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 .


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 a n y r e l a t i v e ma k i n g a o on 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 mu s t b e s h o w n t o t h e t h i r d d e gr 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 ) a n d a f f i n i t y ( r e l a t i v e s b y 6ma r r i a g e ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s a m e a s c a n d i d a t e , b u t t h er e i s n o Page _ o f _ _f a m i 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 u mn . ( f o r Sc h e d u l e A)

B " d 6911-aL9- I i r 9 R>I s j n g 1 I TC c l e f s : Z0 * ' 0 6 2 4

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

DATE PAC I D NUMBER NAME ANDADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT - J I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( MM/ DDI YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMEI D# B a r b a r a A n n e Aszma n S t o n e $1 0 / 2 6 / 0 4 CK# 1 2 1 6 El m S t 5 0 . 0 0G r i n n e l l , I A 5 0 1 1 2I D# J a c k L i d b e t t e r1 0 / 2 6 / 0 4 CK4 W35 34 Wi l d wo o d Dr 5 0 0 . 0 0L a k e G e n e v a , WI 5 3 1 4 7I D #

J e r o me TN u s b a u m1 0 / 2 6 / 0 4 CK# 5 1 0 P a r k Av e Dr 1 0 0 . 0 0New S h a r o n , I A 5 0 2 0 7I D # R a n d a l L P l e i ma1 0 / 2 6 / 0 4 CK# 2 1 1 N9 t h S t 5 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7I D# P a u l S F o s t e r1 0 / 2 6 / 0 4 CK# 6 0 2N9 t h S t 1 0 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7I 8 0 2 6 I . B . E . W. E d u c a t i o n a l Commi t t e e1 0 / 2 6 / 0 4 CK# 1 1 2 5 1 5 t h S t NW 5 , 0 0 0 . 0 00 7 9 5 2 Wa s h i n g t o n DC 2 0 0 0 5I D # 6 0 7 0 I o wa LdwPAC1 0 / 2 6 / 0 4 CK# 5 2 1 E L o c u s t S t , F 1 3 r d 1 , 0 0 0 . 0 03 1 7 1 De s Mo i n e s , I A 5 0 3 0 9I D# i p ` 4 ` 7 4 4 S a c &Fo x T r i b e o f t h e M i s s i s s i p p i i n l o ws1 0 / 2 6 / 0 4 CK# 0 7 2 9 6 0 3 49 Me s k w a k i Road 3 , 0 0 0 . 0 0T a n i a , I A 5 23 3 9 9 6 34I D# ( P I j q I r o n Wor k e r s L o c a l # 6 7 PAC1 0 / 2 6 / 0 4 CK# 1 5 0 1 EA u r o r a Av e 1 , 0 0 0 . 0 05 7 5 De s Mo i n e s I A 5 0 3 1 3I D # 6 1 1 3 AFSCME/ TOWA C o u n c i l 6 1 - P e o p l e1 0 / 2 6 / 0 4 CK# 43 2 0NW2 n d Av e 5 0 0 . 0 00 0 3 0 3 4 De s Mo i n e s , TA 5 0 3 1 3


8/13

Fo r I n s t r u c t i o n s , Se e Back o f F o 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 on a l f u n d s )COMMI TT EE NAME ( Mu s t b e s ame as o n S t a t e me n t o f O r g a n i z a t i o n )

R i e l l y f o r S e na t eSTATE CANDI DATES NOTE : I F A CONTRI BUTI ON I S RECEI VED FROM A S TA TE PAC ( P O L I T I C A L ACTI ON C OMMI T T E E ) , L I S T T HE P AC I D EN T I F I C A T I ONNUMBER AND THE PAC CHECK NUMBER I N THE DESI GNATEDCOLUMN . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I OWA E T HI C SAND CAMPAI GNDI SCLOSURE BOARD.CAU T I ON . S e c t i o n 6 8 B . 3 2 A ( 6 ) , l o r e a C o d e , 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 o p i e d f r o m r e p o r t s a n d s t a t e m e 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 rf o r any c o mme r c i a l p u r p o s e b y an 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 ommi t t e e s .

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 mm i 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 a n y r e l a t i v e m a k i n g a c o n t r i b u t i o n t o t h ec o mm i t t e e . R e l a t i o n s h i p m u s t b e s h o r 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 ) a n d a f f i n i t y ! r e l a t i v e s b y 7 7m a r r i a g e ) . I f s u r n a me o f c o n t r i b u t o r i s t h e s ame a s c a n d i d a t e , b u t t h e r e i s n o Pa ge---o f --f a m i 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 u mn . ( f o r S c h e d u l e A )

s - d G9T T- z L9- T t l 9

SUB- TOTAL 2 0 0 . 0 0TOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e ) $ 1 1 2 , 7 9 2 . 0 0

R > ( s j na T T T C d ai r " ZO - 0 GZ 4

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECE I PTSCHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I DNUM13ER NAME ANDADDRESS OF CONTR I BUTOR RELAT I ONSH I P AMOUNT J I F FORECE I VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUNL-( MMl DDI YR ) AND PAC CHECK ( i f a p p l i c a b l e ) RAI SERNUMBER I NCOMI D# Da r y l Be a l l1 0 / 2 6 / 0 4 1 9 2 8 N2 2 n d S t 2 0 0 . 0 0CK# F or t Do d g e , TA 5 0 5 0 1I D#CK#I D#CK#I D#CK#l D#CK#I D#CK#t D#CK#I D#CK#I D#CK#I D#CK#


9/13

THI S BOXAPPLI ESTOCANDI DATES' COMMI TTEES ONLY :Pu r c h a s e s o f c e r t a i n c a mp a i g n p r o p e r t y c o s t i n g $ 5 00 o r mo r e mus t a l s o b e i n v e n t o r i e d o n Sc h e d u l e H. ( R e f e r t o Sc h e d u l e H i n s t r u c t i o n s . )E x pe nd i t u r e s t o p e r s o n s l 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 , ma n a g i n g , o r g a n i z i n g s e r v i c e s mus t a l s o b e d e t a i l i t e mi z e d o nSc h e d u l e Gb y t h e amo u n t , p u r p o s e , a n d d at e o f e a c h t y p e o f e x pe nd i t u r e mad e b y t h e p e r s o n l 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 o mmi t t e e . ( R e f e r t oSc h e d u l e Gi n s t r u c t i o n s a n d I o wa Cod e 68A. 4 0 2 ( 3 ) ( i ) . )

OT - d 6911 - aL9- T~, 9

( f o r Sc h e d u l e B)

F~s j nu T T t C d a i s : a 0 ~ , 0 6a 4

FOR I NSTRUCTI ONS, SEE BACK OF FORM I 1 . a a e i . F o ' r u t . , ~ SCHEDULEEXPENDI TURES B MONETARY- - MONEY SPENT FROM COMMI TTE E ACCOUNT ( Re v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FORCONTRI BUTI ONSMADE TO STATEWI DEOR LEGI SLATI V ECANDI DATES, L I ST THECANDI DATE I DENT I F I CATI ON NUMBER I N THE DESI GNATED COLUMN ANDTHE D CHECKTHI S BOXI FPACCHECK NUMBERFOREACH EXPENDI TURE . A L I ST OF I D NUMBERS I S AVA I LABL E FROMTHE I OWA AMENDI NGFORMETHI CS&CAMPAI GN DI SCLOSUREBOARD.COMMI TTEE NAME( Mu s t b e same 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 )R i e l l y f o r S e n a t e

CANDI DATE NAME AND ADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BETRANSACTI ON) EXPENDEDEXPENDED C r f a p p l i c a b l e ) ( Di s b u r s e me n t ) WASMADE( MM/ DD/ YR) ANDPACCHECKNUMBERI D# C r r i n n e l l H e r a l d R e g i s t e r A d v e r t i s i n g1 0 / 1 5 / 0 4 8 1 3 5 t h Av e 3 0 2 . 4 0CK# I 0 4 7 G r i n n e l l , I A 5 0 1 1 2I D# Oska l oosa H e r a l d A d v e r t i s i n g1 0 / 1 8 / 0 4 CK# 1 0 4 8 1 9 0 1 AAv eW 3 8 9 . 3 4Os k a l o o s a , I A 5 2 5 7 7I D# S e n a t e M a j o r i t y Fund C o n t r i b u t i o n t o S e n a t e M a j o r i t y Fund1 0 / 1 8 / 0 4 1 4 0 8 L o c u s t 5 , 0 0 0 . 0 0CK# 1 0 4 9 Des Mo i n e s , I A 5 0 3 0 9I D# LUC Me d i a Me d i a B u y s1 0 / 1 8 / 0 4 CK# 2 5 Wh i t l o c k P l a c e SW, S t e 2 0 1 6 3 , 0 0 0 _ 0 0Wi r e M a r i e t t a , GA 3 0 0 6 4I D# Mi dWe s t On e Ban k &T r u s t Wi r e f e e

1 0 / 1 8 / 0 4 CK# Wi r e f e e 1 2 4 So u t h I AS5 2 5 7 7 1 6 . 0 51 D# T r e a s u r e r , S t a t e o f I o wa S a l e s t a x o n r a f f l e p r o c e e d s t h r o u g h1 0 / 2 0 / 0 4 CK# L u c a s S t a t e O f f i c e B u i l d i n g 9 / 3 0 / 0 4 2 . 9 41 0 5 0 Des Mo i n e s , I A 5 0 3 1 9I D# S e n a t e M a j o r i t y Fund C o n t r i b u t i o n t o S e n a t e M a j o r i t y Fund1 0 / 2 0 / 0 4 CK# 1 4 0 8 L o c u s t 3 , 0 0 0 , 0 01 0 5 1 De s Mo i n e s , I A 5 0 3 0 9I D# G a r n e r P r i n t i n g Campa i g n p u b l i c a t i o n - P e o p l e 21 0 / 2 0 / 0 4 CK# 1 6 9 7 NE 5 3 r d Av e P e o p l e 1 , 4 2 5 . 0 01 0 5 2 Des Mo i n e s , I A

SUB- TOTAL $ 7 3 , 1 3 5 . 7 3TOTAL( i f l a s t page o 1 t h i s s c h e d u l e ) $


10/13

T HI S BOX APPL I ES TO CANDI DATES' COMMI TTEES ONLY :P u r c h a s e s o f c e r t a i n c a mp 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 mu s t a l s o b e i n v e n t o r i e d o n S c h e d u l e H _ ( R e f e r t o S c h e d u l e H i n s t r u c t i o n s . )E x p e n d i t u r e s t o p e r s o n s l e n t t t ' r 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 , ma n a g i n g , o r g a n i z i n g s e r v i c e s m u s t a l s o b e d e t a i l i t e mi z e d o nS c h e d u l e G b y t h e a mo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x p e 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 o mm i t t e e . ( R e f e r t oS c h e d u l e G I n s t r u c t i o n s a n d I o w a Code 6 8 AA 0 2 ( 3 ) ( i ) . )

T T ' d 6 9 Th - a L9 - Tb 9 F~s j n Q I I z r

Page _ 2 - - - o f-3( f o r S c h e d u l e B )

dab : a 0 b 0 6 a q

FOR I NSTRUCT I ONS, SEE aACK OFFORM I K Q S a I ) r r ; . SCHEDULEEXPENDI TURES B MONETARY- - MONEY SPENT FROM COMMI TTEE ACCOUNT ( R e v . 0 7 1 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : FORCONTRI BUTI ONSMADE TO STATEWI DEOR L EGI S L AT I V ECANDI DATES, L I S T THE CANDI DATE I DENT I F I CA T I ON NUMBER I N THE DESI GNATED COLUMNANDTHE D CHECK T HI S BOX I FPACCHECK NUMBER FOREACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVA I LABLE FROM THE I OWA AMENDI NGFORMETHI CS & CAMPAI GN DI SCLOSURE 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 )R i e l l y f o r S e n a t e

CANDI DATE NAME ANDADDRESS 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 ) ( D i s b u r s e me n t ) WAS MADE( MMI DDI YR) ANDPAC

CHECKNUMBER

( A r r o w Qu i c k S t i c k e r s f o r Pe o p l e t o Pe o p l e ma i l i n g1 0 / 2 1 / 0 4 CK# 1 0 5 3 1 2 1 Hi g h Av e E $ 1 0 7 . 8 6Os k a l o o s a , I A 5 2 5 7 7I D# Os k a l o o s a P o s t O f f i c e Po s t a g e f o r Pe o p l e t o Pe o p l e ma i l i n g

1 0 / 2 1 / 0 4 CK# 1 0 5 4 1 1 3 6 t h Av e E 2 , 9 6 0 . 0 0Os k a l o o s a , I A 5 2 5 7 7I D# LUC Me d i a Me d i a b u y s

1 0 21 / 0 4 2 5 Wh i t l o c k P l a c e : SW, S t e 2 0 1 3 1 , 0 0 0 . 0 0CK# Wi r e Ma r i e t t a , GA 3 0 0 6 4I D# I v i i d We s t On e Ba n k &T r u s t Wi r e f e e f o r me d i a b u y s1 0 / 2 1 / 0 4 CK# 1 2 4 So u t h I s t St 1 6 . 0 5V d i r e i r : c Os k a l o o s a , I A 5 2 5 7 7I D# C . B . L i q u o r Re f r e s h me n t s f o r wo r k e r s - Pe o p l e t o1 0 / 2 1 / 0 4 CK# 1 2 0 2 A Av e E Pe o p l e ma i l i n g 5 2 . 9 51 0 5 5 Os k a l o o s a , 1 A 5 2 5 7 7I D# Fa r e wa y Re f r e s h me n t s f o r wo r k e r s - Pe o p l e t o1 0 / 2 1 / 0 4 CK# 3 1 1 3 r d Av eW Pe o p l e ma i l i n g 1 9 . 0 71 0 5 6 Os k a l o o s a , I A 5 2 5 7 7I D# J o s h H e g g e n Re i mb u r s e f o r d e c o r a t i o n s f o r1 0 / 2 1 / 0 4 9 2 6 Ma i n S t c a mp a i g n e v e n t p a i d t o B a t e s 3 1 . 8 0CK# 1 0 5 7 G r i n n e l l , I A 5 0 1 1 2 Fl o we r s 1 0 1 2 Br o a d S t G r i n n e l l , T AI D# VOI D1 0 / 2 1 1 0 4 CK# 1 0 5 8

SUB- TOTAL $ 3 4 , 1 8 7 . 7 3TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) $


11/13

THI S BOXAPPLI ESTO CANDI DATES' COMMI TTEES ONLY:P ur c h a s e s o f c e r t a i n c a mp 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 Sc h e d u l e H. ( R e f e r t o Sc h e d ul e H i n s t r u c t i o n s . )E x pe n di 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 , ma n 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 nSc h e d u l e Gb y t h e amo u n t , p u r p o s e , a n d d a t e o f e a c h t y p e o f e x pe nd i t u r e made b y t h e p e r s o n l 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 at e ' s c o mmi t t e e . ( R e f e r t oSc h e d u l e G i n s t r u c t i o n s a n d I o wa Cod e 68A . 4 0 2 ( 3 ) ( i ) _ )

P a g e --3- - - o f - - 3 - 3

( f o r Sc h e d u l e B)

ZT , c l 1 3 9TT- ZL 9 - I t ' 9 R > I s j n a TI i C d Ei , : ZO t 0 GZ 4

FOR I NSTRUCTI ONS, SEEBACKOFFORM I t es 4 ' Dr m : SCHEDULEEXPENDI TURES B MONETARY- - MONEY SPENT FROMCOMMI TTEE ACCOUNT ( Re v . 0 7 1 0 3 ) EXPENDI TURES

STATEPAC COMMI TTEES : NOTE : FORCONTRI BUTI ONSMADE TO STATEWI DEOR LEGI SLATI V ECANDI DATES, L I S T THECANDI DATE I D ENT I F I CATI ON NUMBER I N THE DESI GNATED COLUMN ANDTHE CHECKTHI S BOXI FPACCHECKNUMBER FOREACH EXPENDI TURE_ A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA AMENDI NGFORMETHI CS & CAMPAI GN DI SCLOSURE BOARD.COMMI TTEE NAME ( Mu s t b e s ame a s on St a t e me n t o f Of g an i z a t i o n)R i e l l y f o r S e n a t e

CANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BETRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( MMJDDNR) ANDPACCHECKNUMBERI D# J o s h Heggen Re i mb u r s e f o r c amp a i g n d e c o r a t i o n s1 0 / 2 1 / 0 4 92 6 Ma i n S t p u r c h a s e d f r o mWa l ma r l 2 2 0 3 A 7 , 7 5CK# 1 0 5 9 G r i n n e l l , I A 50112 Av eWO s k a l o o s a , l A1 D# VOI D

1 0 / 2 2 / 0 4 CK# 1 0 6 0I D# VOI D1 0 , 1 2 2 / 0 4 CK# 1 0 6 1I D# -VOI D1 0 / 2 2 / 0 4 CK# 1 0 6 2I D# Tom R i e l l y Re i mb u r s e f o r c e l l p hon e c a l l s made

1 0 / 2 2 / 0 4 CK# 1 1 3 N o r t h Ma r k e t S t f o r c amp a i g n p u r p o s e s p a i d t o US 3 4 8 , 1 31 0 6 3 O s k a l o o s a , TA 5 2 5 7 7 C e l l u l a r O s k a l o o s a , I AI D# Tom R i e l l y Re i mb u r s e f o r p hon e &i n t e r n e t1 0 / 2 2 / 0 4 CK# 1 1 3 No r t h Ma r k e t S t s e r v i c e p a i d t o MCG 1 1 2 1 s l Av eW 1 7 0 . 8 01 0 6 4 O s k a l o o s a , I A 5 2 5 7 7 O s k a l o o s a , I AI D#CK#I D#CK#

SUB- TOTAL $ 5 2 6 . 6 8TOTAL ( i f l a s t page o f t h i s s c h ed u l e ) $ 1 0 7 , 8 5 0 . 1 4


12/13

FORI NSTRUCTI ONS, SEEBACK OF FORMCOMMI TTEE NAME ( Mu s t b e sa me a s o n St a t e me n t o f Or g a n i z a t i o n )

R i e l l y f o r S e n a t e

SUB- TOTAL / $

TOTAL Of l a s t $p a g e o f t h i ss c h ed u l e )

SCHEDULEE I I N K I ND( R e v _ 0 6 19 7 ) CONTRI BUTI ONS[ l CHECK T HI S BOX I FAMENDI NG FORM

2 4 , 1 0 8 . 7 2

' D i s c l o s u r e l a w r e q u i r e s c a nd i d at 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 a n y r e l a t i v e ma k i n g a n i n k i n d c o n t r i b u t i o n t o t h e P a g e I o f 2c o mmi t t e e . R e l a t i o n s h i p mu s t b e shown t o t h e t h i r d d e g r e e o f c on s an gu i n i t y ( b l o o d r e l a t i v e s ) a n d a f f i n i t y ( r e l a t i v e s ( f o r Sc h e d u l e E )b y ma r r i a g e) . ( Se e P a g e 2 o f f o r ms p a c k e t . ) I f s u r n a me o f c o n t r i b u t o r i s t h e s a m e a s c a n d i d a t e , b u t t h e r e i s n of a m i 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 u mn .

El ' d 6911 - ZL 9- I b9 R , ~ I s j n a I I t r d E* , ' ZO V0 6e 4

DATE RELATI ONSHI P DESCRI PTI ON ESTI MATED 4 I F FORRECEI VED NAME ANDADDRESS TO CANDI DATE OF I N K I ND F AI R MARKET FUND- RAI SERMM/ DDI YR OF CONTRI BUTOR ' ( i f a p p l i c a b l e ) CONTRI BUTI ON VALUE CONTRI BUTI ON

I o wa D e m o c r a t i c P a r t y S e n a t e M a j o r i t y me d i a p r o d u c t i o n 3 , 5 0 0 . 0 01 0 / 1 7 / 0 4 Fund 1 4 0 8 L o c u s t s e r v i c e sDe s Mo i n e s , I A 5 0 3 0 9I o wa D e m o c r a t i c P a r t y S e n a t e Ma j o r i t y f i e l d r e s e a r c h 4 , 0 0 0 . 0 01 0 / 1 9 / 0 4 Fund 1 4 0 8 L o c u s tDes Mo i n e s , I A 5 0 3 0 9I o wa D e m o c r a t i c P a r t y S e n a t e Ma j o r i t y me d i a p r o d u c t i o n 7 5 . 0 01 0 / 1 9 / 0 4 Fund 1 4 0 8 L o c u s t s e r v i c e sDe s Mo i n e s , I A 5 0 3 0 9I o wa D e m o c r a t i c P a t t y S e n a t e Ma j o r i t y ma i l d e s i g n & 4 , 9 1 2 . 1 61 0 / 1 9 / 0 4 F u n d 1 4 0 8 L o c u s t p r o d u c t i o nDes Mo i n e s , L A 5 0 3 0 9I o wa D e m o c r a t i c P a r t y S e n a t e M a j o r i t y p o s t a g e f o r m a i l 1 , 3 2 6 . 3 21 0 / 1 9 / 0 4 Fund 1 4 0 8 L o c u s t p r o d u c e dDes Mo i n e s , I A 5 0 3 0 9I o wa D e m o c r a t i c P a r t y S e n a t e Ma j o r i t y me d i a p r o d u c t i o n 3 1 5 . 0 01 0 / 2 0 / 0 4 Fund 1 4 0 8 L o c u s t s e r v i c e sDes Mo i n e s , I A 5 0 3 0 9I o wa D e m o c r a t i c P a r t y S e n a t e Ma j o r i t y m a i l d e s i g n & 5 , 2 7 1 _ 9 01 0 / 2 1 / 0 4 Fund 1 4 0 8 L o c u s t p r o d u c t i o nDes Mo i n e s , I A 5 0 3 0 9I o wa D e m o c r a t i c P a r t y S e n a t e Ma j o r i t y p o s t a g e f o r m a i l i n g 1 , 5 3 5 . 1 41 0 / 2 1 / 0 4 Fund 1 4 0 8 L o c u s tDes Mo i n e s , I A 5 0 3 0 9I o wa D e m o c r a t i c P a r t y S e n a t e M a j o r i t y p h o n i n g 1 , 7 8 4 . 2 01 0 / 2 2 / 0 4 Fund 1 4 0 8 L o c u s tDe s . Mo i n e s , I A 5 0 3 0 9I o wa D e m o c r a t i c P a r t y S e n a t e M a j o r i t y m a i l d e s i g n & 1 , 3 8 9 . 0 01 0 / 2 2 / 0 4 Fund 1 4 0 8 L o c u s t p r o d u c t i o nDes Mo i n e s , I A 5 0 3 0 9


13/13

FOR I NSTRUCTI ONS, SEE BACK OF FORMCOMMI TTEE NAME ( Mu s t b e s ame a s o n S t a t e me n t o f O r g a n i z a t i o n )

R i c l l y f o r S e n a t e :

SUB- TOTAL

TOTAL ( f f l a s tp a g e o f t h i ss c h e d u l e )

SCHEDULEE I I N K I ND( R e v . 0 6 1 9 7 ) CONTRI BUTI ONS

[ ] CHECK THI S BOX I FAMENDI NG FORM

' 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 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 a n y r e l a t i v e ma k i n g an i n k i n d c o n t r i b u t i o n t o t h e Page 2 o f 2c o mm i t t e e . R e l a t i o n s h i p mu s 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 ) a n d a f f i n i t y ( r e l a t i v e s ( f o r S c h e d u l e E )b y ma r r i a g e ) . ( S e e Page 2 o f f o r t e s p a c k e t _ ) 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 a s c a n d i d a t e , b u t t h e r e i s n of a m i 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 u mn .

DATERECEI VED( MMI DDf YR) NAME ANDADDRESSOF CONTRI BUTORRELATI ONSHI PTO CANDI DATE' ( i f a p p l i c a b l e

DESCRI PTI ONOF I N K I NDCONTRI BUTI ONESTI MATEDF AI R MARKETVALUE

I F FORFUND- RAI SERCONTRI BUTI ONI o wa Demo c r a t i c P a r t y Se n a t eF u n d 1 4 0 8MaoryL o c u s tDes Mo i n e s , I A 5 0 3 0 9 p o s t a g e f o r mai l i n g 1 , 5 1 3 . 2 6

1 0 / 2 4 / 0 4 I o wa Demo c r a t i c P a r t y Se n at e Maj o r i t yF u n d 1408 L o c u s tDe s Mo i n e s , I A 5 0 3 0 9me d i a p r o du c t i o ns e r v i c e s 29 4 . 0 0

1 0 / 2 5 / 0 4 I o wa Demo c r a t i c P a r t y Se nat e Maj o r i t yF u n d 1408 L o c u s tDes Mo i n e s , I A 5 0 3 0 9

p h on i n g 4 3 7 . 6 5

1 0 / 2 6 / 0 4 I o wa Demo c r a t i c P a r t y Se n a t e Maj o r i t yF u n d 1408 L o c u s tDes Mo i n e s , I A 5 0 3 0 9

ma i l d es i g n 8 cp r o d u c t i o n 4 , 9 1 2 . 1 6

1 0 / 2 6 / 0 4 I o wa Demo c r a t i c P a r t y Se n at e Maj o r i t yF u n d 1408 L o c u s tDe s Mo i n e s , I A 5 0 3 0 9p o s t ag e f o r mai l i n g 1 , 3 26 . 3 2

7 1

rielly thomas__1516__scanned

Documents

rielly thomas1516scanned