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F F Or i - LEE ANl J NDSON PHONE HO . : 5 1 5 2 3 . 3 2 2 4 1 Oc t . 2 3 2 0 0 4 0 2 : 2 4 PH

F o r I n s t r u c t i o n s , Se e B a 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 TTEE NAME ( M u s t b e same 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 )

S TA TE C ANDI D ATE SNUMBER ANDTH E P A CD I S C L O S U R E BOARD .

C ( 1 W1 n- . tf ` e e - TOTALSUBTOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e )

SCHEDULEA( R e v . D 7 r o a ) MONETARVr t c - C EI PT S0CHECK THI S BOX I FAMENDI NG FORM

TE : I F A CONTRI BUT I ON I S RECEI VED FROMA STATE PAC ( P OL I T I CA L ACTI ON COMMI TTEE) . L I S T THEPAC I DENTI F I CATI ONHECK NUMBER I N THE DESI GNATED COLUMN A L I S T OF t o NUMBERS I S AVA I LABLE FROM THE I OWA ETHI CS AND CAMPAI GN

CAUTI ON : Se ct i o n 68B . 3 2 A ( 6 ) , I o wa Co d e , 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 o d f r o m r e p o r t s a n 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 omme r c i a l p u r p o s 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 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 o l r c t 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 h v e , ma k i n g e c o n t r l b u t , 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 a n o w n t o t h e t h u 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 o t f i n i t y ( r e l a t i v e s b yma 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 at e . b u t ( h a r e i s n o p a g e 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 ed u l e A)

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR REL A T I O NSHI P AMOUNT J I F FORRECEI VED ( i f a p p l i c a b l e ) 70 CAND I 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 DA A ' ` 'YCK# I t o , 5 - - . $25`l o ( v S TNI D # D Y l , ~ ~ " a r Smt

/ 2 . 3 c K# y t 2l J ( t( ( o 56G Z ' 1_ ` ~A Sv ~ 1I D # ( p ~ - 1 , ~ , owJ . ~ 1 t . , r s " sf VI L 3 CK# ! 58 ~ I ~ 0 1 ~ 1 Z ' ' 6 s f - . ~ { ~ I d o_ t , ~ D V > 7 . ~z 7Odf o

lI I D ) t ~ D LOU Cm L

el l , ~ ~, ~~ C~ 1

1J F l - r A t - ~Jg. / / Uv c > v2s CK# j O55_ ( 1 ?o ' ~ uGU h r v n ' b C Z o o ~. - :D A

Z Tr C K # _ -=r1 2 ~ ~ -

I D #13g

~! v ~ ~ C L K T ~Z - 7 Ze>ZK #

AU i r ' l s t s - YA 'I D # U~ - ~CK# n ~ e r n ze c x ~ . s ~Q, c~p

I D #CK#I D #CK#I D #CK#

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FROPT : LEE ANUNDSON PHO^ I E HO . : 515 233 22 ,41 Oc t . 29 2004 02 : 2 5Pr l

THI S BOX APPLI ES TO CANDI 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 0 0 o r mo r e mus t a l s o h 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 p e n d i 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 mus t a l s o b e d e t a i l i t e m i z e d o nSc h e d u l e Gb y t h e a mo 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 n di t u r e mad e 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 nd 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 G i n s t r u c t i o n s a n d I o wa Cod e 6 1 3 A . 4 0 2 ( 3 ) ( i ) , )

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

v

FOR I NSTRUCTI ONS, SEEBACK OF FORM SCHEDULEEXPENDI TURES MONETARY- - MONEYSPENT FROM COMMI TTEEACCOUNT ( Re v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TT EES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI DATES, L I S T THE CANDI DATE I DENT I F I CAT I ON NUMBER I N THE DESI GNATED COLUMN ANDTHE DCHECK T HI S BOX I FPACCHECK NUMBER FOR EACH EXPENDI TURE. AL I ST OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA AMENDI NG FORMETHI CS & CAMPAI GN DI SCLOSURE BOARD.COMMI TTEE NAME ( Mu s t b e , e a s o n St a t e me n t o f Or g a n i z a t i o n)

C ( n I c ~ a r ; 7 t Z , a- - ~~ C f 7 t ,~CANDI DATE NAMEANDADDRESSTO WHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCRI BETRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( Di s b u r s e me n t ) WAS MADE( MM/ OD/ YR) ANDPACCHECKNUMBER

D#OU-43AXI 9 0- 4

cK# / 0 7 4, $ ~ r 7ID# ' p

) lw CK# , ~ ~ ~ 9 14q , s lI D #CK# l o 1 ~~5I D# , ~ I n I G f ( r t { , _ c . L S

"11 , 4 ) CK# ( 0 17I D# ~ ~ a P l ~ s D1 - dwn t Owh cCK# i v l S 1 1 N T i r ' ~ - ~. < ~ a . _z . . d l 0 7

I D I D # L Ul j ma A- t -~23 CK#1 D#f 0

l~~ ya ccCK# I iq~

I D# , l e rr D CK#

SUB- TOTAL $TOTAL ( i f l a s t page o f t h i s s c h e d u l e ) $ ~-

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FROM' : LEE AMUND. S ON PHONE I 1 0 . : 5 1 5 2 3 3 2 2 4 1 Oc t . 29 2 0 0 4 02 : 2 57 P 1

FOR I NSTRUCT I ON

THI 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 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 / 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 mu s t a l s o b e d e t a i l i t e m i 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 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 oS c h e d u l e G i n s t r u c ( i o r s s a n d I o w a Co d e 6 8 A. 4 0 2 ( 3 ) ( i ) . )

Pa g e _ _ - o f ___L

( f o r S c h e d u l e B )

S, SEEBACKOFFORM SCHEDUL EEXPENDI TURES " - MONEYSPENT FROM COMMI TTEE ACCOUNT 1 3 MONETARY

STATE PAC COMMI TTEES : NOTE : F OR CONTRI BUTI ONS MADE TO STATEWI DE OR L E GI S L AT I V E( R e v _ 0 7 ! 0 3 ) EXPENDI TURES

CANDI DATES, L I S T THE CANDI DATE I D E N T I F I C A T I O N NUMBER I N THE DESI GNATEDCOLUMN AND THE Ej CHECK T HI S BOXI FPAC CHECK NUMBER F OR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NG FORMET HI CS & CAMPAI GN DI SCLOSURE BOARD .COMMI TT NAME ( M u s t b e s am e o n St a t e me n t o f O r g a n i z a t i o n )

GANDI DAVE NAME ANDADDRESS TO WHOM 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 s me n t ) WAS MADE( MMI DD/ YR ) AND PAC' ~ CHECKd~OO NUMBERI D# x a -MA- i a s rCK# ~ c 1 ~ I t i t e s ZR $ ~ ~v ~w1D#c K# b a n k ~~ e~ 3r l ~I D#CK#I D#CK#1D#

C K#I D#CK#I D#CK#I D#CK#

SUB- TOTAL $ 257o Or 'TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) $~ / ~e ' a ~ t 4 I

; . I )

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UN 7 ) ~ . U 1 ) r r , s" = , r o c r 5 ~l ~ 1 I n ~ . r l{ 1

. _ C o ~ _ OVA ' , + p op - r - Wtaoc - " J u .