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(,UN RE,4 .~J r6LL
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Office Sought District (if Senate or House)
Coow7Y -S'
Late filed reports are subject to possible civil and criminal penalties .
SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :
I AM FILING A OGr 1:5 '-' D&'C 3 I REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR .
(report date) Indicate one
[]CHECK IF AMENDMENT TO REPORT DATED Local Committees, enter Date of Election
//-Z-oy-
County & Local Committees, enter County in
j~ Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . which Election is held
(You must continue to file reports until a Notice of Dissolution is filed.)
WAs//ING 7oiiJ
SUB-TOTAL..... $ Oo5 °~
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) ('"'also see debts and loans below) ... 6o s °°
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) ... ...... . .. .... . .. .. .. ..... .. .. ..... ......... .. ... $
CANDIDME COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?)
VAI 119 nF r.AYPAInW PPnPPIRTV Xmm Cnharlido W - Aftanh CMorlido Idl
FOR INMUCTIONS, SEE BACK OF FORM
I
SCHEDULE
e
COMMITTEE NAME (Must be same as on Statement of Organization)
r=6R 6p(PPVar7-clRdl~!,
CK#
ID#
CK#
ID#
CK#*.
ID#
CK#
Ip#
CK#'
ID#
CK#
SUB-TOTAL I $ Co
TOTAL (if fastpage of this schedule) $ 6 05 ;`
THIS 80X APPLIES TO CANDIDATES' COMMITTEES ONLY:
Purchases
of certain campaign property costing 6500 or more must also be inventoried on Schedule H. (Refer to Schedule H instructions .)
Expenditures to porsons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on
Schedule G by the amount, purpose, and data 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 6t3A.402(3)(i) .)
FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE I .
D INCURRED
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev. 08/98)1 INDEBTEDNESS
_ _
5T~0°ff~J !~1?rlt XorJ s~xeY'rA-e2.y of 5:)X' o
~Zf .
VorM X66/STrtAT/0VN
L /S 7'
I p ~2 o r.
la §ZL/W7A %1 4 .AA/6
F-PH&-n) oWA xu-J
SUB-TOTAL $
,-of-2
'If actual figure is unknown, show 'estimated' beside the figure. Page z
(for Schedule 0)
SUB-TOTAL $ 5- 15
'If actual figure is unknown, show "estimated" beside the figure. Page 2- of
(for Schedule D)