DR-2 DISCLOSURE

DISCLOSURE SUr '+IARY PAGE (Rev. 01199) REPORT

For office use onhr

COMMITTEE NAME (Must be same as on Statement of Organization) Comm . » 3 yD

NICHOLS FOR SENATE Indexed -
.t^.3
a
Audited ,
IMPORTANT: Indicate type of committee you are reporting for. Computer
( t )StatewKsrLegtslawe Candidate ( 2 )Statewide PAC 13 )State Party ( a )CountyA.ocal Candidate
(S )County PAC (6 )Ballot IssusVFranchise Commits ; 7 )County/City Central Cdmrnittes
(8) eof
563/244-0568 WK
d'~I l
,{ ,1 Z//- . :.r= 5631243__-0293 RES AUGUST 9 . 2002
SIGNATURE OF TREASURER (or person filing this ropoM TELEPHONE DATE SIGNED

Routine Penalties Due For Late Filed Reports Range from $20 to $800

SEE INSTRUCTIONS ON BACK AND COMPLETE THEFOLLOWING SENTENCE:

I AM FILING A DISSOLUTION ,jp p2-

(report date)

C]CHECK IF AMENDMENT TO REPORT DATED Local Cormtittees, enter Date of Electiort

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

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 d this is first report fled.) .................. .. ........ ................................................$ 52 .89

ADD TOTAL MONEY TAKEN IN THIS PERIOD

Schedule A: Cash Contributions total (Attach Schedule A) ................................................. --0__

Schedule F: Loans Received total (Attach Schedule F) ....................................................... --n-

Schedule H: Total Sales of Campaign Property (Attach Schedule H) .................................. --0--
(Schedule H apolies to Candidates' Committees Onlvt
SUB-TOTAL......$ 52 .89
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) . .. ....... ........ ........... ............... ............... 52 .89

Schedule F: Loan Repayments total (Attach Schedule F) ............ ............................ ..... .. .... 52 .89

CASH ON HAND at the end of this reporting period (if final report, balance must __
be zero) (Attach DR-3) . .. .. ... . .. . . . .. ... .. .. .. . ... .. .. ..... .. . . . ... ... . . ........ . ........................... ...................$ --0

UNPAID BILLS (From Schedule D - Attach Schedule D) .. .. .. .. . .. ............................ .......... .. ..........- .....$
IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .. .. .. .. ... .. .. .. .. .. . .. .. . .. .. .. ..... .. ........ .$ 2,947 .11

OUTSTANDING LOANS (From Schedule .;: - Attach Schedule F) .. .. .. .. . ........ .. .. .......... .. .. .. ............ .. . .S
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?) YES __Z_ NO

VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) S --0--,

 FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT B MONETARY

(Rev. 09/97) EXPENDITURES
STATE PAC COMMITTEES: NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE El 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)

NICHOLS FOR SENATE

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT

DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DDIYR) AND PAC
CHECK
NUMBER
07-31-02 ID# HIGHLAND B . NICHOLS PARTIAL LOAN REPAYMENT
1954 GLENDALE RD
CK# 1030 CLINTON IA 52732 $ 52 .89

ID#

CK#

I D#

CK#

I D#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

ID#

CK#

SUBTOTAL $

TOTAL (if last page of this schedule) $ 52 .89

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 personsientities 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 INSTRUCTIGN% SEE BACK OF FORM SCHEDULE

CO MNTTE! NAIL (mart a sarru as on S, mint of Orparrfa#cn) Rw.OQI>i

IN KIND
CONTRIBUTIONS
NICHOLS FOR SENATE

[] CHECK THIS BOX IF

AMENDING FORM

DATE - RELATIONSHIP DESCRIPTION ESTIMATED J IF FOR

RECENED NAME AND ADDRESS TO CANDIDATE OF IN KIND FAIR MARKET FUND-RAISER
(MMIDD/YR) OF CONTRIBUTOR ' (E aDp~cable) CONTRIBUTION VALUE CONTRIBUTION
07-31-02 HIGHLAND B . NICHOLS CANDIDATE LOAN FORGIVEN $2,947 .11

1954 GLENDALE RD

CLINTON IA 52732

SUB-TOTAL

TOTAL (it that

page of this
Schedule)

1 1
' Oisclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page of
cornnittae . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives (for Schedule E)
oy 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 .
 Sl:t1LUULL

COMMITTEE NAME(Must be same as on Statement of Organizabon) F LOANS

(Rev . 08/96) RECEIVED
NICHOLS FOR SENATE i REPAID

NOTE : This schedule reports money loaned to the committee which Is deposited In the committee account . [] CHECK THIS BOX IF
AMENDING FORM
TOTAL UNPAID LOANS FROM LAST REPORTING PERIODS 3,000-00

PART I - MONETARY LOANS RECEIVEDI 11 REPORTING PERIOD PART 11- MONETARY LOAN REPAYMENTS MADEIM REPORTING PERIOD
10nyrnal source of loan, such as a bank, must be shown it a third party is (Loans forgiven must be reported orr Schedule E -- In-Acrd Contributions 1
involved Include loans lion candidate's personal
DATE NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT DATE PAID NAME AND ADDRESS OF LENDER RELATIONSHIP AMOUNT
RECEIVED (Include Endorser's Name, If Applicable) TO CANDIDATE OF LOAN (MM/DD/YR) (Include Endorser's Name, If Applicable) TO CANDIDATE' REPAID
MMDD/YR It Applicable') If A licable
s 7-31-02 HIGHLAND B . NICHOLS $
CANDIDATE 52 .89
1954 GLENDALE RD
CLINTON IA 52732

.89
TOTAL (PART I) TOTAL CASH REPAYMENTS (PART H) $ 52

From Schedule E -- TOTAL LOANS FORGIVEN fi 2,947 .11

-0
TOTAL OUTSTANDING LOANS END OF REPORT PERIOD $

'Disclosure law requires candidate committees to disclose the relationship of any relative
making a contribution to the committee . Relationship must be shown to the third dsWss of
consanguinity (blood relatives) and affinity (relatives by marriage) . (Sea Page 2 of IOtlna
packet .) If surname of contributor Is the same as candidate, but there is no familial
relationship, enter 'not applicable" In the relationship column when It applies . Page_ of 1
(for Schedule F)
 FOR INSTRUCTIONS, SEE BACK OF FORM
FORM
This for
:* tit applcable to stattAa -olldcal committees .
DR-3
Notice of Dissolution NOTICE OF
DISSOLUTION

For Office Use OnIv

Every Notice of Dissolution shall be accompanied by a
completed Disclosure Report Forth current to the date of 3Ua
dissolution. Indexed
Atdilsd o -~
Computer
Cerdlisd Doe of Dissokttion
4-4
COMMITTEE NAVE

Official Name of Committee

NICHOLS FOR SENATE

Street
1954 GLENDALE RD ., PO BOX 1302
CLINTON IA 52732

City, State, Zip Code

Area Telephone
COde 563/244-0568

Effective date of dissolution:

AUGUST 9, 2002
Date Signed

THIS Box APPLIES TO CANDIDATES' COMMITTEES ONLY:

i, the candidate. ceNy that my candidate convnitlee's cash belance is zero, so debts, obligations and bans have been paid or satisfied in accordance
wM law as shown on my corrrnittee's final report and al campaign property and leftover funds have been distributed in accordance with my
committee's last Aled Statement of Orgwftetion.

WHEN TO FILE :
The Notice of Dissolution must be filed within thirty (30) days of the committee's dissolution, with a copy of the
final bank statement attached.