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OCT-19-2004 08 :53

DISCLOSURE SUMMARY PAGE

COMMITTEE NAME (Must

be same as on Statement of Organization)

SETU(Service Employees Int'1 Union)Local 199 COPE Fold

IMPORTANT : Indicate type of committee you are reporting for. 12

(1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party ( 4 )CountylLocal Candidate

(

(

5 )County PAC ( 6 )Ballot Issue/Franchise Committee (7 )Countylgity Central Committee

8 )Support Slate of Candidates

Accountant

SIGNATURE OF TREASURER (or person filing this report)

District (ifSenate or House)

(319)-341-0112

TELEPHONE

DR-2

(Rev . 05/20132)

P .02

DISCLOSURE

REPORT

10- 18= 2004

DATE SIGNED

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

SEE INSTRUCTIONS ON BACK AND COMPLETE THE FOLLOWING SENTENCE :

I AM FILING A

7/15/04-10/14/04

REPORT FOR AN/A (1) ELECTION /(2)NON-ELECTION YEAR_

(report date)

[JCHECK IF AMENDMENT TO REPORT DATED

[3 Check if this is final (termination) report and attach Notice of Dissolution Form DR-3 . (You must continue to file reports until a Notice of Dissolution is filed .)

Indicate one 71

Local Committees, enter Date of Election

County & local Committees, enter County in which Election is held

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 if this is first report filed
of the last reporting period, or must be zero if this is
first report filed .)
., .,
,
.
.
.
,
.$
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) ('also see in-kind below)
, -
,
Schedule
F : Loans Received total (Attach Schedule F)
.,
Schedule H : Total Sales of Campaign Property (Attach Schedule H)
(Schedule H applies to Candid tes' Committees Only)
SUB-TOTAL
S
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B : Expenditures total
(Attach Schedule B) ("'also see debts and loans below)
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)
$
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?)
VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H)
$

909 .2-1

.

3.i53.00

-r

4,055 .23

2 .424 .75

r

YES -x NO

OCT-19-2004

08 :54

FOR INSTRUC710NS, SEE BACK OF FORM

EXPENDITURES -- MONEY SPENT FROM COMMITTEE ACCOUNT

STATE PAC COMMITTEES : NOTE: FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE

CANDIDATES, LIST THE CANDIDATE

PAC CHECK NUMBER FOR EACH

ETHICS & CAMPAIGN DISCLOSURE BOARD .

IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE

EXPENDITURE . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA

COMMITTEE NAME (Must be some as on Statement of Organization)

SCHEDULE

P

. 03

B MONETARY

(Rev, 09191)

EXPENDITURES

CHECK THIS BOX IF AMENDING FORM

SEIU(Service Employees Int'l Union) Local 199 COPE Fund

 

CANDIDATE

NAME AND ADDRESS TO WHOM

DATE

ID NUMBER

EXPENDITURE

EXPENDED

(if applicable)

(Disbursement) WAS MADE

(MM/DD/YR)

AND PAC

CHECK

NUMBER

7/31/0,4 ID# CK# 1064

8/25/04 ID#

SEIU (Int'1 Office) Washington DC 20005

SEIU (Int'1 Office)

CK# 1065 Washington DC 20005

9/21/04 ID# CK# 1066

ID#

CK#

ID#

CK#

ID#

CK#

iD#

C K#

10#

C K#

SEIU (Int'l Office)

Washington DC 20005

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

PURPOSE (DESCRIBE TRANSACTION)

PURPOSE (DESCRIBE TRANSACTION)

AMOUNT

EXPENDED

Monthly

contribution

712 .50

Monthly

contribution

826 .75

Monthly

contribution

885 .50

SUB-TOTAL $

4 24

7.

TOTAL (if last page of this schedule) ~1

$

2_Zru_ rg

Purchases of certain campaign property costing $500 or more must also be inventoried on Schedule H . (Refer to Schedule H instructions.)

Expenditures to persons/entities providing Schedule G by the amount, purpose, and

Schedule G instructions and Iowa Code 58 .6(3)(1).)

consulting, advertising, fund-raising, polling, managing, organizing services must also be detail itemized on

date of each type of expenditure made by the person/entity on

behalf of the candidate's committee . (Refer to

Page

,_L

-

of

1

(for Schedule B)

OCT-19-2004 08 :54

For Instructions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Service Employees Int'l Union) Local 199 C PE Fund

SCHEDULE

A

(Rev . 06/97) I

P .04

MONETARY

RECEIPTS

CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION :

for any commercial purpose by any person other than statutory political committees .

Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or

DATE

RECEIVED

(MMIOD/YR1

PAC ID NUMBER (if applicable) AND "AG CHECK NUMBER

I NAME AND ADDRESS OF CONTRIBUTOR

RELATIONSHIP

TO CANDIDATE'

(if applicable)

AMOUNT

RECEIVED

J IF FOR FUND. RAISER INCOME

7/23/2004

Brian P Flaherty

 

Direct Deposit

1122 So Seventh Ave IC IA 52245

7/23/2004

Annd Gtritit=Arc~ier" -

-

 

Direct Deposit

1744 -115th St West Liber IA 52776

7/23/2004

Cathy Singer Glasson

 

Direct Deposit

1920 - 2nd Ave SE CR IA 52403

7/23/2004

Matt N Loeb

 

Direct Deposit

470 Hawaii Ct IC IA 52246

7/23/2004

-

David C Meggers

Direct Deposit

3371 Ozzie Drive NE Solon IA 52333

7/23/2004

Devin P Mehaffey

 

Direct Deposit

865 Camburn Ct SE CR IA 52403

7/23/2004

Kim R Miller

 

Direct Deposit

805 Spencer Dr IC IA 52246

7/23/2004

Douglas L Peters

 

Direct Deposit

70 E Chestnut NL IA 52317

712312004

Jennifer M Poland

 

Direct Deposit

2040 Glass Rd NE #101 CR IA 52402

7/2312004

Direct Deposit

Kirsten A Running 1210 Highland Ave IC IA 52240

JUD-Iv1^~

3 .00

5 .00

1

15 .00

2 .50

5 .00

2 .50

10 .00

2 .50

2,50

2 .50

TOTAL (if last page of this schedule)

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 degree of consanguinity (blood relatives) and affinity (relatives by marriage) (See Page 2 or loans packet .) . if surname of contrihutor is the same as candidate, but there is no

familial relationship, enter "not applicable" in the relationship column .

Psge

/

of

(for Schedule A)

OCT-19-2004 08 :55 For Instructions, See Back of Form

CONTRIBUTIONS -- MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Service Employees Int'l Union) Local 199 C PE Fund

P.05

SCHEDULE

A I MONETARY

RECEIPTS

(Rev . 06/97)

CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE ., IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LISTTHE PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION, Section 6BB .32A(6), Iowa Code, prohibits

the use of information copied from reports and statements for soliciting contributions or

for any commercial purpose by any person other than statutory political committees.

OAT"

RECEIVED

(MMIDD/YFi)

PAC ID NUMBER of applicable) AND "A(' CHECK fit IMFIER

I

I

NAME AND ADDRESS OF CONTRIBUTOR

RELATIONSHIP TO CANDIDATE - (if applicable)

AMOUNT

RECEIVED

4 IF FOR; FUND- RAISER INCOME

7/23/2004

Rita J Sterler

5 .00

 

Direct Deposit

2131 Plaen View Dr IC IA 52246

7/23/2004

-

SaraiI C - Swisner

40_00

Direct Deposit

917 Bowe St IC IA 52240

7/23/2004

Tawny L Wilson

7 .50

 

Direct Deposit

1110 Conklin St IC IA 52245

7130/2004

Russell A Clark (CR Sch)

5_00

 

102650

4045 Chickadee Ln Hiawatha IA 52233

`7/30/2004

Harless S Clemons (CR Sch)

10 .00

 

102650

505 Sixth St SE CR IA 52401

7/30/2004

Marshall R Clemons (CR Sch)

5_00

 

102650

505 Sixth St SE CR IA 52401

7/30/2004

Wm A Fiacco (CR Sch)

3.00

 

102650

4133 - 22nd Ave SW CR IA 52404

713012004

Jeff L Foster (CR Sch)

5.00

 

102650

3209 Tamara Dr SW CR IA 52404

7/30/2004

Ken D Grout (CR Sch)

2.00

 

102650

1037 Clifton St NE CR IA 52402

7130/2004

Gordon Kaltenbach (CR Sch)

6 .00

 

102650

227 - 11 th St N W CR IA 52405

TOTAL. (if last page of this schedule)

- Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the

committee

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 ielationship column .

Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by

Page

v ,

of

(fur Schedule A)

OCT-19-2004 08 " 55 For Instructions, See Back of Form

CONTRIBUTIONS -- MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Service Employees Intel Union) Local 199 C~PE Fund

JSCHEDULE

A

(Rev . 06/97) I

P .06

MONETARY

RECEIPTS

Q CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION . Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or for any commercial purpose by any person other than statutory political committees .

DATE

PAC ID NUMBER

RECEIVED

(if applicable)

(MM/DDIYfi1

AND '-'AC CHECK NUMBER

7/30/2004

 

102650

7/3012004

 

102650

7/3012004

 

102650

7/30/2004

 

102650

7/30/2004

 

102650

7/3012004

 

102650

7/30/2004

 

102650

7/30/2004

 

102651

7/30/2004

 

102651

7/30/2004

 

227681

NAME AND ADDRESS OF CONTRIBUTOR

TO CANDIDATE' I RECEIVED (H applicable)

RELATIONSHIP

AMOUNT

Joyce E Lucas (CR Sch)

1401 B Ave Vinton IA 52349

Dave L Mart (CR Sch)

926 - 15th Ave SW CR IA 52404

Chris McLees (CR Sch)

411 - 27th St NE CR IA 52402

Tim J Newcomb (CR Sch)

726 E Ave NW CR 1A 52405

Chas A Perry (CR Sch)

1479 Miami Dr NE CR IA 52402

AL J Pospisil (CR Sch)

1619 Arizona Ave NE CR IA 52402

Terry A Slickty (CR Sch)

1128 Brown Ave NE CR IA 52402

Lois J Bassett (CR Sch)

1002 Eastern Dr SE CR IA 52403

Stephanie J Lewis (CR Sch)

1601 - 30th St NW #12 CR IA 52405

Donald J Binegar Jr (IC Sch)

P O Box 373 N English IA 52316

J V v

, v

,

n

w

TOTAL (iflast page of this schedule)

4 .00

5.00

5.00

5 .00

10 .00

1 .00

2 .50

3 .00

5 .00

1 .50

J IF FOR FUND- RAISER INCOME

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 degree of consanguinity (blood relatives) and affinity (relatives by marriage) (See Page 2 of forms packet .) . If surnarne of contributor is the same as candidate, but there is no

familial relationship,

enter "not applicable" in the relationship column .

Page

(for Schedule A)

OCT-19-2004 08 :56 For Instructions, See Back of Form .

CONTRIBUTIONS -- MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Service Employees Int'1 Union) Local 199 COPE Fund

(SCHEDULE

I

(Rev . 06/97) I

A

P.07

MONETARY

RECEIPTS

CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE) . LIST THE PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION : Section 68B,32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or for any commercial purpose by any person other than statutory political committees .

DATE

RECEIVED

(MM/DDIYk)

PAC ID NUMBER (if applicable) AND "AC CHECK NUMBER

I NAME AND ADDRESS OF CONTRIBUTOR

RELATIONSHIP

I

TO CANDIDATE'

(if applicable)

7/30/2004

Kurth T Boyce (IC Sch)

 

227681

4876-120 St NE Solon IA 52333

7/30/2004

Ridhard'Hannan (IC Sch)

 

227681

P 0 Box 3281 Iowa City IA 52244

7/30/2004

John Hoard (IC Sch)

 

227681

Box 466 Hills IA 52235

7/30/2004

Ron Jensen (IC Sch)

 

227681

425-320th St W Liberty IA 52776

7/3012004

Brad

Kuester (IC Sch)

 

227681

2821 S Riverside Dr Iowa City IA 52246

7/30/2004

Jon Lalle (IC

Sch)

 

227681

601 Oakland Ave Iowa City IA 52240

7/30/2004

Brian J Meyer (IC Sch)

 

227681

16 Metric Road Iowa City IA 52240

7/30/2004

Michel Murphy (IC Sch)

 

227681

315 Ellis Ave #1 Iowa City IA 52246

7/3012004

Randy Nguyen (IC Sch)

 

227681

48 Amber Lane Iowa City IA 52240

7/30/2004

Michael O'Connor (IC Sch)

 

227681

290 Elm Ridge Drive North Liberty IA 52317

TOTAL (iflast page of this schedule)

' 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 degree of consanguinity (blood relatives) and affinity (relatives by

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.

page

AMOUNT

RECEIVED

1 .50

1 .50

1-25

1 .00

1 .50

2 .50

1 .50

2_60

1-50

1 .50

$ IlD 41-000)

J IF FOR FUND-

INCOME E

of (for Schedule A)

OCT-19-2004 08 :56 For Instructions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Service Employees Int'1 Union) Local 199 C~PE Fund

SCHEDULE

P .08

A

MONETARY

(Rev . 06/97)

RECEIPTS

CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE! IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL. ACTION COMMITTEE), LISTTHE PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION :

for any commercial purpose by any person other than statutory political committees .

Section 68B.32A(6), Iowa Code, prohibits the use of information copied from. reports and statements for soliciting contributions or

DATE

PAC ID NUMBER

NAME AND ADDRESS OF

CONTRIBUTOR

RELATIONSHIP

AMOUNT

J IF FOR

RECEIVED

(if applicable)

TO CANDIDATE'

RECEIVED

FUND-

(MMIDD/YR) AND "AC CHECK NUMBER

 

(if applicable)

RAISER INCOME

7130/2004

Rodney Perdue (IC Sch)

227681 603 W Paris St W Libert IA 52776

713012004 71

7/30/2004

7/30/2004

7/30/2004

7/3012004

7/30/2004

7/30/2004

7130/2004

7130/2004

227681

227681

227681

227681

227681

227681

1276086

1276086

1276086

- ' Wm Salasberry (IC Sch)

1119 Pine St Iowa City IA 52240

Kimberly Schlabach (IC Sch)

5272 Oakcrest Hill Rd Riverside IA 52246

Gerald Vonstein (IC Sch)

5048-210th St NE Solon IA 52333

Dale Weir (IC Sch)

2145 Palmer Circle Iowa Ci IA 52240

Jerome Wiedemeir

2506 Friendship St IC IA 52245

(IC Sch)

Daryl Lewis (IC Sch)

216 Dartmouth Iowa Cit IA 52245

Marsha Anderson (UIHC)

1975 So Ride Dr Coralville IA 52241

Sandra Anfinson (UIHC)

302 North Fourth St W Branch IA 52358

Matt Bahl (UIHC)

245 Hickory St N Liberty IA 52358

I

TOTAL (if last page of this schedule)

'Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the

committee

marriage) (See Page 2 of forma packet .) . If surriame of contributor is the same as candidate, but there is no familial relationship, enter "not applicable" in the relationship column .

Relationship must be shown to the third degree of Consanguinity (blood relatives) and affinity (relatives by

Page

2 .50

1 .50

1 .50

2,50

1-50

1 .50

5_00

5 .00

2.00

5.00

_

.

of (for Schedule A)

,.

^

OCT-19-2004 08 " 56 For Instructions, See Back of Form

CONTRIBUTIONS -- MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Service Employees I nt;'l Union) Local 199 CT PE Fund

SCHEDULE

A

(Rev . 06/97) I

P .09

MONETARY

RECEIPTS

CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION :

for any commercial purpose by any person other than statutory political committees .

Section 688,32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or

DATE

PAC ID NUMBER

NAME AND ADDRESS OF CONTRIBUTOR

RELATIONSHIP

AMOUNT

q IF FOR

RECEIVED

(if applicable)

TO CANDIDATE'

RECEIVED

FUND-

(MM/DDNR.)

AND "AC CHECK- NUMBER

(if applicable)

RAISER INCOME,

7/30/2004

Michelle Bargren (UIHC)

 

5-00

 

1276086

702 Hod e St North Liberty IA 52317

 

7/30/2004

'Janiob Sarries (UIHC)

 

5.00

 

1276086

1021 - 20th Ave CV IA 52241

 

7130/2004

Rachael Barrow (UIHC)

 

10 .00

 

1276086

3513 Dunham Dr SW CR IA 52404

 

7/30/2004

Deb Benfer (UIHC)

3 .00

 

1275086

1683 Hemin wa Lane IC IA 52240

 

7/30/2004

Deb Benner-Hahn

(UIHC)

5 .00

 

1276086

1232 E Colle e St IC IA 52245

 

7/30/2004

Martha Bradbuly (UIHC)

 

2.00

 

1276086

1116 W Ide Green Rd IC IA 52246

 

7/30/2004

Jana Burkholder (UIHC)

 

1 .00

 

1276086

604 Kimbedde St Tiffin IA 52340

 

7130/2004

Heide Bursch (UIHC)

5 .00

 

1276086

97 Oberlin IC IA 52245

 

713012004

Barry Buschelman (UIHC)

 

5 .00

 

1276086

780 Fairview Ln North Liberty IA 52317

 

7/30/2004

Ann Byrne (UIHC)

5 .00

 

1276086

1302 Oak St Buffalo IA 52728

 
 

i~tu ua

TOTAL (if last page of this schedule)

Disciosure law requires candidate committees to disclose the relationship of any relative making a contribution to the committee . Relationship mull be shown to tree third degree of consanguinity (blood relatives) and affinity (reletlvef by marriage) (See Page 2 of forms packet .) . I( surname of contributor is the same as candidate, but there is no familial relationship, enter "not applicable- in the relationship column .

pate

g

~

-- c~r_~~

lL/

, of

(for Schedule A)

OCT-19-2004 08 :57 For Instructions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SE IU(Ser v ice Empl

oye es Int'l Union) Local 199 C PE Fund

SCHEDULE

P .10

A

MONETARY

(Rev . 06/97)

RECEIPTS

CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE ; IF A CONTRIBUTION i$ RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF 10 NUMBERS IS AVAILABLE FROM THE IOWA ETMICS AND CAMPAIGN 0ISCLO$URE BOARD .

CAUTION : Section 68B .32A(B), Iowa Code . prohibits the use of information copied from reports and statements for soliciting contributions or for any commercial purpose by any person other than statutory political committees .

DATE

PAC ID NUMBER

NAME AND ADDRESS OF CONTRIBUTOR

RELATIONSHIP

AMOUNT

d IF FOR

RECEIVED

(if applicable)

TO CANDIDATE

RECEIVED

FUND-

(MM/DD/YR)

ANO .'-'AC CHECK

(if applirable)

RAISER

NUMBER

.,

INCOME

7/3012004

Marjie Caruth (UIHC)

 
 

1276086

801 Alpine Dr IC IA 52245

7/30/2004

Bev

CleahTian'(U1HC)

'

'

 

1276086

1007 Eighth St Coralville IA 52241

7/30/2004

Lynette Cooper (UIHC)

 
 

1276086

2401 Hwy 6 E #1210 IC IA 52240

7/30/2004

Julie Davis (UIHC)

 
 

1276086

337 Normandy Dr IC IA 52246

 

7/30/2004

Cathy Dostal (UIHC)

 
 

1276086

1985 South Ride Dr CV IA 52241

7/30/2004

Angela Duwa (UIHC)

 
 

1276086

2519 J Ave Williamsburg IA 52361

7130/2004

Carolyn Elliott (UIHC)

 
 

1276086

110 Florida Ave SW CR IA 52404

7/30/2004

Shelley Engman (UIHC)

 
 

1276086

717 Rundell St IC IA 52240

7130/2004

Elizabeth Fisher (UIHC)

 

1276086

1307 Carroll St IC IA 52240

7/30/2004

Anita

Fite (UIHC)

 

1276066

133 Hillside Dr Eldrid e IA 52748

1J~L'Jtl~/h

TOTAL (if last page of this schedule)

5 .00

5 .00

2 .50

5,00

2 .00

5 .00

10 .00

5 .00

2 .50

5 .00

/

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 degree of consanguinity (blood relatives) and affinity (relatives by 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 .

Page

_ of (for Schedule A)

OCT-19-2004 08 :57

For Instructions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Service Employees Int'l Union) Local 199 C PE Fund

P . 11

SCHEDULE

A I MONETARY

RECEIPTS

(Rev, 06197) I

CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE :

NUMBER AND THE

DISCLOSURE BOARD

IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION

PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN

CAUTION :

for any commercial purpose by any person other than

Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or

statutory political committees .

DATE

PAC ID NUMBER

NAME AND ADDRESS

OF CONTRIBUTOR

RECEIVED

(ifapplicable)

 

(MM/DD/Yk)

AND -AC

B

CHECK i

7/30/2004

Karlene Fuller (UIHC)

 

1276086

1611 -13th Street CV IA 52241

7130/2004

Cindy iiui'ik .(uiHC)

 

1276086

1231 Sandusk Ave IC IA 52240

7/30/2004

Joe Galbraith (UIHC)

 

1276086

3021 Raven St IC IA 52245

7130/2004

Nancy Genoar (UIHC)

 

1276086

1252 Coll Dr IC IA 52246

7130/2004

Trisha Godard Shepherd (UIHC)

 

1276086

930223rd Ave Apt C Coralville IA 52241

7130/2004

Lynda Green (UIHC)

 

1276086

2075 Melrose Ave IC IA 52246

7130/2004

Melissia Greiner (UIHC)

 

1276086

26436 - 305th Avenue Keota IA 52248

7/30/2004

Dan Grinstead (UIHC)

 

1276086

1218 Ash St IC IA 52240

7/3012004

Marcia Hahn (UIHC)

 

1276086

2281 Sugar Bottom Rd Solon IA 52333

7/30/2004

Terry Hamilton (UIHC)

 

1276086

715 N Van Buren St IC IA 52245

RELATIONSHIP

AMOUNT

J IF FOR

TO CANDIDATE'

RECEIVED

FUND-

(if applicable)

RAISER

INCOME

 

3.00

 

I

.

 

3 .00

10 .00

5 .00

2 .50

10 .00

5 .00

7 .50

5.00

3 .00

 

$5

,'III

TOTAL (if last page of this schedule)

- Disclosure law requires committee . Relationship

marriage) (See Page 2 of forms packet .) . Il surname of contributor is the same as candidate, bill there is no familial relationship, enter `not applicable- in the relationship column .

candidate committees to disclose the relationship of any relative making a contribution to the must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by

Page

of (for Schedule A)

OCT-19-2004 08 :58

For Instructions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Setvice Employees Int'1 Union) Local 199 C~PE Fund

 

P .12

SCHEDULE

A

MONETARY

(Rev, 06/97)

I

RECEIPTS

a CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN, A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD,

CAUTION : Section 69B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or for any commercial purpose by any person other than statutory political committees .

DATE

PAC ID NUMBER

NAME AND ADDRESS OF CONTRIBUTOR

RECEIVED

(if applicable)

(MM/DD/Yk)

AND "AC CHECK NUMBER

RELATIONSHIP

TO CANDIDATE'

(if applicable)

AMOUNT

RECEIVED

7/3012004

 

1275086

7/30/2004

 

1276086

7/30/2004

 

1276086

7/30/2004

 

1276086

7/30/2004

 

1276086

7/3012004

 

1276086

7/30/2004

 

1276086

7/30/2004

 

1276086

7/30/2004

 

1276086

713012004

 

1276086

Lynn

Hanke (UIHC)

5_00

1001 Memorial Dr SE CR IA 52403

Sarah Helle

(UIHC)

-

5 .00

1330 Upper Old H

6 Oxford IA 52322

Sharon Hicks (UIHC)

2 .00

2639 - 140th Street NW Swisher IA 52338

Melody Hobert-Mellecker (UIHC)

5 .00

300 Main St Hills IA 52235

Claire Hockley (UIHC)

7.50

2647 Newport Rd NE IC IA 52240

Deb Reynolds

Hubbard (UIHC)

3.00

1468 Valley View Drive CV IA 52241

Shelley Jacobus (UIHC)

1 .00

6507 Boxwood Ln NE CR IA 52402

Jennifer Jungen (UIHC)

5.00

P 0 Box 588 North Liberty IA 52317

Norman Kalvig (UIHC)

20_00

1945 Park Ave SE CR IA 52403

Valerie Keffala (UIHC)

5 .00

1109 Prairie DuChien Rd IC IA 52245

!~-rJt3-7 -p FA- L--

TOTAL (if last page of this schedule)

$

5S~

r

' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the committee . Relationship must be shown to the trllrd degree 0( Consanguinity (blood relatives) and affinity (relatives by marriage) (See Page 7 of forms packer .) . If surname of contributor 15 the same as candidate, but there is no

familial relationship,

enter "not applicable" in the relationship column .

Pace

9

of

(for ScFicdule A)

d IF FOR FUND- RAISER INCOME

OCT-19-2004 08 "58

For Instructions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as o» Statement of Organization)

SEIU(Service Employees Int'l Union) Local 199 C

PE Fund

P . 13

SCHEDULE

A ( MONETARY

RECEIPTS

(Rev. 06197)

CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION, Section 68B.32A(B), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or for any commercial purpose by any person other than statutory political committees .

DATE

RECEIVED

(MMIDDIYk)

PAC ID NUMBER (if applicable) AND -AC CHECK NUMBER

7/3012004

 

1276086

7/30/2004

 

1276086

7/3012004

 

1276086

7/30/2004

 

1276086

7/30/2004

 

1276086

7130/2004

 

1276086

7/30/2004

 

1276086

7/3012004

 

1276086

7130/2004

 

1276086

7130/2004

 

1276086

NAME AND ADDRESS OF CONTRIBUTOR

RELATIONSHIP T O CANDIDATE' (if applicable)

AMOUNT

RECEIVED

Teresa A Kingdon (UIHC)

2113 Norcor Ave Apt 4 CV IA 52241

Katherin Kitelnow (OIHC) '

'

'

-

3333 Pheasant Ct NE North Liberty IA 52317

Arlene Klesner (UIHC)

1901 Earl Road IC IA 52246

Amy Kruse (UIHC)

203 Fifth St #1 Coralville IA 52241

Linda Krutsinger (UIHC)

2147 Plaen View Dr IC IA 52246

Cynthia Larew (UIHC)

P 0 Box 441 Lone Tree IA 52755

Paula Laube (UIHC)

712 Walnut St IC IA 52240

Raelene Lenoch (UIHC)

213 Broadway St W Branch IA 52358

Luanne Link (UIHC)

2215 Hickory Court IC IA 52240

Michael Loucks (UIHC)

1495 Falcon Ave Swisher IA 52338

 

2.50

-

5.00

1 .00

5.00

10 .00

1,00

7 .50

1,00

5.00

5 .00

S

TOTAL (if last page of this schedule)

' Disclosure law requires candidate committees to disclose the relationship of any relative making a contribution to the

committee

marriage) (See Page 2 of forms packet .) . If surnarne of contributor is the same as candidate, but there is no familial relationship, enter "not applicable" in the relationship column .

Relationship mint be shown to the third degree of consanguinity (blood relatives) and affinity (relalives by

Page

of (for Schedule A)

J IF FOR FUND- RAISER INCOME

OCT-19-2004 08 :59

For Instructions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Service Employees Int'l Union) Local 199 C PE Fund

P. 14

SCHEDULE

A I MONETARY

RECEIPTS

(Rev, 06197)

© CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIvEO FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD

CAUTION : Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or for any commercial purpose by any person other than statutory political committees .

DATE

PAC ID NUMBER

NAME AND ADDRESS OF CONTRIBUTOR

RECEIVED

(if applicable)

(MMIDD1Yk)

AND "AC CHECK NUMBER

RELATIONSHIP

AMOUNT

J IF FOR

TO CANDIDATE - (if applicable)

RECEIVED

FUND- RAISER INCOME

7/30/2004

7/3012004

7/30/2004

7/3012004

7130/2004

7130/2004

713012004

7/30/2004

7/3012004

7/3012004

 

Wilma Macalalag (UIHC)

 

5 .00

1276086

828 Augusta Circle North Liberty IA 52317

 

June -Masbrth:;h

(UIH(;)

'

5_00

1276086

2387 - 340th St SW Tiffin IA 52340

 

Ann Mason (UIHC)

3 .00

1276086

1032 Oakcrest St IC IA 52246

 

Ruth McKeever (UIHC)

 

5 .00

1276086

302 Walnut St Ti ton IA 52772

 

Mary McKinney (UIHC)

 

3.00

1276086

506 West Seventh St Ti ton IA 52772

 

Mary Jo Meggers (UIHC)

 

5 .00

1276086

3371 Oaie Dr Solon IA 52333

 

Terri Mengler (UIHC)

7 .50

1276086

2215 Second St SW CR IA 52404

 

Jean Miller (UIHC)

5 .00

1275086

3755 Cottage Reserve Rd NE Solon IA 52333

 

Tara Miller (UIHC)

2 .50

1276086

333 Carter St NW CR IA 52405

 

Robert Milne (UIHC)

3,00

1276086

417 Carter St NW CR IA 52405

 

TOTAL, (if last page of this schedule)

Disclosure law requires candidate committees to disclose the relationship

committee . Relationship marriage) (See Page 2

familial relationship,

of any relative making a contribution to the

must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by

of forms packet .). If surname of contributor is the sarne as candidate, but there is no

enter "not applicable' in the relationship column .

Page

} I

of

(for Schedule A)

OCT-19-2004 08 :59 For Instructions, See Back of Form .

CONTRIBUTIONS - MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SETU(Service Employees Ynt'l Union) Local 199 C PE Fund

SCHEDULE

A

(Rev . 06197)

P .15

MONETARY

RECEIPTS

CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION COMMITTEE), LIST THE PAC IDENTIFICATION NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD.

CAUTION: Section 688 .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or for any commercial purpose by any person other than statutory political committees .

DATE

PAC ID NUMBER

NAME AND ADDRESS OF CONTRIBUTOR

RECEIVED

(if applicable)

(MMIDDIYR)

AND''AC CHECK NUMBER

RELATIONSHIP

AMOUNT

TO CANDIDATE

RECEIVED

(if applicable)

7/30/2004

Melinda Myers (UIHC)

 

1276086

1116 A Ave NW CR IA 52405

7/30/2004

Jan Niebes CPC)"

 

1276086

17274 -15th Ave Keystone IA 52249

7/30/2004

Linda Petersen (UIHC)

 

1276086

907 N Gilbert St IC IA 52.245

7/3012004

Margaret Mary Ping (UIHC)

 

1276085

110 Sar ert Dr West Branch IA 52358

7/30/2004

Becky Pottorff-Leaven (UIHC)

 

1276086

1149 Hunter's Run IC IA 52246

7/30/2004

Mary Reidy (UIHC)

 

1276086

2331 East Washington St IC IA 52245

7/30/2004

Jeffrey Rupe (UIHC)

 

1276086

P O Box 218 North Liberty IA 52317

7/30/2004

Nancy Sandstrom (UIHC)

 

1276086

60 David Lee Court North Liberty IA 52317

7/30/2004

Dorothy Satariano (UIHC)

 

1276086

3222 Shasta Ct NE CR IA 52402

713012004

Cheryl Schild (UIHC)

 

1276086

914 - 12th Ave CV IA 52241

:7VOw V W"L

TOTAL (iflast page of this schedule)

$~

20 .00

5 .00

2 .50

3 .00

5 .00

3 .00

3 .00

7 .50

3 .00

3 .00

Disclosure law requires candidate committees to disclose the relatlonship of any relative making a contribution to the commlttec . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by 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 .

Page

(for Schedule A)

q IF FOR FUNO- RAISER INCOME

OCT-19-2004 09 "00 For Instructions, See Back of Form

CONTRIBUTIONS -- MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Service Employees Int'l Union) Local 199 C PE Fund

SCHEDULE

P.16

A

~

MONETARY

(Rev . 06/97)

RECEIPTS

CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE : IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION

NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF 10 NUMBERS I$ AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN

DISCLOSURE BOARD.

COMMrFFEE), LIST THE PAC IDENTIFICATION

CAUTION : Section 6B8 .32A(6), Iowa Code, prohibits the use of information

for any commercial purpose by any person other than statutory political committees .

copied from reports and statements for soliciting contributions or

DATE

PAC ID NUMBER

RECEIVED

(if applicable)

(MM/DO/YR)

AND'-AC

CHECK

7/30/2004

NUMBER

NAME AND ADDRESS OF CONTRIBUTOR

Mary Schlichte (UIHC)

 

1276086

4490 Westover Rd SE CR IA 52403

7(30/2004

'Joyce SCKuitz (U1Hl:) '

 

1276086

13023 Radcliffe Avenue IC IA 52245

7/30/2004

Shanna Seigel

(UIHC)

 

1276086

2820 U Avenue Parnell IA 52325

7/30/2004

Jeanne

Sheetz (UIHC)

1276086 120 Tartan Or North Liberty IA 52317

713012004

Karen Shickell (UIHC)

 

1276086

827 Dover Street IC IA 52245

7/30/2004

Anthony Shrader (UIHC)

 

1276086

1560 - 7th Ave SE CR IA 52403

7/3012004

Vicki Siefers (UIHC)

 

1276086

15 Brown Deer Knoll CV IA 52241

7/30/2004

Pam Simons (UIHC)

 

1276086

1310 Franklin St IC IA 52240

7/30/2004

Terry

Simons (UIHC)

 

1276086

510 Kimberlite St Tiffin IA 52340

7/30/2004

Chris Slater (UIHC)

 

1276086

2760 Turkey Creek Ln NE IC IA 52240 .

RELATIONSHIP

O CANDIDATE'

(if applicable)

AMOUNT

RECEIVED

10_00

3.00

5 .00

5 .00

10 .00

5.00

3 .00

5 .00

5 .00

5 .00

J IF FOR FUND- RAISER INCOME

TOTAL (if fastpage of this schedule)

Disclosure law requires candidate committees to disclose the relationship of any relatlve making a contribution to the committee . Relationship must be shown to the third degree of consanguinity (blood relatives) and affinity (relatives by 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 .

Page ,

of (for Schedule A)

OCT-19-2004 09 :00 For Instructions, See Back of Form

CONTRIBUTIONS - MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Service Employees Int;'l Union) Local 199 C 1'E Fund

SCHEDULE

A

(Rev . 06/97)

P .17

CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE! IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICAL ACTION

NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD .

COMMITTEE), LIST THE PAC IDENTIFICATION

CAUTION : Section 68B .32A(6), Iowa Code, prohibits the use of information copied from reports and statements for soliciting contributions or for any commercial purpose by any person other than statutory political committees .

DATE

PAC ID NUMBER

NAME AND ADDRESS OF CONTRIBUTOR

RECEIVED

(if applicable)

(MM/DD/YR)

AND ''AC CHECK NUMBER

713012004

Mary

Stessman (UIHC)

 

1276086

3788 Sunaura Drive NE IC IA 52240

 

7/30/2004

.

.

Sue 5we&ihgen (UIHC) "

.

:

.

1276086 422 Melrose Ct IC IA 52246

7/30/2004

Wanda Thackery (UIHC)

 

1276086

604 First Ave So Mount Vernon IA 52314

7/3012004

Trisha Turnis

(UIHC)

 

1276086

4519 Walker St NE CR IA 52402

7/30/2004

Diane Van Ersvelde (UIHC)

 

1276086

3051 Meadow Rd NE North Libel IA 52317

7/30/2004

Jo Vonderhaar (UIHC)

 

1276086

1023 Marc Street IC IA 52240

7/30/2004

Angela Wernke Trenkamp (UIHC)

 

1276086

361 Camden Rd IC IA 52245

7/3012004

Patsy Wheeler (UIHC)

 

1276086

2761 Rhine Creek Way NW Oxford IA 52322

713012004

Sherry Whetstone (UIHC)

 

1276086

110 Swisher View Dr SW Swisher IA 52338

7/30/2004

Pat Wolf (UIHC)

 

1276086

1409 Western College CR IA 52404

RELATIONSHIP

AMOUNT

TO CANDIDATE'

RECEIVED

(if applicable)

 

1 .00

5 .00

1_00

5 .00

1 .00

3 .00

10,00

7.50

5 .00

1 .00

JUD-IV1/1L

i

I"

 

c `~l

TOTAL (if last page of this schedule)

' 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 degree of consanguinity (blood relatives) and affinity (relatives by marriage) (See Page 2 of lorms packet,) If surname of contributor is the same as candidate, but there is no

familial relationship, enter "not applicable" in the relationship column .

Page

of (for Schedule A)

,I IF FOR FUND- RAISER INCOME

OCT-19-2004 09 :01

For Instructions, See Back of Form

CONTRIBUTIONS -- MONEY TAKEN IN

(Including candidate's personal funds)

COMMITTEE NAME (Must be same as on Statement of Organization)

SEIU(Service Employees Int'1 Union) Local 199 C PE Fund

SCHEDULE

A

(Rev . 06/97) I

P . 18

MONETARY

RECEIPTS

0 CHECK THIS BOX IF AMENDING FORM

STATE CANDIDATES NOTE : If A CONTRIBUTION IS RECEIVED FROM A STATE PAC

NUMBER AND THE

DISCLOSURE BOARD .

(POLITICAL ACTION

COMMITTEE) . LIST THE PAC IDENTIFICATION

PAC CHECK NUMBER IN THE DESIGNATED COLUMN . A LIST OF ID NUMBERS IS AVAILABLE FROM THE IOWA ETHICS ANO CAMPAIGN

CAUTION : Section 68B.32A(B) . Iowa Code, prohibits the use of information copied for any commercial purpose by any person other than statutory political committees .

from repoRs and statements for soliciting Contributions or

DATE

PAC ID NUMBER

NAME AND ADDRESS OF

CONTRIBUTOR

RELATIONSHIP

RECEIVED

(if

applicable)

 

TO CANDIDATE'

(MM/DDIYR)

AND "AC

CHECK

(if applicable)

Ni IlytgFR

 

7/30/2004

Joan Comer Wright (UIHC)