FOR.;`~,ISTRUCTIONS.

SEE BACK OF FORM FORM

DR-2 I DISCLOSURE
DISCLOSURE SUMMARY PAGE (Rev . 01/98) REPORT

For Office Use Only

i r
COMMITTEE
5 ,
NAME (Must be same as on Statement of Organization) Comm . #
Vl ¢ ;1n b0v s 4o V- Y1r1 I c11W I Te rr!/ Indexed _

uv~
Audited
IMPORTANT: Indicate type of committee you are reporting for: Lo Computer L L/ -V
( 1 )Statewide/Legislative Candidate ( 2 )Statewide PAC ( 3 )State Party (4 )County/Local Candidate
(5 )County PAC (6 )Ballot Issue/Franchise Committee (7 )County/City Central Committee
(8 )Support Slate of Candidates

5/s - Z&R - 39142

SIGNATURE OF TREASURER (or person filing this report) TELEPHONE 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 3-AnuaY'h Z ZZ i -), PQ --SPO RT 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

County & Local Committees, enter County in

[] 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.)

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. 0
ADD TOTAL MONEY TAKEN IN THIS PERIOD
Schedule A: Cash Contributions total (Attach Schedule A) .... .. .. ... .. ........ ... .. ... .. ....... .. ..... .. ..
5 70 70 . dO
Schedule F: Loans Received total (Attach Schedule F) ............ ..... .. . .. .. .... .. .......... .. .. ....... .. .. C) . OU
Schedule H: Total Sales of Campaign Property (Attach Schedule H) .. ...... .. ............ .. .. ... .. .. 0-00

(Schedule H applies to Candidates' Committees Only)

SUB-TOTAL . ....$
- 70`] 0 . C~0
SUBTRACT TOTAL MONEY SPENT THIS PERIOD
Schedule B: Expenditures total (Attach Schedule B) .. .... ......... .. .. .. . .. .. .. .. ....... . .. .. .. .. .............
Schedule F: Loan Repayments total (Attach Schedule F) ....... .... .. ... .. ...... ..... . .... .... .. ..... ...... 0-co

CASH ON HAND at the end of this reporting period (if final report, balance must
be zero) (Attach DR-3) .......... . . .. ... .. . . .... .. .. ... ........... .. .. .. .. ... .... ........ ..... .. .. .. ..... .. . .... ................. $ 35! l . 33

UNPAID BILLS (From Schedule D - Attach Schedule D) .... ........... .. ........ .. ... .. .. .... ... .. ... .. ... .. .... .. ..... .. .$ 6-00
,~

IN KIND CONTRIBUTIONS (From Schedule E - Attach Schedule E) .. ..... .. ... ........... .. ... .. ................... $ 14 9o- 44
OUTSTANDING LOANS (From Schedule F - Attach Schedule F) . .. ........ ..... ....... .. .... ... .. ........... ..... .. . $ 0 .00
CANDIDATE COMMITTEES ONLY :
CONSULTANT BREAKDOWN (Schedule G Attached?) YES \NJ NO

VALUE OF CAMPAIGN PROPERTY (From Schedule H - Attach Schedule H) $

For Instructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 06/97) I RECEIPTS
(Including candidate's personal funds)
Q CHECK THIS BOX IF
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

CISnhot-s Gicyr Michoe I Tcrr y

STATE CANDIDATES NOTE: IF A CONTRIBUTION IS RECEIVED FROM A STATE PAC (POLITICALISACTION COMMITTEE), LIST THE PAC IDENTIFICATION
THE IOWA ETHICS AND CAMPAIGN
NUMBER AND THE PAC CHECK NUMBER IN THE DESIGNATED COLUMN. A LIST OF ID NUMBERS AVAILABLE FROM
DISCLOSURE BOARD .
statements for soliciting contributions or
CAUTION: Section 68B.32A(6), Iowa Code, prohibits the use of information copied from reports and
for any commercial purpose by any person other than statutory political committees .

NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT 4 IF FOR

DATE PAC ID NUMBER
(if applicable) TO CANDIDATE' RECEIVED FUND-
RECEIVED
(if applicable) RAISER
(MM/DD/YR) AND PAC CHECK
NUMBER INCOME

ID# ~,Iairc ~Isi,

$ SG . oc-)
S~ 1 o °y 5 si-
CK# Nws+ Oes Won?es, VA So-705
ID* IZQC.11,, I (A)4) I'ers
W 3 I' 7 Sj- ree t 4*IZ ~ia»c.cz. r
'-,60 .00
g/2-7 /01 CK#
17-k- s I iI'-g

sr
ID# 12arVae ~ -l2lfe1r~
'117-1101 CK#
3 I s s~- I 7- ¬>a >7~~ 7s. 00
Olzs Momeq -Ch 5031(4
I D# kadj= ( tAja1 }ie rS
W21-1101 CK#
713 / -7 4i gIrc4t flArcc 500b,(30
Det Moly)eC 5031q
ID# M44MkrC09
112-1101
5
2-%-00
CK#
~N»ot he 03 ? 1
ID# kt3yr)e Terry
K-O ZZ-aone Qrim br her- 50.00
10///0J CK#
I4urn e 34
ID#
batu4ne McAs1r=1,V
4800 GatA Ortue - Sfie. ~'ZSo .oo
015101 CK# 1Z5
Wegf . h _
-
ID# IZArdt,~ U1a i t s
S SO
1117 101 CK# 2-171 Grand Aue " b .6 o
oines =ft OZ 5
Wev~
ID# Llkl4ne Irry
1 eOZZ Tcrne Si S6,00
1111-5/01 . CK# orcst br,ue b -h~n
ITf"Til16 le _c> S 7734
ID# TOhj Ll1Q j`fbn
CK# 145 /4 Al pn7c pr. S a. o a
111 61 01
Urhord~ le,,o~ .SO3aa
SUB-TOTAL
003 10
5
TOTAL (if last page of this
schedule) r
disclose the relationship of any relative malting a contribution to the
Disclosure law requires candidate committees to and affinity (relatives by
committee. Relationship must be shown to the third degree of consanguinity (blood relatives) candidate, but there is no Page of
marriage) (See Page 2 of forms packet .) . If surname of contributor is the same as
relationship column. (for Schedule A)
familial relationship, enter "not applicable" in the
 For Iristiructions, See Back of Form SCHEDULE
A MONETARY
CONTRIBUTIONS -- MONEY TAKEN IN (Rev . 06/97) RECEIPTS
(Including candidate's personal funds)
CHECK THIS BOX IF I
COMMITTEE NAME (Must be same as on Statement of Organization) AMENDING FORM

Y)Qlshbors -Gov lm*1c.Yloe ! -rei^r,J1

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 NAME AND ADDRESS OF CONTRIBUTOR RELATIONSHIP AMOUNT v IF FOR
RECEIVED (if applicable) TO CANDIDATE' RECEIVED FUND-
(MM/DD/YR) AND PAC CHECK (if applicable) RAISER
NUMBER INCOME
ID#
helda+izo} -~- Y)')irJl~/e
l1IL510 I CK# 71 1 1voO0LANO Z S .dD
5 ,0 1 0
ID#
Sow +-2044i
f 15/01
1-4k-arc1
CK# 3116 So1Mm r k Ulst'vk Dr. s30-00
s ,»eS 503a 1

Harp-Y A. /wrtl S
ID#
~1 al CK#
211 W. matadowlA»c s lob-ao V
MOVKhq (1 +OW y1 ZA 50/5 ,P
ID#
27n Gram i40
IZl ~1~ 1 CK# . ~.
" +_ 0" rnoyes _Zk
ID# -rereso. MCC ornrne
I I jZc Jo r CK#
I IOy Crn~t-is Ave. S 160 .00
Des Monnes ?A 50V 5
! D#
CK#

ID#

CK#

ID#

CK#

I D#

CK#

I D#

CK#

SUB-TOTAL

TOTAL (if last page of this .70

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 Page of
familial relationship, enter "not applicable" in the relationship column. (for Schedule A)
 FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE

B MONETARY
EXPENDITURES - MONEY SPENT FROM COMMITTEE ACCOUNT (Rev . 09197) EXPENDITURES

STATE PAC COMMITTEES : NOTE : FOR CONTRIBUTIONS MADE TO STATEWIDE OR LEGISLATIVE CHECK THIS BOX IF
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE
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)

(2) ~)bp v'S 9cw- 1c~pQ~~2rr

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
DATE ID NUMBER
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
ID# (prl-rr~ Prinl-av P!-rr,h'1'1b oF lef - I¢rhaacJP
17 3`I C. Grar4 Ave. ell uc )0 ,e
y 12.1 l of . 39Z . z,,
CK# h~r,p S $ ,
0e5MD1reZ,,~~ 031 1U

ID# Ses(-1'-osf Prin4er P1--oofio Cope uefer

N24 to t-" '1-1W~- 1'~q ~SfiYa ro~ ~ormS (.p
q/21 to I CK# 2.0 11 ~~ molnes~ ~ So3c~
ID# K,l) lu,s pro proofs of '
la~)/ol S LiD°10S
` '
150 Cornpo;o)r» GQrd S SZ(a . IFS
CK# Zb) Z
mb tines,'A So3c9
ID# I<Ink,os GOlor pyoaFS O~ r
.o~fz+ s(-e !-~ S2t~ . y~1
)bjZ JOI CK#Zb/3 L400 C ,~k
caw+~jgy, ~,IS
fles MofneS V 4, roc 4°I

ID# 9AjCn-l SLUE 12 1'Y~oY~ .}~S pf' r

/015~a 1 I1 + s~ -sit aos' Iti¢b 97 +1+t, 1~~-)n5 S yZD .pO
CK#Zp14 YboW1e% 1CA
r->-
-S

ID# Tcrry
I'Y) .~ho~ 2e ir" burc r:4
7i3 I? si- 1*fL S E'~~rsOr~- .Tackson nl»nC1Y 5' ZOO .Od
CK#2 .015 Ocs Mo)»es, ate. 5,03114 TirlcZ1s
(,Parl-y Fon~~)oh

ID# n ra'1Oe I Tt r l^Y 2C I Mbb fsM,-j fir ,

M )m . c .x ptec log
7) 3 ( t4 S l- 12- S 12-6. a-4'
101-401 CK# w1(v *jmf OPCr eA
ries Y)')D I»e5 503/U r"Si v .
ID# barkv Ptinlel- r'rorY4rQi's CA>t,.
17.341 E, &ra,,A AID-e- S lO Co6, ~U
coyj S, lol l ) S c-1C YS
J0 7-1 01 CK# 201
bec %01` ) csS t c
C
am. A a ;l,, io 1 30 SUB-TOTAL $

TOTAL (if last page of this schedule) $

THIS BOX APPLIES TO CANDIDATES' COMMITTEES ONLY :

H instructions .)
Purchases of certain campaign property costing $540 or more must also be inventoried on Schedule H . (Refer to Schedule
be detail itemized on
Expenditures to persons/entities providing consulting, advertising, fund-raising, polling, managing, organizing services must also committee. (Refer to
expenditure made by the personientity on behalf of the candidate's
Schedule G by the amount, purpose, and date of each type of
Schedule G instructions and Iowa Code 56 .6(3)(i) .)

(for Schedule B)
 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 E 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)

~,, .
`Ae I Nboys ~~ %I LA-Vaq\'TerY
CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
1D#

-
loj q101 z ~MI e
C~'tpho4rcp ) pins
$ ~3. 53
cK#Z,c~18
yes IT01beS ~ Svs/~ ~Y c1~r kn n

ID# ~~r ~ TSpIh~J

Io11(J10I -SJoo W efL S
31~.`~°I
bcs "wtes XA Std o
{'role sckltul)tng l

10 19 01
CK#ZbII

ID# RQ .'.'
QS>~E Web gi 4,-- Y~2U ~h~¢»~'
S 25V

o~sr'1~ios
StC 9S6
/ 1 cK#~ZO
oe' Y y)4Q-,TA 5036
00
))Z
ID#
4hs~»~ firms .s /_/ 5U
101Z3 cK#ZtJ2.1
~~
Oes MorneS, ZA S03oq
ID# ~~ ~~
S~mQs
~ S 35. aO
1012-3 ]b I CK#2-p
22 Des " bw,es, ~ So3Dc,

ID# Ktr IGoS ~~ ~ Gor f ro )SQY

. qao Looos~- S~'e
llb LC} oI CK#ZoZ3 l ~P
LUCAS "61 -1:k S03~f

ID# ~x 'QSS Y1~'I ~aa~b TICS

hg
X708 ~~royer~l1 S 3 .3q
h/~1~ol CK#~z~
o~ (~lomes,~.~ so3 ~a

ID# Pa9f
y'00 L
p~ZlaI01 CK# Z-OZ5 -rerry
ces bl`(Y?S .S 503
SUB-TOTAL $
d
TOTAL (if last page of this schedule) $

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 persons/entities 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 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 CHECK THIS BOX IF
CANDIDATES, LIST THE CANDIDATE IDENTIFICATION NUMBER IN THE DESIGNATED COLUMN AND THE
PAC CHECK NUMBER FOR EACH EXPENDITURE . A UST OF ID NUMBERS IS AVAILABLE FROM THE IOWA AMENDING FORM
ETHICS & CAMPAIGN DISCLOSURE BOARD.

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

e, hb ors
CANDIDATE
~- o~- 'm I' C69, 1l--_Rrr \J
NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
ID# kin k_03 Phbk ezpnm OP
400 Loe os-I- s fie 1_<.0
YY" $ 3 .-
101 z.8~ o I cK#Zoz(D Des vY)ol~as ,fit 5031
rZV5+V,k+ .

ID# MicVWj -Rrry 2c t'tir1~U~G p

rOr ~(~, ~f '
Jo~2°I~ol
7I3 1 -7 1v IL
Kar s l
_ SZ 5D
CK#ZO Z'+ bcs ot»as T~t Sa3W
ID# 8dL) F_
i/ - S~ ~ ~b c1 ~e c1eUC~op 6vo S,
~
I! I oI cK# ZpZg' 'Des MoiMS, ZA 5193[x/
ID# U411 rcerS F h-" S'
ease
Zg~~ Tra~c l ~tue
01 cK#ZoZ`1 ides YY/b)nes~, S 04)
ID# l~llall lei rrcn >'~i r+, ~~clbpYrkn~' S~ `),
ZY~geYsal r ~ 5C~
5 a
cK#ZO'3o ixs Md1nOs
LrA sds

SJ
cK#Zo,>31
~I I I I ~ol C->
bes Y'UTgs , _em SD3a
ID# ck:e6ls >=cr-~lralser ~od. s
34016 Zrlweml) AK C~S.Sa
It 15 dot CK# Z03a
DO& mdv=,Z sa3),:~
ID# E+C.r1419LUE Dell phone r~bvr~
550 11 ~ S~ --5fc acs
cK#?o33 Des rno, y)M TA 61 3P
IzJ3 ~o~

SUB-TOTAL $ a T~
TOTAL (if lastpage of this schedule) $

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 persons/entities providing consulting, advertising, detail itemized on
fund-raising, polling, managing, organizing services must also becommittee.
Schedule G by the amount, purpose, and date of each type of expenditure made by the person/entity on behalf of the candidate's (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(1).)

(for Schedule B)
 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 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)

e) ~nhon "-ov NiCxWe ` 'Tq- rY

CANDIDATE NAME AND ADDRESS TO WHOM PURPOSE AMOUNT
DATE ID NUMBER EXPENDITURE (DESCRIBE TRANSACTION) EXPENDED
EXPENDED (if applicable) (Disbursement) WAS MADE
(MM/DD/YR) AND PAC
CHECK
NUMBER
ID# t'YIk 1 TCrry fGen~bDl Iv
1Z) 4 101 J-4 P PY)»~}C r, ir~'v1cIgGS
CK# ZV3~
'~S'Y~'bl»GS.
_,A
ShSI~
$ (!~7 D a
ID# d9b11G C)00nN hW I bm Wk r
100101 coc)r)- qve S Ci Z
CK#
2035 Dft NoIneS, -<A so3p~
ID# I96K Cocm-II;i Apd 1 fbvs IDO-abaSt/Uofev- g ~ ~ e, '
IZI 19161 CK#ZM(b W C_nvr+Lw1_ I
bCS TAefm, SMCPJ
ID# C~Luc- I ~»e ~r
iz~ 1/ 0 ( Ro, Gox Ct3o I S 64.9y
CK#Z03'* ~sT~a~r,es, Soap LQ
ID#

CK#

ID#

CK#

CK#

ID#

CK#

SUB-TOTAL $'P-7' 09

TOTAL (if last page of this schedule)

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 personslentifles 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 personlentity on behalf of the candidate's committee . (Refer to
Schedule G instructions and Iowa Code 56 .6(3)(i) .) -

(for Schedule B)
 'FOR INSTRUCTIONS, SEE BACK OF FORM SCHEDULE
E IN KIND
COMMITTEE NAME (Must be same as on Statement of Organization) (Rev . 06/97)1 CONTRIBUTIONS

b Q i ghbcY s qr 1'Y) ichoe I Ter r y

F-1 CHECK THIS BOX IF
AMENDING FORM

DATE RELATIONSHIP DESCRIPTION ESTIMATED 4 IF FOR

RECEIVED NAME AND ADDRESS TO CANDIDATE OF IN KIND FAIR MARKET FUND-RAISER
(MMIDDIYR) OF CONTRIBUTOR ' (if applicable) CONTRIBUTION VALUE CONTRIBUTION

1~8e4 n)o1'nas I year

$12.7101 Z$ Z8 S. -9'7'!;; dor»utn hQMG j 5 " OU
Des YY?oirles So 3 17 ~1I SI~~ ~-i n
c~a~ cRis ~ 3u G s,~I~~s
q
1 f° i 7o't co ++ gt f~~.
Wes F IJcs YY70fber
z~ 5oa(95
Qac.1Y1q¢1 1NA IJMrS 4!or
-ease
L
Io/ i 1 o 1 7 3 1-7 44, S+ J*/ Z fiarw~e
nrtirn CAm" II7~h .s16Qo .oa
~S MoiȢs ~, 5o3Iq
Greed i-1* len we I I s Foop Fort
11115101 17oI IwcontANto Fund raIse1r s 365.A3
Ces Mo l" es. za 5a 30~

4?nchcre f U1al+ers l-1os'I-css

I I~IS~o I 7/3 17 S~' 'i-Z IanCc~ Ch Pi- 3d -~
Qe3 Mome4, -ZA S03Ili R»draYSaY

I I ~ ~ 1
SUB-TOTAL
I4go, 44

TOTAL (if last $

page of this
11M .44
schedule)

`Disclosure law requires candidates to disclose the relationship of any relative making an in kind contribution to the Page ~- of
(for Schedule E)
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 .