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FOR I NSTRUCT I ONS, SEE BACKOF FORMDI SCLOSURE SUMMARY PAGE

P o l i t i c a l P a r t y ( i f a p p l i c a b l e )D e m o c r a tD i s t r i c t ( i f Se n a t e o r H o u s e )8 7

COMMI TT EE NAME ( Mu s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n )

I MPORTANT : I n d i c a t e b y # t y p e o f c o mm i t t e e y o u a r e r e p o r t i n g f o r : 1 J1 ) S t a t e w i d e / L e g i s l a t i v e / J u d g e S t a n d i n g f o r R e t e n t i o n C a n d i d a t e ( 2 ) S t a t e PAC ( 3 ) S t a t e P a r t y( 4 ) C o u n t y C e n t r a l Co mmi t t e e ( 5 ) C o u n t y C a n d i d a t e ( 6 ) C i t y C a n d i d a t e ( 7 ) S c h o o l B o a r d o r O t h e rP o l i t i c a l S u b d i v i s i o n C a n d i d a t e ( 6 ) C ou n t y PAC ( 9 ) C i t y PAC ( 1 0 ) S c h o o l B o a r d o r O t h e r P o l i t i c a lS u b d i v i s i o n PAC ( 1 1 ) L o c a l BaCANDI DATE COMMI TT EES ONC a n d i d a t e Na meN a t h a n R o s s C o mi s k e yOf f i c e S o u g h tS t a t e R e p r e s e n t a t i v e

L a t e r e p o r t s a r e s u b j e c t t o p o s s i b l e c i v i l a n d c r i mi n a l p _ P u r s u a n t t o I o wa C o d e s e c t i o n 6 8 B . 3 2 A ( 7 )t h e c a n d i d a t e , f o r a c a n d i d a t e ' s c o mmi t t e e , a n d t h e c h a i r p e r s o n , f o r a n y o t h e r t y p e o f c o mm i t t e e , i s t h ei n d i v i d u a l r e s p o n s i b l e f o r f i l i n g t i me l y a nd a c c u r a t e r e p o r t s .

I AM F I L I N G A Ma y 1 9 , 2 0 0 6( r e p o r t d a t e )

CHECK I F AMENDMENT TOREPORT DATEDC h e c k i f t h i s i s f i n a l ( t e r m i n a t i o n ) r e p o r t a n d a t t a c h N o t i c e o f D i s s o l u t i o n F o r m DR- 3 .( Y o u mus t c o n t i n u e t o f i l e r e p o r t s u n t i l a DR- 3 i s f i l e d . )

REPORT FOR ( 1 ) ELECT I ON / ( 2 ) NON- ELECT I ON YEAR .I n d i c a t e b y #

STATEMENT OF CASH ON HAND

R e s e t F o r m

CASHON HAND a t t h e b e g i n n i n g o f t h e r e p o r t i n g p e r i o d . ( T o t a l o f a l l f u n d s h e l d b y t h ec o mm i t t e e . T h i s amo u n t MUST b e t h e s ame a s t h e c a s h o n h a n d a t t h e e n do f t h e l a s t r e p o r t i n g p e r i o d o r mu s t b e z e r o i f t h i s i s f i r s t r e p o r t f i l e d . ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

CASHON HAND a t t h e e n d o f t h i s r e p o r t i n g p e r i o d ( i f f i n a l r e p o r t b a l a n c e mus tb e z e r o ) ( A t t a c h DR- 3 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

* ' UNPAI D B I L LS ( F r o m Sc h e du l e D - A t t a c h Sc h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* I N KI ND CONTRI BUTI ONS ( F r o m Sc h e d u l e E - A t t a c h S c he d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $* * OUTSTANDI NG LOANS ( F r o m S c he d u l e F - A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? )CANDI DATE COMMI TT EES ONLY :VALUE OF CAMPAI GN PROPERTY( F r o m Sc h e d u l e H - A t t a c h Sc h e d u l e H)STATE COMMI TTEES : Su bmi t a r e c o n c i l e d c a mp a i g n a c c o u n t b a n k s t a t e m e n t i n J a n u a r y o f e a c h y e a r .

FORMDR- 2 I DI SCLOSURE( Re v . 1 2 / 2 0 0 5 ) REPORTF o r Of f i c e Us e On l yComm. #L o g g e d I nS c a n n e dComp u t e r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _A u d i t e d

F i l e w i t h :I o wa E t h i c s a n d Camp a i g nD i s c l o s u r e B o a r d5 1 0 E . 1 2 " ' , S t e . 1 ADe s Mo i n e s , I o w a 5 0 3 1 9Fa x : 5 1 5 - 2 8 1 - 3 7 0 1

3 1 a - _ 1 S q _ g 1 1 1SI GNATURE OFPE" F I L I N G REPO TELEPHONE DATE SI GNED

L o c a l C o mm i t t e e s , e n t e r D a t e o f E l e c t i o n

Co un t y & L o c a l C o mmi t t e e s , e n t e r Co u n t y i nw h i c h E l e c t i o n i s h e l d

5 2 2 . 1 0ADD TOTAL MONEY TAKEN I N T HI SPERKSc h e d u l e A : C a s h C o n t r i b u t i o n s t o t a l ( A t t a c h S c he d u l e A ) ( * a l s o s e e i n - k i n d b e l o w ) . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d u l e F : L o a n s Re c e i v e d t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Sc h e d u l e H : T o t a l S a l e s o f Camp a i g n P r o p e r t y ( A t t a c h Sc h e d u l e H) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( Sc h e d u l e H a oo l i e s t o Ca n d i d a t e s ' Co mmi t t e e s On l y )SUB- TOTAL . . . . . . . . . . . . . . . . . . . . . . . $ 1 , 4 2 4 . 4 8

SUBTRACT TOTAL MONEY SPENT T HI S PERI ODSc h e d u l e B : E x p e n d i t u r e s t o t a l ( A t t a c h Sc h e d u l e B) ( * * a l s o s e e d e bt s a n d l o a n s b e l o w ) . . . . . . . . . . . . . . . . . 1 , 4 2 3 . 5 5Sc h ed u l e F : L o a n Re p a y me n t s t o t a l ( A t t a c h Sc h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . 0 0

9 0 2 . 3 80 _. 0 0 _0 . 0 0

0 . 9 30 . 0 00 . 0 00 . 0 0YES0 . 0 0

NO

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Fo r I n s t r u c t i o n s , Se e Ba c k o f Fo r mCONTRI BUTI ONS - - MONEYTAKEN 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 ( Mu s t b e s ame 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 i t i z e n s F o r N a t h a n R o s s C o mi s k e y

R e s e t F o r m

STATE CANDI DATES NOTE : I F A CONTRI BUT I ON I S RECEI VED FROM A STATE PAC ( P OL I T I CAL ACT I ON COMMI TTEE) , L I ST THEPAC I DENTI F I CATI ONNUMBER AND THEPAC CHECK NUMBER I N THE DESI GNATED COLUMN. A L I S T OF I D NUMBERS I S AVAI LAB LE FROMTHE I OWA ETHI CS AND CAMPAI GND I SCLOSURE BOARD .NOTE : ANY PERSON, OTHERTHANAN I NDI V I D UA L , THAT CONTRI BUTES MORE THAN $ 7 5 0 TO YOURCAMPA I GN MAY HAVE F I L I NGRESPONS I BI L I T I ES AND SHOULD I MMEDI ATELY CONTACT THE BOARD .CAUT I ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , 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 p i e 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 r f o r a n yc 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 a n s t a t u t o r y p o l i t i c a l c o mmi t t e es .

SUB- TOTAL

TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e)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 d i s c l 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 t i v e ma k i n g a c o n t r i b u t i 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 s h o w n t o t h e t h i r 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 a f f i n i t y ( r e l a t i v e s b y 1 1ma 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 a t e , b u t t h e 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 Sc h e du l e A )

SCHEDULEA MONETARY( Re v . 0 7 / 0 3 ) RECEI PTS

CHECK THI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAMEAND ADDRESS OF CONTRI BUTOR RELAT I ONSH I P AMOUNT I F FRECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE` RECEI VED FUND( MM/ DDI YR) AND P AC CHECK ( i f a p p l i c a b l e ) RAI S

NUMBER I NCOI D# M i c h a e l H a r l a n d $ 4 0 . 0 02 / 1 / 0 6 CK# 1 5 6 9 2 7 5 t h S t1 0 4 3 L e t t s I A 5 2 7 5 4I D# F r a n k C B e s t 5 0 . 0 02 / 5 / 0 6 CK# 0 0 2 BB 3 1 9 6 Bo x 1 2 71 0 5 0 1 2I D# G l o r i a B N e w e l l 8 0 0 02 / 1 3 / 0 6 CK# P O Bo x 1 8 87 3 0 2 C o l u mb u s J u n c t i o n , I A 5 2 7 3 8I D# S h e r r i R i n e y 5 5 . 0 04 / 0 8 / 0 6 CK# 1 6 2 8 2 Hi g h w ay 3 4C a s hI D# J a m e s L H a l l 2 0 0 . 0 04 / 1 7 / 0 6 CK# 1 1 1 7 I s e t t Av e

Wa e l l o I A 5 2 6 5 3I D# U n i t e mi z e d C o n t r i b u t i o n 4 7 7 . 3 8CK#

I D#CK#

I D#CK#

I D#CK#

I D#CK#

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T HI 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 0 0 o r mo r e m u s t a l s o b e i n v e n t o r i e d o n S c he d u l e H . ( R e f e r t o Sc h ed 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 he 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 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 n d i d a t e ' s c o mmi t t e e . ( R e f e r t oS c he d u l e G i n s t r u c t i o n s a n d I o w a Code 6 8 A . 4 0 2 ( 3 ) ( i ) . )

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

FORI NSTRUCTI ONS, SEE BACK OF FORM R e s e t F o r m SCHEDULEEXPENDI TURES B MONETARY- - MONEYSPENTFROMCOMMI TTEEACCOUNT ( R e v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : F OR CONTRI BUTI ONS MADE TO STATEWI DE OR LEG I 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 AND THE D CHECK T HI S BOX I FPAC CHECK NUMBER F OR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROMTHE I OWA AMENDI NGFORMETH I CS & CAMPAI GN DI SCLOSURE BOARD .COMMI TTEE NAME ( Mu s t b e s ame a s o n St a t e me n t o f O r g a n i z a t i o n )C i t i z e n s F o r N a t h a n R o s s C o m i s k e y

CANDI DATE NAME ANDADDRESS TOWHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCR I BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e me n t ) WAS MADE( MM/ DD/ YR) AND PACCHECKNUMBER

I D# M e n a r d s p a i n t & p a i n t s u p p l i e s3 / 9 / 0 6 CK# 1 0 0 2 9 2 2 WA g e n c y Rd $ 3 4 . 1 7W e s t B u r l i n g t o n , I A 5 2 6 5 5ID# S t a p l e s p a p e r , i n k & e n v e l o p e s3 / 1 5 / 0 6 CK# 1 0 0 3

1 0 4 WA g e n c y Rd 4 2 . 6 2We s t B u r l i n g t o n , I A 5 2 6 5 5I D# I n t e r n a l R e v e n u e S e r v i c e S a l e s T a x3 / 2 0 / 0 6 CK# 1 9 7 3 N R u l o n Wh i t e B l v d 1 3 5 . 0 0O g d e n , UT 8 4 4 0 4I D# T r e a s u r e r S t a t e o f I o w a G a mb l i n g P e r m i t3 / 3 1 / 0 6 CK# 1 0 0 4 3 2 1 E 1 2 t h S t 4 0 . 0 0De s Mo i n e s , I A 5 0 3 1 9I D# D i g i t a l Of f i c e S o l u t i o n s P a p e r4 / 6 / 0 6 CK# 1 0 0 5 2 3 1 S 3 r d S t 5 3 . 5 0B u r l i n g t o n , I A 5 2 4 0 1I D# Ha r ma n Gr a p h i c s s i g n f o r Wa p e l l o o f f i c e4 / 1 2 / 0 6 CK# 4 0 9 E Mt P l e a s a n t S t 4 5 . 0 01 0 0 6 W e s t B u r l i n g t o n , I A 5 2 6 5 5I D# Wa l - Ma r t i n k & p a p e r4 / 1 8 / 0 6 CK# C o r a l v i l l e , 1 A 5 2 2 4 1 2 1 . 9 51 0 0 7I D# Wa l - Ma r t i n k , p a p e r & p e n s4 / 2 0 / 0 6 CK# Mu s c a t i n e , I A 2 9 . 0 31 0 0 8

SUB- TOTAL $ 4 0 1 . 2 7TOTAL ( i f l a s t p a g e o f t h i s s c h e du l e ) $

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T HI 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 0 0 o r mo r e m u 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 m u 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 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 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 t i o n s a n d I o w a Code 6 8 A . 4 0 2 ( 3 ) ( i ) . )

A t 1 2 . IPag e3of ( f o r S c h e d u l e B )

FOR I NSTRUCT I ONS , SEE BACK OF FORM R e s e t F o r m SCHEDULEEXPENDI T URES B MONETARY- - MONEY SPENT FROM COMMI TTEE ACCOUNT ( R e v . 0 7 / 0 3 ) EXPENDI TURES

STATE PAC COMMI TTEES : NOTE : F OR CONTRI BUT I ONS MADE T O STATEWI DE OR LEGI SLAT I VE D CHECK T HI S BOX I FCANDI DATES, L I S T THE CANDI DATE I DENT I F I CAT I ON NUMBER I N THE DESI GNATED COLUMN AND THEPAC 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 NGFORMETHI CS & CAMPAI GN DI SCLOSURE BOARD .COMMI TTEE NAME ( Mu s t b e s a m e 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 )C i t i z e n s F o r N a t h a n R o s s C o m i s k e y

CANDI DATE NAME AND ADDRESS T O WHOM PURPOSE AMOUNTDATE I D NUMBER EXPENDI TURE ( DESCR I BE TRANSACTI ON) EXPENDEDEXPENDED ( i f a p p l i c a b l e ) ( D i s b u r s e m e n t ) WAS MADE( MM/ DD/ YR) AND PAC

CHECKNUMBER

I D # S h e r r y C o m i s k e y i n k , c a r d s t o c k , p a i n t & p a i n t r o l l e r s4 / 2 0 / 0 6 CK# PO Bo x 1 8 5 $ 2 8 . 2 8Mo r n i n g S u n , I A 5 2 6 4 0I D# US P o s t a l S e r v i c e s t a m p s4 / 2 3 / 0 6 CK# Mo r n i n g S u n ,

I A 5 2 6 4 0 3 9 . 0 01 0 1 0

I D# Wa l - Ma r t i n k4 / 2 3 / 0 6 B u r l i n g t o n , 1 A 5 2 6 0 1 1 9 . 1 9CK# 1 0 1 0D# S t a p l e s i n k & p a p e r5 / 1 / 0 6 CK# 9 1 1 Hi g h wa y 1 W 4 0 . 5 31 0 1 1 I o wa C i t y , I A 5 2 2 4 5

I D# E & L G u n s r a f f l e p r i z e5 / 5 / 0 6 Wa p e l l o , I A 2 7 . 0 0CK# 1 0 1 2I D# S t a p l e s i n k & e n v e l o p e s5 / 9 / 0 6 9 1 1 Hi g h wa y 1W 3 4 . 3 1CK# 1 0 1 3 I o w a C i t y , I A 5 2 2 4 51 D # S t a p l e s i n k5 / 1 0 / 0 6 1 0 4 WA g e n c y Rd 4 6 . 1 9CK# 1 0 1 4 W e s t B u r l i n g t o n , I A 5 2 6 5 5I D# S t a p l e s i n k5 / 1 1 / 0 6 9 1 1 Hi g h wa y 1W 1 5 . 6 8CK# 1 0 1 5 I o w a C i t y , I A 5 2 2 4 5

SUB- TOTAL $ 2 5 0 , 1 8TOTAL ( i f l a s t p a g e o f t h i s s c h e d u l e ) $

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T HI S BOX APP L I E S T O CANDI DATES ' COMMI TT EES ONLY :P u r c h a s e s o f c e r t a i n c a m p 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 m u 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 m u 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 / 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 t i o n s a n d I o w a C o d e 6 8 A. 4 0 2 ( 3 ) ( i ) . )

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

FOR I NSTRUCT I ONS , SEE BACK OF FORM R e s e t F or m SCHEDULEEXPEND I TURES B MONETARY- - MONEY SPENT FROMCOMMI TTEE ACCOUNT ( R e v . 0 7 1 0 3 ) EXPENDI TURES

STATE PAC COMMI TT EES : NOTE : F OR CONTRI BUTI ONS MADE TO STATEWI DE OR L E G I S L A T I V E CHECK T HI S BOX I FC A ND I D A T E S , L I S T T HE CANDI DATE I D E NT I F I C A T I O N NUMBER I N THE DESI GNATED COLUMN ANDTHEPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S A V A I L A B L E FROM THE I OWA AMENDI NG FORME T H I C S & CAMPAI GN DI SCLOSURE BOARD .COMMI TT EE NAME ( M u s t b e s ame a s o n S t a t e me n t o f O r g a n i z a t i o n )

C i t i z e n s F o r N a t h a n R o s s Co mi s k e yCANDI DATE NAME ANDADDRESS T OWHOM 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 e me n t ) WAS MADE( MM / D D/ Y R ) ANDPACCHECKNUMBERI D # C i t i z e n s F o r N a t h a n R o s s C o m i s k e y c l o s e o u t a c c o u n t a t Co l u mb u s3 / 2 4 / 0 6 PO Bo x 1 8 5 J u n c t i o n S t a t e Ban k $ 7 . 9 6CK# 1 4 6 7 4 0 Mo r n i n g S u n , I A 5 2 6 4 0

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

SUB- TOTAL $TOTAL ( i f l a s t p a g e o f t h i s s c h ed u l e ) $

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' 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 s t o d i s c l 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 t i v e ma k i n g a n i n k i n d c o n t r i b u t i o n t o t h e Pa g e 1 o f 1c o mmi t t e e . R e l a t i o n s h i p must b e s h o w n t o t h e t h i r 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 a f f i n i t y ( r e l a t i v e s ( f o r Sc h e d u l e E)b y ma r r i a g e ) . ( S e e Page 2 o f f o r m s p a c k e t . ) I f s u r n ame o f c o n t r i b u t o r i s t h e same a s c a n d i d a t e , b u t t h e r e i s n of 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 .

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