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FOR I NSTRUCTI ONS, SEE BACK OF FORMDI SCLOSURE SUMMARY PAGE

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R e s e t F o amCOMMI TTEE NAME ( M u 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 )S t e v e O l s o n f o r S t a t e Re p r e s e n t a t i v eI M P OR T A N T I n d i c a t e b y * t y p e o f c o m m i t t e e y o u a r e r e p o r t i n g f o r I 1( 1 ) 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 C o m m i t t e e ) ~ d 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 ( . t 1 ) 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 a l l , = ~ ) ?=,fCANDI DATE COMMI TTEES ONLY :Ca n d i d a t e NameS t e v e O l s o nO f f i c e S o u g h t

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ADD TOTAL MONEY TAKEN I N T H I S PERI ODS c 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 h e d u l e A ) ( * a l s o s e e i n - k i n d b e l o w ) . . . . .S c 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 S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S c h e d u l e H T o t a l S a l e s o f C a mp a i g n P r o p e r t y ( A t t a c h S c h e d u l e H ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( S c h e d u l e H a w l i e s t o C a n d i d a t e s ' C o mm i t t e e s O n l y lSUB- TOTAL . . . $ 1 4 , 6 9 8 . 2 3

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" UNPAI D B I L L S ( F r o m S c h e d u l e D - A t t a c h S c h e d u l e D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $` I N K I ND CONTRI BUTI ONS ( F r o m S c h e d u l e E - A t t a c h S c h e d u l e E ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $' " ` O U T S T A N DI N G L OANS ( F r o m S c h e d u l e F - A t t a c h S c h e d u l e F ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $CANDI DATE COMMI TTEES ONLYCONSULTANT BREAKDOWN ( S c h e d u l e G A t t a c h e d ? )VALUE OF CAMPAI GN PROPERTY ( F r o m S c h e d u l e H - A t t a c h S c h e d u l e H )

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( 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 TT EENAME ( Mu s t be s ame a s o n S t a t eme n t o f Or g an i z a t i o n)S t e v e Ol s o n f o r S t a t e R e p r e s e n t a t i v e

Reset F o r e s t

STATECANDI DATES NOTE: I F A CONTRI BUT I ON I S RECEI VED FROMA STATE PAC ( P OL I T I CAL ACT I ON COMMI TTEE) , L I S T THE PAC I DENT I F I CATI ONNUMBER AND THE PAC CHECKNUMBER I N THE DESI GNATED COLUMN . A L I S T OF I D NUMBERS I S AVA I LABLE FROMTHE I OWA ETHI CSAND CAMPAI GNDI SCL OSURE BOARDCAUTI ON : Se ct i o n 68 B . 3 2 A ( 6 ) , I o wa Cod e , p r o h i b i t s t h e use o f i n f o r ma t i o n c op i e d f r om r e p o r t s an d s t a t e me nt 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 rf o r an y c omme r c i a l p u r p o s e b y an 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 ommi t t e e s .

SUB-TOTAL

TOTAL ( i f l a s t page o f t h i s s c h e du l e )* D i s c l o s u r e l aw r e q u i r e s c a n d i d a t e c ommi 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 ny r e l a t i v e mak i n g a c o n t r i b u t i o n t o t h ec ommi t t e e . R e l a t i o n s h i p mus t b e s h own 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 ( Wood r e l a t i v e s ) a nd a f f i n i t y ( r e l a t i v e s b y 1 2ma r r i a g e ) . 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 as c a n di d a t e , b u t t h e r e i s no P a g e o f _f a mi 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 d u l e A)

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

CHECK T HI S BOX I FAMENDI NG FORM

DATE PAC I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELA T I ONSHI P AMOUNT 1 I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE* RECEI VED FUND-( MM/ DD/ YR) AND PACCHECK ( i f a p p l i c a b l e ) RAI SENUMBER I NCOMI D# Mar k B e r t r a m $ 2 0 0 . 0 01 0 / 2 1 / 0 4 CK# 1 5 0 5W. P r a i r i e Wo o dP o l k C i t y , I A 5 0 226I D# Ka y Wag ne r1 0 / 2 1 / 0 4 CK# 5 2 9 6 Coach man Rd 5 0 . 0 0B e t t e n d o r f , I A 5 2 7 22

De Wi t t R e p u b l i c a n Women1 0 / 2 1 / 0 4 CK# 665 D e Wi t t , I A 5 2 7 4 2 7 5 . 0 0I D# 9 5 1 1 C l i n t o n Coun t y R e p u b l i c a n Women1 0 / 2 1 / 0 4 CK# a5 3 C l i n t o n , I A 5 2 7 3 2 1 0 0 . 0 0I D# Mi c h a e l Th oma1 0 / 2 1 / 0 4 CK# 2 1 8 0 1 G r e a t R i v e r Rd 2 0 0 . 0 0L e Cl a i r e , I A 5 2 7 5 3I D# C a r o l C a i n1 0 / 2 6 / 0 4 CK# 1 6 3 4 2 0 0 t h Av e 5 0 . 0 0De l ma r , I A 5 2 0 3 7I D# 6 4 4 5 RI VERPAC # 6 4 4 51 0 / 2 1 / 0 4 CK# 4 0 0 E 3 r d S t r e e t 1 0 0 . 0 01 2 0 7 Dubuque, I A 5 2 0 0 1 - 2 3 9 5I D# FAS PAC - Fa r eway S t o r e s , I n c . PAC1 0 / 2 1 / 0 4 CK# 2 6 0 0 E. 8 t h S t . 1 0 0 . 0 05 1 3 8 Bo o ne , I A 5 0 0 3 6I D# Commonwea l t h PAC1 0 / 2 1 / 0 4 CK# P . O . Bo x 1 7 8 0 1 , 0 0 0 . 0 01 0 4 4 Bi r mi n g h am, MI 4 8 0 1 2I D# 6 0 7 2 I F AP AC - I o wa PAC

1 0 / 2 1 / 0 4 CK# 4 3 1 E . L o c u s t S t r e e t , S u i t e 3 0 0 3 0 0 . 0 01 0 7 7 De s Mo i n e s , I A 5 0 3 0 9

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( 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 as o n S t a t e me n t o f O r g a n i z a t i o n )S t e v e Ol s o n f o r S t a t e R e p r e s e n t a t i v e

R e s e t F o r m

STATECANDI DATES NOTE : I F A C ON T R I B U T I ON I S R E CE I V E D FROM A S T A T E PAC ( P O L I T I C A L A C T I O N C OM MI T T E E ) , L I S T T HE PAC I D EN T I F I C AT I ONNUMBER AND T HE PAC CHECK NUMBER I N T HE D E S I G NA T E D COL UMN . A L I S T OF I D NUMBERS I S A V AI L A B L E FROM THEI OWA E T H I C S AND C A MP A I G ND I S C L O S UR E BOARD.CAUTI ON : S e c t i o n 6 8 B . 3 2 A ( 6 ) , I o w a C o d e , p r o h i b i t s t h e u s e o f i n f o r m a 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 m e 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 rf o r a n y c o m m e 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 mm i t t e e s .

SUB- TOTALTOTAL ( f f l a s t p a g e o f t h i s s c h ed u 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 m m i 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 m m i t t e e . R e l a t i o n s h i p m u 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 2 2m a r r i a g e ) I f s u mame o f c o n t r i b u t o r i s t h e s am e 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 m n . ( f o r S c h e d u l e A )

SCHEDULEA MONETARY( R e v . 0 7 / 0 3 ) RECEI P T S

CHECK T H I S BOX I FAMENDI NG FORM

DATE PA C I D NUMBER NAME AND ADDRESS OF CONTRI BUTOR RELATI ONSHI P AMOUNT I F FORECEI VED ( i f a p p l i c a b l e ) TO CANDI DATE' RECEI VED FUND-( M M / D D/ Y R ) A ND PAC CHECK ( i f a p p l i c a b l e ) RA I SERNUMBER I NCOMI D # 6 2 9 1 I HA PAC1 0 / 2 1 / 0 4 CK# 1 0 0 E . Gr a nd - S u i t e 1 0 0 $ 2 5 0 . 0 02 4 0 2 De s M o i n e s , I A 5 0 3 0 9I D # 6 1 6 0 I o wa I n d e p e n d e n t B a n k e r s PAC1 0 / 2 6 / 0 4 CK # 1 6 0 3 2 2 n d S t r e e t S u i t e 2 0 2 2 0 0 . 0 02 2 0 9 Wes t De s M o i n e s , I A 5 0 2 6 6I 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 mu 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 mu s t a l s o b e d e t a i l i t e mi 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 l 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 mm i 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 ) . )

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

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

STATE PAC COMMI TTEES : NOTE : FOR CONTRI BUTI ONS MADE TO STATEWI DE OR LEGI SLAT I VECANDI DATES, L I S T THE CANDI DATE I D EN T I F I C AT I ON NUMBER I N THE DESI GNATED COLUMN AND THE CHECK T HI S BOX I FPAC CHECK NUMBER FOR EACH EXPENDI TURE . A L I S T OF I D NUMBERS I S AVAI LABLE FROM THE I OWA AMENDI NG FORMETHI CS &CAMPAI GN DI SCLOSURE BOARD .COMMI TTEE NAME ( Mus t b e s am e 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 )S t e v e Ol s o n f o r S t a t e R e p r e s e n t a t i v e

CANDI DATE NAME ANDADDRESS TOWHOM 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/ DD/ YR) ANDPACCHECKNUMBERI D # Re p u bl i c a n P a r t y o f I o wa Ad v e r t i s i n g1 0 / 1 8 / 0 4 C K# v 2 1 E . 9 t h S t r e e t $ 3 , 2 0 0 . 0 01 0 4 1 e sMo i n e s , I o wa 5 0 3 0 9

I D# e pu b l i c a n P a r t y o f I o wa C o n t r i b u t i o n1 0 / 1 7 / 0 4 CK#1 0 42 2 1 E . 9 t h S t r e e t 1 , 0 0 0 . 0 0e sMo i n e s , I o wa 5 0 3 0 9

I D # V i c t o r y E n t e r p r i s e s Ad v e r t i s i n g1 0 / 1 7 / 0 4 2 0 0 S . W . 3 0 t h 1 , 2 2 4 . 0 0CK# 1 0 4 3 a v e n p o r t , I A 5 2 8 0 2

I D # P P r i n t i n g L e t t e r Ma i l i n g &Po s t a g e1 0 / 2 2 / 0 4 CK#1 0 44 . O . Box 7 47 3 , 5 4 5 . 3 0u s c a t i n e , I A 5 2 7 6 1 - 0 7 4 7I D# Ke e ne y We l d i n g S i g n B r a c k e t s

1 0 / 2 2 / 0 4 CK# P . O . Bo x 1 7 1 , 1 2 3 . 5 01 0 4 5 Mi l e s , I A 5 2 0 6 4I D # o v a Ca mp a i g n S o l u t i o n s I n v i t a t i o n s , En v e l o p e s , Re p l y Ca r d s

1 0 / 2 2 / 0 4 CK#1 0 4 6 0 4 Ma i n S t r e e t 1 , 0 3 6 . 8 7mes, I A 5 0 0 1 0I D#CK#

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FORI NSTRUCTI ONS, SEEBACK OF FORMCOMMI TT EE NAME ( Mu s t b e s ame as o n St a t eme n t o f O r g a n i z a t i o n )S t e v e Ol s o n f o r S t a t e R e p r e s e n t a t i v e

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El CHECK THI S BOX I FAMENDI NG FORM

' D i s c l o s u r e l a w r e q u i r e s c a nd i d at 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 an 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 Page 1 o f 1c o mmi t t e e . R e l a t i o n s h i p mus 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 ns an gu i n i t y ( b l o o d r e l a t i v e s ) an 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) . ( Se e Page 2 o f f o r ms 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 s ame 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 nt 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 .

DATERECEI VED( MM/ DD/ YR)

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