i-ITr' OF PLEIA, IA . Fax :641-932-22 1-717 Dec 29 '04 14 :58 P .

02/04

Notice of Dissolution FORM (Rev, i~oa)

I DR-3
NOTICE OF
DISSOLUTION

Fe Qf_AC" Us nl

Comm . 9
Irdeki!ed _-
Audltsd
Gampu~r
C"fled Gets of Disaolu6on

COMMITTEE NAME

Carl Gragg for Supervisor

. Official Name of Commlttrs

900 South 13th Street

Street
v
Albia, Iowa 52531

City, State . Zip Code

{ 641 932-7590 -
Area Telephone
~~Code

WHEN To FILE:
The Notice of Dissolution. muss be flied )0thin thirty (30) days of completion of all the following :

1. All debts, ;owns and obligations have assn paid or transferred ;

2. All campaign funds have been spent,
3. All campaign property sold or transferred (candidates only); end
4. A final report disdoeing a.1 transactions closing ;,he committee .

;or state candidates and state PACs . a finai bank statement must be filed with, the Notice of Dissolution or as soon es
possible if the bank statement is not available at the time the Notice of Dissolution is filed,

Carl Gragg

Signature of Candidata or Treasurer (if candidate's e oa Cnalr or Treasurer !~f ?AC)

Date Signed

FOR INSTRUCTIONS, SEE BACK OF FORM

This form is not applicable to statutory political committees .

TOTAL r' , 01