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NONCEOF
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For Office Ues Onlv

Audited
Computer /")l Y\
Noticeof Dissolution CertifiedDateof Dissolution-

Mrilto:
IECDB
510 Eastlf, SuitelA
Des Moines,Iowa 50319

of Committee

Street

iTrL 773 -IL|U

Arcxr Telephone
Code

TUHET{
TO FILE:
The Notice of Dissolutionmust be filed within thirty (30) days of completionof all the following:

1. All debts,loansand obligationshave been paid or hansfened;

2. Allcampaigntunds have been spEnt;
3. All campaignpropertysold or transfened(candidatesonly);and
4. A final report disclosingall transac{ionsclosing the commiftee.

For state candidatesand state PACs, a final bank statementmust be filgd with the Notice of Dissolutionor as soon as
possibleif the bank statementis not the time the Noticeof Dissolutionis filed.

candidate'scommittee/Signatureof Chair or Treasurer (if PAC)

o/, /c/0?
DateSigned

FORINSTRUCTIONS, SEEBACKOF FORM

This form ls not appllcableto statttrory polftical committees.