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Noticeof Dissolution CertlfiedDate of Dissoludon

Mail to:
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Des Moinesnlowa 503| 9

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Area Tolephone
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UU}IENTO FILE:
The Notce of Dlssolutionmud be filed witrin thirty (30) rbys of comptetionof alt the fotlowing:
1. All d€bts.loss and obligationshave been paid or hansfened;
2. All campaignftnds have been ryen(
3. Al campalgnpropertysold or bslsfsred (candiddesonly);and
4. A final reportdlscloSngalltransactionsclosingthe commifie.

For state candidate and state PACs,a ffnal bank e*atementmust be filed with fte Noticeof Dlssolutlonor aa soon as
possiblelf the banketaternentb not avaihle at the dme lhe l.loticeof Dissolutionis fited.

(if canddate'scommifiee/Sigpatureof Chdr or Treasurer(if PAC)

FORINSTRIJCTPNS,SEEBAGKOF FORil
Thie form is not applicabb to ffilbry potitlcal commttbes.

IIUOIS 90UC IUA-If, t90?89€6I8 XVd 9ttno 6007/lZ/90