Generated On: 3/30/2010 11:16:13 AM

Date Posted
DR-3: Notice of Dissolution 11/17/2009 DR-3
ID: 13908 Comm. # 13908

Name: Burgess for City Council Filed 11/17/2009

Type: City Candidate - City Council Audited 3/30/2010

Status: Filed Certified

Committee Name Burgess for City Council

Address 7036 Wilshire Blvd

City, State, Zip Windsor Heights, IA 50324-4822

Phone 515-278-2670

Effective Date of Dissolution................................................................................. 11/17/2009

Ann Burgess 11/17/2009

Signature of Treasurer Date Signed

THIS BOX APPLIES TO CANDIDATE COMMITTEES ONLY:

I, the candidate, certify that my candidate committee's cash balance is zero, all debts, obligations and loans have
been paid or satisfied in accordance with law as shown on my committee's final report and all campaign property
and leftover funds have been distributed in accordance with my committee's last filed Statement of Organization.

David Burgess 11/17/2009

Signature of Candidate Date Signed

IOWA ETHICS AND CAMPAIGN DISCLOSURE BOARD | 510 EAST 12th, SUITE 1A | DES MOINES, IA 50319 | (515) 281-4028 1 of 1