Generated On: 2/2/2011 10:30:38 AM

Date Posted
DR-3: Notice of Dissolution 1/31/2011 DR-3
ID: 18621 Comm. # 18621

Name: Committee to Elect Jason Carlstrom Filed 1/31/2011

Type: County Candidate - Attorney Audited

Status: Filed Certified

Committee Name Committee to Elect Jason Carlstrom

Address 1306 Fargo Ave

City, State, Zip Spirit Lake, IA 51360

Phone 712-330-2159

Effective Date of Dissolution................................................................................. 1/31/2011

Tamara Kelly 1/31/2011

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.

Jason Carlstrom 1/31/2011

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