Notice of Dissolution: For Instructions, See Back of Form This Form Is Not Applicable To Statutory Political Commi 5 Z

Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

VI 2 f:D) 1A V, J Ln~_ i!!1( F.

2-

Notice of Dissolution -Cur?-FORM


;
DR-3
(Rev. 07103)

NOTICE OF
DISSOLUTION
Mxi1 to :
IECDB
510 East 12'°, Suite lA For Office Use Only
Des Moines, Iowa 50319
Comm. #
Indexed
Audited
Computer ~ 0l
Certified Date oo Dissolution h

i ~1Y COMMITTEE NAME


t~

~rUI ;W `
Official Name of Com ittee

Street

'
SLU E S~~r .. V Sa3~
City, State, Zip Code

s, ,f:~9 ,57- 30Y'Z


Area Telephone
Code

WHEN TO FILE :
The Notice of Dissolution must be filed within thirty (30) days of completion of all the following :

1. All debts, loans and obligations have been paid or transferred ;


2. All campaign funds have been spent ;
3. All campaign property sold or transferred (candidates only); and
4. A final report disclosing all transactions closing the committee.

For state candidates and state PACs, a final bank statement must be flied with the Notice of Dissolution or as soon as
possible If the bank statement is not available at the time the Notice of Dissolution Is filed.

Signature of Candidate or .~isweHif~csn'dtdste'sTammtrM-igj/Signature of Chair or Treasurer (if PAC)

O
Date Signed

FOR INSTRUCTIONS, SEE BACK OF FORM Post-It- Fax Note 7671 Date 5 _7j o(' Not 10. Z
This form Is not applicable to statutory political commi To From
+ t
Co .tDept Co

Phone u Phone # ~`
Fax fi Fax n

You might also like