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2004 12 09 - DR3
2004 12 09 - DR3
07/03)
DR-3
Reset Form I NOTICE OF
Mail to : DISSOLUTION
IECDI3
510 East 12`h,Suite IA For Office Use Only
Des Moines, Iowa 50319
Comm . #
Indexed
Audited
Computer
Certified Date of Dissolution
COMMITTEE NAME
Jr ~e c 7L l~a h -
f/a _*~ 4e. J1 /v r J 1/o A- t l /`
Official Name of Committee
c
Street
WHEN TO FILE :
The Notice of Dissolution must be filed within thirty (30) days of completion of all the following :
For state candidates and state PACs, a final bank statement must be filed 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 Treasurer (if candidate's committee)/Signature of Chair or Treasurer (if PAC)
v Date Signed