Generated On: 8/19/2009 11:15:33 AM

Date Posted
DR-3: Notice of Dissolution 1/16/2009 DR-3
ID: 18402 Comm. # 18402

Name: Chelesvig for Supervisor Filed 1/16/2009

Type: County Candidate - Supervisor Audited 8/19/2009

Status: Filed Certified

Committee Name Chelesvig for Supervisor

Address 903 4th Ave. N.E.

City, State, Zip Belmond, IA 50421

Phone 641-444-4629

Effective Date of Dissolution................................................................................. 1/16/2009

Stephen McClintock 1/16/2009

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.

Carolyn Chelesvig 1/16/2009

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