FORM N v @ev.

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Statementof Dissolution
EffectiveJanuary1,2010, this form must be filed electronicallyby
moststate committees.EffectiveJanuary1,2011, this form must
be filed electronicallyby most localcommittees.pteasecheck
with the Boardto see if you are requiredto file it electronically.
Independentexpenditurecommitteesmust file this form
Certified Date of Dissolution
electronically.

Committee to Elect Mark McGee

fficialName of Committee
2216RodneyAve

Street
CouncilBluffs,IA 51503

City, Strate,Zp Code

7r2 310-0761
()
Area Telephone
Code

WHEN TO FILE:
The Stratementof Dissolutionmust be filed within thirty (30) days of completionof all the following:

1. All debts, loans and obligationshave been paid or fansfened;

2. Allcampaignfundshave been spent;
3. All campaignpropertysold or transfened(candidatesonly); and
4. A final reportdisclosingalltansactions closingthe commifteehas been filed.

For state candidatesand stratePACs, a linal bank stiatementmust be filed with the Statementof Dissotutionor as soon as
possibleif the bank statementis not availableat the time the Statementof Dissolutionis filed.

or Treasurer(if candidate's of chair or Treasurer(if pAc)

committee[signature

FOR INSTRUGTIONS,
SEE BACK OF FORM

Board
Address:
510E 12eStreet
Ste1A,DesMoines,
lASO3lg FaxNumber515-2814073