11/07/07 11:08 FAX 515 830 0123, oos [Fora ‘Rev. O73) DR3 fis | ones or DISSOLUTION cane 8 (I Indexed SE = Notice of Dissolution Cortes Dat of iesotuon, Malle: revs ‘510 Bast 12, Suite 1A. Calhoun for Sate Hoase Des Moines, iowa 50319 Oficial Name of Commitee 766 Whit Tail Way C—O Polk City. 50226-1230 City, Sate, Zip Code 515) s30-038s Area Telephone Code WHEN TO FILE: ‘The Notice of Dissolution must be fled within thity (30) days of completion of all the following: 1. All debts, loans and obligations have been pald 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 ransactions closing the committe, For state candidates and state PACs, a final bank statement must be fled withthe Notice of Dissolution or as soon as possible if the bank statemeny isnot available at the time the Notice of Dissolution is fled. Thetswece. Signature of aithdate or Treaster (f candidate's commitoa) Signature of Chai or Trasurer W PAG) U-2-07 Date Signed FOR INSTRUCTIONS, SEE BACK OF FORM This form is not applicable to statutory political committees.