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06/16/2015 09 : 52 Image# 15951474893 PAGE 1 / 25 REPORT OF RECEIPTS AND DISBURSEMENTS FEC FORM 3X For Other Than An Authorized Committee OFCE Use Only 1. TYPE OR PRINT NAME OF COMMITTEE (in full)
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0616 09 52 image is a form used for reporting specific information to the relevant authorities.
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