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04/23/2015 01 : 11 Image# 15951217812 PAGE 1 / 17 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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Page 1-17 is a specific form used for reporting certain information to the appropriate authorities.
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