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08/14/2014 18 : 57 Image# 14970085684 PAGE 1 / 74 REPORT OF RECEIPTS AND DISBURSEMENTS FEC FORM 3 1. For An Authorized Committee NAME OF COMMITTEE (in full) Office Use Only Example: If typing, type
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Page 174 refers to the first page of the Form 1040, U.S. Individual Income Tax Return.
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