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01/31/2016 10 : 14 Image# 201601319004965683 PAGE 1 / 10 REPORT OF RECEIPTS AND DISBURSEMENTS FEC FORM 3 1. For An Authorized Committee NAME OF COMMITTEE (in full) OFCE Use Only Example: If typing,
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172 Gravesend Neck Road is a physical address located in Brooklyn, New York.
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