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04/10/2013 17 : 46 Image# 13961280173 PAGE 1 / 12 REPORT OF RECEIPTS AND DISBURSEMENTS FEC FORM 3 1. For An Authorized Committee NAME OF COMMITTEE (in full) OFCE Use Only Example: If typing, type
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0410 17 46 image is a specific form or document used for reporting certain information to the relevant authority.
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