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CAMPAIGN TREASURER IS REPORT SUMMARY 1 :0,V 'YL t0 RJ t g (1) Name OFFICE USE ONLY d./ II 10 S 12Le'd, 4; :CBJ (2) c. Address (number and sure /LD., C)tes1o j 17L W(o City, State, Zip Code D Check

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ldctes1o -j is a form used for reporting certain financial information.

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ldctes1o -j typically requires the reporting of income, expenses, assets, and liabilities.

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