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FORM 1 2009 STATEMENT OF your Please Print or name, and position below: name mailing address, agency I FINANCIAL INTERESTS I LAST NAME FIRST NAME MIDDLE NAME : FOR OFFICE USE ONLY: Babcock, Thomas
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Please print or name refers to the specific item or name that needs to be provided or written on a document or form.
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The individual or entity specified in the instructions or guidelines is required to file please print or name.
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