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01/31/2014 12 : 41 Image# 14960317103 PAGE 1 / 6 REPORT OF RECEIPTS AND DISBURSEMENTS FEC FORM 3X For Other Than An Authorized Committee OFCE Use Only 1. TYPE OR PRINT NAME OF COMMITTEE (in full)
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0131 12 41 image is a form used for reporting specific financial information to the authorities.
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