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FORM 1 STATEMENT OF 2001 Please address, agency name, a ND PO on e low : b site FINANCIAL INTERESTS LAST NAME FIRST NAME MIDDLE NAME : FOR OFFICE USE ONLY: i CG/ l. L. / ems GCI MAILING ADDRESS :
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Begin by providing your personal information such as your full name, address, contact details, and any other information requested accurately and legibly.
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Bformb 1 statement is a financial disclosure form.
Individuals or entities with financial interests or holdings.
Fill out all sections of the form accurately and completely.
To disclose financial interests and holdings.
Information about financial assets, income, and liabilities.
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