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05×08/2012 18 : 59 Image# 12951655824 PAGE 1 × 7 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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0508 18 59 image is a form used for reporting specific information to the relevant authorities.
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