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EXHIBIT EXHIBIT EXHIBIT 01/10/2012 17 : 07
Image# 12950051668PAGE 1 / 83REPORT OF RECEIPTS
AND DISBURSEMENTS FEC
FORM 3
1. For An Authorized Committeeman OF
COMMITTEE (in full)OFCE Use Only12FE4M5Example:
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Information that must be reported on appendix DPDF typically includes details about the transaction, parties involved, and any relevant disclosures required by law.
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