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09/06/2020 03 : 24Image# 202009069267084448PAGE 1 / 4STATEMENT OF ORGANIZATION FEC FORM 1Office Use Only1.NAME OF COMMITTEE (in full)Example: If typing, type over the lines.(Check if name is changed)12FE4M5Independent 4021
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4021 Wood River Dr is a specific address, likely a residence or property located in a particular area.
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