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04/15/2014 18 : 00 Image# 14960755548PAGE 1 / 148REPORT OF RECEIPTS AND DISBURSEMENTSFEC FORM 3 1.For An Authorized CommitteeNAME OF COMMITTEE (in full)Office Use OnlyExample: If typing, type over

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Page 1 148 refers to a specific form or document used for tax reporting purposes, typically related to certain income or deductions.

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