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07/15/2013 16 : 54 Image# 13941140040 PAGE 1 / 124 REPORT OF RECEIPTS AND DISBURSEMENTS FEC FORM 3 1. For An Authorized Committee NAME OF COMMITTEE (in full) OFCE Use Only Example: If typing, type
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0715 16 54 image refers to a specific form or document used for reporting financial information.
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