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FOR I NSTRUCTI ONS . SEE BACK OF FORM

COMMA I T TEE NAME ( M u s t b e same as o n St a t emen t o f O r g a n i z a t i o n )Gr a n z o w f o r St a t e Hous e Commi t t e eI MPORTANT : I n d i c a t e t y pe o f c o mmi t t e e y ou a r e r e po r t i n g f o r( 1 ) S t a t e wi d e / L e g i s l a t i v e Ca nd i d a t e ( 2 i St at e wi d er PAC, ( ' 3 ) S c a t # ' P a

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FOR I NSTRUCTI ONS, SEEBACKOF FORMEXPENDI TURES - MONEY SPENT FROMCOMMI TTEE ACCOUNT

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