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Address changed iCQLi CRosspofAj-re WAV 4. Party Affiliation 5. OfficS Sought 3. Is This New Statement (c) City, State, and ZIP Code jir Amended (' ) 6. state & District of Candidate DESIGNATION OF PRINCIPAL CAMPAIGN COMMITTEE 7. I hereby designate the foilowing named political committee as my Principal Campaign Committee for the election(s). (year of election) NOTE: This designation should be filed with the appropriate office listed in the instructions, (a) Name of Committ.

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