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Ease type or print in ink. 7011 MAR - I AM 9: Itl. NAME OF FILER (LAST) (FIRST) (MIDDLE) JOHAI CH1 HAlG1. Office, Agency, or Court Agency Name 00511'/1 eONTIi.DLL fI 'J Or-r.:IC Division, Board, Department, District, if applicable Your Position If filing for mUltiple positions, list below or on an aUachment. Agency: Position: 2. Jurisdiction of Office 81 State (Check at least one box) o Judge (Statewide Jurisdiction) o County of ----------- """":r"'.P.'--- :,..::"' .,-.

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