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REPORT OF RECEIPTS FEC AND DISBURSEMENTS FORM 3 For An Authorized Committee Office Use Only
1. NAME OF TYPE OR PRINT Example: If typing, type 12FE4M5 COMMITTEE (in full) over the lines. Brenda Lawrence for Congress
Brenda Lawrence for Congress ADDRESS (number and street) P.O. Box 3060
Check if different than previously Southfield MI 48037
reported. (ACC)