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Year 2010 temporary budget to make available the ... - Jersey City

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Page_of<br />

Vendor Name:<br />

Continuation Page<br />

C. 271 POUTICAL CONTRIUTION DISCLOSUR FORM<br />

Required Pursuant To N.J.S.A. 19:44A-20.26<br />

Contribu<strong>to</strong>r Name ReciDient Name Date Dollar Amount<br />

$<br />

o Check here if <strong>the</strong> inormation is continued on subsequent page( s)<br />

.

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