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Non-State Committee Member Exhibit A

Candidates Name_____________________

Signature___________________________

Printed Name

Signature

County

Phone

1_____________________________________________________________________________

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3_____________________________________________________________________________

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Exhibit A, Page 2
Printed Name

County

Signature

Phone

10____________________________________________________________________________

11____________________________________________________________________________

12____________________________________________________________________________

13____________________________________________________________________________

14____________________________________________________________________________

15____________________________________________________________________________

16____________________________________________________________________________

17____________________________________________________________________________

18____________________________________________________________________________

19____________________________________________________________________________

20____________________________________________________________________________

Exhibit A, Page 3
Printed Name

County

Signature

Phone

21____________________________________________________________________________

22____________________________________________________________________________

23____________________________________________________________________________

24____________________________________________________________________________

25____________________________________________________________________________

26____________________________________________________________________________

27____________________________________________________________________________

28____________________________________________________________________________

29____________________________________________________________________________

30____________________________________________________________________________

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