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2. 
4. Legislative Contact:
   Legislative Contact:
   Contact Date
6. Who contacted you?
8. Name:
10. Phone:
12. Email:
14. Legislator/Legislative Office/ Agency:*
16. Information Requested:*
18. Information provided:*
20. Comment:*
22. Person contacted by Legislator/Legislative Office?
24. Department:
26. Name:
28. Email
30. Phone
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32. 1. Receive an email copy of this form.
33. Email address

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34. Submit

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