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#Candidate ID Number|Date Received|Last Revised By|Last Revised Date|Postmark Date|Microfilm Number|Candidate Last Name|Candidate First Name|Candidate Middle Initial|Candidate Phone|Candidate Address|Candidate City|Candidate State|Candidate Zip|County|Title|Agency|Agency Address|Agency Phone|Immediate Supervisor|Supervisor Title|Conflict|Nature of Benefit|Candidate Receive Benefit|Family Receive Benefit|Name of Family Memeber|Business Receive Benefit|Business Name|Member of Legislature Only