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Please fill out this form so we know who is supporting and so we know how to contact you and most importantly fax letters of support on your letterhead to
Lloyd Levine’s office to be listed officially as a supporter 916-319-2140.
Only fields with a *
are Required

E-mail Address: *
Name *
Company
Title
Street Address
City *
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Phone
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Have you read the Bill text for AB1634? *
Are you registered to vote in California? *
Would you like to volunteer in your area?
May we send you updates on AB1634? *
Do you have a pet?
Comments:
Do you support AB1634? *