July 26, 2017
The document is dated 07/26/17.
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This document is a heavily redacted personal information form, part of a public records request (No. 17-295) processed by the Department of Justice (DOJ). The form includes fields for details such as hometown, ethnicity, and income, but all the corresponding information has been blacked out. The document is dated July 26, 2017, and is page 31 of a 95-page set.
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