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* 1. Please fill out the following information.

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* 2. Who was at the meeting with you?

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* 3. Whose office did you visit?

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* 4. Who did you meet with? Please include the name and title of those who attended from the Member's office.

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* 5. Is this Member on the Congressional Historic Preservation Caucus?

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* 6. Did you discuss the Historic Preservation Fund?

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* 7. Did you discuss historic tax credits?

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* 8. Did you discuss historic preservation and infrastructure?

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* 9. Please describe any other topics discussed.

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* 10. Is follow-up with this person necessary?

T