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This might sound a little complex, but what I'd do is this: take it to a *nix machine or a Windows machine running Cygwin. Using Ghostview, run pdf2ps to convert it to a PostScript file. You can then edit the postscript file using a graphics program or even by hand using a text editor (PostScript is like a macro language for printers)
Then just use ps2pdf to convert it back again.
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