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Your smart list looks right to me (assuming that there are no advanced filter logic set as well).
You can compare your data of your smart list with the "Results" tab of the smart campaign and see if those values match up.
What your results tab and smart list may not account for is the same person filling out the same form multiple times with potentially different values. Your smart campaign may send out an email alert for a specific scenario and at another time just skip to default. Hence in the results tab the activity would be shown twice, but in your smart list it would only show the record once.
Let me know if this helps compare your data.