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Form 3911
22
1987322
Name asquale Carpentier
Age 42 years
Declaration ofinion. No 5259
issued by District
Court of Waterbury
onlhe
9/19/99
3405-
Order. signed, the 16 day of
Name, June of residence of wife:
,9.1924
Names ages and places, sofresidence ofminor
dhildren
Parguale Carpention
(Signature of holder.)
New Old cerlificate. Na
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Context sent to Scholar
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