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No. 9321261 Name DRANGINIS, Leah residing at 272 Fairview Drive, Kensington, Conn. Date of birth 8/10/39 Date of order of admission 6/10/71 Date certificate issued June 10, 1971 by the Superior Court at New Britain Petition No. 8089 Alien Registration No. A10 917 193 Leah (COMPLETE AND TRUE SIGNATURE OF HOLDER)

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