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No. 7571001
Name SZUBOWICZ, Leonard
residing at 218 Roxbury Road, New Britain, Conn.
Date of birth 10/10/10 Date of order of admission 4/8/58
Date certificate issued
April 8, 1958
by the
Superior
Court at
New Britain
Petition No. 5909
Alien Registration No. A8 149 051
Leoward
(Complete Pubowray and true signature of holder) I'
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Document identity
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