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No. 8841676 R Name SLUPCZEWSKI, Hedwig residing at 90 Morin Street, Oakville, Conn. Date of birth Oct. 5, 1946 Date of order of admission Feb. 13, 1969 Date certificate issued February 13, 1969 by the Superior Court at Litchfield, Conn. Petition No. 7756 Alien Registration No. A7 258 350 Hedwing (COMPLETE Slupgenski AND TRUE SIGNATURE OF HOLDER)

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