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No. 8841713 R Name SULLIVAN, Christiane Marie residing at 70 Cutler Street, Watertown, Connecticut, Date of birth July 30, 1949ate of order of admission Apr. 23, 1970 Date certificate issued April 23, 1970, by the Superior Court at Litchfield, Conn. Petition No. 7793 Alien Registration No. A10 912 833 Caristiana Sallivan (COMPLETE AND TRUE SIGNATURE OF HOLDER)

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