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No. 3185171 Reverse Name DOMINICI, FRANCESCO VOCXXXT "g99 side Dect XX pg55 residing at 181 Union Street, Waterbury, Connecticut Age 40 years. Date of order of admission January 15, 1930 Date certificate issued January 15, 1930 by the Common PleasCourt at Waterbury, Connecticut Petition No. 5789 Francesco Dominici (Complete and true signature of holder)

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