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No. 7090042 Name DUMOND, Antoinette residing at R.F.D. Belgrade, Maine 10l76Pg201 Date of birth March 24, 1909 Date of order of admission Sept. 25, 1953 Date certificate issued September 25, 1953 by the Superior Court at Waterbury, Connecticut Petition No. 4951 Alien Registration No. 6510407 antoinette Dumond (Complete and true signature of holder)

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