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No. 8841987
Name SZMAJLO, Jan
Vol. 85, Pg. 63
residing at
3 Twining Avenue, Waterbury, Conn.
Date of birthMay 10,1925 Date of order of admission Apr. 23, 1970
Date certificate issued
April 23, 1970
by the
SUPERIOR Court at WATERBURY, CONNECTICUT
Petition No.
7916
Alien Registration No. A12 850 649
Jon (COMPLETE Szmajlo AND TRUE
SIGNATURE OF HOLDER)
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