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rol XLIX rg 129 No. 4723220 Name ZEMEIR, Stanley Frank Decl XXIX rg Pg771 771 residing at 20 Greenwood Street, Naugatuck, Connecti- cut Age 43 years. Date of order of admission January 15, 1940 Date certificate issued January 15, 1940 by the Common Pleas Court at Waterbury, Connecticut Petition No. 9979 Stanlee Frank Zemeir (Complete and true signature of holder)

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Document identity
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