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No. 6829809 Name PALACIOS, Joe residing at 430 - 26th St. San Diego, Calif. Date of birth 12/6/83 Date of order of admission 1/20/50 Date certificate issued January 23rd, 1950 by the Superior Court at San Diego, Ca li fornia Petition No. 14727 Alien Registration No. 7791858 o for (Complete Pularion and signature true of holder)