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2-19-71-notice of name charge to Robert Hurley No. 9013347 Name JAWOR, Tadeusz residing at 247 Washington Street, New Britain, Conn. Date of birth 1/22/34 Date of order of admission 4/24/69 Date certificate issued April 24, 1969 by the Superior Court at New Britain Petition No. 7643 Alien Registration NAll 236 421 Tadeurs2 Jawer (COMPLETE AND TRUE SIGNATURE OF HOLDER)

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