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No. 9441705 Name MACIEJEWSKI, Andrew Lucjan residing at 150 Market Street, New Britain, Conn. Date of birth 4/17/55 Date of order of admission 11/9/72 Date certificate issued November 9, 1972 by the Superior Court at New Britain Petition No. 8251 Alien Registration No A14 306 139 andrew (COMPLETE Surjan AND TRUE SIGNATURE Maciejewshi OF HOLDER)

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