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No. 8412561 Name WISNIEWSKI, Richard Bernard residing at 22 Silver Street, New Britain, Conn, Date of birth 5/21/46 Date of order of admission 4/14/64 Date certificate issued April 14, 1964 by the Superior Court at New Britain Petition No. 6919 Alien Registration No. All 490 946 Richard Bernard Wimieaski (COMPLETE AND TRUE SIGNATURE OF HOLDER)

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