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No. 9013326 Name ZARRELLI, Maria Consiglia residing at 249 Mill Street, Southington, Conn. Date of birth 4/5/51 Date of order of admission 1/9/69 Date certificate issued January 9, 1969 by the Superior Court at New Britain Petition No. 7748 Alien Registration NA14 772 164 (COMPLETE AND TRUE SIGNATURE OF HOLDER)

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