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No. 7094065 Name KAZMIERSKI, Pauline residing at 4 East Main St., Terryville, Conn. Date of birth Feb 9 1894 Date of order of admission June 16, 1954 Date certificate issued June 16th 1954 by the Superior Court at Winsted, Connecticut Petition No. 6656 Alien Registration No. 2 2 930 488 Pauline Kamiurski (Complete and true signature of holder)

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