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R. No. 8572929 Name HILL, John residing at Flanders Road, Woodbury, Connecticut Date of birth July 22,1915ate of order of admission June 2, 1964 Date certificate issued June 2, 1964 by the Superior Court at Litchfield, Conn. Petition No. 7530 Alien Registration No. A10 913 028 > John (COMPLETE AND Hire TRUE SIGNATURE OF HOLDER)

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