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R. No. 7566049 Name VOLLAND, Heide residing at 36 Alice St. Torrington, Connecticut Date of birth Sept 13, 1939 Date of order of admission Feb.18,1958 Date certificate issued February 18, 1958 by the Superior Court at Winsted, Connecticut Petition No. 7109 Alien Registration No. A7 455 220 Heide Volland (Complete and true signature of holder)

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