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No. 8841976
Name da Costa, Alberto
Vol. 85, Pg. 48
residing at 29 Cliff Street, NAUGATUCK, CONNECTICUT
Date of birtl Oct. Oct.5,1933 5, Date of order of admission Apr. 23, 1970
Date certificate issued
April 23, 1970
by the
SUPERIOR
Court at WATERBURY, CONNECTICUT
Petition No. 7901
Alien Registration No. A12 850 243
Alberta da Costa
(COMPLETE AND TRUE SIGNATURE OF HOLDER)
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