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vol XLVII Pg 208
No. 4623608
Name DOLECKI, Wladyslaw
Decl XXIX pg566
residing at 65 Rose Street, Waterbury, Connecticut
Age 53 years. Date of order of admission Sept. 13, 1939
Date certificate issued September 13, 1939
by the
Common Pleas
Court at Waterbury, Connecticut
Petition No.
9558
of
Wilidyslaw Dalecki
(Complete and true signature of holder)
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