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No. 8481475
Name
DUMAS, Fernand
Vol.82,Pg.75 75
residing at 325 North Main Street, Waterbury, Conn.
Date of birth Feb. 21, 1922 Date of order of admission Jan.16,196 1963
Date certificate issued January 16, 1963
by the
SUP ERI OR
Court at WATERBURY, CONNECTICUT
Petition No. 6988
Alien Registration No. A8 708 594
Kiernand Dumas
(COMPLETE AND TRUE SIGNATURE OF HOLDER)
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