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No. 4722962
rol XLVIII pg131
Name DVILINSKAS, John
Declxxix Rg 715
residing at 699 Nor th Riverside Street, Waterbury,
Connecticut
Age 46
years. Date of order of admission September 14,1939
Date certificate issued
September 14, 1939
by the
Common Pleas
Court at Waterbury, Connecticut
Petition No. 9731
10hn Prilinkas
(Complete and true signature of holder)
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Document identity
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