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No. 3944143 Name STEPHAN KRCH residing at R. F. D. No. 3, Stafford Springs, Conn. Age 49 years. Date of order of admission September 11,1936 Date certificate issued September 11th, 1936, by the Superior Court at Rockville, Connecticut Petition No. 1103 Stephorn Rrch (Complete and true signature of holder)

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