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No. 6976069
Name CHAMPAGNE, Laurette
residing at 73 Yale Street, Bridgeport, Conn.
Date of birth 10/12/08
Date of order of admission 3/11/52
Date certificate issued
Mar. 11, 1952
by the
Superior
Court at
Bridgeport Conn.
Petition No. 37565
Alien Registration No. 7794799
Surrette Champagne
(Complete and true signature of holder)
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Document identity
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Page context
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