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No. 8821205 Name PHILLIPS, Ann Tepla residing at 9 Lafayette Street, Willimantic, Conn. Date of birth Jan.1,1944 Date of order of admission Nov. 6, 1968 Date certificate issued November 6, 1968 by the Superior Court at Putnam, Connecticut Petition No. 5570 Alien Registration No. A7 168 732 an (COMPLETE Tepla AND Phillips TRUE SIGNATURE OF HOLDER)

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Page context
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