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No. 8284228 Name NOVICK, Tofilia residing at 260 Pleasant Street, Willimantic, Conn. Date of birthApr 5, 1889 Date of order of admission May 10, 1962 Date certificate issued May 10, 1962 by the Superior Court at Putnam, Connecticut Petition No. 5318 Alien Registration No. A4 590 480 Tofili norris & (COMPLETE AND TRUE SIGNATURE OF HOLDER)

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