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No. 9584242 Name BALLIS, Felia residing at 18 Center St., New London, Conn. Date of birth 7/20/1954 Date of order of admission 6/13/1974 Date certificate issued June 13, 1974 by the Superior Court at New London, Conn. Petition No. 11562 Alien Registration No. A14 315 629 Felia Ballis (COMPLETE AND TRUE SIGNATURE OF HOLDER)

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Document identity
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