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No. 7029141 Name WINICKI, Nathan residing at 4717 Campo Dr., San Diego, Calif Date of birth 8/15/98 Date of order of admission 1/18/52 Date certificate issued January 21, 1952 by.the Superior Court at San Diego, Calif. Petition No. 16307 Alien Registration No. 7747034 Inabhan Winidu (Complete and true signature of holder)