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No. 7029235 Name RIVAS, Herminia residing at 4727 - Idaho Sta, San Diego, Calff Date of birth 5/21/90 Date of order of admission 3/21/52 Date certificate issued Mar ch 24, 1952 by the Superi or Court at San Diego, Calif. Petition No. 16383 Alien Registration No. 4256195 Hermonic Rimas (Complete and true signature of holder)