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EFTA01263124
ay of Birth France A i (if any) None Security 9 Deb of LaW Arrival (month/clay/year) 9/19/95 '4114. a 70051451304 Current INS Slake H-18 Visa QI. 0 Expires on (nonei/daytyear) .1/4/95 • Part 2. Application Type. (check one) I am applying for adjustment to permanent resident status becaus
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