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I <br /> FULL NAME OF FATHER 1' <br /> 4 AFFIDAVIT <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> COUNTY OF RARNSTART,E ss.: <br /> p' - <br /> ` <br /> LINDA TDA TFFFFRR C OOMRS <br /> - — --I being duly sworn,deposes and says that(s)he resides at 94 MAIN SMREET <br /> that deponent has knowledge of the birth of DAR TTTS T.OWF.T.T. ('00MRS _ <br /> named on the reverse side of this blank. <br /> rI Registry of Vital Records and Statistics Negative Statement for years <br /> t►p. �!�Nl� _J fJ�- p_ - issued on <br /> N 1 111 io1 I-j I (date) I ' <br /> andA AA VOTER RECORD <br /> 0 Proof of residence for the parents for year of birth: MASHPEE CENSUS II <br /> it <br /> and <br /> ❑Attested copy of parents'marriage certificate issued by JANE D. LABUTE <br /> -- on MAY 6, 1986 <br /> and <br /> Further,The evidence in writing made at or near the time of birth submitted to substantiate the affidavit was I ' <br /> e, I <br /> � J! <br /> NOTARIZED STATEMENT BY MADELEINE FOODF. <br /> 4 <br /> 1� <br /> 'rl; IY I <br /> Deponents'Srgnature(s) u <br /> i; <br /> I I <br /> Address <br /> Sworn to and <br /> ,subscribed before me, I jvS fi'' <br /> this'' $ay of 9 <br /> � 'I�t4tl•y <br /> �I <br /> ity or town clerk,assistant clerk,or notary) <br /> u <br /> CITY AND TOWN CLERKS MUST TRANSMIT A COPY OF THIS RETURN TO THE <br /> COMMISSIONER OF PUBLIC HEALTH AT ONCE. R <br /> ,t; <br /> - II <br /> it <br /> i <br /> n <br /> li <br /> rt <br /> �II <br /> 41 F.L.V'ICoom6s _ _ <br /> A, <br /> ,r. <br /> i <br /> i <br /> ,r. <br /> L. <br /> �To <br /> IIS <br /> x;` u <br /> t u <br /> AN <br /> kM1 <br />