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T address) Pat Garcia & Chris Jones 123 Long St., My Town Relationship parents same as above same as above to to b. Child's name Place of birth Date of birth Sex Residence information is the same as given above for child a. (If NOT the same, provide the information below.) Period of residence to Person child lived with (name and present address) Address present Relationship Confidential to to to c. Additional children are listed on Attachment 3c. (Provide requested informatio.

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