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Get Ma Form R-408

Residence-Street Address City, Town, or Location 2a. 2b. County State Date of Birth (mo., day, yr.) Number of this Marriage (1st, 2nd, specify) 2c. 2d. 3. 4. Wife-Name First Middle Last Maiden Name 5a. WIFE 5b. Usual Residence-Street Address City, Town, or Location 6a. 6b. County State Date of Birth (mo., day, yr.) Number of this Marriage (1st, 2nd, specify) 6c. 6d. 7. 8. Date of this Marriage (mo., day, yr.) Number of Children Born Alive of this Marriage Number.

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