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NAME: BOB PROSPERO ADDRESS: 1 FIELD BLVD UGLY, CA 12345 MAN#: 237-12-1234 ACCT#: DOB: 11223368 04/01/1941 SSN# 999-99-9993 RACE: U SEX: M RELIGION: AGO MARITAL STATUS: D MANAGING MD: DR. B. ELAPSE
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The address of Bob Prospero is 123 Main Street, Anytown, USA.
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Bob Prospero is required to file his own address.
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