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Diane: KillianAllan c/o RR 1152 W 475 S Farmington, Utah State Republic, w/o the United statesAffidavit Of Status I, Diane: KillianAflan, a woman, am over the age of consent, am a creation of GodAlmighty
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1152 475 w s is a tax form that is used to report certain types of income.
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