,L S E C ~ *\.

2p*4

3 Y[ii 3 +%IS

SOCIAL SECURITY

C E R T I F I C A T I O N

Pursuant to the provisions of Title 42, United States Code, Section 3505, and

the authority vested in me by 45 F.R. 47245-46, 1 hereby certify that I have legal

custody of certain records, documents, and other information established and

maintained by the Social Security Administration, pursuant to Title 42, United

States Code, Section 405, and that the annexed are true and complete copies of

certain of such documents in my custody as aforesaid.

I also certify that the annexed computer printout showing the date the

information was recorded is a true and complete copy of such document in my

custody for Social Security Number 042-68-5649 in the name of Brooke C.

IN WI-TLIESS WHEREOF, I have hereunto set my hand and caused the seal of the

Social Security Administration to be affixed this 3oth day of September, 201 0.

,a4

E'Tk$P,'

Division Director Division of Earnings Record Operations Office of Central Operations

* * * REC 2010272 153133 HF773FGO H % H 3 ( 'IT'QYAF' 1'QAF (F-B2B ) * * *

NUMI ~ ~ ~ : 0 9 / 2 9 / 1 0 SSN:042-68- 5649 XC' : IJNTT : GABREL, PG:001 ,

ACCOUNT SSN:042-68-5649 ETC:O RFNr77084403296 DOC:081 1DN:P NAME N M : BROOKE , C , TIERNEY

NL2: BROOKE , , TIERNEY BIRTH ~0~:08/13/1976 PLB: BRIDGEPORT , CT SEX:F ETB:l PARENT MNA: LESLIE JEPSON

FNA: ROBERT TIERNEY INTERNAL FMC:1 CYD:03/31/1977

c>~L S E C t

2~-

Y i i i 4- '/*ISTv~+

SOCIAL SECURITY

C E R T I F I C A T I O N

Pursuant to the provisions of Title 42, United States Code, Section 3505, and

the authority vested in me by 45 F.R. 47245-46, 1 hereby certify that I have legal

custody of certain records, documents, and other information established and

maintained by the Social Security Administration, pursuant to Title 42, United

States Code, Section 405, and that the annexed are true and complete copies of

certain of such documents in my custody as aforesaid.

I also certify that the annexed computer printout showing the date the

information was recorded is a true and complete copy of such document in my

custody for Social Security Number 042-68-9248 in the name of Antoinette Rosie

IN WITNESS WHEREOF, I have hereunto set my hand and caused the seal of the

Social Security Administration to be affixed this 3oth day of September, 201 0.

Division Director Division of Earnings Record Operations Office of Central Operations

* * * REC 201 0273. 1 5 3 I 39 lIF"/ ' / t l~ ' l~:O l ' , . ' l ! ! ' I l ' f - ) ' i ' / \ I , ' I , I -I / \ I, ( I I * I ' I ' * A

ACCOUNT SSN:042 hH ' ) ) / I t 3 I - : ' ~ ' ( ' : I ) I<l.'N / I ' I 0 0 I I ) t J 1

NAME NAA: A N T 0 I NI~:'l"I'l*: , I : I I , I )I.:Mc I

N L 2 : ANrI'OINI~:'1"I'I~: , , lAlJ(;l 1 I ! ; : ;A BIRTH DOB: 05/30/1 8 ' )0 l ' l ~ l i : , 1 ' 1 ' l a ' c ' l : * :;la:X: L? E'I'B: 1 PARENT MNA: J U L L A I ,AO

FNA: DOMINIC I \ I J ( ; L l SSA INTERNAL FMC:3 CYD:04/0~/197~