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Edings, date of last departure from the United States (Attach evidence) Place of residence at time of deportation or removal from United States (city and state) Place deportation or removal hearing held or application for removal made (city and state) Detention facility or jail where detained (city and state) (If not detained, write "None.") Length of residence in the United States (years) Country to which deported or removed Port/location of departure from the United States PART IV. REAS.

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