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	Account Type: Devotee Retirement Fund Title: Mr. Mrs. Ms. Miss Dr. First Name: Last Name: Gender: Male Female Date of Birth:  /   /  Address Address Type: Home Work Street Address: City: State AK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip: Phone Phone Type: Cell Home Work Phone Number:         Format: Country Code, Area Code, Prefix, Suffix(extension) Email Email Type: Home Work Email Address: Gothram: Nakshatram: None Selected Ashvini Bharani Krittika Rohini Mrigashirsha Ardra Punarvasu Pushya Ashlesha Magha Purva Phalguni Uttara Phalguni Hasta Chitra Swati Vishakha Anuradha Jyeshtha Mula Purva Ashadha Uttara Ashadha Abhijit Sravana Dhanishta Shatabhisha Purva Bhadrapada Uttara Bhadrapada Revati P.Proshthapada U.Proshthapada Thiruvadirai