Partly-printed DS, one page, 5.25 x 3, no date. Friar's Club data card filled out and signed by Reagan, "Ronald Reagan," writing his address ("360 N. Camden Dr. B. H."), phone number ("CA 67071"), and day and month of birth ("Feb. 6"). In fine condition, with staple holes to the upper left corner. Encapsulated and graded by PSA/DNA as "NM-MT 8."
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