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Keith ConfortiCard is definitely a fake. It's logical to assume this would have been printed in the day as a one color card (black ink) on standard card stock. The forger did a nice job with the only exception that he left the image sepia toned. If it were faded black ink, the type in Ruth's name would match it and they don't. That tells me this was created digitally from an RGB or CMYK image with plain black type beneath.
It is a nice job on the aging, though.