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Your Data:
First name
Last name
Your Email address
Data of the other Person:
First name
Last name
Email of the other Person
Birhtdate of the Person
Death day
Upload File
Upload proof of death (Max 15MB)
With this i accept that all my data are right, also the data of the other Person.
Submit
We are very sorry for your loss, we will contact you within a few hours (3 to 12 Hours typically)
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