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Get Pa Rev-1737-1 2015

Vit must be completed and sworn to by a person having personal knowledge of these facts, preferably by a surviving spouse or member of the decedent s family. ENTER DECEDENT INFORMATION BELOW START Decedent s Name (Last, First and Middle Initial) Social Security Number Date of Death MMDDYYYY MM/DD/YYYY Date of Birth MM/DD/YYYY MMDDYYYY First Line of Address Second Line of Address City or Post Office State ZIP Code The following information is submitted in support of the statemen.

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