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Authorization - Jon M Brock

Name of decedent:   

Name of person identifying decedent:    

Relation to decedent:     

I agree to identify the decedent through online identification. I acknowledge that I am the
next of kin, have viewed the photo online, and identified the photo as the decedent listed
above.


Signature of person identifying decedent:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

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Timestamp

Audit

September 30, 2025 4:02 pm EDT

Authorization - Jon M Brock Uploaded by fh admin - test@fortyau.com IP 49.36.67.173