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Please do not complete this form without being instructed by the county staff.
Call 254-757-5174 should you need assistance.
Legal Next of Kin
Enter Relationship to Deceased
Enter name and relationship separated by comma of the designated person
Enter Decedent Name
Enter name as listed on state issued driver's license or identity card. You will need to verify state issued driver's license and/or identification with Health Services upon request.
This field is not part of the form submission.
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