Identification of next-of-kin

Information on the applicant

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Complete name

Name of the organization

Email address

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Phone number

Mailing address

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Non

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Non

Information about the deceased

Name of the deceased

Given name(s) of deceased

Date of birth of the deceased

DD - MM - YYYY

Place of birth of the deceased (City, Province/State, Country)

Date of death of the deceased

DD - MM - YYYY

Place of death of the deceased (City, Province/State, Country)

Marital status of the deceased

Name of spouse

Name of deceased spouse

Name of divorced spouse

Date of birth of spouse

DD - MM - YYYY

Spouse's place of birth (City, Province/State, Country)

Date of marriage

DD - MM - YYYY

Place of marriage (City, province/state, country)

Date of death of spouse

DD - MM - YYYY

Place of Death (City, Province/State, Country)

If applicable, date of death of spouse

DD - MM - YYYY

Place of Death (City, Province/State, Country)

Date of divorce

DD - MM - YYYY

Place of divorce (City, province/state, country)

Information about parents

Father's name

Given name(s)

Family name

Father's date of birth

DD - MM - YYYY

Father's place of birth (City, Province/State, Country)

Father's date of death

DD - MM - YYYY

Father's place of death (City, Province/State, Country)

Mother's name

Given name(s)

Family name

Mother's date of birth

DD - MM - YYYY

Mother's place of birth (City, Province/State, Country)

Mother's date of death

DD - MM - YYYY

Mother's place of death (City, Province/State, Country)

Date of marriage of parents

DD - MM - YYYY

Parents' place of marriage (City, Province/State, Country)

If parents were separated and one or both had another spouse, please provide their names.

Information about the immediate family

Brothers and sisters of the deceased (including half-brothers and half-sisters)

0

Name 1

Given name(s)

Last name

Date of birth 1

DD - MM - YYYY

Birthplace 1 (City, Province/State, Country)

Name 2

Given name(s)

Last name

Date of birth 2

DD - MM - YYYY

Birthplace 2 (City, Province/State, Country)

Name 3

Given name(s)

Last name

Date of birth 3

DD - MM - YYYY

Birthplace 3 (City, Province/State, Country)

Name 4

Given name(s)

Last name

Date of birth 4

DD - MM - YYYY

Birthplace 4 (City, Province/State, Country)

Name 5

Given name(s)

Last name

Date of birth 5

DD - MM - YYYY

Birthplace 5 (City, Province/State, Country)

If more than 5 siblings, please indicate their name(s) and date(s) of birth in the box.

Information on the paternal line

Father's brothers and sisters (including half-brothers and half-sisters)

0

Do not answer if the research does not concern the paternal line

Name 1

Given name(s)

Last name

Date of birth 1

DD - MM - YYYY

Birthplace 1 (City, Province/State, Country)

Name 2

Given name(s)

Last name

Date of birth 2

DD - MM - YYYY

Birthplace 2 (City, Province/State, Country)

Name 3

Given name(s)

Last name

Date of birth 3

DD - MM - YYYY

Birthplace 3 (City, Province/State, Country)

Name 4

Given name(s)

Last name

Date of birth 4

DD - MM - YYYY

Birthplace 4 (City, Province/State, Country)

Name 5

Given name(s)

Last name

Date of birth 5

DD - MM - YYYY

Birthplace 5 (City, Province/State, Country)

Name 6

Given name(s)

Last name

Date of birth 6

DD - MM - YYYY

Birthplace 6 (City, Province/State, Country)

Name 7

Given name(s)

Last name

Date of birth 7

DD - MM - YYYY

Place of Birth 7 (City, Province/State, Country)

Name 8

Given name(s)

Last name

Date of birth 8

DD - MM - YYYY

Birthplace 8 (City, Province/State, Country)

Name 9

Given name(s)

Last name

Date of birth 9

DD - MM - YYYY

Birthplace 9 (City, Province/State, Country)

Name 10

Given name(s)

Last name

Date of birth 10

DD - MM - YYYY

Birthplace 10 (City, Province/State, Country)

If more than 10 siblings, please indicate their name(s) and date(s) of birth in the box.

Information on the maternal line

Mother's siblings (including half-brothers and half-sisters)

0

Do not answer if the research does not concern the maternal line

Name 1

Given name(s)

Last name

Date of birth 1

DD - MM - YYYY

Birthplace 1 (City, Province/State, Country)

Name 2

Given name(s)

Last name

Date of birth 2

DD - MM - YYYY

Birthplace 2 (City, Province/State, Country)

Name 3

Given name(s)

Last name

Date of birth 3

DD - MM - YYYY

Birthplace 3 (City, Province/State, Country)

Name 4

Given name(s)

Last name

Date of birth 4

DD - MM - YYYY

Birthplace 4 (City, Province/State, Country)

Name 5

Given name(s)

Last name

Date of birth 5

DD - MM - YYYY

Birthplace 5 (City, Province/State, Country)

Name 6

Given name(s)

Last name

Date of birth 6

DD - MM - YYYY

Birthplace 6 (City, Province/State, Country)

Name 7

Given name(s)

Last name

Date of birth 7

DD - MM - YYYY

Place of Birth 7 (City, Province/State, Country)

Name 8

Given name(s)

Last name

Date of birth 8

DD - MM - YYYY

Birthplace 8 (City, Province/State, Country)

Name 9

Given name(s)

Last name

Date of birth 9

DD - MM - YYYY

Birthplace 9 (City, Province/State, Country)

Name 10

Given name(s)

Last name

Date of birth 10

DD - MM - YYYY

Birthplace 10 (City, Province/State, Country)

If more than 10 siblings, please indicate their name(s) and date(s) of birth in the box.

Other information that may be useful to us.

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Information on the applicant

Information about the deceased

Information about parents

Information about the immediate family

Information on the paternal line

Information on the maternal line

Other information that may be useful to us.

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