Request for Assistance Please complete the following information to request assistance. We understand that the information may be of questionable veracity and that certain details cannot be shared publicly; however, as much information as is available/permissible will greatly improve the research process and minimize delays. Submissions are private and we will honor any requests to withhold information from case posts. Such information will only be shared with the case admin as background knowledge for running the case and preparing their report (note that SSNs fall into this category automatically).Submitting AgencyName of Agency(required)AddressCityStateZipWebsiteEmail(valid email required)TelephoneContact Person(required)Decedent InformationDecedent Name:(required)Nicknames or Aliases, if any:SexMaleFemaleTransgender (please provide additional info in notes)(required)Date of Death:(required)Death Location (City, County, and State)Date of Birth:Birth Location (City, County, and State):Estimated Age at Death (if no DOB is available):Social Security Number:An SS5 form has:not been requestedbeen requested (waiting for reciept)been recieved(required)Address where decedent lived at time of SS5 application (including City, County, and State):Mother's name (including mother's maiden name, if known):Father's nameVeteranUnknownYesNoBranch of service:Dates of service (approximate okay):Last Known Address (including City, County, and State):Race:Identifying marks (tattoos, etc.):Height:Weight:Employer Information, if any:How identification was made:Additional Case Notes - Please share any family details, sources of information, or other details that might be helpful:Visitor Verification - please answer so we know you aren't a robotWhat color is snow?