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Get Affidavit of Disclaimer of Interest by Heir of Tanadgusix Corporation Shareholder

I, , swear upon my oath or affirm under (print full legal name) penalty of perjury, that to the best of my knowledge, information and belief: 1. ( Decedent ) died on , (deceased shareholder) (date of death) as shown by the attached certified copy of the Decedent s Death Certificate. 2. Decedent owned shares of Settlement Common Stock (number) ( Stock ) in Tanadgusix Corporation. 3. I am.

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