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Get DS-2060 2014-2024

Remarks Continue on reverse if necessary. SEAL Signature on all copies of the United States of America. For Additional Certified Copies see DS-2060 03-2014 Formerly OF-180 Notification or copy sent to Federal Agencies SSA Middle name Informed by telegram or telephone. U*S* Department of State REPORT OF DEATH OF A U*S* CITIZEN OR U*S* NON-CITIZEN NATIONAL ABROAD Date of Issue mm-dd-yyyy Post SSA No* Age Date mm-dd-yyyy and Place of Birth Evidence of U*S* Citizenship Last name Name in full Address in U*S*A. Permanent or Temporary Address Abroad Date of death Day Month Place of death Number and street or Hospital/ hotel Hour Minute City Year Country Cause of death Including authority for statement - if physician include full name and official title if any First name Disposition of the remains Local law governing disinterment of remains provides that Person or official responsible for custody of effects and accounting therefore Traveling/residing abroad with relatives or friends as follows NAME ADDRESS DATE mm-dd-yyyy NOTIFIED Copy of this report sent to SENT VA OPM Other State Agency The original copy of this document and information concerning the effects are being placed in the permanent files of the Floor Dulles VA 20189-1150. U*S* Department of State REPORT OF DEATH OF A U*S* CITIZEN OR U*S* NON-CITIZEN NATIONAL ABROAD Date of Issue mm-dd-yyyy Post SSA No* Age Date mm-dd-yyyy and Place of Birth Evidence of U*S* Citizenship Last name Name in full Address in U*S*A. Permanent or Temporary Address Abroad Date of death Day Month Place of death Number and street or Hospital/ hotel Hour Minute City Year Country Cause of death Including authority for statement - if physician include full name and official title if any First name Disposition of the remains Local law governing disinterment of remains provides that Person or official responsible for custody of effects and accounting therefore Traveling/residing abroad with relatives or friends as follows NAME ADDRESS DATE mm-dd-yyyy NOTIFIED Copy of this report sent to SENT VA OPM Other State Agency The original copy of this document and information concerning the effects are being placed in the permanent files of the Floor Dulles VA 20189-1150. .

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