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Get SC DHEC 0640 2009-2024

Fees submitted:__________________ DEATH CERTIFICATES Name of deceased: _____________________________________________________________________________________________________ First Middle Last Suffix Date of death: _____________________ Sex:_______ Age at death:_______ City/County of death:__________________________________ Specify the number and type of certification(s) requested: ____ Death long ($12) ____ Additional long ($3 each) ___.

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