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Get WV DFA-MA-1 2012-2024

Al Collection Other Other ► ◄ NOTE: You may be required to provide additional information and/or verification. Are any of the assets listed not available to the owner due to joint ownership, court proceedings/orders, etc? YES NO If “Yes,” which assets and why? Are any of the assets listed set aside for burial? YES NO If “Yes,” which assets? Has anyone received a lump sum payment? If “Yes,” list person, type and date. YES NO Name Type of Payment Page 4 of 14 Date Has anyon.

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