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GOVERNOR BURIAL AT SEA CLEARANCE Date: To: Department of Public Health and Social Services ATTN: Vital Statistics From: EMAS Administrator, Guam EPA Subject: Burial at Sea Clearance The Guam EPA hereby issues the following “Burial at Sea Clearance” for: Name of Deceased: _________________________________________ At the Request of: Name: _________________ Contact Number: _________ Relation to Deceased: _________________ Address: _________________________________ This burial will .

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