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Report A Case

For which country*:

Name, first name*:
Rank:
Age:

Last office:

Years of service:

City*:

Life partner:
Children:

Cause of death*:
Date of death*: .. (e.g. "31.02.2002")

Circumstances of death:

Source:
Newspaper etc.


Your email address:
The e-mail address will not be published and not stored. It will only be used for possible queries and/or to inform you when your contribution has been published.



(*Mandatory information)



Enter deceased service dog

Name*:
Age:

Last office:

Years of service:

City*:

Cause of death*:
Day of death*: ..

Circumstances of death:

Source:
 Newspaper reports etc.


Your e-mail address:
 The e-mail address will not be published and not stored. It will only be used for possible queries and/or to inform you when your contribution has been published.



(*Mandatory information)



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