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Death Records - Sample Report

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THIS IS A SAMPLE REPORT

This is a sample report and is provided for illustrative purposes only. Fictitious data may be contained in this sample report.

#
 Name
Date of Birth
Date of Death
Age at Death
State Resided
Zip Code Resided
Benefit Paid to Zip Code
S.S.N.
State Issued
 1. FUDD, HUBERT G
01-07-1930
08-01-1992
62
20032
227-34-0000
VA
 2. FUDD, JEFFREY
03-05-1920
09-XX-1981
61
VA
22186
22186
228-12-0000
VA
 3. FUDD, JAMES A
12-13-1910
11-12-1993
82
22171
227-22-0000
VA
 4. FUDD, RALPH N
01-11-1936
02-09-2000
64
08004
08004
145-28-0000
NJ
 5. FUDD, WALTER H
10-07-1940
08-01-2003
62
20198
225-52-0000
VA
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