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Application for Burial Allowance - War Veteran, County of Westmoreland

  1. Phone (724)830-3530, Fax (724)830-3010

  2. I hereby certify that I buried the above named veteran, as herein before stated, and that the expense of the funeral was

  3. Your electronic signature indicates your agreement with the following statements: By typing my name in the above box and clicking the submit button I certify the above statements to be true and correct, to the best of my knowledge.

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  5. This field is not part of the form submission.