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D EKU, PLC
A TTO RN E Y AN D C OU N SELLOR AT L AW
8336 MONROE ROAD, SUITE 205
LAMBERTVILLE, MICHIGAN 48144
DEKULAW@SBCGLOBAL.NET
AT
L AW
DEKULAW@SBCGLOBAL.NET
DATE OF BIRTH:
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TELEPHONE NUMBERS:
HOME: (______)________________________ CELL: (______)________________________
MARITAL STATUS: _____Single _____ Married _____ Divorced _____ Separated
SPOUSES NAME: __________________________________________________________
DATE OF BIRTH:
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Age:
Relationship:
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If any of the children live and/or reside at a different address than yours please provide
the address below. If more pages are necessary please just make copies.
FULL NAME:
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DATE OF BIRTH:
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COUNTY OF :
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TELEPHONE NUMBERS:
HOME: (______)________________________ CELL: (______)________________________
FULL NAME:
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DATE OF BIRTH:
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COUNTY OF :
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TELEPHONE NUMBERS:
HOME: (______)________________________ CELL: (______)________________________
FULL NAME:
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DATE OF BIRTH:
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COUNTY OF :
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TELEPHONE NUMBERS:
HOME: (______)________________________ CELL: (______)________________________
Copyright 2013, John V. Deku, PLC Page 3
If there are other persons who are not listed above who you wish to be Co-Trustees and
have full possessory rights of the NFA firearms to be held by this trust please list them below
and provide the required information. If more pages are necessary please just make copies.
FULL NAME:
_____________________________________________________
DATE OF BIRTH:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
COUNTY OF :
________________________________
TELEPHONE NUMBERS:
HOME: (______)________________________ CELL: (______)________________________
FULL NAME:
_____________________________________________________
DATE OF BIRTH:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
COUNTY OF :
________________________________
TELEPHONE NUMBERS:
HOME: (______)________________________ CELL: (______)________________________
FULL NAME:
_____________________________________________________
DATE OF BIRTH:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
COUNTY OF :
________________________________
TELEPHONE NUMBERS:
HOME: (______)________________________ CELL: (______)________________________
Copyright 2013, John V. Deku, PLC Page 4