2
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18
Connected Entities
Organization referenced in documents
EFTA01650943
have any burial expenses. (If not, skip to 9.) Also. attach a copy of Me funeral home contract, other bills for burial expenses, and a photocopy of the Death Certificate, if you have them. Phone L ___1 -- Name dFoetalHome: Address: Street Cs.rommirsadr Siart. Z p Code Page 2 cr I EFTA01650946 9 If the vi
EFTA01651057
have any burial expenses. (If not, skip to 9.) Also. attach a copy of the funeral home contract, other bills for burial expenses, and a photocopy of the Death Certificate, if you have them. Name of Funeral Home Address Phone ft State Zip Code Rev. September 2015 Page 2 of EFTA01651059 9 If the victim was inju

Medicaid
OrganizationUnited States social health care program for families and individuals with limited resources
Victim Services
OrganizationFBI Victim Services
the State of New York
LocationState in the northeastern United States
the New York City Commission of Human Rights
OrganizationOrganization referenced in documents
HIPAA
OrganizationOrganization referenced in documents
Social Security Benefits
OrganizationOrganization referenced in documents
Complete Address
PersonPerson referenced in documents
New York State Law
OrganizationOrganization referenced in documents
See the Court Ordered Restitution Information
OrganizationOrganization referenced in documents
First Hospital
OrganizationOrganization referenced in documents
the New York State Department of Health'
OrganizationOrganization referenced in documents
the Social Security Death Benefit
OrganizationOrganization referenced in documents
S. Swan
OrganizationOrganization referenced in documents
OVictim Assistance Program
OrganizationOrganization referenced in documents
Disability Insurance
OrganizationOrganization referenced in documents
Primary Insurance Company
OrganizationOrganization referenced in documents
Governmental Agency Name
OrganizationOrganization referenced in documents
The New York State Public Health Law
OrganizationOrganization referenced in documents