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No. 212722 IN THE UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT ___ UNITED STATES OF AMERICA, v.PlaintiffAppellee,MONQUEL DEJUANLEE PAULK, DefendantAppellant. ___ On Appeal from the United

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Start by providing your personal information such as name, address, and contact details in Section 1 of the form.

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In Section 2, provide information about the deceased individual such as their name, date of birth, date of death, and social security number.

03

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Individuals who are requesting benefits on behalf of a deceased individual

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Family members or legal representatives of the deceased individual

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Form 21-2722 is a specific form used for reporting information related to a designated regulatory process or compliance requirement.

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Entities or individuals who meet certain criteria defined by the governing body or regulation pertaining to Form 21-2722 are required to file this form.

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