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199 Bleecker Street,New York, NY 10012 Phone: 212 6142300 Fax: 212 2543116APPOINTMENT OF AGENT TO CONTROL DISPOSITION OF REMAINS I, ___ (Your name and address) being of sound mind, willfully and voluntarily
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Phone 212 614-2300 refers to a contact number, and 'fax' likely indicates a fax service associated with that number.
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